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Project Background

National Program

Choosing Wisely, an initiative of the American Board of Internal Medicine (ABIM) Foundation, aims to promote conversations between clinicians and patients by helping patients choose care that is:

  • Supported by evidence
  • Not duplicative of other tests or procedures already received
  • Free from harm
  • Truly necessary

Prompted by Choosing Wisely organizers, physician specialty societies identified a list of "low value" services and procedures that both:

  • Were commonly used, and
  • Whose necessity should be questioned and discussed

Activity in Washington State

In 2013, the Washington Health Alliance, Washington State Hospital Association, and Washington State Medical Association formed a statewide Choosing Wisely task force and a year later published a report analyzing claims from commercial payors and Medicaid in order to reveal variation in the utilization of 11 low-value services. The second edition of the report was released in 2016. 

Opioid Prescribing

Qualis Health is also conducting similar analyses and outreach related to prescription opioid use among Washington's Medicare beneficiaries.

Thanks to Special Innovation Project funding from CMS, Qualis Health is performing three key tasks to bolster the Choosing Wisely initiative in Washington:

  • Publishing aggregate results of our analysis of Medicare Fee-for-Service claims data for several measures which, when combined with the commercial and Medicaid data accessed by the Alliance, helps create a more complete picture of our state. Results are available on our website; the first round was also published in the 2016 Alliance report.
     
  • Mailing confidential reports to providers whose rate of ordering one or more of the targeted services is worse than the state average.  By law, we cannot release the names of these providers.
     
  • Promoting the use of free tools and resources to encourage discussions about the targeted services—among stakeholders across the state and, most importantly, between healthcare providers and patients.