Vinay Kini
Weill Medical College of Cornell University, NY·Medicine & Clinical Research
Low-value care is medical care whose harms or costs outweigh its benefits. It can physically harm patients, trigger unnecessary follow-up tests and procedures, and leave patients with needless out-of-pocket costs.
- Fields
Medicine & Clinical Research
Public Health & Epidemiology
Social Science
- Topics
low-value care
coronary artery disease
percutaneous coronary intervention
- Grants
- 1 known grant, through Mar 2029
What they work on
- Test whether commonly used claims-based measures of low-value care for patients with coronary artery disease are accurate by comparing them against the gold standard of medical chart review.
- Measure the frequency, costs and trends of low-value cardiovascular services among a national sample of Medicare beneficiaries with coronary artery disease, and build a priority list of services to target for reduction.
- Use a difference-in-differences analysis of NCDR clinical data to test whether bundled payments for elective PCI change rates of low-value PCIs and disparities in appropriate PCIs.
- Assess whether the elective PCI bundled payment model changes the use of other validated low-value services, using linked Medicare claims data.
More about the research
Patients with coronary artery disease (CAD), the narrowing of the arteries that supply the heart, are at especially high risk. Studies estimate that up to half of their tests and 15% of their procedures may be low-value. Reducing this waste requires accurate measurement. Yet most widely used measures are based on insurance claims (billing records), and most have never been checked against chart review, the gold standard of examining patients' medical records.
Why it matters
For people with coronary artery disease, low-value tests and procedures can cause physical harm, extra procedures and needless out-of-pocket costs. Validated measures could support quality improvement and accountability programs. A priority list could show policymakers which services to reduce first. Evaluating bundled payments could reveal whether this policy reduces low-value care or creates unintended harms, such as disparities in access to appropriate procedures for racial and ethnic minorities.
Known grants
From NIH and NSF research grants. Labs often have other funding we can't see.
Closest labs
Aaron Schwartz
University of Pennsylvania, PA·Public Health & Epidemiology
Measure how many Medicare Advantage patients faced prior authorization (insurer pre-approval) for heart-related services from 2016–2024, and which clinical, demographic and geographic groups were most affected, using UnitedHealth policy and claims data.
Shipra Arya
Stanford University, CA·Medicine & Clinical Research
Test whether greater market competition among surgeons is associated with higher rates of guideline-discordant small abdominal aortic aneurysm repair and tibial interventions for claudication, using linked Vascular Quality Initiative–Medicare and Veterans Health Administration data.
John Mafi
University of California-Los Angeles, CA·Medicine & Clinical Research
Build governance and infrastructure for rapid, reproducible evaluation of AI clinical decision-support tools for dementia, using UC Health Data Warehouse EHR and imaging data and the ATLAS genotyped biobank.
The school
Weill Medical College of Cornell University: 35 labs on PI Pages, $1.6B a year on research, 59 research doctorates a year.
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