Value-based Care

What is the Shared Decision Making Payment Model?

The Center for Medicare and Medicaid Innovation (CMMI) is conducting a new payment model test that aims to integrate shared decision making (SDM) into the routine clinical practices of ACOs.  After including SDM in provider quality measures, this payment model represents a new level of commitment to bringing the practice to scale.  The SDM Model aims to help Medicare ACOs provide these benefits for more of their patients, while improving their population’s outcomes and their position for shared savings.
 

How does the SDM model work?

The ACOs participating in CMS’ SDM payment model test must provide Shared Decision Making (SDM) to Medicare beneficiaries with any of six highly prevalent conditions as broadly and efficiently as possible. 

Stable ischemic heart disease

Hip osteoarthritis

Knee osteoarthritis

Back pain (stenosis and/or herniated disc)

Localized prostate cancer

Benign prostate hyperplasia (BPH)

The SDM Model requires participating ACOs to use a structured process that entails the following steps:

Identifying eligible beneficiaries that have one of the conditions listed above

Distributing evidence-based decision aids that match the relevant condition

Furnish the SDM service (includes discussion with provider, decision and documentation thereof)

Tracking and reporting

How Does WiserCare Support the CMS SDM Payment Model? 

WiserCare supports each step in the SDM model process with IPDAS-compliant modules for each of the six conditions. Our cloud-based, configurable platform allows for efficient, scalable use by providers and patients in both primary and specialty settings:

  1. Engagement at the right time: WiserCare is ordered and patient invitations are sent through the EHR, patient portal or secure email before or between visits, before a decision is made. This process can be adjusted to suit clinic workflows and maximize usage without disruption.

  2. Timely, private patient preparation: Patients use WiserCare at home, on their own time, to prepare in advance and arrive at their next appointment (or phone call) decision-ready. Our decision modules model individualized outcome probabilities for each patient and elicit goals and values, and uses these inputs to provide evidence-based guidance and education.

  3. Shared insights: Patients receive a full decision guide after completion, and providers get a short summary, so the next interaction can occur efficiently and with shared understanding.

  4. Integrated reporting: WiserCare supports all necessary provider reporting on patient and physician usage, as well as delivers patient and provider surveys post-use and post-visit.

Does WiserCare Have Experience with Providers?

WiserCare was purpose-built by a practicing physician and internationally recognized decision scientist to make SDM work seamlessly in routine practice, maximizing its benefits without requiring more time in visit.  WiserCare is used by physicians at several large AMCs and health systems across a variety of clinical areas. Our impact persists across settings and specialties and has been published in peer-reviewed journals.
 

How Can We Learn More?

We look forward to discussing our approach and experience, and how we can help you maximize the value of the SDM program for your ACO.  Please reach out to Tom Poole at 614-458-8261 or at tompoole@wisercare.com to schedule a conversation and demo.