Kate Chenok, a director at Pacific Business Group on Health, provides the purchaser perspective on shared decision making and maternity care. This presentation was part of a Shared Decision Making Month webinar -- Maternity Care and Shared Decision Making: Improving Care for Mothers and Babies.

1. Purchaser Perspectives on
Shared Decision Making
Kate Eresian Chenok
Director, New Initiatives

2. PBGH Members
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3. PBGH 2015 Vision
A health care system transparent about the quality, cost and
outcomes of care, where consumers are motivated to seek
the right care at the right price and providers are incented
to offer better quality, more affordable care.
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4. Purchasers are concerned about trends in
Caesarian sections
Delivery Trends:
Caesarian delivery rates have now risen to over 32% in the U.S. (up from less
than 20% in 1996) with no evidence of better outcomes
Payment Trends
Caesarian delivery reimbursement averages 33% more than that for
spontaneous vaginal birth
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5. More expensive for both purchasers and
consumers
Source: The Costs of Having a Baby in the US, Truven, January 2013
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6. What purchasers are looking for:
 Affordability
 Appropriate use
 Reward for efficient providers
 Accountability
 Patient engagement
 Collaboration across specialties
 Evidence based practice
 Delivery System Innovation
 Payment redesign
 Health IT
 Continual learning
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7. What do purchasers think about Shared
Decision Making?
 Want patients highly engaged in making care decisions
 Expect SDM as part of accountable, high quality care
 Have a wide range of definitions of SDM
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8. One quarter offer formal Shared Decision
Making programs. Most offer:
Online decision support
Telephonic nurse support
Case management
Online cost calculators and comparison tools
Online and in person wellness programs
Educational materials
Onsite clinics which provide direct care
Source: December 2012 survey of PBGH members
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9. Evaluate programs they offer according to:
Employee engagement
Health improvement
Cost
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10. Think it’s part of high quality care
 Expect it from providers
 Expect health plans to support
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11. Opportunities for Shared Decision Making in
maternity care – links to purchaser goals:
 Affordability
 Appropriate use
 Reward for efficient providers
 Accountability
 Patient engagement
 Collaboration across specialties
 Evidence based practice
 Delivery System Innovation
 Payment redesign
 Health IT
 Continual learning
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