What Makes Better Care? The Series. Part 4: Patient Activation and Empowerment
As the House and Senate get close to releasing their versions of comprehensive payment and delivery reform legislation, the Campaign For Better Care, with the help of students from the Harvard School of Public Health, will be doing a series of blog posts this week highlighting our 10 Principles for Better Care.
4. Patient Activation and Empowerment: Patient activation and patient empowerment methods result in better health outcomes, reduced costs, reduced disparities, and better satisfaction with one’s health care. Practitioners, Department of Public Health, patients and community agencies all have a role in developing a system that gives patients confidence and tools to navigate a new system.
Information is power. When patients better understand and manage their own health they not only become healthier, they also help reduce costs to the health care system. The Commonwealth has an interest in both of these outcomes and should take concrete steps to help inform and empower patients towards better health.
- ACOs and other care entities should be required to measure and publicly report patient confidence or patient activation measures in a way that is understandable by consumers, and should be included among the quality indicators used to set payment rates. In order to get providers to promote patient activation and empowerment, the Commonwealth must align incentives to reward efforts towards these goals. By publicly reporting patient confidence or activation measures, consumers will gain information about provider quality and providers will have an incentive for quality improvement. Using these measures as quality indicators for provider payment allows reimbursement for these activities which otherwise would not occur.
- DPH or the Oversight Board should support and encourage best practices for use of patient empowerment and decision support tools. Tools such as chronic disease self- management, shared decision making, and end of life support tools improve care, allow for increased patient choice, and reduce costs. The Commonwealth should provide a mechanism to disseminate evidenced and effective patient empowerment and decision support tools, and should introduce rules that ensure reimbursement for its usage.
Most patients do not spend most of their life at the doctor’s office. The role of health care providers must evolve to include helping patients take charge of their own health. Patient activation and empowerment methods, such as motivational interviewing and shared decision making, are likely to deliver quality in health care to consumers. It is important to realize that if providers are not reimbursed for efforts leading to patient activation and empowerment, they are unlikely to spend time or money on such activities. It is therefore imperative that the Commonwealth ensure that these activities are properly reimbursed and that providers have the ability to implement them.
-Akash A. Desai