Value Conversations Series

The ABIM Foundation, in partnership with Consumer Reports, has developed and implemented the highly successful "Choosing Wisely®" campaign. Medical specialty societies partnering in Choosing Wisely have published nearly 500 evidence-based recommendations that can be used as critical guideposts for conversations between patients and clinicians about avoiding inappropriate care and helping to create a culture of stewardship of healthcare resources. However, one must recognize that good stewardship of healthcare resources is not only a matter of making sure that clinicians understand evidence-based recommendations, but also a matter of helping clinicians learn how to deliver care differently.

Medium: Online Presentation

Joint Provider: Costs of Care

Commercial Support: Funding for these modules was provided by the ABIM Foundation with support from Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of RWJF.

The following four modules can be found in the series:

First, Do No (Financial) Harm: Having Value Conversations with Patients About Tests
More Americans than ever before are now on high-deductible insurance plans, meaning they have to pay out-of-pocket for at least the first few thousands of dollars of healthcare costs before their insurance coverage kicks in. For the average American, these out-of-pocket costs can be financially burdensome and have led to an increasing recognition that medical care can result in a side effect called “financial harm”. This financial harm can lead to other negative downstream effects, such as patients avoiding future helpful medical tests, procedures, or therapies; an inability to participate in other health programs; or going without basic needs such as food. Because of higher out-of-pocket costs, patients want to know how much their health care may cost them ahead of time and ways that they can mitigate these costs. Using a simple, 3-step framework, clinicians can work together with their patients to help address costs of care and reduce financial harm.

GOTMeDS: Having Value Conversations with Patients about Medication Costs
It is well known that patients face significant—and continually rising—out-of-pocket drug costs. Research has shown that these costs can lead to medication underuse, resulting in poor disease management and costly complications. There is also research concluding that patients and clinicians agree that there should be more discussion about out-of-pocket drug costs. To avoid the serious and costly complications of medication underuse, clinicians must be able to screen patients for potential cost-related issues and be prepared to provide counseling and strategies to help decrease their out-of-pocket drug costs.

Teamwork Time: Having Value Conversations with Inter-professional Team Members
Previous research has shown that inter-professional communication improves patient outcomes in regards to quality and safety. Based on this research, clinicians must understand how to improve inter-professional communication, in order to also improve the value of care, thereby reducing overtreatment and further developing clinicians as effective stewards of healthcare resources.

Costly Conversations: Having Value Conversations with Supervisors and Consultants 
Focusing on avoiding overtreatment and providing patients and families with high-value care is a relatively new concept in most areas of medicine meaning health professionals may have varying levels of understanding and background for thinking about these issues. In the hospital it can be particularly challenging to navigate various hierarchies and different perspectives. Many of us can recall times where we had to respond to a supervisor who was asking us to do something for a patient that we did not necessarily agree with, or a situation where the supervisor’s motivation was unclear. There are a few communication strategies that can be used in these situations, along with a framework1 for effective conflict resolution, advocacy, and mutual support so that we can all engage in conversations among the inter-professional team that ultimately help provide high-value care for our patients.

Target Audience

Health care providers of all specialties including physicians, nurses, nurse practitioners and physician assistants.

Learning Objectives

At the conclusion of this activity, participants will be able to:

  • Discuss the problem of “financial harm” for individual patients;
  • Describe strategies to reduce out-of-pocket drug costs for patients;
  • State how to incorporate inter-professional communication into clinical decision-making to prevent overtreatment;
  • Discuss strategies for “managing up” and effectively starting conversations about high-value care with supervisors.

*For a complete list, please reference the individual modules.

Additional information
ACGME/ABMS Core Competencies: 
Patient Care and Procedural Skills
Practice-based Learning and Improvement
Interpersonal and Communication Skills
Systems-based Practice
For more information, please contact:
CME Coordinator Contact Name: 
September Wallingford
CME Coordinator Contact Email: 
Available credit: 
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Participation
Activity opens: 
Activity expires: 
  Vineet Arora, MD, MAAP
  Education Director - Costs of Care
  Associate Professor of Medicine
  Assistant Dean of Scholarship & Discovery,
  Pritzker School of Medicine
  Director of GME Clinical Learning Environment and Innovation
                            University of Chicago Medicine
                            Chicago, IL


This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of The University of Chicago Pritzker School of Medicine and Costs of Care. The University of Chicago Pritzker School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.
Credit Designation Statement
The University of Chicago Pritzker School of Medicine designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nurses and other healthcare professionals will receive a Certificate of Participation.  For information on the applicability and acceptance of certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME, please consult your professional licensing board.
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