NEW YORK (July 22, 2021)—The national, independent nonprofit FAIR Health has recently been awarded a grant from The John A. Hartford Foundation, a national organization dedicated to improving the care of older adults, to pilot a new set of shared decision-making (SDM) and other health care engagement tools geared toward older adults with serious illness. The initiative, which launched on July 1, will include a robust dissemination campaign and evaluation of the new tools.
SDM, or the collaborative conversation between clinicians and patients and/or their caregivers to decide on treatment options that incorporate patient values and preferences, has shown promise for increasing patient satisfaction, reducing decisional conflict and increasing adherence to clinical recommendations. SDM tools, such as decision aids, also may reduce unnecessary spending in health care for both patients and providers. Research has demonstrated that SDM tools have particular promise in geriatric care, given the obstacles to informed consent posed by dementia and vision/hearing impairment, as well as multimorbidity and polypharmacy. The active involvement of older adults in decisions about their care has been associated with a decrease in depression and an increase in clinical knowledge.
As part of the first project phase, FAIR Health will conduct a needs assessment to inform the project, including the design of a set of new health care engagement and SDM tools. FAIR Health's new tools will build on its existing repository of tools, including those for SDM that are currently focused on palliative care scenarios. The tools created will include new decision aids—educational materials combining clinical and cost information for specific health scenarios—and new "total treatment cost" scenarios highlighting the range of costs associated with conditions particularly relevant to older patients.
FAIR Health will pilot the new tools and evaluate their perceived utility and value among relevant patient and caregiver populations. Notably, the project will also feature a dissemination campaign that will test different strategies geared toward older patients and their caregivers in distinct media markets nationwide. FAIR Health's work will be guided by a project advisory board, which will include palliative care expert Diane Meier, MD, FACP, FAAHPM, and will be informed by input from Glyn Elwyn, MD, PhD, MSc, an SDM expert based at the Dartmouth Institute with whom FAIR Health has collaborated on previous SDM initiatives.
The new initiative will expand on FAIR Health's previous grant-funded initiatives in the SDM sphere, which resulted in the development of SDM tools that present medical treatment options alongside cost information. In addition to The New York Community Trust grant-awarded project to create decision aids related to palliative care scenarios, which were launched on March 2020, in April 2021, with funding from The Fan Fox & Leslie R. Samuels Foundation, FAIR Health launched a clinician-oriented website that offers palliative care SDM tools and an educational SDM toolkit. FAIR Health also is currently implementing an initiative, funded by the New York State Health Foundation, to pilot a set of SDM tools on clinical scenarios especially pertinent to patients of color.
FAIR Health President Robin Gelburd said, "We at FAIR Health are grateful to The John A. Hartford Foundation for supporting this important initiative that will build on our efforts to thread cost information into key health care decision-making discussions. With this grant, we will seek to equip older adults and their caregivers with the tools and resources needed to support improved health insurance literacy and empower them to make informed treatment decisions with reliable cost information."
The John A. Hartford Foundation Vice President of Program Rani E. Snyder said, "We are thrilled to be collaborating with FAIR Health to pilot health care engagement tools that incorporate costs of care to move toward more equitable health care access for older adult patients and their families. In line with The John A. Hartford Foundation's ongoing efforts to create age-friendly health systems, support family caregivers and improve serious illness and end-of-life care, we look forward to working closely with FAIR Health on this new project."
FAIR Health is a national, independent nonprofit organization that qualifies as a public charity under section 501(c)(3) of the federal tax code. It is dedicated to bringing transparency to health care costs and health insurance information through data products, consumer resources and health systems research support. FAIR Health possesses the nation's largest collection of private health care claims data, which includes over 34 billion claim records and is growing at a rate of over 2 billion claim records a year. Certified by the Centers for Medicare & Medicaid Services (CMS) as a national Qualified Entity, FAIR Health also receives data representing the experience of all individuals enrolled in traditional Medicare Parts A, B and D.
The John A. Hartford Foundation, based in New York City, is a private, nonpartisan, national philanthropy dedicated to improving the care of older adults. For more than three decades, the organization has been the leader in building a field of experts in aging and testing and replicating innovative approaches to care. The foundation has three priority areas: creating age-friendly health systems, supporting family caregivers, and improving serious illness and end-of-life care. Working with its grantees, the foundation strives to change the status quo and create a society where older adults can continue their vital contributions