Report: Advancing Shared Decision Making among Older Adults with Serious Health Conditions

Feb 22, 2023

Shared decision making shows promise for engaging older patients and their caregivers/care partners in healthcare decisions and reducing unnecessary spending and healthcare costs, according to a report from FAIR Health – a national nonprofit whose mission is to help people understand healthcare costs and health coverage and to bring transparency to healthcare costs and insurance.

Shared decision making involves communication between patients (and if applicable, their caregivers/care partners) and providers to decide on tests, treatment and care based on clinical evidence, balancing risks and outcomes with patient and caregiver/care partner preferences and values.

The initiative, which is funded by The John A. Hartford Foundation, offered actionable insights regarding the challenges older adults face when making healthcare decisions and tools with cost information to help facilitate shared decision making among older adults, family caregivers and care partners. To evaluate the initiative, FAIR Health gathered data from surveys and website analytics and conducted focus groups with patients, caregivers and providers.

Key program findings include the following:

  • A majority of older adults, family caregivers and care partners found the content, resources and tools useful. From the September launch of the Older Adults section through the end of the grant period in December, Older Adults tools and resources received 10,312 unique visitors. Of those surveyed, 74 percent found the tools, resources and content “useful” or “very useful”; 67 percent felt that the Older Adults section increased their knowledge and understanding of shared decision making; and 65 percent of respondents agreed that the section helped them understand how to manage their healthcare costs.
  • Shared decision making is perceived as a vehicle for patient empowerment. Providers, patients, family caregivers and care partners alike believed that the tools, content and resources empowered individuals to become more active participants in their health and healthcare decision making.
  • Patients, family caregivers and care partners voiced frustrations around healthcare costs, billing and a lack of transparency in the healthcare system. Healthcare costs, confusing billing systems and a lack of general transparency in the healthcare system were cited as barriers to accessing care and services.
  • Checklists and links to external resources were popular among older adults, family caregivers and care partners. Forty-eight percent of survey respondents stated that links to the external resources were most helpful in decision making, with an additional 39 percent saying the checklists were most helpful.
  • Barriers to shared decision making exist at the point of care and at home. Barriers to shared decision making cited by the focus group participants included lack of access to technology, low health literacy and time constraints in appointments.

More detailed information is available in the FAIR Health report here.