Ben Moulton, JD, MPH, and Michael J. Barry, MD, revisit the Aligning Incentives meeting held last May and discuss seven essential ways for widespread implementation of shared decision making. This presentation was part of a Shared Decision Making Month webinar -- Aligning Incentives for Patient Engagement Revisited

1. # S D M m o n t h
Aligning Incentives for Patient
Engagement Revisited

2. Why Aligning Incentives?
Ben Moulton, JD, MPH
Senior Legal and Health Policy Advisor
March 24, 2014

3. 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
#SDMmonth

4. 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?
#SDMmonth

5. 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
• TheAligning Incentives Statement
• http://bit.ly/1ps4cT3
#SDMmonth

6. Today’s Experts
Michael J. Barry, MD
Informed Medical
Decisions Foundation
Dominick L.
Frosch, PhD
Gordon and Betty
Moore Foundation
Kathy Norman
WindingWaters Clinic
#SDMmonth

7. F o r W i d e s p r e 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, MD
President
March 24, 2014

8. Seven Essential Levers
• Organizational culture
• Provider training
• Delivery and information system
design
• Reimbursement model
• Insurance benefit design
• Patient decision aids
• Measurement and feedback
#SDMmonth

9. 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.
#SDMmonth

10. Provider Training
• Enables providers to
better understand and
value the process and
embrace their role in
engaging patients
#SDMmonth

11. 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
#SDMmonth

12. 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
#SDMmonth

13. 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
#SDMmonth

14. 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
#SDMmonth

15. Measurement and Feedback
• Measurement helps project
teams evaluate the
effectiveness of
implementation
• Measures can provide
valuable information on
patient preferences and
decision quality
#SDMmonth

16. Thank You!
www.sdmmonth.org
#SDMmonth