Our analysis showed that potential overuse of bone density scans (DEXA scans), cancer antigen 125 blood tests (CA-125), and electrocardiography (ECG) among individuals with employer-sponsored insurance remained high but declined consistently between 2008 and 2013:
- The national rate of potential overuse for medical services in the study exhibited a sustained downward trend between 2008 and 2013: from 21.2 to 13.7 per 1,000 women for DEXA scans, from 4.7 to 3.3 per 1,000 women for CA-125 tests, and from 87.5 per 1,000 individuals in 2009 to 84.6 per 1,000 in 2013 for ECGs.
- The total national spending associated with potential overuse of DEXA scans, CA-125 tests and ECGs in the population with employer-sponsored insurance was $154 million in 2013.
- Clinicians may be more cognizant of test appropriateness criteria through such efforts as the Choosing Wisely campaign and ACP’s High Value Care Initiative, as well as health plans’ efforts to promote evidence-based medicine.
- The adoption of clinical guidelines and decision support tools at the point of care may help in reducing the overuse of medical services.