# S D M m o n t h

Aligning Incentives for Patient Engagement Revisited

Why Aligning Incentives?

Ben Moulton, JD, MPHSenior Legal and Health Policy Advisor

March 24, 2014

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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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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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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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Today’s Experts

Michael J. Barry, MDInformed Medical Decisions Foundation

Dominick L. Frosch, PhDGordon and Betty Moore Foundation

Kathy NormanWinding Waters Clinic

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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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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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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Provider Training

• Enables providers to better understand and value the process and embrace their role in engaging patients

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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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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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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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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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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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Thank You!www.sdmmonth.org