Conversations Will Drive Success

It’s hard to believe we’re slowly approaching the six-year mark of the Choosing Wisely campaign. On one hand, we are buoyed by the embrace of the campaign’s goals and methods by numerous stakeholders around the country. On the other, we realize how much more work there is still to be done. I can’t help but feel, however, that the new electricity in the air around the country that is activating so many to change the status quo is affecting our work as well.

Earlier this month, the Washington Health Alliance (WHA), one of our most engaged Choosing Wisely grantees, released a study that examined 47 tests and treatments identified by specialty societies as overused or low-value. The results of the study showed that 36 percent of health care spending in the Evergreen State went toward low-value treatments and procedures, totaling an estimated $282 million, with almost half of the 1.3 million individuals involved in the study receiving a low-value service.

What struck me most about WHA’s report, aside from its grim results, was the organization’s motivation for taking on this work– a hope that the public release of its findings would generate a “much-needed community dialogue among key stakeholders about low-value care.”

This is Choosing Wisely.

Not content to just show how badly needed further engagement is, WHA also included five actionable steps, defined as a “Call To Action.” They include:

  • “Overuse must become central to honest discussions of health care value in Washington state.”
  • “Clinical leaders and medical specialty societies in the state of Washington must take up the mantle and lead provider efforts to incorporate reduction of overuse into local practice culture.”
  • “The concepts of ‘choosing wisely’ and shared decision-making must become the bedrock of provider-patient communications.”
  • “We need to keep our collective ‘foot on the gas’ to transition from paying for volume to paying for value.”
  • “Value-based provider contracts must include measures of overuse, and not just measures of access and underuse.”

Through the public release of their study and calling on others to begin an earnest conversation about unnecessary health care services, their potential harm and attendant costs, WHA is defining what will be needed from all of us currently involved in this campaign to keep this important work going.

For our part, we are entering into a new partnership with an important stakeholder — purchasers through the National Alliance of Healthcare Purchaser Coalitions (formerly the National Business Coalition on Health), which serves 12,000 member groups in both the private and public sectors. Through this new collaboration, we are hoping to heighten employer/purchaser as well as consumer awareness about unnecessary procedures and treatments and the resources available to combat overuse. This new collaboration also provides us with an opportunity to more deeply examine information dissemination strategies that can lead to specific actions and impact.

Thanks to the work of WHA, we see our work is more important than ever. There’s no better time to start — or even expand — our conversations.



Daniel B. Wolfson
EVP & COO, ABIM Foundation