Two noteworthy articles caught my attention this week. One was an article by Wall Street Journal columnist Laura Landro called, How Doctors Rate Patients. The other was a March 27th piece by Rob Garver in the Fiscal Times titled, Hospitals Plot the End of Insurance Companies.
Two noteworthy articles caught my attention this week. One was an article by Wall Street Journal columnist Laura Landro called, How Doctors Rate Patients. The other was a March 27th piece by Rob Garver in the Fiscal Times titled, Hospitals Plot the End of Insurance Companies. While these two articles are not in any way directly related to each other, taken together they provide what I think is a brilliant treatise on the path toward accountable care.
Ms. Landro reviews how some hospitals, health plans and employers are now scoring patients on how engaged or “activated” they are in their care. It turns out that highly activated patients generally have much better health outcomes. The Patient Activation Measure or PAM scoring system was developed at the University of Oregon’s Health Policy Research Group. It provides a way categorize patients into one of four so-called activation levels. It does this by asking patients to rate between 1 and 100 how strongly they feel about certain statements related to their health and their healthcare providers. The four levels of patient activation look something like this (Source Insignia Health).
So, to my own way of thinking (and perhaps too simplistically) if all provider organizations also become insurance companies, and all insurance companies also become provider organizations, then we have a clear path to a healthcare system that can actually deliver on the value-based care envisioned by the Accountable Care Act. However, in order to control for possible reverse and equally perverse incentives to provide too little care in such organizations, we must also measure “patient activation” and find ways to move the majority of patients to PAM scores in Level 3 or Level 4. That it seems would deliver the balance of power needed to keep what’s best for the population vs. what’s best for individuals in check.
Prior to the Internet age, personal computers, smartphones, social networking, ubiquitous information access, and analytics the above might not have been possible. But patients now have what they need to be smarter, more engaged and activated consumers of healthcare if only we can teach more of them how to use the tools they now have at their disposal. What do you think?