Anthem Continues to Encourage Shared Decisionmaking Practices

April 2016

Anthem, a health insurance plan provider, trained health care providers from Accountable Care Organizations (ACOs) in California, Colorado, and Nevada on the SHARE Approach to shared decisionmaking.

The training is part of Anthem's value-based, patient-centered care payment program, Enhanced Personal Health Care (EPHC). The goal of the EPHC program is to provide physicians and their teams with as many tools and resources as possible to make their jobs easier and more effective, and to help improve patient care. The EPHC program includes shared decisionmaking as a key element of patient-centered care.

Neha Patel is a community transformation manager for the western EPHC transformation team, which works with ACOs and Anthem-affiliated practices in California, Colorado, and Nevada. Patel attended an Agency for Healthcare Research and Quality (AHRQ) SHARE Approach train-the-trainer workshop in Colorado to learn about best practices in shared-decisionmaking training. Patel said, "A lot of us [on the EPHC teams] have become trainers, and it's great because we can share this knowledge with a lot more providers in the hopes they will implement the program into their workflows and processes."

During the workshop, Patel learned a number of valuable strategies for teaching providers how to implement shared decisionmaking with their patients. The strategies shared by AHRQ SHARE Approach trainers included storytelling, providing real-life examples, incorporating video elements, and facilitating role-playing exercises.

Patel found that by providing hints or "little nuggets of wisdom based on experience" you can give physicians and their teams easy ways to engage in shared decisionmaking with patients.

Patel said, "The concepts behind shared decisionmaking are not that complicated; they're pretty intuitive. But, as with most things, putting them into practice or seeing them live is a whole other story."

Patel said, "The concepts behind shared decisionmaking are not that complicated; they're pretty intuitive. But, as with most things, putting them into practice or seeing them live is a whole other story."

SHARE Approach

The SHARE Approach is a five-step process for implementing shared decisionmaking, which offers physicians and other health care professionals the training and tools to help patients compare the potential benefit, harm, and risk of various treatment options for their conditions through meaningful dialogue about what matters most to the patient. The five steps are:

Five-step process for implementing

SHARE Approach Training at Biannual EPHC Meeting

Biannually, EPHC care consultants meet with representatives from ACOs across California to provide important program updates. The meeting is also an opportunity for the ACO representatives to share best practices and network with each other.

Equipped with best practices and new strategies for training providers, Patel conducted a modified version of the SHARE Approach workshop. The SHARE Approach training took place over 2 days and included many of the modules from AHRQ's workshop as well as modified role-playing exercises. Patel provided participants with various roles to work through certain scenarios using shared-decisionmaking techniques from either the provider or patient perspective. The training attracted 22 attendees, including nurses, case managers, administrators, and physician champions from large ACOs. Feedback from the participants indicated the training was valued and well enjoyed. Participants seemed to particularly like the role-playing activities.

Patel expects these attendees to champion shared decisionmaking within their ACOs and use these strategies in their own practices with patients.

Recommendations for Implementing the SHARE Approach Training

Patel believes the in-person training is a great opportunity for health care providers to learn how to put shared decisionmaking into practice in a controlled setting. Based on her experience attending the AHRQ SHARE Approach Workshop and conducting her own training at the EPHC biannual meeting, Patel had the following recommendations to others who are planning to deliver the SHARE Approach training:

  • Incorporate more role-playing activities into the shared-decisionmaking training as an effective way to engage the audience. If participants appear reluctant to engage in role-playing exercises, or the training is too large to do role playing effectively, videos are great alternative tools. People can watch a provider and patient engage in shared decisionmaking, and offer feedback and ask questions based on what they observed.
  • Make sure to have an interactive portion of the training. This gives participants an opportunity to network and engage with each other. This is where people can share ideas and tips based on their personal experiences with patients. In Patel's experience, the interactive part of the training is "one of the things they [participants] really did enjoy."
  • Discuss ways providers can take what they learned during the shared-decisionmaking training, and put it into practice. Storytelling and real-life examples are great ways to do this.

Benefits of Using Shared Decisionmaking in Practice

Patel feels strongly that shared decisionmaking can improve how a patient makes health care decisions. And the SHARE Approach training gives providers the strategies and resources they need to encourage patients to be active participants in their health care. Patel said, "Sometimes patients don't realize that they have a choice because they don't understand that they're part of the process, and they're part of the decision."

Patel also expressed that providers are more likely to use these strategies with their patients when there are requirements for shared decisionmaking. For example, the Centers for Medicare & Medicaid Services has shared decisionmaking requirements—including the use of a decision aid— for reimbursement for the screening for lung cancer with low-dose computed tomography (LDCT) in eligible patients. Patel said, "People are definitely much more inclined to take a look at it [shared decisionmaking] because they have to, and it's a great way to open up that door."

Overall, Patel believes patients who engage in shared decisionmaking with their providers will feel empowered, and will be much more likely to follow through with their treatment plan.

About the Educator

Neha Patel is currently the Manager for Community Transformation for the West Region, Colorado, and California, for the Enhanced Personal Health Care (EPHC) program at Anthem. Before joining the EPHC team, Neha began at Anthem in 2008 as a Behavioral Health Care Manager, and also worked in the field as Patient Centered Care Consultant, Sr. helping primary care practices to reduce costs, improve quality, and improve patient satisfaction.

Prior to joining Anthem, Neha worked as a Licensed Professional Counselor in private practices, inpatient and residential settings, and in community mental health centers. Neha holds a Masters in Management from Colorado State University, and is currently working toward a Masters in Counseling Psychology from the University of Denver.

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Page last reviewed September 2016
Page originally created September 2016
Internet Citation: Anthem Continues to Encourage Shared Decisionmaking Practices. Content last reviewed September 2016. Agency for Healthcare Research and Quality, Rockville, MD.