The Patient Protection And Affordable Care Act

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On March 20, 2010 President Barack Obama signed into law the Patient Protection and Affordable Care Act (ACA). With that signature, a new healthcare paradigm set into motion. Under Title III: Improving the Quality and Efficiency of Healthcare, Section 3506 requires establishment of programs that develop, test and disseminate “patient decision aids”. Tools that are designed to facilitate collaborative shared decision making between health care providers and patient beneficiaries. This provision outlines requirements to promote engagement of all stakeholders in informed decision making, mandates provision of up-to-date clinical evidence for all treatment options and promotes decision making that accounts for individual beliefs, preferences and circumstances.
Considerable evidence demonstrates the clinical effectiveness and potential cost reduction associated with shared decision making. A review by the Cochrane Collaborative published in 2014 evaluated 115 randomized control trials with 34,444 participants for the effectiveness of decision aids for persons facing treatment or screening decisions. The data demonstrate use of decision aids results in better than usual care in several quality domains. Namely shared decision making had a positive effect on patient knowledge, communication with the health care provider, improved patient engagement in the decision making process and provided more realistic outcome expectations. Interestingly, decision aids were also
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