On February 21, 2013, the ABIM Foundation held a news conference releasing recommendations from 17 leading medical societies. These recommendations outlined common medical services that, according to the available evidence, are unnecessary and perhaps even harmful to patients. These recommendations came out in a second wave of the Choosing Wisely campaign, which has encouraged physicians and patients to question the use of more than 130 tests and procedures. The Incidental Economist’s Aaron Carroll described the campaign’s intent to reduce medical waste and overtreatment in a post on the AcademyHealth blog last week.  The news conference featured a panel of 17 representatives from the specialist societies. From the ABIM Foundation, Christine Cassel, M.D., President and CEO, and Daniel Wolfson, M.H.S.A., Executive Vice President and COO discussed the success and future of the campaign and also shared that 15 additional societies will join the Choosing Wisely campaign and release lists this year. James Guest, J.D., President and CEO of Consumer Reports described the ABIM Foundation’s partnership with Consumer Reports to disseminate the campaign’s message to consumers.  The specialty societies shared their processes for developing their lists and mentioned that this phase was simply a “starting point” to identify all unnecessary yet overused procedures. Few societies described controversy in developing their recommendations, and they cited cross-specialty collaboration and a focus on the evidence as key to this successful collaboration. While the Choosing Wisely campaign developed lists of overused services, the goal of the campaign is to encourage physicians and patients to discuss the value of these services on a case-by-case basis rather than an outright proscription of the services involved. This, too, seemed to aid the societies in collaborating and developing lists through a consensus-based process.  The second half of the news conference featured a panel of experts who discussed the potential for Choosing Wisely to reduce unnecessary care. Dissemination of the Choosing Wisely message is a logical and needed next step, and the Robert Wood Johnson Foundation is making investments in support of these efforts. A grant to the ABIM Foundation will build awareness among providers and patients about the societies’ recommendations. Defining the success of the Choosing Wisely campaign also emerged as a key question in need of evidence-based measurement. AcademyHealth is the national program office for Changes in Health Care Financing and Organization (HCFO), an initiative of the Robert Wood Johnson Foundation. Starting today, researchers Carrie Colla, Ph.D., Dartmouth College, and Meredith Rosenthal, Ph.D., Harvard University, begin their HCFO-funded grant to assess the prevalence, variation, and correlates of overuse of low-value services, as designated by the Choosing Wisely campaign. The goal of this study is to lay the ground work for an effective policy agenda to reduce future utilization of low-value services. They also aim to generate hypotheses about effective payment and insurance reforms to moderate the provision of these services. This grant can begin to generate evidence around the Choosing Wisely designated services and, as Aaron Carroll alluded to in his blog post, help inform efforts to link this initiative with needed payment reform.

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