Case Managers: Patient Engagement and Shared Decision-Making
Why should Case Managers promote shared decision-making? Because last week CMS announced two new models from the CMS Innovation Center that will increase patient engagement in care decisions by putting more information in the hands of Medicare beneficiaries. These two Beneficiary Engagement and Incentives (BEI) Models are the Shared Decision Making Model (SDM Model) and the Direct Decision Support Model (DDS Model). For more information, check:
Beneficiary (patient) engagement broadly refers to the actions and choices of individuals with regard to their health and health care, and these decisions impact cost, quality and patient satisfaction outcomes.
Shared decision making, a term first coined in 1982, can ensure that treatment decisions, for the many medical conditions that do not have one clearly superior course of treatment, better align with beneficiaries' preferences and values. In order to achieve shared decision making, patients must be included in the discussion of treatment alternatives and engaged in selecting their preferred treatment. One facet of shared decision making is the use of patient education tools that present information about common medical choices. These tools do not supplant provider-beneficiary conversations about treatment options; instead, they better prepare beneficiaries to engage in those conversations.
A key factor in the success of case management is communication. Case managers routinely communicate with patients, families, clinical staff, payers, durable medical equipment vendors and community resource providers about treatment alternatives. Communication is used not only to obtain or convey information but also to build relationships and establish trust.
With patients, the establishment of trusting relationships allows for patient engagement, which ensures the best health outcomes and positively impacts the patient for a longer term of self-care and self-advocacy. Athena Forum courses advocate patient engagement and prepare case managers with key concepts of patient engagement, shared decision making and communication strategies. The concepts are woven throughout the various courses.