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Mindfulness in Motion MIM: An Onsite Mindfulness Based Intervention MBI for Chronically High Stress Work Environments to Increase Resiliency and Work Engagement

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Spillover Effects From A Consumer-Based Intervention To Increase High-Value Preventive Care.

Betsy Q Cliff¹, Richard A Hirth², A Mark Fendrick³

¹Betsy Q. Cliff ( bqcliff@umich.edu ) is a doctoral candidate in the Department of Health Management and Policy, University of Michigan School of Public Health, in Ann Arbor.

Health Affairs (Project Hope)

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Summary

Promoting high-value medical services may inadvertently increase low-value care. A study found that encouraging preventive visits led to more high-value services but also a rise in low-value services. Future interventions need to deter low-value care.

Keywords:

consumer incentives high-value services insurance benefit design low-value services preventive care

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Area of Science:

Health Services Research
Health Economics
Preventive Medicine

Background:

Efficient health systems aim to increase high-value medical services and decrease low-value services.
Interventions promoting high-value care may have unintended consequences on the utilization of low-value services.

Purpose of the Study:

To examine the impact of an insurance benefit change promoting high-value preventive services on the use of both high- and low-value medical services.
To assess the spillover effects of increased preventive visits on the utilization of low-value services.

Main Methods:

Quasi-experimental design comparing state employees with a modified insurance benefit plan to a control group with stable plans.
Analysis of service utilization in the first two years following the 2011 insurance benefit change.
Statistical association of increased preventive visits with changes in high- and low-value service use.

Main Results:

In the first year post-intervention, the likelihood of high-value service use increased by 11.0 percentage points, and low-value service use increased by 7.9 percentage points.
Approximately 74% of the increase in high-value services and 57% of the increase in low-value services were associated with greater use of preventive visits.
These findings suggest a direct link between increased preventive care utilization and subsequent use of low-value services.

Conclusions:

Interventions designed to boost high-value preventive services can lead to unintended increases in low-value services.
Future health system interventions should incorporate strategies to deter the use of low-value care alongside promotion of high-value services.
The study highlights the need for comprehensive benefit designs that balance the promotion of effective care with the mitigation of wasteful services.