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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
     

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. 

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 four 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 four low-value services is statistically higher than the state average. (The next set of letters are scheduled to be sent in mid-October 2017.) We will not release the names of these providers.
     
  • Promoting the use of free tools and resources to encourage discussions about low value services—among stakeholders across the state and, most importantly, between healthcare providers and patients.