Cms, Ahrq Provides New Options To Improve The Medical Insurance Patient Contact

Before the new Congress and incoming Trump administration act to repeal the Affordable Care Act, the Obama administration is pushing forward with two new reforms authorized by the ACA. Both are meant to increase patient engagement of Medicare beneficiaries.

Thursday, the Centers for Medicare and Medicaid Services, in conjunction with the Agency for Healthcare Research and Quality, announced the two programs, called the Shared Decision Making Model and the Direct Decision Support Model. Both will be managed by the Center for Medicare and Medicaid Innovation, which the ACA created and which Trump’s pick for HHS secretary, Rep. Tom Price, seems opposed to.

The Shared Decision Making Model will have participants in Accountable Care Organizations test a four-step process for engaging patients with specific health conditions in the decision-making process. “The 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,” according to a post on the CMS blog.

The authors of the blog post, CMS Chief Medical Officer Dr. Patrick Conway and AHRQ Director Dr. Andy Bindman, estimated that this model will improve patient engagement for 150,000 Medicare beneficiaries per year.

The Direct Decision Support Model seeks to bring patient engagement outside the physician office through a new mechanism called Decision Support Organizations. These organizations will offer patients evidence-based information on specific conditions and treatment options via a website or mobile app.

“It will use patient-friendly material to educate patients about their condition and encourage them to have a conversation with their practitioners about care options to determine what care is best for them. Providing information directly to patients about their health decisions acknowledges that patients make decisions about their medical conditions outside of, as well as inside, their doctor’s office,” Conway and Bindman explained.

CMS expects 700,000 people to benefit from the DDS model annually.

“These models will look to move beyond current practices and examine new ways to engage with patients with regard to their health and healthcare, and hopefully increase quality of care delivered, increase patient satisfaction, and provide value in the cost of care delivered,” according to Conway and Bindman.

The CMS Innovation Center is now taking applications for Decision Support Organizations and for existing ACOs interested in trying the Shared Decision Making Model. Letters of intent are due March 5.

But will the new administration even let this program get off the ground after Donald Trump takes office Jan. 20?

Photo: Spencer Platt/Getty Images

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