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Massachusetts health care — wonky, with a healthy dose of reality

Patient Activation = Better Care Experiences

Patient Activation = Better Care Experiences

July 17, 2013

Health care providers, take note: a new study published in Health Affairs reports that patients who are “activated” recount greater satisfaction in their healthcare encounters. Patient activation refers to how empowered a patient feels in managing his or her own health. The article, “When Seeing the Same Physician, Highly Activated Patients Have Better Care Experiences than Less Activated Patients,” details how patient activation promotes heightened patient satisfaction. Previously, some theorized that improvements in patient experience arise because activated patients are more adept at seeking out those providers who provide the most patient-centric care. The study’s findings, however, indicate that experiences are more positive because patient engagement actually improves the quality of the patient-provider transaction. A novel and important insight from the study is that activated patients had better experiences when compared to less activated patients with the same provider. This tells us that we’re not seeing selection bias, but real effects resulting from improved patient-provider interactions. How does activation promote better experiences? Research shows that activated patients see themselves as occupying a critical role in the patient-provider relationship, and view the interaction as one between partners working together to manage the patient’s care. Less activated patients assume a more passive role. Highly-activated patients are, in turn, more successful at eliciting the kind of interaction and care that they feel they need. This makes the patient’s clinical experience more positive. Health care providers should therefore pursue strategies to activate patients.  Provider reimbursement is increasingly being tied to patient satisfaction measures, and public reporting of patient experience ratings is becoming more common. Many of the factors that influence how patients report their healthcare experiences—characteristics such as race, income, and age—cannot be changed. Patient engagement, however, is a variable that the provider can actually influence. So, how can we promote patient engagement? Clearly, patients and providers must each do their part to further the patient’s engagement. Just as important is the environment of our care delivery system. To truly encourage patient activation, we must structure our health care payment system so that it furthers these interactions. For instance, providers should be reimbursed for providing services such as counseling to motivate behavioral change, which has been shown to activate patients. Patient engagement has already been shown to increase care quality and reduce costs. (Check out February’s edition of Health Affairs, which was dedicated to this issue). This study adds to those positive findings and further strengthens the case for why patient activation should be promoted whenever possible. To see some of the study’s highlights, take a look at the Commonwealth Fund’s summary of the findings. -Claudia Kraft