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Employer News | March, 2015
Employer News | March, 2015

Are You Paying for Unnecessary Care?

Univera Healthcare recently announced that it became one of just a few health plans across the country to enter into a licensing agreement with Consumer Reports on Choosing Wisely®, a nationwide initiative to promote shared decision making between patients and doctors to improve the quality of care, and reduce unnecessary spending on services that have little or no proven benefit.

As a result, we will be better equipped to develop new approaches to care with area physicians, hospitals and health care facilities, and innovative wellness programs to the health plan’s members and employer group clients.

Choosing Wisely is a physician-led initiative developed by the American Board of Internal Medicine Foundation. Together, more than 60 medical societies have contributed more than 300 care recommendations that the Choosing Wisely initiative seeks to promote.

“Our analysis of regional health care data will guide us to the Choosing Wisely recommendations that we know will have an immediate and positive impact on the quality of care in upstate New York,” said Matthew Bartels, M.D., Univera Healthcare medical director for clinical quality.

According to Bartels, unnecessary care and waste have been well documented in the medical literature. A 2012 report from the Institute of Medicine calculated that about 30 percent of health spending was wasted on unnecessary services, excessive administrative costs, fraud and other problems. Moreover, inefficiencies cause needless suffering. By one estimate referenced by the IOM, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state.

With Choosing Wisely, doctors are encouraged to initiate open and honest conversations about options for care, tests and procedures, so that the treatment ultimately chosen is evidence based, doesn’t duplicate other tests or procedures, is safe and is truly necessary. As the consumer communicator of the Choosing Wisely campaign, Consumer Reports publishes resources such as consumer-friendly magazine articles, brochures and web stories to help explain the Choosing Wisely recommendations put forth by the medical societies. More details about the campaign are available online at ConsumerHealthChoices.org.

“Having developed more than 100 Choosing Wisely brochures about overused imaging, tests, drugs and procedures, we are particularly determined that information relevant to each patient’s clinical situation be provided at the right time,” said Dominic Lorusso, director, Health Partnerships at Consumer Reports. “These brochures are intended to inform consumers so conversations between doctors and patients can happen in the most open fashion.”

Choosing Wisely is endorsed by consumer and business groups including AARP, the National Business Group on Health, Service Employees International Union and medical specialty societies, including the American Academy of Family Physicians, the American College of Surgeons and the American Society of Clinical Oncology.

About Consumer Reports

Consumers Reports is an expert, independent, nonprofit organization whose mission is to work for a fair, just, and safe marketplace for all consumers and to empower consumers to protect themselves. As consumers become increasingly involved in their own health decisions, they need unbiased, accurate, evidence-based information to compare their options and to make appropriate choices for themselves and their families. For more information about Consumer Reports Health go to ConsumerHealthChoices.org.


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