• AcademyHealth: Does shared decision making cost more?

      05/29/2013
      Aaron Carroll

    Austin wrote a piece on a recent study on “shared decision making” earlier today. I also happened to write a piece on that study, and you should go read it over at the AcademyHealth blog right now!

    @aaronecarroll

     

     
      Health Policy
      AcademyHealth, shared decision-making
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    • by Brad F on May 29th, 2013 at 21:18

      Aaron
      I dont follow you here:

      Finally, since this is an inpatient population, it’s likely that physicians might already be incentivized to spend as little as possible. If reimbursement is DRG-based, then this might not be representative of how physicians might act in other settings.

      If this is the case, SDM should not make any difference. Economic drivers and supply side preferences rule. Additionally, inpt docs more attuned to Part B (as we receive incentives based on productivity to some extent). Also, OIG highly discourages any gainsharing on RU reduction incentives.

      Brad

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      • by Aaron Carroll on May 29th, 2013 at 21:24

        I think you’re making my point. If docs are already biased or nudged to save money, I AGREE that SDM shouldn’t lower spending.

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        • by Brad F on May 29th, 2013 at 21:30

          Actually, no.

          I am saying they are untethered to RU. They have lesser interests in DRGs (I am not saying none),

          However, some docs buy into SDM (I know some, including myself).

          If 20% of providers engage in a process hospitals welcome–pushed by HCAHPS, PR, and public transparency via the web, SDM might lower costs.

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    • by Floccina on May 31st, 2013 at 11:32

      Do we know if other countries have more or less shared decision making?

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