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Patient Activation Measure® (PAM®) Named in MACRA as a Tool to Help an Estimated 600,000 Health Professionals Improve Clinical Care and Health Outcomes for Medicare Patients

December 14, 2016

Patient Activation Measure® (PAM®) Named in MACRA as a Tool to Help an Estimated 600,000 Health Professionals Improve Clinical Care and Health Outcomes for Medicare Patients

Over 60 major health systems, hospitals and clinics across the United States use PAM to improve health outcomes and deliver high-quality, patient-centered care.  PAM, MACRA, MIPS fact sheet PDF  

The Patient Activation Measure® (PAM®) has been identified as a Merit-based Incentive Payment System (MIPS) measure within the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) which clinicians and other health professionals can implement to improve the quality of care for Medicare beneficiaries.  This change comes about as MACRA establishes a new payment program for clinicians who serve patients enrolled in Medicare’s fee-for-service plan (Part B).  The Centers for Medicare and Medicaid Services (CMS) predicts that over 600,000 clinicians can choose to participate in MIPS when the new payment program goes into effect in 2019, with the first performance period beginning on Jan. 1, 2017.  

As the Medicare reimbursement model shifts toward reimbursing value-based care, physicians will increasingly be held accountable for keeping utilization in check. PAM – the gold standard for measuring patient activation – helps health professionals meet MIPS requirements that reward delivery of high-quality patient care, by helping to increase patient activation.

A ‘Best in Class’ National Quality Forum-endorsed performance measure, PAM, assesses the knowledge, skills and confidence integral to managing one’s own health and healthcare.  With the ability to measure activation and uncover insights into self-management competencies, PAM enables providers to deliver patient care and education that is tailored to each individual’s capabilities, helping patients become more successful managers of their health over time.  More than a decade of published research has consistently shown that as activation increases, healthcare utilization declines and satisfaction with care increases.

“Patient self-management is at the heart of value-based care and achieving many of the MACRA performance measures that are dependent on changing patient behavior,” said Chris Delaney, CEO of Insignia Health.  “With PAM, providers will better understand the prospective risk of their Medicare patient population, and can then tailor support to each patient’s level of activation,” he added.

Scored on a 0-100 scale, PAM reveals four levels of activation, from low (1) to high (4). PAM has been validated across a wide array of demographic and socioeconomic characteristics in dozens of countries.  Lower-activated individuals (PAM levels 1 and 2) are at significantly greater risk for poor health outcomes.

Results from a recent study show how PAM predicts which patients are more likely to utilize expensive and avoidable hospitalization and emergency visits, and which patients are more likely to develop a chronic health condition within the next year.  Other studies also reveal that as activation increases patients take medications as directed, are more satisfied with their healthcare and experience lower healthcare costs.

For more details, view our PAM, MACRA, and MIPS fact sheet.

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About Insignia Health: Insignia Health is the gold standard provider of patient activation solutions that pinpoint population health risk, improve health outcomes, reduce healthcare costs and increase patient/member satisfaction. Our Patient Activation Measure® (PAM®) is a predictive powerhouse backed by over a decade of health activation research and insight gained from supporting hospitals, health systems, health plans, life science firms and government agencies around the globe. Our products and services help organizations exceed performance objectives by measuring activation and tailoring care programs to specific activation levels. We strive to lessen disease, illness burden and premature deaths around the world. Insignia Health is headquartered in Portland, Oregon. Visit www.insigniahealth.com, email info@insigniahealth.com or follow us on Facebook and Twitter.

Press Release PDF

PAM, MACRA, MIPS fact sheet PDF