Educating Older Adults About Shared Decision-Making, Treatment Costs

FAIR Health is launching a new website this week aimed at informing older adults and their caregivers about treatment options, including tools related to cost, quality, and shared decision-making.

The national, independent nonprofit said the section includes information about navigating insurance and improving financial literacy.

Shared decision making, said Robin Gelburd, JD, president of FAIR Health, “involves a conversation between the provider and the patient or the caregiver on behalf of the patient about different treatment options and care to elicit the patient’s preferences and values, which would then allow the patient to choose a clinical pathway that meets those needs.”

There are 5 shared decision-making tools for patients to use when faced with early-stage breast cancer, hip osteoarthritis, hip replacement, spinal stenosis, or fast-growing prostate cancer. The tools combine clinical and cost information linked with different treatment options.

In an interview with The American Journal of Managed Care^®, Gelburd said the 5 conditions were picked on the basis of the volume seen in the organization’s database of 38 billion billed procedures, as well as from the different focus groups the organization conducted with patients, caregivers, providers, and subject matter experts.

The 3 conditions added to the cost tool—Alzheimer disease/dementia, heart failure, and major depression—are particularly relevant to older adults, she said. The tool returns estimates based on geographic location for in-network and out-of-network services.

In addition to the tools, the newly created Older Adult section adds content about the conditions, a section on financial health literacy, checklists with suggested questions to ask providers during visits, and links to related external resources.

Gelburd said the website is different from other existing consumer-oriented ones.

“As far as we know, we’re the first that pairs the rigor of the clinical offerings and pathways with the rich cost information that we have in our repository; there are none that we are aware of that really link at the procedure level, the different cost components from an in- and out-of-network perspective, with those clinical decision aids."

The organization’s first shared decision-making tool targeted palliative care, with information about nutritional assistance, breathing assistance, and dialysis.

The project was funded by The John A. Hartford Foundation.