Improving Value

Shared Decision Making

The healthcare system in the United States is very complex and patients often struggle to obtain, communicate, and understand health information and services. Providers often fail to provide adequate information patients need to make the best decisions about their care and treatment options. Additionally, when patients can be overwhelmed or lack confidence in their own choices. It is often difficult for patients with low levels of health literacy to follow instructions on how to care for themselves or to adhere to treatment regimens, such as taking their medicines.

Patient activation refers to a patient's knowledge, skills, capacity, and willingness to manage their healthcare and health outcomes. There is strong evidence that suggests patients who are more actively involved in their healthcare experience better health outcomes and potentially incur lower costs.

A 2008 study by the Center for Studying Health System Change found that the level of patient activation varies considerably in the U.S. population. The study found that activation levels are especially low for people with low incomes, less education, Medicaid enrollees, and people with poor self-reported health. Higher activation levels are associated with much lower levels of unmet need for medical care and greater support from healthcare providers for self-management of chronic conditions. Shared decision making can lead patients to seek a more active role in their treatment and feel confident that they can contribute to discussions about their medical care.