www.ehfcn.org

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2

30%

healthcare expenditure

waste

Healthcare “Waste” defined

“healthcare spending that can be eliminated without reducing the quality of care” The New England Health Institute (NEHI)

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4

waste

waste with intention

40%40%

Integrity violations

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fraud

waste with intention

15%

40%corruptio

n45%abuse

Patients are exposed to:

– Physical harm due to low value care as the result of

• Underuse (capitation) – substandard medical devices or incomplete DRG’s

• Over(use)consumption (unnecessary and or to expensive care) (fee for service)- lots of invasive tests with no added value (lack of legal basis for the development and enforcement of clinical guidelines)

– Financial harm due to• Informal payments• Refusal of reimbursement by payer (non compliant

billing) 6

Healthcare spending without waste• Patients must be

– Informed– Educated– Made responsible

• Healthcare professionals must be – Informed– Educated– Made responsible

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