Examining the Choosing Wisely List of Tests and Treatments with Uncertain or Low Value as a Way to Reduce Waste in the U.S. Health Care System

The researchers assessed the prevalence, variation, and correlates of overuse of low-value services, as designated by the Choosing Wisely initiative. The Choosing Wisely initiative is a collaborative effort by the ABIM Foundation, Consumer Reports, and leading medical specialty societies that identified common tests or procedures whose necessity should be questioned and discussed. Using administrative data from Medicare and the Surveillance Epidemiology and End Results (SEER) program from January 1, 2006 – December 31, 2010, the researchers: (1) ascertained the precision with which they can measure overuse of low-value services with Medicare claims data; (2) described the prevalence of these services nationally and by region; and (3) examined the patterns and correlates of overuse of low-value services. The goal of the project was to lay the ground work for a policy agenda to reduce future utilization of low-value services and to generate hypotheses about effective payment and insurance reforms to moderate the provision of these services.