CMS Looks to Increase Patient Engagement with New Models

The Centers for Medicare & and Medicaid Services (CMS) has announced two new models from the CMS Innovation Center (CMMI) that will aim to increase patient engagement in care decisions by putting more information in the hands of Medicare beneficiaries.

These two beneficiary engagement and incentives (BEI) models are the Shared Decision Making Model (SDM Model) and the Direct Decision Support Model (DDS Model), CMS said in a Dec. 8 blog post. The BEI models will look to test different approaches to shared decision making, acknowledging that beneficiaries make decisions regarding treatment options in a variety of ways, and that facilitating a better understanding of their health and healthcare decisions is key towards improved beneficiary engagement, according to CMS.

Specifically, wrote Patrick Conway, M.D., principal deputy administrator and chief medical officer, CMS, the SDM Model will test the integration of a specific, structured four-step process to shared decision making into routine clinical practice workflows of practitioners participating in accountable care organizations (ACOs), which have the potential to result in informed and engaged beneficiaries who collaborate with their practitioners to make medical decisions that align with their values and preferences. This model seeks to determine if this design results in improved beneficiary outcomes and lower Medicare spending while maintaining or improving quality, and whether it results in increased beneficiary satisfaction with care decisions.

Beneficiaries who have one of the six preference-sensitive conditions will be offered an in-person collaborative process by their clinician that can help them understand and thoughtfully weigh their treatment options. These conditions include: stable ischemic heart disease, hip or knee osteoarthritis, herniated disk or spinal stenosis, clinically localized prostate cancer (cancer that is confined to the prostate gland), and benign prostate hyperplasia. For example, information provided will help the beneficiary decide whether surgery or other medical treatments are the right choice for them.