PANEL DISCUSSION: DECISION MAKING AMONG VULNERABLE POPULATIONS NEW TO THE HEALTH CARE SYSTEM

In a rapidly changing health care system, one constant remains: Providers are tasked with helping their patients make optimal decisions about what health care interventions to pursue so as to reach the highest quality health outcome.  This issue is ever important, as the White House this year tasked Medicare with tying 90% of all traditional medicare payments to quality.  This initiative intends to make health care providers more accountable for the quality and cost of the care they deliver.  Achieving the best patient outcomes, however, involves complex, interactive decision making by the patient, the physician, and health care organizations.  Although the ultimate goal is to seek what is best for the patient, each actor may have competing interests that alter that process.  As a consequence, a central question is:  How do we align the decision-making process of each actor in health care so that their decisions improve patient health?

These issues came to the forefront with the passage of the Affordable Care Act (ACA).  At the end of 2013, 52 million uninsured Americans became eligible for insurance. Uninsured individuals are disproportionately low-income and are more likely to suffer from untreated or poorly managed chronic health conditions.  The ACA aims to improve health care access, lower out-of-pocket costs, and improve health through better prevention and management of chronic conditions.  These goals will be achieved only if individuals understand how to use health insurance to meet their financial and health needs.  The Choosing Wisely campaign, which aims to advance a national dialogue on avoiding wasteful or unnecessary medical procedures, and leading national groups such as the Patient Centered Outcomes Research Institute (PCORI), continue to promote discussions about what works best, for whom, and under what conditions?  These discussions are particularly important among vulnerable groups such as those newly insured who are navigating health insurance for the first time.

Our panel discussion will involve stakeholders at the patient, provider, researcher, and organizational level.  We will have representatives from Washington University School of Medicine, Olin School of Business, The College of Arts and Sciences, Brown School of Social Work, and BJC Healthcare discussing how to “Choose Wisely” and match health care needs to patient outcomes among vulnerable populations, particularly those new to insurance with the passage of the ACA.