Employers Find Value in Choosing Wisely

March 21, 2019

Neil Goldfarb

Neil Goldfarb, chair of the Board of Governors of the National Alliance of Healthcare Purchaser Coalitions, views driving value as central to the National Alliance’s mission to support mid-sized and large employers in both the public and private sectors in optimizing health care delivery for their employees.

That is what drew the organization to partnering with the Choosing Wisely campaign last fall to raise awareness among its full membership of 50 regional coalitions representing more than 12,000 purchasers and 45 million Americans, about overused health care services.

A dozen coalition members were already familiar with Choosing Wisely, but a seed grant from the ABIM Foundation enabled the national organization to initiate a broader awareness initiative through a webinar, in-person meetings and the creation of an action brief that explains the campaign, its concept of the “Five Questions You Should Ask Your Doctor” and the topic of overuse in imaging tests.

“The National Alliance views Choosing Wisely as so important to our core value mission that we transitioned the temporary Advisory Committee established under the ABIMF grant to an ongoing member affinity group that will continue to meet on a regular basis” said Goldfarb, President and CEO of the Greater Philadelphia Business Coalition on Health. The affinity group will provide a forum for coalitions to learn from each other’s experiences, share best practices and identify opportunities for national value-improvement efforts initiated through regional coalitions.

The four-page action brief, distributed to leadership of the member coalitions, explains the rationale for the Choosing Wisely campaign, noting the estimated $750 billion spent annually in the United States on low-value care, and provides action steps that employers can take to address low-value care.

It introduces the “5 Questions to Ask Your Doctor” wallet card as a conversation starter for patients and physicians, and identifies imaging tests as an opportune area to reduce overuse and improve quality of care and patient safety. The brief also provides employer, physician and patient case studies on the benefits of adhering to Choosing Wisely recommendations.

Earlier this month, the National Alliance highlighted Choosing Wisely in recommendations it submitted to U.S. Sen. Lamar Alexander (R-Tenn.), chair of a Senate committee on health, in response to his request for ideas from health care leaders on ways in which Congress could address the rising costs of health care in the United States.

Joanne Bilotta, Manager of Choosing Wisely outreach for the Rhode Island Business Group on Health (RIBGH), said that her group has taken a vigorous approach to educating employers and the general public about unnecessary care and the tools that Choosing Wisely provides. Members have committed to incorporating Choosing Wisely into their wellness programs and their operating budgets to highlight the campaign in their workplaces.

“What worked with seat belt and anti-smoking campaigns were that the messages came from everywhere in the community as well as from the employer,” said Bilotta, who organized a special kickoff event in 2016 at Brown University that drew 150 supporters, including the governor, legislators and community leaders in addition to RIBGH members. In April, Brown will release a study identifying the amount of low-value health care in the state.

“This is something that employers can embrace because we’re not making this a heavy lift for them. It’s not difficult or expensive,” she said. RIBGH has gathered data about overuse in the state, as well as success stories to share about effective interventions based on Choosing Wisely.

More recently, RIBGH has launched a broader outreach by working with health insurance brokerages to introduce the campaign to their employer clients, and by getting the largest medical practices in the state to address at least three recommendations and track and share the results with RIBGH. The Care Transformation Collaborative of Rhode Island is incorporating Choosing Wisely into its model for transforming practices into patient-centered medical homes.

In addition to distributing patient brochures to large health care practices, smaller employers, senior citizen centers and community groups such as the United Way, they have distributed press releases, participated in radio talk shows and purchased airtime to broadcast a public service announcement, and provided the PSA to physicians’ offices to screen in their waiting rooms.

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