When it comes to getting physicians not to order low-value laboratory tests, money talks. At least, that is the punchline of a new study finding that changes in payment policies are more effective than clinical practice recommendations in curbing utilization of low-value tests. The Diagnostic Challenge Overtreatment or low-value care accounts for roughly $75.7 billion to $101.2 billion worth of waste in the US. And those estimates are probably well below actual costs to the extent that “tests beget tests” and lead to unnecessary medical procedures. But while overutilization of low-value tests has been well documented, the question of how and why these patterns continue and how they can be changed has received far less attention. Of course, there have been initiatives to reduce such overutilization, particularly via programs to educate physicians about the problem and recommend best practice guidelines discouraging them from ordering low-value tests. One notable example is “Choosing Wisely,” a set of recommendations from the American Board of Internal Medicine. The JAMA Study Published online on Feb. 10 in JAMA Internal Medicine, the study is based on cross-sectional analysis of claims data to compare the effects of the Choosing Wisely recommendations versus payment policies for two laboratory […]