Extending the P4P agenda, part 1: How Medicare can improve patient decision making and reduce unnecessary care: An agenda for Medicare to help drive improvements through pay-for-performance and shared decision making

Health Affairs

Volumn 26, Issue 6, 2007, Pages 1564-1574

  Wennberg, John E ^a,b   O'Connor, Annette M ^c,d,e   Collins, E Dale ^b,f   Weinstein, James N ^a,b  

^a DARTMOUTH INSTITUTE FOR HEALTH POLICY AND CLINICAL PRACTICE   (United States)

^b DARTMOUTH MEDICAL SCHOOL   (United States)

^c Center for Gerontological Nursing   (United States)

^d UNIVERSITY OF OTTAWA   (Canada)

^e OTTAWA HOSPITAL RESEARCH INSTITUTE   (Canada)

^f DARTMOUTH HITCHCOCK MEDICAL CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

DECISION MAKING; ECONOMICS; FEMALE; GOVERNMENT; HEALTH CARE QUALITY; HUMAN; LEGAL ASPECT; MALE; MEDICARE; PATIENT PARTICIPATION; REIMBURSEMENT; REVIEW; UNITED STATES; UNNECESSARY PROCEDURE;

CENTERS FOR MEDICARE AND MEDICAID SERVICES (U.S.); DECISION MAKING; FEMALE; HUMANS; MALE; MEDICARE; PATIENT PARTICIPATION; QUALITY ASSURANCE, HEALTH CARE; REIMBURSEMENT, INCENTIVE; UNITED STATES; UNNECESSARY PROCEDURES;

EID: 36849002910     PISSN: 02782715     EISSN: 02782715     Source Type: Journal    
DOI: 10.1377/hlthaff.26.6.1564     Document Type: Review

References (22)

1. J.E. Wennberg, E.S. Fisher, and J.S. Skinner, "Geography and the Debate over Medicare Reform," Health Affairs 21 (2002): w96-w114 (published online 13 February 2002; 10.1377/hlthaff.w2.96).
2. A.M. O'Connor et al., "Decision Aids for People Facing Health Treatment or Screening Decisions," Cochrane Database of Systematic Reviews no. 2 (2003): CD001431.
3. A.M. O'Connor et al., "Toward the Tipping Point: Decision Aids and Informed Patient Choice," Health Affairs 26, no. 3 (2007): 716-725.
4. J.N. Weinstein et al., "Trends and Geographic Variations in Major Surgery for Degenerative Diseases of the Hip, Knee, and Spine," Health Affairs 23 (2004): VAR-81-VAR-89 (published online 7 October 2004; 10.1377/hlthaff.var.81).
5. E.H. Wagner et al., "The Effect of a Shared Decisionmaking Program on Rates of Surgery for Benign Prostatic Hyperplasia: Pilot Results," Medical Care 33, no. 8 (1995): 765-770.
6. G.A. Hawker et al., "Determining the Need for Hip and Knee Arthroplasty: The Role of Clinical Severity and Patients' Preferences," Medical Care 39, no. 3 (2001): 206-216.
7. The SPORT studies demonstrate the importance of patient preference in determining the need for surgery for low-back pain. See, for example, J.N. Weinstein et al., "Surgical versus Nonoperative Treatment for Lumbar Disc Herniation: The Spine Patient Outcomes Research Trial (SPORT) Observational Cohort," Journal of the American Medical Association 296, no. 20 (2006): 2451-2459.
8. O'Connor et al., "Decision Aids."
9. O'Connor et al., "Toward the Tipping Point."
10. G. Elwyn et al., "Developing a Quality Criteria Framework for Patient Decision Aids: Online International Delphi Consensus Process," British Medical Journal 333, no. 7565 (2006): 417.
11. F. Légaré, "Implementation of the Ottawa Decision Support Framework in Five Family Practice Teaching Units: An Exploratory Trial" (Doctoral dissertation, University of Ottawa, 2005).
12. K.R. Sepucha, F.J. Fowler Jr., and A.G. Mulley Jr., "Policy Support for Patient-Centered Care: The Need for Measurable Improvements in Decision Quality," Health Affairs 23 (2004): VAR-54-VAR-62 (published online 7 October 2004; hlthaff.var.54).
13. O'Connor et al., "Toward the Tipping Point."
14. The breast cancer program at Dartmouth-Hitchcock Medical Center has integrated the components of decision support. Readers may access a virtual tour of the shared decision-making program at http://www.hitchcock.org/dept/csdm (accessed 23 July 2007).
15. For more information on Engrossed Second Substitute Senate Bill (ESSB) 5930, chap. 259, Laws of 2007, see RedOrbit News, "Washington Becomes First State to Endorse Shared Medical Decision Making," Press Release, 2 May 2007, http://www.redorbit.com/news/display/?id=922404 (accessed 11 September 2007);
16. and Washington State Legislature, "SB 5930 - 2007-08," http://apps.leg.wa.gov/billinfo/summary.aspx?bill=5930&year=2007 (accessed 11 September 2007).
17. The bonus could be designed to compensate hospitals for loss of revenue resulting froma drop in surgery.
18. M. Holmes-Rovner et al., "Are Decision Aids the Best Way to Improve the Quality of Clinical Decision-Making?" Medical Decision Making (forthcoming).
19. National Health Service, Institute for Innovation and Improvement, NHS Sustainability Model and Guide, http://www.institute.nhs.uk/option, com_joomcart/Itemid,26/main_page,document_product_info/products_id,291.html (accessed 15 August 2007).
20. K. Gravel, F. Légaré, and I.D. Graham, "Barriers and Facilitators to Implementing Shared Decision-Making in Clinical Practice: A Systematic Review of Health Professionals' Perceptions," Implementation Science 1, no. 6 (2006): 16-30.
21. W. Hugh Maloney, president, Washington State Medical Association, testimony before the Washington State Senate Committee on Health and Long-Term Care, 2 February 2007.
22. American College of Physicians, "The Advanced Medical Home: A Patient Centered, Physician-Guided Model of Health Care," Policy Monograph, 2006, http://www.acponline.org/hpp/adv_med.pdf (accessed 15 August 2007).