CMS stops testing shared decision-making model due to lack of interest

Doctor with patient
CMS has cancelled a project to test shared decision-making because of a lack of interest among accountable care organizations.

The Centers for Medicare & Medicaid Services has decided not to test one of its planned shared decision-making models because of a lack of accountable care organization participants.

“After careful consideration, [CMS] is announcing its decision to not test the Shared Decision-Making (SDM) Model because an insufficient number of [ACOs] were interested in participating in the model,” the agency said in a posting on its web site.

CMS had planned to test two models with different approaches to encourage shared decision-making and strengthen patient engagement, the SDM model and the Direct Decision Support (DDS) model.


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CMS had hoped to get a group of practices participating in 50 ACOs across the country to test the SDM model, along with 50 ACOs to participate in a control group. The model was set up to test a specific approach to integrate a structured, four-step shared decision-making process into clinical practice of practitioners participating in ACOs. Only those ACOs participating in the Medicare Shared Savings Program or Next Generation ACO model were eligible to participate in the SDM model.

The model would have been considered an Alternative Payment Model under the Medicare Access and CHIP Reauthorization Act, but not an Advanced APM or APM under the Merit-based Incentive Payment System (MIPS).

The DDS model will test a shared-decision approach provided outside of the clinical delivery system by so-called Decision Support Organizations, which provide health management and decision-support services, CMS said.

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