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Patient Activation Measure® (PAM®)

Learn more about the leading assessment of patient activation

PAM Survey

The PAM survey can be used on its own to accurately assess activation for an individual or collectively for a population.

However, when PAM-based health coaching tools like Coaching for Activation® (CFA) or Flourish® are applied within a holistic model of care, healthcare providers and organizations can proactively align resources and tailor support depending on who needs more or less assistance in improving health self-management behaviors.

PAM Steps

Step 1:
Measure Activation

PAM step 1

It all starts with the PAM® survey.

The Patient Activation Measure® is a 10- or 13-item survey that assesses an individual’s knowledge, skills and confidence integral to managing one’s own health and healthcare.  

PAM is available in multiple versions and over 35 languages. It can be administered in a variety of formats (phone, tablet, email, paper) and environments (home, office, clinic, hospital).

PAM Versions

Carer/Caregiver PAM 10 or PAM 13

Parent PAM 10 or 13

Developmental Disability 13

Provider Support of Patient Activation (CSPAM®)

PAM is a validated patient-reported outcome measure (PROM) that takes about 3-5 minutes to complete. Respondents simply indicate how much they agree or disagree with each statement.  

PAM Scoring

Insignia Health’s proprietary survey scoring algorithm produces a PAM Score along an empirical, interval-level scale from 0-100 that correlates to one of four levels of patient activation. PAM Levels 1 and 2 indicate lower patient activation, while PAM Levels 3 and 4 indicate higher patient activation.

PAM Levels with descriptions

Step 2:
Align Resources

PAM Step 2

Analyzing PAM score and PAM level provides guidance for aligning resources – health coaches, case managers, telehealth providers, training videos, informational materials — with an emphasis toward assisting individuals with lower activation.

PAM provides an objective segmentation of 
your population, both within and across health conditions. Patient activation becomes the lens through which available touchpoints within your healthcare organization can be focused, mobilized or created to address gaps in care.

Step 3:
Measure-Align-Tailor Support

PAM Step 3

A one-size-fits-all approach to care might appear to be an efficient solution from an organizational perspective. However, it likely overserves individuals with higher activation and underserves individuals with lower activation.

Tailoring support by activation level – to both individuals and groups – aligns the right resources at the right time to the right people. Health goals and action steps should be adjusted accordingly. 

Engagement Frequency

Individuals in PAM Level 4 are proactive with their health, have developed strong self-management skills, and are resilient in times of stress or change. They can be challenged to achieve more advanced health behaviors and only need periodic, low-touch engagement to prevent regression in activation.

Individuals in PAM Level 1 likely do not yet understand the importance of their role in managing their own health. They need more frequent engagement and fewer, simplified goals aimed at addressing fundamental gaps in knowledge and limited self-management skills.

PAM Engagement Levels

Return to Step 1:
Measure Activation (Reassessment)

PAM step 1

To measure the impact of your tailored support and to better evaluate the quality of your aligned resources, it’s important to continue to measure patient activation at regular intervals.

Even a single point change in PAM score is meaningful. By periodically re-administering the PAM survey, the impact of patient support strategies and programs can be understood well in advance of traditional outcome measures.

Evaluation metrics for treatments and interventions can be objectively measured based on the change in PAM score with each successive assessment. PAM score then becomes the benchmark for determining progress for both individuals and populations over time.

PAM Reassessment Graphic