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

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Evidence suggests that shared decision-making can play a role in advancing a value-based care delivery system.
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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,”, last modified December 2013,

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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