Unnecessary health care is a tremendous problem that negatively impacts individuals and also increases health care costs across the system. While much scholarly attention has been paid to the role of patients and providers, payors' role in contributing to the problem is underexplored. The article recommends that payors should nudge providers away from unnecessary care by requiring electronic alerts intended to deter unnecessary care.
D.Armao, R.C.Semelka, and J.Elias, Jr., “Radiology’s Ethical Responsibility for Healthcare Reform: Tempering the Overutilization of Medical Imaging and Trimming Down a Heavyweight,”Journal Magnetic Resonance Imaging35, no. 3 (2012): 512-17 at 516; N. Nassery et al., “Systematic Overuse of Healthcare Services: A Conceptual Model,” Applied Health Economics & Health Policy 13, no. 1 (2015): 1-6, at 1-2.
3.
J.Mantel, “Spending Medicare’s Dollars Wisely: Taking Aim at Hospitals’ Cultures of Overtreatment,”University Michigan Journal Law Reform49, no. 1 (2015): 121-77, at 132-33; R.S. Saver, “Health Care Reform’s Wild Card: The Uncertain Effectiveness of Comparative Effectiveness Research,” University Pennsylvania Law Review 159, no. 6 (2011): 2147-2207, at 2174.
4.
T.S.Jost, “The American Difference in Health Care Costs: Is There a Problem? Is Medical Necessity the Solution?”Saint Louis University Law Journal43, no. 1 (1999): 1-26, at 15.
5.
M.A.Hall and C. E.Schneider, “Patients as Consumers: Courts, Contracts, and the New Medical Marketplace,”Michigan Law Review106, no. 4 (2008): 643-689, at 653-656; W.N. Epstein, “Price Transparency and Incomplete Contracts in Health Care,” Emory Law Journal 67, no. 1 (2017): 1-58, at 3.
6.
K.Baicker, A.Chandra, and J.S.Skinner, “Saving Money or Just Saving Lives? Improving the Productivity of US Health Care Spending,”Annual Review Economic4 (2012): 33-56, at 38.
See, e.g., Ariz. Admin. Code § R9-22-101 (2017); La. Stat. Ann. § 22:2392 (2015).
10.
S.M.Grosso, “Rethinking Malpractice Liability and ERISA Preemption in the Age of Managed Care,”Stanford Law & Policy Review9, no. 2 (1998): 433-461, at 435.
11.
See, e.g., P. H.Schuck, “Rethinking Informed Consent,”Yale Law Journal103, no. 4 (1994): 899-959, at 924; Erin Sheley, “Rethinking Injury: The Case of Informed Consent,” Brigham Young University Law Review 2015, no. 1 (2015): 63-120, at 63; N.N. Sawicki, “Modernizing Informed Consent: Expanding the Boundaries of Materiality,” University of Illinois Law Review 2016, no. 3 (2016): 821-872, at 827.
R.H.Thaler and C.R.Sunstein, “Libertarian Paternalism,”American Economic Review93, no. 2 (2003): 175-179, at 175 (coining the term “Libertarian Paternalism.”); R.H. Thaler and C.R. Sunstein, Nudge: Improving Decisions About Health, Wealth and Happiness (New York: Penguin Group, 2008): at 4-6.
14.
Id.
15.
See, e.g., C.R.Sunstein, Why Nudge? The Politics of Libertarian Paternalism (Yale University Press, 2014): at 59; See, e.g., K.R. Laughery and M.S. Wogalter, Designing Effective Warnings, Reviews of Human Factors and Ergonomics, available at <http://www.safetyhumanfactors.org/wp-content/uploads/2011/12/283LaugheryWogalter2006.pdf> (last visited October 31, 2018), at 241-42.
16.
See, e.g., A.Capron and D.Spruijt-Metz, “Behavioral Economics in the Physician-Patient Relationship: A Possible Role for Mobile Devices and Small Data” in I.G.Cohen, H.F.Lynch, and C.T.Robertson, eds., Nudging Health: Health Law and Behavioral Economics (Johns Hopkins University Press, 2016), at 234.
17.
See W.N.Epstein, “The Health Insurer Nudge,”Southern California Law Review91, no. 4 (2018): 593-656.
18.
D.Wolfsonet al., “Engaging Physicians and Consumers in Conversations About Treatment Overuse and Waste: A Short History of the Choosing Wisely Campaign,”Academic Medicine89, no. 7 (2014): 990-995, at 990; Choosing Wisely, available at <http://www.choosingwisely.org> (last visited November 1, 2017).
M.S.Ridgely and M.D.Greenberg, “Too Many Alerts, Too Much Liability: Sorting Through the Malpractice Implications of Drug-Drug Interaction Clinical Decision Support,”Saint Louis University Journal of Health Law & Policy5, no. 2 (2012): 257-296, at 280.
