Blue Cross Blue Shield of Massachusetts is taking other significant steps to improve the quality and safety of health care by working to reduce or eliminate the overuse, underuse, and misuse of health care services. As part of our promise to "always put our members' health first," we are taking steps to ensure that our members get the right care, in the right amount, at the right time, and in the right place.

Overuse

Overuse occurs when expensive drugs, technology, or procedures are used even when providing little or no proven benefit—and when they are used before proven, less costly treatments are even attempted. The New England Health Institute found that reducing the overuse of hospital emergency departments for non-emergencies alone could save the nation more than $20 billion.

Underuse

Underuse occurs when proven treatments or appropriate testing is not used on patients who would benefit from the treatments or testing, such as when diabetic patients do not receive the care they need to keep their condition in check. In 2003, the RAND Corporation found that only 60 percent of patients with chronic conditions receive the care they need. This underuse of treatments, drugs, and other therapies to manage conditions such as diabetes, high blood pressure, and asthma negatively affect a patient's health outcome and result in billions of dollars in added costs to the system.

Misuse

Misuse occurs when preventable errors or mistakes are made, such as when patients are given the wrong medication or are the victim of a hospital-acquired infection. As recently as spring 2009, HealthGrades^®' reported that "medical mistakes still occur at an alarming rate" in American hospitals. This misuse of care can result in patient harm and billions of dollars in unnecessary costs to the system.