There is room to improve the value of cancer care and reduce costs by implementing the Choosing Wisely recommendations, according to a retrospective analysis involving more than 37,000 individuals.

Investigators looked at how closely 12 cancer centers in the southeastern US followed Choosing Wisely recommendations. Cost savings were estimated on the basis of a potential 95% adherence rate and average cost difference. Among the results:

• Patient characteristics were similar whether they received Choosing Wisely recommended care or not.
• Agreement varied by Choosing Wisely recommendation from 39% to 94%.
• Significant inconsistency was observed at centers for all recommendations, with difference as high as 89%.
• Nonadherence was linked with higher costs in every area.

The authors estimated that if agreement increased to 95% for all measures, there would be a $19 million difference in total cost of care per quarter.