The problem of unwarranted variation in care in the United States has attracted wide attention from the press, policy makers and, increasingly, physicians interested in quality improvement and healthcare reform. There is wide variation in the practice of medicine and the use of medical resources including underuse of effective care, misuse of preference-sensitive care, and overuse of supply-sensitive care. Research shows that surgery costs can be reduced up to 40 percent when patients are actively involved in clinical decision-making.

CMR offers a program designed to support improved decision making, satisfaction, and outcomes for a set of highly variable surgical procedures that includes low back surgery, hip and knee replacement, and hysterectomy. A consistent approach to building trust, teaching employees about healthcare consumerism, and addressing their holistic informational needs is the cornerstone of this service. The goal is to reduce the high number of unnecessary surgeries and to improve hospital selection for certain procedures.

Decision-support services in this program typically include the following diagnoses:

• Carotid endarterectomy
• CABG
• Hysterectomy
• Knee replacement
• Hip replacement
• Low back surgery
• Lumpectomy
• Mastectomy
• Prostatectomy