Alliance Release of County-Level Data Report: Choosing Wisely

September 23, 2014

o:              Quality Leaders, Chief Medical Officers, and Public Relations Executives

From:         Tanya Carroccio, Director of Quality & Performance Improvement
Mary Kay Clunies-Ross, Vice President, Communication and Public Affairs

Subject:     Alliance Release of County-Level Data Report: Choosing Wisely

The purpose of this bulletin is to provide information about the Washington Health Alliance’s report on the Choosing Wisely initiative in Washington State. The report uses county-level claims data to show variation in the use of diagnostic testing and treatment across the state, but does not include the clinical information a physician might consider to make a about patient care. Variation between counties is considerable.

This is the first analysis of its kind in the country and is likely to garner considerable media attention when the report is released later this week.

The data in the report is presented at the county level; however, hospitals and providers should be prepared to answer questions about their own practices and how they are working to ensure appropriate use of health care.  Please note, chief executives and administrators are not included the mailing list for this bulletin. Please share this message internally as appropriate.

WSHA recommends that hospitals review the report and be prepared for internal and public discussions surrounding appropriate care and treatment options. The report is expected to be released this week. As soon as it is available, we will post the report at:

We have included talking points at the end of this bulletin to answer questions you might receive from reporters.

Health care leaders should also review the Choosing Wisely Action Manual at, which was developed to assist organizations with integrating evidence-based best practices.

Choosing Wisely® is an initiative of the American Board of Internal Medicine (ABIM) Foundation to help providers and patients engage in conversations about the overuse of tests and procedures and support efforts to help patients make smart and effective care choices.

As a part of the campaign to decrease health care waste, specialty societies were asked to identify evidence-based tests, procedures or medications that under certain circumstances could be considered unnecessary and even harmful. In Washington State, members of the Medical Officer Collaborative are serving on a joint Choosing Wisely Taskforce to support and promote the recommendations in our state. Members of the collaborative selected the Choosing Wisely campaign as a top Call to Action initiative.

The taskforce was involved in selecting the measures that are analyzed in the Alliance report. Premera and Group Health then provided the specifications and the Alliance conducted the analysis and wrote the report. As noted in the report, the measures have not been examined by outside experts, such as a certified measurement organization. In the short term, the report is intended to promote discussions within the provider community and with the public. In the long term, this is also the beginning of the opportunity to further refine the measures with better data and analytics.

For information about the report, the action manual, or the CMO Collaborative, contact Tanya Carroccio, (206) 577-1841.  For media related questions, contact Mary Kay Clunies-Ross, (206) 216-2894.

Talking Points on Alliance Report

Data like this is essential to achieving the triple aim of better quality, lower cost, and better health.

Claims data lacks information about decisions made at the clinical level, but it can help identify areas where best practice identification and implementation can help achieve that goal.

WSHA, WSHA members and CMOs were involved in this process:

  • The Choosing Wisely Taskforce recommended the measures to focus on for this report.
  • The taskforce was also instrumental in developing the action manual, which will help implement clinical behavioral change

Washington hospitals have been working to reduce patient exposure to imaging through the national Partnership Patients Leading Edge Advance Practice Topics work over the past year. Recently, many of our hospitals have join the 100k Children’s Campaign to reduce radiation exposure in kids.

We hope this report starts more conversations with patients and providers as they make decisions about what kind of tests and care are appropriate and necessary in their individual case.

Hospitals and health care providers in Washington State have a long and successful track record of working together to improve care. We are optimistic that we will see similar success in efforts to ensure diagnostic tools and treatments are used appropriately.

More about the report:

  •  Use of diagnostic testing is an issue that is complex and involves several decision makers. To reduce utilization will require the involvement and cooperation of physicians, patients, and insurance companies.
  • This report provides data that will allow us to benchmark our progress to ensure diagnostic tools and treatments are only used when they are truly needed.
  • While no single data source can tell the whole story, this report provides a valuable benchmark in areas that are worth working on.


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