shared decision making and its implications for Medicare

shared decision making and its implications for Medicare C h A p t e R 7 Chapter summary Medicare beneficiaries face certain challenges when making health care decisions. Although they are insured, on average, they are more likely to be poorer, less educated, cognitively impaired, faced with multiple chronic conditions, and less health literate than other consumers. All these factors may increase their difficulty understanding the information they receive about their health conditions and the risks and benefits posed by different treatments. In an effort to mitigate these problems and to make care more patient centered, some clinicians have adopted a model of shared decision making. Shared decision making is the process by which a health care provider communicates personalized information to patients about the outcomes, probabilities, and scientific uncertainties of available treatment options, and patients communicate their values and the relative importance they place on benefits and harms. The goal of shared decision making is to improve patients’ knowledge of their condition and give them a more realistic perception of treatment outcomes so that they can arrive at treatment decisions with their physicians that reflects their values and preferences. Information is conveyed through patient decision aids that provide patients with evidence-based, objective information on all treatment options for a given condition. Decision aids are generally used when the choice among treatment options depends heavily on patient assessment of risks and benefits. Some policymakers In this chapter • Roots of shared decision making • Health literacy and shared decision-making tools • Adoption and evaluation of shared decision-making programs • Lessons learned to date on physicians ’ use of shared decision making • Use of shared decision making for certain populations • Shared decision making i