Patient Engagement and Shared Decision-making

Title Date
Bridging the Disconnect Between Patient Wishes and Care at the End of Life

NIHCR Policy Analysis No. 12

Most Americans want to die at home, but most die in hospitals or other facilities. Most people care more about quality of life than prolonging life as long as possible, but many receive invasive, life-sustaining treatments that diminish quality of life. Often, the disconnect between patient wishes and actual care…

Patient Engagement During Medical Visits and Smoking Cessation Counseling

JAMA Internal Medicine

Importance: Increased patient engagement with health and health care is considered crucial to increasing the quality of health care and patient self-management of health. Objective: To examine whether patients with high levels of engagement during medical encounters are more likely to receive advice and counseling about smoking compared with less…

Accountable Care Organizations 2.0: Linking Beneficiaries

JAMA Internal Medicine

There is broad consensus among physicians, hospital and health insurance leaders, and policy makers to reform payment to health care providers so as to reduce the role of fee for service, which encourages high volume, and instead to use systems that reward better patient outcomes, such as bundled payments for…

Privately Insured People’s Use of Emergency Departments: Perception of Urgency is Reality for Patients

HSC Research Brief No. 31

Many privately insured people with an urgent medical problem go to hospital emergency departments (EDs) even though they could be treated safely and at lower cost elsewhere. Understanding why insured patients decide to seek care in EDs rather than other settings can help purchasers and payers safely guide patients to…

The Potential of Reference Pricing to Generate Health Care Savings: Lessons from a California Pioneer

HSC Research Brief No. 30

In the context of high health care costs and wide variation in hospital prices, purchasers are seeking ways to encourage consumers to make more price-conscious choices of providers. The California Public Employees’ Retirement System (CalPERS) in 2011 adopted a strategy—known as reference pricing—to guide enrollees to hospitals that provide hip…

Hospital Quality Reporting: Separating the Signal from the Noise

NIHCR Policy Analysis No. 11

Gaps in hospital safety and quality have prompted public and private payers to push for greater accountability through clinical quality measurement and reporting initiatives, which have grown rapidly in the past two decades. With U.S. health care costs high and rising, purchasers increasingly are seeking to identify high-value hospitals that…

U.S. Families’ Use of Workplace Health Clinics, 2007-2010

NIHCR Research Brief No. 10

Despite heightened employer interest in workplace clinics as a cost-containment tool, only 4 percent of American families in 2010 reported visiting a workplace clinic in the previous year—the same proportion as in 2007, according to a national study by the Center for Studying Health System Change (HSC). The severe 2007-09…

High-Intensity Primary Care: Lessons for Physician and Patient Engagement

NIHCR Research Brief No. 9

To prevent costly emergency department visits and hospitalizations, a handful of care-delivery models offer high-intensity primary care to a subset of patients with complex or multiple chronic conditions, such as diabetes, congestive heart failure, obesity and depression. Early assessments of high-intensity primary care programs show promise, but these programs’ success…

Policy Options to Encourage Patient-Physician Shared Decision Making

NIHCR Policy Analysis No. 5

Major discrepancies exist between patient preferences and the medical care they receive for many common conditions. Shared decision making (SDM) is a process where a patient and clinician faced with more than one medically acceptable treatment option jointly decide which option is best based on current evidence and the patient’s…

Lessons from the Field: Making Accountable Care Organizations Real

NIHCR Research Brief No. 2

Policy makers hope that the development of accountable care organizations (ACOs)—organized groups of physicians, hospitals or other providers jointly accountable for caring for a defined patient population—can improve health care quality and efficiency. An examination of existing provider efforts to improve care delivery illustrates that substantial financial and time investments…

Comparative Effectiveness Research and Medical Innovation

NIHCR Policy Analysis No. 3

Many believe the renewed U.S. public investment in determining what treatments work best for which patients in real-world settings—known as comparative effectiveness research (CER)—will improve patient care by strengthening the evidence base for medical decisions. A major goal of CER is to encourage the use of effective therapies and discourage…

Employer Wellness Initiatives Grow Rapidly, but Effectiveness Varies Widely

NIHCR Research Brief No. 1

While employer wellness programs have spread rapidly in recent years, few employers implement programs likely to make a meaningful difference in employees’ health—customized, integrated, comprehensive, diversified programs strongly linked to a firm’s business strategy and strongly championed by senior leadership and managers throughout the company. Employers that lack the ability…