These two new models are:
- The Direct Decision Model: engages patients outside the traditional clinical care setting about specific conditions and their overall health care. The goal is to determine if this will help Medicare and Medicaid beneficiaries be more informed and empowered about their health care decisions, costs, and patterns of care and treatment.
- The Shared Decision Making Model: implements a structured decision-making process within a physician’s office or other clinical care setting. This is designed to evaluate what kids of collaborations, conversations, and decisions take place when patients and practitioners work together on care decisions.
CMMI will be the entity responsible for managing the implementation of these models. While CMMI has been criticized in the past for their “one size fits all” approaches to care, we welcome this step in a new direction and will listen carefully within the community to see how these new models are being implemented, evaluated, and augmented as the models are tested.
We hope the CMMI continues to encourage and embed more patient-centered models in their guidelines and regulations in the coming months. Blanket, universal policies don’t work in a world where science increasingly is showing that disease is a function of the individual genome.
PIPC was invited to meet with CMMI’s Beneficiary Engagement team as they were creating both these models. Our primary goals in this effort were to ensure payment models support value that matters to patients, are tested in transparent fashion, and actively engage a wide variety of stakeholders, especially organizations representing patients. We will continue to provide feedback to the agency as these models are tested in the real world.
Patient engagement is my ministry and these new CMMI decision-making models will be an important first step in ensuring that patients are given the role they need, want, and deserve when it comes to their individual care decisions. As these new models evolve, please share your experiences with us so we can effectively work with Congress and the new Administration to ensure patient engagement remains an important focus for CMS in the new year and beyond.
For additional information about PIPC’s work to promote patient engagement, please see our white paper entitled A Roadmap for Increased Patient Engagement at CMMI.