Funding from The John A. Hartford Foundation Supports Groundbreaking Shared Decision-Making and Cost Transparency Initiative for Older Adults

With generous funding from The John A. Hartford Foundation, FAIR Health will develop, disseminate and evaluate a new set of shared decision-making (SDM) and other healthcare engagement tools geared toward older adults and their caregivers, in an expansion of its existing repository of tools for SDM in palliative care.

The John A. Hartford Foundation awarded funding to FAIR Health in connection with its project “A National Initiative to Advance Cost Information in Shared Decision Making for Serious Health Conditions.” The 18-month initiative will expand upon FAIR Health’s existing repository of SDM tools for palliative care scenarios through the creation of new decision aids—educational materials combining clinical and cost information for specific health scenarios—related to the care of older adults with serious illness. As part of the grant, FAIR Health will also launch new “total treatment cost” scenarios highlighting the range of costs associated with conditions particularly relevant to an older population. FAIR Health will pilot the new tools and evaluate their perceived utility and value among relevant patient and caregiver populations. Notably, the initiative also will involve testing of messaging and strategies in four media markets nationwide. The project will culminate in a report on FAIR Health’s findings and contribute to the growing field of research on the utility of SDM in geriatric care.

Each phase of the grant-funded initiative will be guided by the input of a multi-stakeholder Project Advisory Board, which will include Diane Meier, MD, FACP, FAAHP, an expert in geriatric and palliative care. FAIR Health will also consult renowned SDM expert Glyn Elwyn, MD, PhD, MSc, on the project and its evaluation.

Research has demonstrated that SDM, the collaborative conversation between clinicians and patients and/or caregivers to decide on treatment options that take into account patients’ preferences and values, can lead to higher consumer satisfaction and lower decisional regret with no adverse effect on clinical outcomes. SDM also shows promise for reducing healthcare costs for both patients and providers. The benefits of SDM may be particularly pronounced in geriatric care settings, given older adults’ lower rates of health literacy and the added decisional complexity caused by multimorbidity and polypharmacy.

FAIR Health has previously received grants for projects involving the creation, dissemination and evaluation of SDM tools that combine clinical options and their associated costs. Thanks to funding from The New York Community Trust, FAIR Health was able to create a set of three decision aids on palliative care scenarios, which were launched in March 2020 on FAIR Health’s website for consumers, fairhealthconsumer.org. FAIR Health’s other grant-funded projects in the SDM sphere include the development of FAIR Health’s clinician-oriented website, fairhealthprovider.org, which launched in April 2021 with the support of The Fan Fox & Leslie R. Samuels Foundation, and a current project, funded by the New York State Health Foundation, to pilot a set of certified decision aids complemented with FAIR Health cost information on clinical topics particularly relevant to patients of color.