Table 2.

Policy Options Related to the Integration of Patient‐Report Information with Incentives

National Policy Making within Current Scope of Authority for CMS/HHS

Develop and field test protocols for integrating open‐ended patient narratives into CAHPS for Medicare, Medicaid, and the health insurance exchanges

Pilot test collecting patient narratives under all federally mandated CAHPS initiatives

Pilot test the inclusion of patient comments collected through CAHPS on the Medicare Compare websites including Physician Compare

National Policy Making Requiring Legislative Authorization

Establish federal funding for patient‐related information in all health care settings, on the condition that the information collected under these auspices be freely shared with all payers and providers to whom they are relevant

Based on results from the research described in Table 1, establish minimum thresholds for the proportion of incentives linked to patient feedback in both payer and provider‐based incentive arrangements.

Establish demonstration projects to test different models of data collection harmonization for PRI across payers and providers. These pilots would be implemented at the state or community level. Different models to be tested would include: (a) a public utility model: all data collected and held in trust by a public agency or single private contractor acting under government authority; (b) a private model in which government provides funding and sets ground rules, but all data are collected by private actors; and (c) various hybrid models that would collect some forms of PRI under a public utility, others under private auspices.

State‐/Community‐Level Policy Making

Initiate a set of demonstration projects (with targeted grants to provider organizations and payers) to experiment with ways of enhancing a “culture of learning” from patient experience. These would place a particular emphasis on: (a) networking smaller practices to allow for practitioners to share ideas about responding to patient feedback; (b) integrating information from multiple sources of PRI into a coherent picture of the patient experience with particular clinicians and practices; and (c) more effectively leveraging incentives for responding to PRI to encourage improved clinical outcomes, particularly for aspects of PRI (e.g., PROMs) that can be most closely

linked with specific clinical outcomes.