President Obama’s re-election now makes it all but certain that implementation of the Affordable Care Act (ACA) will progress. With a clearer picture of the health care landscape ahead of us, the Informed Medical Decisions Foundation and our colleagues will continue to pursue the opportunities laid out in the ACA to foster nation-wide implementation of shared decision making (SDM). I’d like to point out two key organizations established through the ACA that we hope to work closely with over the coming years. The first being the Center for Medicare & Medicaid Innovation (CMMI), which cultivates health care transformation by finding new ways to pay for and deliver better care and better health at lower costs.
And some of the momentum is coming from state legislators or health officials who want a shared decision-making component in some of the latest models for cutting waste and improving quality in health care spending, like "medical homes." Washington state began encouraging shared decision making in it's state's health care systems about five years ago; Massachusetts joined in last summer when it passed its sweeping health cost control law, according to Benjamin Moulton, the senior legal adviser to the Boston-based Informed Medical Decisions Foundation.
As in may cases in health care, shared decision-making isn't new. It's been lying in the weeds quietly growing, waiting for the right time to re-emerge. Its roots trace back to the 2001 report, 'Crossing the Quality Chasm' by the Institute of Medicine, which emphasized shared decision-making in the 10 rules for redesigning health car processes. And those of us who are getting on up there, as they say -- I mean in collective wisdom not age, of course -- remember that it dates back to 1989 when John Wennberg, M.D., co-founded the Informed Medical Decisions Foundation at Dartmouth-Hitchcock Medical Center. (And if anyone knows how long it takes for new ideas to take hold in health care, it's Dr. Wennberg.)