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Non-clinical Prevention Opportunities and Waste in the U.S. Healthcare System

      The National Academy of Medicine (formerly known as the Institute of Medicine) estimated in 2010 that wasteful healthcare spending cumulatively totaled approximately $765 billion per year, or nearly one third of all healthcare spending.
      Adjusting to 2016 healthcare expenditure totals,
      • Hartman M
      • Martin AB
      • Espinosa N
      Catlin A; the National Health Expenditure Accounts Team. National health care spending in 2016: spending and enrollment growth slow after initial coverage expansions.
      unnecessary medical spending costs the average American more than $3,400 per year. Yet, the authors argue that even this sizable figure understates the magnitude of healthcare waste as it excludes a large array of missed upstream prevention opportunities.
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      REFERENCES

      1. Yong PL Saunders RS Olsen LA The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. National Academies Press, Washington, DC2010
        • Hartman M
        • Martin AB
        • Espinosa N
        Catlin A; the National Health Expenditure Accounts Team. National health care spending in 2016: spending and enrollment growth slow after initial coverage expansions.
        Health Aff (Millwood). 2018; 37: 150-160
        • Berwick DM
        • Hackbarth AD
        Eliminating waste in U.S. health care.
        JAMA. 2012; 307: 1513-1516
        • Bentley TG
        • Effros RM
        • Palar K
        • Keeler EB
        Waste in the U.S. health care system: a conceptual framework.
        Milbank Q. 2008; 86: 629-659
        • Reducing Waste in Health Care
        Health Affairs Health Policy Brief.
        Published December 13, 2012
        • McGinnis JM
        • Williams-Russo P
        • Knickman JR
        The case for more active policy attention to health promotion.
        Health Aff (Millwood). 2002; 21: 78-93
        • Hood CM
        • Gennuso KP
        • Swain GR
        • Catlin BB
        County health rankings: relationships between determinant factors and health outcomes.
        Am J Prev Med. 2016; 50: 129-135
        • Taylor LA
        • Tan AX
        • Coyle CE
        • et al.
        Leveraging the social determinants of health: what works?.
        PLoS One. 2016; 11e0160217
        • McConnell KJ
        • Chang AM
        • Cohen DJ
        • et al.
        Oregon's Medicaid transformation: an innovative approach to holding a health system accountable for spending growth.
        Healthc (Amst). 2014; 2: 163-167
        • Kitzhaber J
        John Kitzhaber: on achieving healthcare transformation.
        Healthc Financ Manage. 2013; 67: 54-59
        • National Academies of Sciences Engineering, and Medicine
        Cost-Benefit Analysis of Providing Non-emergency Medical Transportation.
        National Academies Press, Washington, DC2005
        • Powers BW
        • Rinefort S
        • Jain SH
        Nonemergency medical transportation: delivering care in the era of Lyft and Uber.
        JAMA. 2016; 316: 921-922
        • Margolis DJ
        • Malay DS
        • Hoffstad OJ
        • et al.
        Economic burden of diabetic foot ulcers and amputations: Data Points #3.
        Agency for Healthcare Research and Quality, Rockville, MD2011 (Data Points Publication Series)
        • Lewis VA
        • Larson BK
        • McClurg AB
        • Boswell RG
        • Fisher ES
        The promise and peril of accountable care for vulnerable populations: a framework for overcoming obstacles.
        Health Aff (Millwood). 2012; 31: 1777-1785
        • Mahadevan R
        • Houston R
        Supporting social service delivery through Medicaid accountable care organizations: early state efforts.
        Center for Health Care Strategies, Published February 2015
        • Centers for Medicare & Medicaid Services, HHS
        Medicare Program; Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive Under the Physician Fee Schedule, and Criteria for Physician-Focused Payment Models. Final rule with comment period.
        Fed Regist. 2016; 81: 77008-77831
        • Bradley EH
        • Canavan M
        • Rogan E
        • et al.
        Variation in health outcomes: the role of spending on social services, public health, and health care, 2000–09.
        Health Aff (Millwood). 2016; 35: 760-768
        • McCullough JM
        • Leider JP
        Government spending in health and nonhealth sectors associated with improvement in county health rankings.
        Health Aff (Millwood). 2016; 35: 2037-2043
        • Chaiyachati KH
        • Hubbard RA
        • Yeager A
        • et al.
        Association of rideshare-based transportation services and missed primary care appointments: a clinical trial.
        JAMA Intern Med. 2018; 178: 383-389
        • Pryor K
        • Volpp K
        Deployment of preventive interventions: time for a paradigm shift.
        N Engl J Med. 2018; 378: 1761-1763
        • Braveman PA
        • Egerter SA
        • Woolf SH
        • Marks JS
        When do we know enough to recommend action on the social determinants of health?.
        Am J Prev Med. 2011; 40: S58-S66
        • Gottlieb LM
        • Quinones-Rivera A
        • Manchanda R
        • Wing H
        • Ackerman S
        States’ influences on Medicaid investments to address patients’ social needs.
        Am J Prev Med. 2017; 52: 31-37
        • McCullough JC
        • Zimmerman FJ
        • Fielding JE
        • Teutsch SM
        A health dividend for America: the opportunity cost of excess medical expenditures.
        Am J Prev Med. 2012; 43: 650-654