FAIR Health Launches Shared Decision-Making Tools for Palliative Care

March 10, 2020
Robin Gelburd, JD
Robin Gelburd, JD
Robin Gelburd, JD

Robin Gelburd, JD, is the President of FAIR Health, a national, independent nonprofit organization with the mission of bringing transparency to healthcare costs and health insurance information. FAIR Health possesses the nation’s largest collection of private healthcare claims data, which includes over 31 billion claim records contributed by payers and administrators who insure or process claims for private insurance plans covering more than 150 million individuals. Certified by CMS as a national Qualified Entity, FAIR Health also receives data representing the experience of all individuals enrolled in traditional Medicare Parts A, B and D; FAIR Health houses data on Medicare Advantage enrollees in its private claims data repository. Gelburd is a nationally recognized expert on healthcare policy, data and transparency.

On March 10, FAIR Health launched a groundbreaking website feature that combines clinical and cost information to support seriously and chronically ill patients and their caregivers in the process of shared decision making (SDM) with clinicians for 3 palliative care scenarios.

The new feature is the most recent addition to fairhealthconsumer.org, FAIR Health’s free, award-winning consumer website, which enables consumers to estimate the typical costs of medical and dental procedures in their geographic areas and provides rich educational materials on the fundamentals of health insurance. A national, independent nonprofit organization dedicated to bringing transparency to healthcare costs and health insurance information, FAIR Health powers the cost information on FAIR Health Consumer with its database of billions of private healthcare claims—the largest in the nation. The same database provides the cost data for the new SDM feature, fairhealthconsumer.org/shared-decision-making.

SDM, the discussion between patients/caregivers and healthcare providers regarding various treatment options, has been known to increase patient engagement and reduce healthcare costs. But in the past, the utility of SDM tools, or decision aids, has been limited by the absence of cost data to complement the clinical information. As part of a pilot generously funded by The New York Community Trust (The Trust), the new SDM tool combines cost data from FAIR Health with Option Grid™ decision aids from EBSCO Information Services, cofounded by Dr. Glyn Elwyn, BA, MD, MSc, PhD, professor at the Geisel School of Medicine at Dartmouth College.

Intended to support the conversation between clinicians and patients/caregivers, and designed for ease of use, the decision aids offer clinical and cost information related to:

  • Kidney dialysis for patients with kidney failure (whether to continue or stop)
  • Nutrition options when swallowing is difficult
  • Breathing assistance (whether to continue or stop).

FAIR Health will collaborate with organizations and professionals who provide palliative care services in the New York metropolitan area in order to promote awareness of this resource. The project will also include an evaluation of the SDM tools to help inform future initiatives and tools.

Irfan Hasan, Program Director of Health and Behavioral Health at The Trust, commented: “Palliative care decisions in cases of serious and chronic illness are fraught with emotional and personal significance. The Trust is proud to support FAIR Health’s efforts to aid those decisions.”

Diane E. Meier, MD, Director of the Center to Advance Palliative Care, Icahn School of Medicine at Mount Sinai, stated: “Having witnessed the need for clear and accurate information when making critical health decisions during chronic and serious illness, I am heartened by FAIR Health’s effort to promote shared decision making for patients and caregivers when they most need clarity and guidance.”

The new shared decision-making tool on FAIR Health Consumer is a natural extension of our commitment to cost transparency and to helping consumers navigate the complexities of the healthcare system. We look forward to assisting patients and their caregivers as they make serious decisions in consultation with their clinicians.