Medicare is burning billions on treatments that do little good and can even harm seniors, and the waste keeps showing up in the government’s own data.
Story Highlights
- Medicare’s advisers report billions spent each year on “low-value” services that offer little or no benefit.
- About 71 low-value services per 100 beneficiaries were delivered in 2022, with spending up to $5.8 billion.
- Roughly one in three beneficiaries receives at least one such service in a given year.
- Fee-for-service payment rewards volume and fails to block low-value care, according to Medicare’s own commission.
Medicare’s Watchdog Flags Persistent Waste
The nonpartisan Medicare Payment Advisory Commission reported that traditional Medicare delivered between 34 and 71 low-value services per 100 beneficiaries in 2022. The commission estimated Medicare spent between $1.9 billion and $5.8 billion on those services that year. The commission defines low-value care as services that bring little or no clinical benefit or may cause more harm than help. These findings come from the commission’s 2024 data book and mirror earlier results across the past decade.
The commission’s public brief adds a plain warning: low-value care drives costs and can expose patients to injury from needless tests and procedures. The brief draws on earlier research and shows the problem spans imaging, cancer screenings, preoperative testing, and cardiovascular procedures. That spread hints at a culture of “more is better,” even when the evidence for benefit is thin or negative. The bottom line is simple: seniors get billed, taxpayers pay, and health risks rise without clear gains.
How Payment Rules Feed the Problem
The current fee-for-service system pays each time a provider furnishes a billable item or service. The commission explains that this model gives broad access but also bakes in an incentive to do more, not necessarily to do what works best. The commission’s 2018 chapter stated the coverage process does not prevent low-value services, and use of such services is prevalent. That means the waste is structural, not a few bad actors gaming the system.
The commission and related summaries propose a common-sense fix: tilt cost-sharing and payment toward high-value care and hold the line on low-value care. That approach would lift useful care while putting friction on waste. It would also protect seniors from cascades of follow-up scans and procedures that start with a needless test. Advocates note that education alone, like past “Choosing Wisely” lists, did not cut low-value use much without real payment and accountability changes.
Scope: How Many Seniors, How Much Money
Across years of analysis, the commission has found a steady range: roughly one quarter to over one third of beneficiaries receive at least one low-value service in a year. In earlier snapshots, the commission reported 65 instances per 100 beneficiaries and spending as high as roughly $5.8 billion, depending on how broad or narrow the measures were. The consistent totals show this is not a one-off blip but a standing drain on the Medicare trust funds and family budgets alike.
The 2024 data echo that pattern. About 71 low-value services per 100 beneficiaries were delivered in 2022, with spending up to $5.8 billion under broader measures. That is real money, even if it is a smaller share of total Medicare outlays. Every wasteful dollar is one not used for life-saving drugs, cancer care, or stronger rural access. For seniors on fixed incomes, fewer pointless tests also means fewer copays, less stress, and lower risk of harm from follow-on procedures.
Accountability Under President Trump
President Trump’s administration faces this legacy problem head-on. The commission’s 2026 summaries stress the same core issue: fee-for-service rewards volume. Policymakers can act by tightening coverage rules around clearly low-value services and by steering cost-sharing relief to proven, high-value care. That mix keeps choice for seniors while protecting taxpayers. It also respects the principle that government should pay for what works, not what pads bills without helping patients.
Conservatives want a Medicare that honors work, protects family budgets, and guards liberty from wasteful bureaucracy. Cutting low-value care advances all three. It defends the solvency of the program seniors earned. It reduces needless medical risks. And it reins in a payment machine that too often values quantity over results. The commission’s data give a roadmap. Now it is time to reward value, expose waste, and put patients first — not paperwork and profit.
Sources:
cnav.news, medpac.gov, milbank.org
