Reducing Unnecessary Medical Care

Knowing who delivers more appropriate care is the critical first step to improving physician performance and patient care.

Our clinically-validated Appropriate Use Measures attribute performance results to individual physicians, enabling healthcare organizations – accountable care organizations (ACOs), risk-based providers, and commercial and government payers – to act on these insights and capture the value of reducing unnecessary care.

Physician Engagement

  • Understand areas of strength and opportunities for improvement across your network
  • Identify outliers for one-on-one discussions and a ‘second look’ at clinical decisions
  • Nudge physicians to improve, using peer-comparison as intervention
  • Promote peer-sharing between physicians in your group or network

Network Management

  • Identify improvement opportunities and prioritize clinical initiatives for your specialists
  • Steer patients to more appropriate specialists using Centers of Excellence and other referral management and patient navigation tools
  • Integrate appropriateness measures into specialist profiling programs
  • Incent improved appropriateness via quality-based compensation programs
  • Optimize utilization management processes by rewarding high-performers with an appropriateness FastPass

Learn more about how Practicing Wisely can work in your organization

Importantly, Practicing Wisely reports do not only provide an assessment of a physician’s practice, they serve as a tool physicians can use to improve their practice of medicine.

Thomas Simmer, MD, Chief Medical Officer, BCBSM