As part of the Choosing Wisely (CW) campaign, ASCO and the American Society for Therapeutic Radiology and Oncology have recommended against specific, yet commonly performed, treatments and procedures. We conducted a retrospective analysis of Medicare claims data to examine concordance with CW recommendations across 12 cancer centers in the southeastern United States. Potential cost savings were estimated on the basis of a potential 95% adherence rate and average cost difference.

Significant variability was noted across centers for all recommendations, with as much as an 89% difference. Non Concordance was associated with higher costs for every measure. If concordance were to increase to 95% for all measures, we would estimate a $19 million difference in total cost of care per quarter. The analysis included 37,686 patients with cancer with Fee-for-Service Medicare insurance. Concordance varied by CW recommendation from 39% to 94%. The primary purpose of this study was to evaluate the concordance with six ASCO and three ASTRO CW recommendations in one cancer care network composed of 12 cancer centers of varying size and practice structure across five states in the southeastern United States.

Finally, we aimed to determine whether the concordance with recommendations was associated with lower total Medicare costs of care and to calculate the potential savings associated with optimal concordance levels (95%). Overall, our purpose was to identify opportunities for improving value within our network.