Patient Engagement Supports Better Outcomes, Lower Costs, Study Finds

People who are actively engaged in managing their health and health care tend to have better outcomes and lower healthcare costs, a study by researchers from George Washington University, the University of Oregon, and Fairview Medical Group finds.

Based on an analysis of more than thirty-two thousand primary care patients, a majority of them female, the report, When Patient Activation Levels Change, Health Outcomes and Costs Change, Too (8 pages, PDF), found that higher baseline activation levels — a metric developed to quantify an individual’s knowledge, skill, and confidence in managing his or her own health care — were predictive of better outcomes for nine of thirteen indicators, including clinical indicators associated with diabetes and heart disease. The study also found that more actively engaged patients were more likely to demonstrate healthy behaviors, receive preventive screenings such as pap smears and mammography, and avoid hospitalization and emergency room visits during the two-year study period.

According to the study, projected billed costs for patients who maintained the highest of four activation levels over two years were 31 percent lower than for those who stayed at the lowest levels of activation, 14 percent lower than for those whose activation level fell from the highest to the second highest, and 27 percent lower than for those whose activation level fell from one of the two highest levels to one of the two lowest. Funded by the Gordon and Betty Moore Foundation and published in Health Affairs, the report concludes that while the findings do not prove causality between active patient engagement and better clinical, behavioral, and utilization outcomes, the association is lasting.

"For accountable care organizations and other delivery systems looking to reduce costs and improve the health of those they care for, this study suggests that patient activation can be a critical pathway to achieving these goals," said Judith Hibbard, professor emerita and senior researcher of the Health Policy Research Group at the University of Oregon. "The greater the activation level, the greater the odds of better outcomes and lower costs."