{"subscriber":false,"subscribedOffers":{}} Enhanced Support For Shared Decision Making Reduced Costs Of Care For Patients With Preference-Sensitive Conditions | Health Affairs

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Research Article

Enhanced Support For Shared Decision Making Reduced Costs Of Care For Patients With Preference-Sensitive Conditions

Affiliations
  1. David Veroff ( [email protected] ) is senior vice president of research and development at Health Dialog in Boston, Massachusetts.
  2. Amy Marr is a senior scientist of research and development at Health Dialog in Portland, Maine.
  3. David E. Wennberg is CEO of the Northern New England Accountable Care Collaborative, in Portland, Maine.
PUBLISHED:No Accesshttps://doi.org/10.1377/hlthaff.2011.0941

Shared decision making is an approach to care that seeks to fully inform patients about the risks and benefits of available treatments and engage them as participants in decisions about the treatments. Although recent federal and state policies pursue the expanded use of shared decision making as a way to improve care quality and patient experience, payers and providers want evidence that this emerging model of care is cost-effective. We examined data obtained from a yearlong randomized investigation. The study compared the effects on patients of receiving a usual level of support in making a medical treatment decision with the effects of receiving enhanced support, which included more contact with trained health coaches through telephone, mail, e-mail, and the Internet. We found that patients who received enhanced support had 5.3 percent lower overall medical costs than patients who received the usual level of support. The enhanced-support group had 12.5 percent fewer hospital admissions than the usual-support group, and 9.9 percent fewer preference-sensitive surgeries, including 20.9 percent fewer preference-sensitive heart surgeries. These findings indicate that support for shared decision making can generate savings. They also suggest that a “remote” model of support—combining telephonic coaching with decision aids, for example—may constitute a relatively low-cost and effective intervention that could reach broader populations without the need for the direct involvement of regular medical care team members.

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