A 10-step program to successfully reduce low-value care

The cost of health care in the United States is approaching 18% of the gross national product, an expenditure that is competing with dollars being used for other purposes. One way to reduce the cost of care is by identifying and reducing low-value care (LVC): patient care that offers little to no benefit in specific clinical scenarios, adds cost, and may, through adverse effects or adverse outcomes, actually harm patients. The authors have been involved in identifying and reducing LVC for more than 15 years and have created a practical, 10-step approach to effectively integrate LVC reduction programs into medical systems. The approach has been tested, with results reported in peer-reviewed journals. Key steps include assembling accurate, meaningful data; creating simple yet dramatic practitioner reports; learning to identify and manage the stages of change; and developing an outreach strategy anchored in nonjudgmental communication, explicit core values, and a well-articulated reason to focus on reducing LVC.