Interventions Aimed at Reducing Use of Low-Value Health Services: A Systematic Review

Med Care Res Rev. 2017 Oct;74(5):507-550. doi: 10.1177/1077558716656970. Epub 2016 Jul 8.


The effectiveness of different types of interventions to reduce low-value care has been insufficiently summarized to allow for translation to practice. This article systematically reviews the literature on the effectiveness of interventions to reduce low-value care and the quality of those studies. We found that multicomponent interventions addressing both patient and clinician roles in overuse have the greatest potential to reduce low-value care. Clinical decision support and performance feedback are promising strategies with a solid evidence base, and provider education yields changes by itself and when paired with other strategies. Further research is needed on the effectiveness of pay-for-performance, insurer restrictions, and risk-sharing contracts to reduce use of low-value care. While the literature reveals important evidence on strategies used to reduce low-value care, meaningful gaps persist. More experimentation, paired with rigorous evaluation and publication, is needed.

Keywords: interventions; low-value care; overuse; systematic review; waste.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Choice Behavior
  • Decision Support Systems, Clinical / statistics & numerical data
  • Evidence-Based Medicine / methods*
  • Humans
  • Physicians*
  • Primary Health Care*