The Centers for Medicare and Medicaid Services (CMS) on December 8, 2016, announced two new models from the CMS Innovation Center to increase patient engagement by providing beneficiaries with more information. Both models are based on beneficiary engagement and will test different approaches to shared decision making, acknowledging that patients make decisions about treatment in a variety of ways. The first, the Shared Decision Making (SDM) model, will test a structured four-step process of shared decision making between practitioners and beneficiaries. CMS says this model will address a number of barriers to shared decision making, such as inadequate time or resources. The model will focus on six preference-sensitive conditions: hip osteoarthritis, stable ischemic heart disease, knee osteoarthritis, herniated disk and spinal stenosis, localized prostate cancer, and benign prostate hyperplasia. Clinical evidence does not clearly support any one treatment option for these conditions, CMS says, and the SDM model can help a beneficiary decide whether the right option is surgery or some other type of medical treatment. CMS says it plans to operate the SDM model in 50 accountable care organizations (ACOs) and an equal number of comparison-group ACOs. CMS said it expects to engage more than 150,000 Medicare beneficiaries per year though this model. The other model, the Direct Decision Support (DDS) model, will test an approach to shared decision making outside the doctor's office. Beneficiaries under this model will be provided with access to a website or application that offers unbiased, evidence-based information on condition and treatment options. CMS hopes that testing this model will help determine whether engaging beneficiaries outside a clinical care setting will enable them to become more engaged and make better informed decisions. An independent evaluation will be conducted on both models.

HRC Recommends: Patient and family engagement is necessary for safe, high-quality care and optimal patient outcomes. Risk managers may wish to review the CMS decision models; forward and share them with relevant individuals and departments, such as those in Who Should Read This; and consult the HRC resources listed in Related Resources. Risk managers may also wish to inventory their organization's existing policies and procedures and quality and safety initiatives to identify those that incorporate involvement of family and friends and assess how the organization operationalizes family engagement in patient care. The organization can then assess its progress in promoting patient and family engagement and plan further strategies.