Chapter 3

Value and Waste

Waste: A Global Problem with Local Solutions

A 2012 report from the Institute of Medicine (IOM) estimated that about one-third of healthcare spending in the United States—a total of about $765 billion a year—is “waste.” Some of that waste is driven by broader societal issues, such as fraud or a lack of health insurance, but many of the categories of waste identified by the IOM can be addressed through Lean, including “inefficiently delivered services” ($130 billion) and “unnecessary services” ($210 billion).

While the United States and other countries try to address systemic waste through payment reform and other national initiatives, health systems can take action locally to reduce large amounts of waste. In 2011, ...

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