Patient activation is critical to achieving optimal health for all

Achieving optimal health depends upon patient activation: helping patients gain the knowledge, skills, and confidence to manage their health.
Clinical Policy Perspectives Value-Based Care

This article written by Hilary Hatch, Chief Clinical Officer at Phreesia, originally appeared on LinkedIn on Oct. 2, 2023. It has been lightly edited and republished here with permission. 

At Phreesia, we take great pride in supporting patients’ ability to self-manage their health. We’re committed to giving providers the tools they need to deliver patient-centered care, and we’re thrilled that CMS has designated the Patient Activation Measure® performance measure (PAM®-PM) as a high-priority and outcome measure for MIPS in 2024. 

Patients often feel overwhelmed and discouraged when it comes to managing their health and navigating the health care system. To that end, CMS has stated its quality mission is “to achieve optimal health and well-being for all individuals.” 

Achieving optimal health for all individuals requires truly supporting patients to self-manage their health and health care needs. This is what patient activation is at its core: helping patients gain the knowledge, skills, and confidence they need to manage their health. The Patient Activation Measure (PAM) is the gold standard when it comes to measuring patient engagement, and decades of research has shown that supporting people to self-manage their health results in improved outcomes and lower costs, across patient populations and disease states. 

We at Phreesia believe that if people have access to the right support and are receiving high quality care, they should be gaining in their ability to self-manage their health. 

CMS recently included the “Gains in Patient Activation Measure (PAM) Scores at 12 months” performance measure (PAM-PM) in its final rule for the 2024 Merit-based Incentive Payment System (MIPS) Physician Fee Schedule, recognizing that patient activation is critical to improving the quality of care across specialties and conditions. CMS said this measure is a “broadly applicable” and “high priority” quality measure that “ensures capture of the patient voice and experience of care related to the patient’s understanding and confidence in the ability to manage their health and be an active partner in their health care journey.” The measure is included in 18 specialty sets and across 5 MIPS Value Pathways for heart health, cancer care, neurological care, rheumatology patient care, and kidney health. 

Health care providers, medical societies, patient advocacy organizations, Federally Qualified Health Centers (FQHCs) and others wrote letters in support of the PAM-PM’s inclusion in MIPS. Groups as diverse as the National Alliance on Mental Illness (NAMI), the American Academy of Orthopedic Surgeons (AAOS), the American Diabetes Association (ADA) and AHIP all chimed in. 

  • The ADA writes that with the PAM, “providers and patients can work together …. PAM promotes self-efficacy, which leads to expanded patient knowledge, confidence, and the ability for beneficiaries to manage their own care, all of which the ADA supports.” 
  • The AAOS describes PAM as “particularly relevant for the measurement of long-term quality outcomes for orthopedic surgery and is already in use among our members.” 
  • The American Nurses Association (ANA) notes PAM’s value “as a tool to address chronic conditions, ensure care is patient-centered, and reduce costs for the Medicare program.” 

At Phreesia, we believe the PAM-PM gives providers the tools to deliver true person-centered care. The PAM-PM can improve patient outcomes in underserved populations because it gives providers the information to meet their specific needs and is a good complement to SDOH screening. To achieve “optimal health and well-being” for all, we have to be willing to tailor support to what patients need to self-manage their care. Some organizations require more resources to engage their population and meet their social needs—the PAM helps us understand this and move closer to health equity. 

This is the starting point to ensure the patient voice is represented in clinical care. I’m so proud to be putting my time into this work, and of Phreesia’s stewardship of the PAM-PM as a tool to make the patient the priority in the delivery of care.

A free version of the PAM survey, translations of the survey, and automated scoring are available to eligible clinicians/groups wanting to report the PAM-PM for MIPS in 2024.