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Issue Brief: The Promise of Shared Decision-Making in Improving Value in the US Healthcare System

Summary

Evidence suggests that shared decision-making can play a role in advancing a value-based care delivery system.

Shared decision-making (SDM) is a collaborative process used by patients and clinicians to make decisions regarding tests, treatments, and care plans based on clinical evidence as well as a patient’s preferences, values, and care goals.1 Decision aids (DAs) are evidence-based tools that supplement clinician advice and support the implementation of SDM. These tools support patients in their care decision-making by outlining treatment information and evidence, as well as helping to drive a decision grounded in patient values and preferences.2 Stakeholders across the healthcare spectrum are increasingly testing and adopting shared decision making (SDM), spurred by the overall move toward value-based and patient-centric care. This issue brief summarizes the advancing field of research and outlines potential areas of further exploration to improve the science of SDM.

Key Findings

  • SDM has the potential to play a critical role in the success of value-based payment models.
  • Evidence suggests SDM can improve key measures of healthcare quality that matter to patients.
  • Evidence also suggests SDM has the potential to drive more appropriate healthcare utilization, which could reduce unnecessary costs in the system.

The full impact of well-done SDM remains unattained because existing evidence reflects the nascent state of SDM practice and science. More comprehensive, patient-centered approaches to assessing value (such as the Patient-Perspective Value Framework Initiative) can elevate SDM to the next level in supporting the evolution of a value-based healthcare system.

Read the full report here.

1. National Learning Consortium, “Shared Decision Making,” HealthIT.gov, last modified December 2013, https://www.healthit.gov/sites/default/files/nlc_shared_decision_making_fact_sheet.pdf.

2. Stacey D. Légaré et al., “Decision aids for people facing health treatment or screening decisions,” Cochrane Database of Systematic Reviews, no. 4 (April 12, 2017): [7], DOI:10.1002/14651858.CD001431.pub5.

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