As much as 20 to 40 percent of all health care spending in Massachusetts is wasteful, much of it squandered on unnecessary hospital readmissions and emergency room visits, according to a new state report released yesterday.

The study estimates wasteful spending in 2012 at a staggering $15 billion to $27 billion. The biggest single category $700 million was spent on readmissions of patients recently discharged from hospitals. Unnecessary ER visits tallied up $550 million in waste. Total health spending in the Bay State is estimated at $69 billion.

A lot of it is totally useless, if not harmful, said Stuart Altman, chairman of the Health Policy Commission, a state watchdog group charged with monitoring health care costs, which issued the report. The worst offenders are areas that actually dont add any value, but are destructive, like people going back to the hospital when they dont need to.

The first-of-its-kind report also found that preventable infections acquired in health care settings cost $10 million to $18 million a year.

Massachusetts first in the nation to adopt universal health coverage spends more per capita on health care than any other state, and health care costs here have grown faster than the national average. A 2012 state law aims to curb the growth of health care spending.

The Health Policy Commissions report notes that costs vary widely among the states hospitals.

Some hospitals deliver high-quality care with lower operating expenses, the report said, while many higher-expense hospitals achieve lower quality performance.

Former Beth Israel Deaconess Medical Center chief executive Paul Levy said the findings are a good first step but wont spur hospitals into action not unless their names are on the report.

The Massachusetts Hospital Association said the report uses outdated numbers that dont show the progress hospitals are making on tackling costs.

Massachusetts hospitals are working collaboratively ... to improve care while becoming even more costefficient, including in the areas identified in the report as examples of wasteful spending, the MHA said in a prepared statement.

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Watchdog report details waste in Mass. health care