ISSUE

: Shared decision-making (SDM) has been lauded as the “pinnacle of patient-centered care” and shown to increase patient satisfaction, reduce decisional conflict, and improve care outcomes; however, the definitions and processes of SDM are not consistent. With the continued move toward value-based care, stakeholders are debating whether SDM and patient decision aids (PtDAs) are cost-effective mechanisms to reduce healthcare costs and utilization.

OVERVIEW

: The National Pharmaceutical Council (NPC) and Discern Health conducted a systematic review to evaluate the impact of SDM and PtDAs on healthcare cost and utilization and found that these processes can decrease utilization (e.g., certain surgeries and unwanted crisis care) while increasing recommended cancer screening, medication adherence, and advance care planning. However, the definitions of SDM/PtDAs and outcomes assessed are heterogeneous, findings are more robust in some areas than others, and researchers have raised questions about the unintended consequences and pitfalls in implementing SDM.

Building on project findings, this panel will debate the controversies around using SDM and PtDAs. Kimberly Westrich will moderate the panel and pose questions for the panelists to debate:

• What counts as SDM and what is the role of PtDAs?
• What is the evidence that SDM reduces utilization or saves costs?
• Do patients want SDM?
• Do providers know how to deliver SDM?
• Do the risks of unintended consequences undermine the benefits?
• Should providers and payers invest in SDM and PtDA initiatives?

Debate time will be divided evenly between the presenters, with a ten-minute introduction, thirty minutes for panel questions, fifteen minutes for audience discussion, and a five-minute wrap-up. For each topic, Theresa Schmidt, Alan Balch, and Karen Fields will offer researcher, patient advocate, and provider perspectives respectively. The audience will be encouraged to share their experiences using SDM and PtDAs and will be engaged throughout via interactive polling.