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Even though health systems have strong incentives to provide efficient, high-value care, their makeup and bureaucracy might provide other incentives that result in low-value care.

A study in JAMA Internal Medicine provides new insights into low-value care—i.e., care that is provided and paid for but has little or questionable medical value. Low-value care has been identified as an area where U.S. health care costs could be reduced, if replaced by higher-value practices.

The study, by researchers at Harvard and Dartmouth, found that low-value care was found more often in U.S. health systems in the South and West, in systems that had relatively lower numbers of primary care providers, in systems without a major teaching hospital, and in systems that served a higher proportion of non-white patients.

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