Low-value care—the use of unnecessary and potentially harmful health care services—accounted for roughly $200 billion in wasteful spending in the United States in 2011. In 2012 the ABIM Foundation and Consumer Reports launched the Choosing Wisely® campaign, inspired by the idea that professional societies and health care providers should take the lead in defining and motivating efforts to reduce the use of low-value care. But decreases in that use have been slow in coming. We discuss the campaign’s significant accomplishments in the past five years and summarize the work that is needed to fulfill the promise of Choosing Wisely. We focus on innovations in three main areas: identifying high-priority clinical targets, developing theory-based interventions, and evaluating interventions in ways that are clinically meaningful.