AI Sharpens the Scalpel: How Analytics is Redefining Surgical Quality

NEW YORK, NY – December 03, 2025 – In a move signaling a significant shift in how corporate America procures healthcare, World Class Health (WCH), a global provider of Centers of Excellence (CoE) networks, announced a strategic partnership with the healthcare analytics firm Global Appropriateness Measures (GAM). The collaboration aims to embed GAM’s physician-led, AI-driven data directly into the process of selecting and contracting with top-tier surgeons, tackling one of the most persistent and costly problems in medicine: unnecessary care.

This partnership moves beyond traditional quality metrics, promising to leverage sophisticated algorithms to ensure that when an employee undergoes surgery, the procedure is not only performed well but is the right procedure in the first place. For businesses struggling under the weight of rising healthcare costs, this data-driven approach to surgical appropriateness represents a powerful new lever for both cost containment and improved employee wellbeing.

The $760 Billion Problem: A System Plagued by Waste

The U.S. healthcare system is the most expensive in the world, yet a staggering portion of that spending does not translate to better health. A landmark 2019 study published in the Journal of the American Medical Association estimated that approximately 25% of all healthcare spending—totaling between $760 billion and $935 billion annually—is waste. A primary driver of this inefficiency is what experts call "overtreatment" or "low-value care."

This category of waste includes tests, medications, and surgical procedures that provide little to no benefit to the patient and, in some cases, may even cause harm. From unnecessary imaging scans for lower back pain to aggressive surgical interventions for conditions that could be managed conservatively, these decisions contribute to inflated costs, patient risk, and poor outcomes. The challenge has been identifying this waste at a granular level. While hospital-level metrics like readmission and complication rates are common, they don't capture whether a procedure should have been performed at all.

This is the multi-billion-dollar issue the WCH-GAM partnership is designed to address. By focusing on the "appropriateness" of care, the initiative targets the clinical decision-making process itself, aiming to filter out procedures that don't align with evidence-based best practices before they ever happen.

A New Prescription: Physician-Led AI

At the heart of this new strategy is Global Appropriateness Measures' unique methodology. Founded by physicians from The Johns Hopkins University School of Medicine, GAM is not just another data analytics company. Its approach is built on a foundation of deep clinical expertise, which it uses to guide and inform its powerful algorithms. This fusion of human wisdom and machine intelligence is what makes its model so compelling.

GAM's process begins not with code, but with clinicians. The company’s consortium of physicians conducts thousands of interviews with specialists across more than 40 medical fields to define what constitutes appropriate care for specific conditions. This "clinical wisdom" is combined with an intensive review of the latest medical literature to establish evidence-based standards.

Only then does the technology take over. GAM’s sophisticated algorithms analyze massive datasets of physician practice patterns, comparing individual doctors against the consensus-driven standards. The system is designed to identify "unwarranted practice variation"—instances where a physician’s treatment choices fall significantly outside the norm without clear clinical justification. This isn't about punishing doctors, but about providing objective, data-driven insights to highlight outliers and promote adherence to best practices. Research underpinning this model has shown that when physicians are presented with this peer-benchmarked data, a vast majority adjust their practices to align with the established consensus.

Remodeling the Center of Excellence

For World Class Health, which connects the employees of self-insured companies to its curated network of elite medical centers, this data provides a new, sharper tool for quality control. A Center of Excellence is defined by its ability to deliver superior outcomes for complex procedures. Historically, that has been measured by factors like surgical volume, low complication rates, and patient satisfaction. The integration of GAM’s analytics adds a critical new dimension: appropriateness.

Now, when WCH evaluates a surgeon or a hospital for its network, it will have data-driven insights into not just how well they perform a surgery, but how often they recommend surgery when less invasive options might be better. This allows WCH to build a network of providers who are not only technically skilled but are also judicious and evidence-based in their clinical reasoning.

“At World Class Health, quality isn’t a box to check—it’s a clinical imperative,” said Dr. Kumar Dharmarajan, WCH’s Co-Founder and Chief Medical Officer, in the announcement. “Our physicians deliver excellent outcomes, including low readmission rates, and follow evidence-based guidelines to ensure patients receive the right, necessary care. That’s why GAM’s deep focus on outcomes and appropriateness metrics aligns perfectly with our shared commitment to global clinical excellence.”

This enhanced vetting process promises direct benefits for patients, steering them away from the potential harm and lengthy recovery of an unnecessary operation and toward providers who prioritize the most effective treatment path.

The Business Case for Better Medicine

While the clinical benefits are clear, the business implications for employers are transformative. For years, HR and benefits leaders have struggled to control healthcare spending without simply shifting costs to employees. The WCH-GAM partnership represents a more strategic approach: reducing costs by eliminating wasteful and ineffective care.

When an employee avoids an unnecessary $50,000 spinal surgery, the employer saves that direct cost, along with associated expenses from lost productivity, disability leave, and potential follow-up care for complications. By building a network that systematically filters out low-value care, WCH can offer its corporate clients a powerful return on investment.

“By delivering actionable, meaningful insights on clinician and facility performance, this partnership will help reduce instances of low-value care and overtreatment—main drivers of the more than $760 billion wasted in US healthcare each year,” noted Dr. Will Bruhn, Co-Founder and CEO of GAM.

This move reflects a broader industry trend toward value-based care, where payment is tied to outcomes rather than volume. As other health benefits platforms also adopt GAM’s metrics, a new competitive benchmark is emerging. Employers are no longer just asking if their health plan provides access to good doctors; they are demanding access to the right care, delivered at the right time. This partnership illustrates that data-driven analytics are becoming the essential instrument for achieving that goal, ensuring that every healthcare dollar is spent on care that truly improves health.