Report: Primary care physicians tied to nearly a quarter of low-value spending

A new report shows that a sizeable portion of low-value health care spending is tied to a patient’s primary care provider.

According to the report, ‘Primary Care Physicians and Spending on Low-Value Care,’ which will be published in the Annals of Internal Medicine, researchers looked at Medicare Part B claims from a 20 percent random sample of beneficiaries enrolled from 2007 to 2014. They found that services ordered or performed by primary care physicians who had at least 20 attributed beneficiaries accounted for a median of 8.3 percent of their attributed patients’ overall spending on low-value services, while services the physicians referred out accounted for a median of 15.4 percent.

Specialties accounting for the greatest portion of low-value spending were:

• Cardiology
• Primary care
• Ambulatory surgical centers
• Internal medicine
• Orthopedic surgery
• Gastroenterology

“Future research should investigate practice patterns of outlier (primary care physicians) responsible for a major share of their patients' low- value spending, referral tools and payment strategies that facilitate (primary care physician) management of low-value care beyond services PCPs perform, and methods to minimize low-value measurement burden in primary care,” the authors say in the report.