How Prevalent and Costly are Choosing Wisely Low-Value Services? Evidence from Medicare Beneficiaries

October 2014

In 2012, the ABIM Foundation announced the Choosing Wisely® initiative, which encourages physicians, patients, and other health care stakeholders to engage in conversations about medical tests and procedures that may be unnecessary and, in some instances, cause harm. Under the initiative, specialty societies developed lists of five evidence-based recommendations of tests and treatments that physicians and patients should question. The goal of the initiative is to encourage physicians to be responsible stewards of finite health care resources and to reduce low-value care. Drawing on HCFO-funded work, Carrie H. Colla, Ph.D., The Dartmouth Institute for Health Policy and Clinical Practice, and colleagues examined the prevalence, geographic variation, and Medicare spending associated with tests identified as low-value by select specialty societies. In particular, they examined the use of non-indicated cardiac testing in low-risk patients  and short-interval bone density testing   to quantify the use and spending associated with these low-value services.