Ensuring Appropriate Medical Care

Ensuring Appropriate
Medical Care

Background

MBGH has partnered with the American Board of Internal Medicine (ABIM) Foundation to promote the Choosing Wisely initiative. Choosing Wisely seeks to advance a national dialogue on avoiding unnecessary medical tests, treatments and procedures. It encourages and eases conversations between doctors and patients that lead to non-duplicative services supported by evidence, free from harm, and truly necessary.

Business Case for Employers

One in every three dollars spent on healthcare in the U.S. is estimated to be for low-value health care services, resulting in a system that is wasting as much as $760 billion to $935 billion annually.1  This includes care that is clinically unnecessary, duplicative, or delivered in costly setting.

Just 12 percent of U.S. adults, regardless of education level, have proficient health literacy, according to the U.S. Department of Health and Human Services. This means that over 77 million people have difficulty with common health tasks such as participating in care decisions. Choosing Wisely offers simple, patient-friendly resources to help people better understand their care options and effectively advocate for themselves.2


1https://jamanetwork.com/journals/jama/article-abstract/2752664 
2https://health.gov/communication/literacy/issuebrief/

Action Steps for Employers

Use the tools provided by Choosing Wisely to educate employees about avoiding overuse and how to engage in conversations about appropriate care with their physician.

  • Become familiar with the Choosing Wisely initiative and educate employees during open enrollment, through lunch-and-learns and at your onsite medical clinic; post information in your employee newsletter, cafeteria, restrooms, through social media and other communication channels.
  • Distribute the “5 Questions to Ask your Doctor” brochures, flyers and wallet cards. Hang the “5 Questions to Ask your Doctor” poster in high-traffic areas. Promote the Choosing Wisely app
  • Make It Personal– Distribute brochures on seasonal topics, such as antibiotic prescriptions for colds during flu season or imaging for head injuries during pre-season sports.
  • Examine data for commonly over-prescribed procedures (i.e. imaging), dollars spent, and opportunities to reduce unnecessary utilization.
  • Work with consultants, health plans, and other vendors to develop a strategy for influencing change (e.g., appropriate utilization management for low-value tests and procedures; reaching out to providers with high rates of inappropriate imaging).
  • Consider value-based insurance design strategies such as increasing co-pays for low-value tests.

Resources