CMS Includes the Patient Activation Measure in its Merit-Based Incentive Payment System Starting in 2024

December 01, 2023 at 06:00 AM EST

Phreesia is very pleased to announce that the Centers for Medicare and Medicaid Services (CMS) has included the Patient Activation Measure Performance Measure (PAM-PM) in its Merit-Based Incentive Payment System (MIPS), as well as in 15 specialty-specific measure sets and five MIPS Value Pathways (MVPs), subsets of measures for specific conditions.

The Patient Activation Measure (PAM) measures a patient’s knowledge, skills and confidence to self-manage their health. Insignia Health, a wholly owned subsidiary of Phreesia, is the measure steward of the PAM. Activated patients feel comfortable advocating for themselves and asking for support from their care team to manage their own health. But many patients who feel discouraged and overwhelmed need more targeted support and resources.

“Supporting patients in taking a more active role in their care drives better outcomes, especially for patients who need it most,” said Hilary Hatch, PhD, a clinical psychologist and Phreesia’s Chief Clinical Officer. “It’s incredibly gratifying to see CMS include the Patient Activation Measure Performance Measure in its program as a high priority outcome measure. It’s a real testament to the agency’s commitment to person-centered care and health equity.”

In its 2024 Medicare Physician Fee Schedule published on Nov. 16, CMS said the PAM Performance Measure “ensures capture of the patient voice and experience of care related to the patient's understanding and confidence in the ability to manage their health and be an active partner in their health care journey."

The PAM was developed nearly two decades ago by healthcare services researcher Judith H. Hibbard, DrPH, at the University of Oregon. Since then, a large body of research—more than 800 peer-reviewed research studies—demonstrates the unique value of PAM. Evidence has shown that care teams can use a variety of interventions tailored to patients’ needs to increase PAM scores, improve outcomes, and lower costs. PAM is already used by hundreds of healthcare organizations across the country, and beginning in 2024, MIPS-participating providers can report on gains in patient activation as a new quality measure.

"The PAM plays a key role in helping us better understand our patients, allocate our resources efficiently and get patients the support they need," said Beth Wrobel, CEO of HealthLinc, a federally qualified health center in northwest Indiana with 12 freestanding clinics. "We use the PAM in many ways, including to assess patients' activation level and screen them for unmet social needs so that we can deploy our limited resources to patients who need them most."

"Activated patients are better able to self-manage their care and adhere to treatment, and they have better outcomes,” said Tony Nguyen, Systems Analyst & Implementation Lead at Congress Orthopaedic Associates, an orthopedics group in California. “As a practice that uses the Patient Activation Measure and participates in MIPS, we're incredibly excited to see that PAM will be a MIPS measure going forward. We believe it will improve the care we provide, and in turn, the health and lives of our patients."

Dave White, a nationally known patient advocate who has worked with organizations like the Patient Centered Outcomes Research Initiative and the Kidney Health Initiative, emphasized the transformative power of patient activation.

“Getting support to take a more active role in my care made a difference and will for other people living with kidney disease and a range of conditions as CMS includes the Patient Activation Measure and screening for social drivers of health in MIPS,” said White.

Support for the inclusion of the PAM in MIPS during the public comment period came from groups as diverse as the American Society of Nephrology (ASN), American College of Cardiology (ACC), American Academy of Neurology (AAN), American Nurses Association (ANA), National Alliance on Mental Illness (NAMI), the American Academy of Orthopedic Surgeons (AAOS), National Kidney Foundation (NKF), the American Diabetes Association (ADA), American Occupational Therapy Association (AOTA) and AHIP.

About Phreesia

Phreesia is the trusted leader in patient activation, giving providers, health plans, life sciences companies and other organizations tools to help patients take a more active role in their care. Founded in 2005, Phreesia enabled more than 120 million patient visits in 2022–more than 1 in 10 visits across the U.S.–scale that we believe allows us to make meaningful impact. Offering patient-driven digital solutions for intake, outreach, education and more, Phreesia enhances the patient experience, drives efficiency and improves healthcare outcomes. To learn more, visit www.phreesia.com.