Healthcare Utilization and the Progress of the Choosing Wisely Campaign

The right payment system will align the patient’s incentives with the provider’s incentives, said Margaret E. O’Kane, MHA. For instance, it’s no good for Medicare to use patient-centered medical homes and accountable care organizations, if patients, particularly high-need patients, do not have an incentive to use those delivery models.

On the topic of utilization, the panelists moved on to discuss the Choosing Wisely campaign. While the campaign is admirable, and some of the lists provided by specialty societies are helpful, that’s not the case across the board, O’Kane said.

Leah Binder was actually surprised that the societies were willing to put the lists together, and that they’re pushing the lists to be used in their community. But she would like to see the campaign go further.

“I mean what they focused on were tests and preventive kinds of procedures that are not the big money,” she said. For example, she was thinking about spinal surgeries and caesarean sections in mind. Binder added, “There’s a long list of very significant procedures that they did not address and so I think that’s the next step.”

Finally, the campaign isn’t measurable, so it’s difficult to tell how much progress has been made, she said. Unfortunately, O’Kane added, there are so many exceptions with Choosing Wisely that trying to measure it just is not practical.