Reducing Low-Value Care Through the Smarter Care Virginia Initiative.

Smarter Care Virginia was linked to a 10.4% fewer share of patients receiving at least one of nine low-value services in Virginia, with a -1.1 percentage-point absolute reduction.

• Why it matters: Low-value care costs over $100 billion annually and persists despite evidence of clinical and financial harms, but statewide, health-system–partnered feasibility is uncertain.
• What they did: In a difference-in-differences quality improvement study, 6 intervention health systems were compared with 12 control systems in Virginia from 2019 to 2022 using patient-attributed rates for nine clinician-selected low-value services.
• The result: After the intervention, low-value service use fell from 10.5% to 8.5% in the intervention group versus 10.7% to 9.1% in controls, with no statistically significant change in adverse events or spending.

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