Primary Care Physicians and Spending on Low-Value Care.

In this retrospective study of low-value spending on Medicare beneficiaries, most PCPs performed or ordered less than 9% and referred out less than 16% of their attributed patients’ spending on low-value services. Study limitations include that findings are dependent on the low-value services analyzed, some services may have been misclassified as low-value, and the analysis excluded hospital outpatient services because those claims do not identify the referring physician. In addition, some beneficiaries may have been misattributed to a PCP, and results may not be generalizable to unattributed beneficiaries. Future research should investigate practice patterns of outlier PCPs responsible for a major share of their patients’ low value spending, referral tools and payment strategies that facilitate PCP management of low-value care beyond services PCPs perform, and methods to minimize low-value measurement burden in primary care