Medicare Savings-Medical Discussion Guides

Medicare Savings-Medical Discussion Guides

Senior Calling Doctor Web

Third Way asked Avalere Health to examine the potential federal costs or savings of implementing a policy which would advance the use of medical discussion guides, also known as decision aids, for shared decisionmaking between doctors and patients in preference-sensitive care. The policy recommends that the use of decision aids be standard medical practical practice starting in areas where cost-saving potential has been documented and proposes five key strategies:1) create a verification process where health plans report on whether patients were offered decision aids in their decision-making process; 2) establish federal standards for decision aids; 3) require health professionals with substandard use of decision aids to seek pre-authorization of payments for services affected by decision aids; 4) engage health professionals in the shared decision-making process and use of decision aids through CME and medical school curriculum; and 5) reform state informed consent laws to reflect that shared decision-making and the use of decision aids is the standard for valid informed consent.

Avalere estimated the impact of DAs for four conditions that are prevalent among the Medicare population: breast cancer, ischemic heart disease, hip and knee osteoarthritis, and lower back pain. We estimate that the proposed policy would reduce federal spending by approximately $9 billion over the 2015-2024 federal budget window. This amount reflects the change in spending resulting from patients’ shifts from selective surgical treatment to the alternative procedure.

To read this Report, open the attached PDF.

  • Health Care Costs51
  • Affordable Care Act38