Aligning Incentives for Patient Engagement Revisited
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# S D M m o n t h
Aligning Incentives for Patient Engagement Revisited
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Why Aligning Incentives?
Ben Moulton, JD, MPHSenior Legal and Health Policy Advisor
March 24, 2014
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#SDMmonth
The Problem
•Misaligned incentives in health care create challenges for implementing routine practice of shared decision making -- leads to a lack of patient and family engagement
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#SDMmonth
Working Toward A Solution
• Aligning Incentives for Patient Engagement stakeholder meeting May 23 and 24, 2013• 80+ stakeholders (diverse group)• Patient advocates, payers, providers,
researchers and policy makers
•Question: How do we better align incentives to foster widespread implementation of SDM?
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#SDMmonth
Taking Action
•Meeting attendees identified seven essential levers which could either enable or impede the successful implementation of SDM• White Paper• http://bit.ly/1fUi9nr
•Developed a call-to-action roadmap toward sustainable models of SDM• The Aligning Incentives Statement • http://bit.ly/1ps4cT3
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#SDMmonth
Today’s Experts
Michael J. Barry, MDInformed Medical Decisions Foundation
Dominick L. Frosch, PhDGordon and Betty Moore Foundation
Kathy NormanWinding Waters Clinic
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Fo r Wi d e s p re a d I m p l e m e n t a t i o n o f S D M
The Seven Essential Levers
Michael Barry, MDPresident
March 24, 2014
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#SDMmonth
Seven Essential Levers
•Organizational culture• Provider training•Delivery and information system design• Reimbursement model• Insurance benefit design• Patient decision aids•Measurement and feedback
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#SDMmonth
Organizational Culture
• A SDM supportive culture is prerequisite for widespread implementation• Acknowledge that SDM holds value for all stakeholders: patients, families, care providers, health care organizations, and payors.
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#SDMmonth
Provider Training
• Enables providers to better understand and value the process and embrace their role in engaging patients
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#SDMmonth
Delivery and Information System Design
•Develop a SDM delivery system that “makes the right thing easy to do”• Implement a team-based approach to SDM that involves all members of the care team
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#SDMmonth
Reimbursement Model
• New delivery models such as ACOs and PCMHs may be effective in accelerating adoption of SDM• Consider possible benefits of bundled payment models which may bridge to ACO contracting
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#SDMmonth
Insurance Benefit Design
• Increase in cost sharing or raising deductibles can drive patients away from the care they need• Consider incentives for patients who participate in SDM• Identify high value preventative care and reduce costs to make them more accessible
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#SDMmonth
Patient Decision Aids
•High-quality decision aids are crucial for widespread adoption of SDM• Consider alternative channels for distribution of DAs to increase accessibility• Continue to promote standards so DAs are free from bias and evidence based
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#SDMmonth
Measurement and Feedback
•Measurement helps project teams evaluate the effectiveness of implementation•Measures can provide valuable information on patient preferences and decision quality
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#SDMmonth
Thank You!www.sdmmonth.org