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. Author manuscript; available in PMC: 2017 Jul 1.
Published in final edited form as: JAMA Intern Med. 2016 Jul 1;176(7):998–1004. doi: 10.1001/jamainternmed.2016.2086

Table 2.

Low-Value Care Among Adults With Medicaid or Commercial Insurance During 2013a

Commercial
Medicaid
No. of Patients
Qualifying Patients Affected (95% CI), % No. of Patients
Qualifying Patients Affected (95% CI), %
Low-Value Care Service Source Affected Qualifying Affected Qualifying
Any All 35 739 314 023 11.4 (11.3–11.5) 10 304 69 338 14.9 (14.6–15.1)
Imaging for nonspecific low-back pain CW 13 005 82 659 15.7 (15.5–16.0) 4273 18 871 22.6 (22.1–23.2)
Head imaging for uncomplicated headache CW 7285 65 931 11.0 (10.8–11.3) 4323 23 211 18.6 (17.7–18.7)
Head imaging for syncope CW 673 7466 9.0 (8.4–9.7) 449 3174 14.1 (12.9–15.4)
Imaging for plantar fasciitis CW 2002 10 986 18.2 (17.5–19.0) 180 1450 12.4 (10.8–14.1)
T3 tests for hypothyroidism CW 5098 31 228 16.3 (15.9–16.7) 619 5891 10.5 (9.7–11.3)
Preoperative chest radiography CW 1694 39 169 4.3 (4.1–4.5) 755 7848 9.6 (9.0–10.3)
Abdomen CT combined studies CMS 2097 28 075 7.5 (7.2–7.8) 664 13 416 4.9 (4.6–5.3)
Simultaneous brain and sinus CT CMS 356 9742 3.7 (3.3–4.0) 357 7761 4.6 (4.1–5.1)
CT for uncomplicated acute rhinosinusitis CW 1799 59 961 3.0 (2.9–3.1) 343 11 992 2.9 (2.6–3.2)
Arthroscopic surgery for knee osteoarthritis NICE 1127 23 190 4.9 (4.6–5.1) 164 6143 2.7 (2.3–3.1)
Thorax CT combined studies CMS 113 9287 1.2 (1.0–1.4) 76 3822 2.0 (1.6–2.4)
Preoperative echocardiography CW 227 39 169 0.6 (0.5–0.7) 88 7848 1.1 (0.9–1.4)
Spinal injections for low-back pain Literature 2720 130 587 2.1 (2.0–2.2) 290 37 299 0.8 (0.7.0.9)
Preoperative stress testing CW 115 39 169 0.3 (0.24–0.35) 46 7848 0.6 (0.4–0.8)
Preoperative pulmonary function testing CW 96 38 380 0.25 (0.20–0.30) 42 7693 0.5 (0.4–0.7)
Electroencephalogram for headache CW 72 59 936 0.1 (0.09–0.15) 60 20 091 0.3 (0.2–0.4)

Abbreviations: CMS, Center for Medicare & Medicaid Services Quality Net; CT, computed tomography; CW, American Board of Internal Medicine Choosing Wisely Initiative; NICE, United Kingdom National Institute for Health and Care Excellence.

a

Columns report patient-level measures of low-value care. For example, 3174 Medicaid patients had at least 1 visit during 2013 that placed them at risk for receiving head imaging for syncope (qualifying patients). Of these at-risk patients, 449 received low-value head imaging at least once during 2013 (affected patients). The study sample includes nonpregnant, nondual eligible adults aged 18 to 64 years.