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The U.S. spends huge amounts of money on health care that does little or nothing to help patients, and may even harm them. In Colorado, a new analysis shows that the number of tests and treatments conducted for which the risks and costs exceed the benefits has barely budged despite a decade-long attempt to tamp down on such care.

This story also ran on CBS News. It can be republished for free.

The state including the government, insurers, and patients themselves spent $134 million last year on what is called low-value care, according to the report by the Center for Improving Value in Health Care, a Denver nonprofit that collects billing data from health plans across Colorado. The top low-value items in terms of spending in each of the past three years were prescriptions for opiates, prescriptions for multiple antipsychotics, and screenings for vitamin D deficiency, according to the analysis.

Nationwide, those treatments raise costs, lead to health complications, and interfere with more appropriate care. But the structure of the U.S. health system, which rewards doctors for providing more care rather than the right care, has made it difficult to stop such waste. Even in places that have reduced or eliminated the financial incentive for additional testing, such as Los Angeles County, low-value care remains a problem.

And when patients are told by physicians or health plans that tests or treatments arent needed, they often question whether they are being denied care.

While some highly motivated clinicians have championed effective interventions at their own hospitals or clinics, those efforts have barely moved the needle on low-value care. Of the $3 trillion spent each year on health care in the U.S., 10% to 30% consists of this low-value care, according to multiple estimates.

Theres a culture of more is better, said Mark Fendrick, director of the University of Michigan Center for Value-Based Insurance Design. And more is better is very hard to overcome. Email Sign-Up

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To conduct its study, the Center for Improving Value in Health Care used a calculator developed by Fendrick and others that quantifies spending for services identified as low-value care by the Choosing Wisely campaign, a collaborative effort of the American Board of Internal Medicine Foundation and now more than 80 medical specialty societies.

Fendrick said the $134 million tallied in the report represents just a small piece of the universe of no- and low-value care in Colorado. The calculator tracks only the 58 services that developers were most confident reflected low-value care and does not include the costs of the cascade of care that often follows. Every dollar spent on prostate cancer testing in men over 70, for example, results in $6 in follow-up tests and treatments, according to an analysis published in JAMA Network Open in 2022.

In 2013, Childrens Hospital Colorado learned it had the second-highest rate of CT abdominal scans a low-value service among U.S. childrens hospitals, with about 45% of kids coming to the emergency room with abdominal pain getting the imaging. Research had shown that those scans were not helpful in most cases and exposed the children to unnecessary radiation.

Digging into the problem, clinicians there found that if ER physicians could not find the appendix on an ultrasound, they swiftly ordered a CT scan.

New protocols implemented in 2016 have surgeons come to the ER to evaluate the patient before a CT scan is ordered. The surgeons and emergency doctors can then decide whether the child is at high risk of appendicitis and needs to be admitted, or at low risk and can be sent home. Within two years, the hospital cut its rate of CT scans on children with abdominal pain to 10%, with no increase in complications.

One of the hardest things to do in this work is to align financial incentives, said Lalit Bajaj, an emergency physician at Childrens Colorado who championed the effort, because in our health care system, we get paid for what we do.

Cutting CT scans meant less revenue. But Childrens Colorado worked with an insurance plan to create an incentive program. If the hospital could hold down the rate of high-cost imaging, saving the health plan money, it could earn a bonus from the insurer at the end of the year that would partly offset the lost revenue.

But Bajaj said its tough for doctors to deal with patient expectations for testing or treatment. Its not a great feeling for a parent to come in and I tell them how to support their child through the illness, Bajaj said. They dont really feel like they got testing done. Did they really evaluate my child? More from the Mountain States

That was a major hurdle in treating kids with bronchiolitis. That respiratory condition, most often caused by a virus, sends thousands of kids every winter to the ER at Childrens, where unneeded chest X-rays were often ordered.

The data was telling us that they really didnt provide any change in care, Bajaj said. What they did was add unnecessary expense.

Too often, doctors reading the X-rays mistakenly thought they saw a bacterial infection and prescribed antibiotics. They would also prescribe bronchodilators, like albuterol, they thought would help the kids breathe easier. But studies have shown those medicines dont relieve bronchiolitis.

Bajaj and his colleagues implemented new protocols in 2015 to educate parents on the condition, how to manage symptoms until kids get better, and why imaging or medication is unlikely to help.

These are hard concepts for folks, Bajaj said. Parents want to feel their child has been fully evaluated when they come to the ER, especially since they are often footing more of the bill.

The hospital reduced its X-ray rate from 40% in the 17 months before the new protocols to 29% in the 17 months after implementation, according to Bajaj. The use of bronchodilators dropped from 36% to 22%.

Part of the secret of Childrens success is that they brand their interventions. The hospitals quality improvement team gathers staff members from various disciplines to brainstorm ways to reduce low-value care and assign a catchy slogan to the effort: Image gently for appendicitis or Rest is best for bronchiolitis.

And then we get T-shirts made. We get mouse pads and water bottles made, Bajaj said. People really do enjoy T-shirts.

In California, the Los Angeles County Department of Health Services, one of the largest safety-net health systems in the country, typically receives a fixed dollar amount for each person it covers regardless of how many services it provides. But the staff found that 90% of patients undergoing cataract surgery were getting extensive preoperative testing, a low-value service. In other health systems, that would normally reflect a do-more-to-get-paid-more scenario.

That wasnt the case here in LA County. Doctors didnt make more money, said John Mafi, an associate professor of medicine at UCLA. It suggests that theres many other factors other than finances that can be in play.

As quality improvement staffers at the county health system looked into the reasons, they found the system had instituted a protocol requiring an X-ray, electrocardiograms, and a full set of laboratory tests before the surgery. A records review showed those extra tests werent identifying problems that would interfere with an operation, but they did often lead to unnecessary follow-up visits. An anomaly on an EKG might lead to a referral to a cardiologist, and since there was often a backlog of patients waiting for cardiology visits, the surgery could be delayed for months.

In response, the health system developed new guidelines for preoperative screenings and relied on a nurse trained in quality improvement to advise surgeons when preoperative testing was warranted. The initiative drove down the rates of chest X-rays, EKGs, and lab tests by two-thirds, with no increase in adverse events.

The initiative lot money in its first year because of high startup costs. But over three years, it resulted in modest savings of about $60,000.

A fee-for-service-driven health system where they make more money if they order more tests, they would have lost money, Mafi said, because they make a profit on each test.

Even though the savings were minimal, patients got needed surgeries faster and did not face a further cascade of unnecessary testing and treatment.

Fendrick said some hospitals make more money providing all those tests in preparation for cataract surgery than they do from the surgeries themselves.

These are older people. They get EKGs, they get chest X-rays, and they get bloodwork, he said. Some people need those things, but many dont.

Markian Hawryluk: MarkianH@kff.org, @MarkianHawryluk Related Topics Health Care Reform Health Industry Insurance States Colorado Doctors Hospitals Contact Us Submit a Story Tip

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US

Woman missing for more than 60 years found ‘alive and well’

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May 4, 2025

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Woman missing for more than 60 years found 'alive and well'

A woman in the US who has been missing since 1962 has been found “alive and well”, authorities have said.

Audrey Backeberg left her home in Reedsburg, Wisconsin, in July that year when she was 20 years old, Sauk County Sheriff’s Office said.

Investigators pursued numerous leads over the years but the case eventually went cold.

However, during a review of cold cases earlier this year, a detective reassessed all the case files and evidence, and re-interviewed several witnesses – and found Ms Backeberg.

The 82-year-old was “alive and well” – living outside of the state of Wisconsin, the sheriff’s office said.

Ms Backeberg was married and had two children when she disappeared on 7 July 1962, according to the Wisconsin Missing Persons Advocacy organisation.

She left her home to pick up her salary but never returned, causing her husband to ask family members where she was.

Shortly afterwards their 14-year-old babysitter claimed she and Ms Backeberg had hitchhiked to Wisconsin’s capital city Madison and then caught a bus to Indianapolis, Indiana.

The teenager said when she arrived she became nervous and wanted to go home, while Ms Backeberg refused to return and was last seen walking near a bus stop.

Ms Backeberg’s marriage was troubled and there were allegations of abuse, the Wisconsin Missing Persons Advocacy organisation said, with a criminal complaint having been filed days before she went missing.

Her relatives insisted she would never abandon her children, the organisation added, and her husband passed a polygraph test and maintained his innocence.

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‘We talked for 45 minutes’ – detective

Detective Isaac Hanson, who found Ms Backeberg, said her sister’s Ancestry.com account was vital in helping him locate her address.

“That was pretty key in locating death records, census reports, all kinds of data,” he told local news station WISN.

“So I called the local sheriff’s department, said, ‘Hey, there’s this lady living at this address. Do you guys have somebody, you can just go pop in?’

“Ten minutes later, she called me, and we talked for 45 minutes.”

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‘She sounded happy’

Mr Hanson said Ms Backeberg may have left home due to marital issues, but it was unclear why she had stayed away for so long.

He said he had promised to keep their conversation private.

“I think she just was removed and, you know, moved on from things and kind of did her own thing and led her life,” he said.

“She sounded happy. Confident in her decision. No regrets.”

Sauk County Sheriff’s Office said Ms Backeberg made the choice to leave and her disappearance “was not the result of any criminal activity or foul play”.

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Sports

Jets-Blues Game 7 preview: Key players to watch, final score predictions

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May 4, 2025

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Jets-Blues Game 7 preview: Key players to watch, final score predictions

  • Multiple Contributors

May 4, 2025, 07:00 AM ET

It all comes down to this. The Presidents’ Trophy-winning Winnipeg Jets host the St. Louis Blues in the 200th Game 7 in Stanley Cup playoffs history Sunday (7 p.m. ET, TBS).

One team will advance to the second round, while the other will get an early start to the offseason — and try to fix what went wrong.

For the Blues, this is the club’s 19th all-time Game 7, the most of any non-Original Six team. They have gone 10-8 in Games 7s, with the most recent one being the 2019 Stanley Cup Final against the Boston Bruins, which they won 4-1.

This version of the Jets has much less Game 7 history on which to draw; their only Game 7 was a second-round victory over the Nashville Predators in 2018.

Who wins this one? We’ve gathered the ESPN hockey family to identify the key players to watch in the contest — as well as their final score predictions.

Who is the one key player you’ll be watching in Jets-Blues?

Ryan S. Clark, NHL reporter: If he plays, it’s Mark Scheifele. The hit in Game 5 from Brayden Schenn and/or Radek Faksa generated quite a bit of conversation about what is arguably the most physically demanding series in the first round. Scheifele’s play this season and this series prior to the hit reinforces what makes him a legit top-line center in this league. We saw how the Jets maneuvered around his absence for the final two periods of Game 5, while Game 6 proved why they need contributions from everyone if he can’t go.

But again, that’s if Scheifele plays. He skated Saturday in a tracksuit, with Scott Arniel saying the center will be a game-time decision Sunday.

Arda Öcal, NHL broadcaster: Connor Hellebuyck is the obvious answer here for me because he’s been “Vezina” at home (especially Game 2) and “Vezina from Temu” on the road.

Hellebuyck has allowed four or more goals in seven straight road playoff games, which ties the second longest such streak in Stanley Cup playoff history. But Game 7 is at home. The pressure is on but he’s in comfortable confines, surrounded by a “Whiteout.” Which version of Hellebuyck do we get Sunday night?

Kristen Shilton, NHL reporter: Connor Hellebuyck, of course. Has there been a Jekyll/Hyde performance like this in recent years?

The Vezina finalist can play lights-out at home and like a fish out of water on the road. Does that trend continue in Game 7? What version of the goalie shows up for this one?

But as a bonus, I’ll toss Pavel Buchnevich into this equation. He’s been driving the Blues’ offense, and if Hellebuyck is on his A-game then St. Louis is going to need Buchnevich to channel his hat trick energy from Game 3 to help the Blues pull off a stunning road win.

Greg Wyshynski, NHL reporter: Jordan Binnington renewed his title as one of the NHL’s most clutch goaltenders with his 31-save performance in Team Canada’s 4 Nations Face-Off championship win over the U.S. — including six saves in overtime. He first earned it in 2019, backstopping the Blues to the Stanley Cup with Game 7 wins over Dallas and Boston.

Now he’s got a chance to reestablish those credentials.

Binnington had a 0.82 goals-against average and a .968 save percentage in those prior Game 7s. While Hellebuyck has been terrible in St. Louis, Binnington hasn’t been much better in Winnipeg, generating an .861 save percentage and a 3.44 goals-against average and giving up four goals in two of the three games. But as 4 Nations showed, Binnington can meet the moment. (Although this time, Kyle Connor will actually be in the lineup for the opposition. Not that we’re bitter or anything.)

The final score will be _____.

Clark: 4-3 Jets. There have been a few themes in this series. The first being that offense hasn’t been an issue — the teams have combined to score more than six goals in all but one game. The second is that the home team has won every game; I say that continues, and the Jets advance.

Öcal: 6-5 Jets. Hellebyuck doesn’t have his best game, but the Jets outscore that challenge, and Kyle Connor scores another third-period goal in this series to win it.

Shilton: 5-4 Jets. The Jets have been too good on home ice to let this one slip away. That’s not to say a St. Louis win would be surprising, but even if Hellebuyck is off, Winnipeg’s offense should be able to provide enough buffer that the Jets can squeak through with a narrow victory to advance.

Wyshynski: 5-3 Jets. The Jets would be toast if this game were played in St. Louis because it’s a demonstrable fact that Hellebuyck is a disaster on the road in the playoffs. He’s slightly below replacement at home in the postseason, but Winnipeg will take that considering his three removals on the road.

The Blues are first in the playoffs in 5-on-5 offense and goals-for percentage at home. But Winnipeg is second in both categories. Hellebuyck calms down, and the offense gets ratcheted up at home, especially now that Nikolaj Ehlers has a game under his belt, having not played since April 12 due to a foot injury.

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Environment

Meet Bodo – the 35 mph electric golf cart that thinks it’s a G-Wagen

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2 hours ago

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May 4, 2025

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Meet Bodo – the 35 mph electric golf cart that thinks it's a G-Wagen

Bodo G-Wagon electric golf cart; via Mecum Auctions.

With a fully-enclosed, G-Wagen-inspired body and an 80 mile electric range, the Bodo G-Wagon golf cart is the NEV you need when you decide it’s time to get serous one-upping the rest of the Palm Beach country clubbers.

If you love the look of the $230,000 Mercedes-Benz G580 off-roader, but think the 579 hp, 6,800 lb. electric 4×4 is probably overkill for occasional trips to the golf course and country club, this G-Wagen-inspired golf cart might be just what you’re looking for.

The shiny black 2024 Bodo G-Wagon sold at Mecum Auctions last month for $31,900, which seems like it might not be a lot of money to the sort of person who decides to take a flyer on a goofy, limited-use EV that ships with real, metal doors, power windows, heating and air conditioning, fully digital instrument cluster and infotainment, and a “posh,” caramel leather interior.

It even has windshield wipers, power steering, and a rear-seat entertainment system that’s built into the front headrests!

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It’s really nice in there

Under the hood, the Bodo packs a 15 kW (20 hp) electric motor drawing power from a 10 kWh li-ion battery that won’t deliver a scorching 0-60 mph time (it only goes 35), but will deliver you and your buddies from one end of any golf course in North America and back several times over, thanks to the G-Wagon’s 80 mile range.

The official Mecum Auctions listing goes into a bit more detail, and I’ve included it here, in case it gets deleted after a while and you’re just finding this for the first time in 2027:

Be the envy of any country club or golf community showing up with this 2024 Bodo G-Wagon Golf Cart. Perhaps more appropriately known as an E-Wagon, this baby G-Wagon is powered by a 15kW motor with a 10kWh lithium battery. Boasting an 80-mile range and a 35 MPH top speed, the Bodo is an enclosed, luxury golf cart that pampers occupants with heating and air conditioning, rear-seat entertainment, power windows, power locks and a posh, caramel-colored interior. With the Bodo fitted with power steering and 4-wheel power disc brakes with brake boost, drivers will think they’re in a full-size G-Wagon, thanks to the multiscreen entertainment cluster, the rearview camera, windshield wipers, turn signals, running lights and so much more.

Finished in black with the right amount of brightwork, the overall vibe is one of jaw-dropping, smile-inducing fun. While the Bodo would be an excellent choice for any golf community, it should also prove to be hugely popular around a race track or car condo community as well, or maybe even a neighborhood with its own airplane runways. Over the past decade in particular, the demand for unique, luxury golf carts has been on the rise, and understandably so. The number of luxury communities with specific interests in sports, aero and auto has also been on the rise, with people buying homes in these exclusive locations to better engage with like-minded people. All too often a golf cart is the perfect way to get around these gated neighborhoods, and this one is enclosed, comes with the amenities of a full-size car and is infinitely more stylish.

MECUM AUCTIONS

You can check out a few more photos of the 2024 Bodo G-Wagon golf cart that sold at Mecum, below – and if you want one for yourself, you’re in luck! I found this brand-new 2025 “G600 E-Wagon” (in white) for $23,900 at Gulf Carts in Santa Rosa Beach, Florida. Head on down to the comments and let us know if you buy it.

SOURCE | LOTS MORE PHOTOS: Mecum Auctions.

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