CMS Includes the Patient Activation Measure in its Merit-Based Incentive Payment System Starting in 2024

Phreesia is very pleased to announce that the Centers for Medicare and Medicaid Services (CMS) has included the Patient Activation Measure Performance Measure (PAM-PM) in its Merit-Based Incentive Payment System (MIPS), as well as in 15 specialty-specific measure sets and five MIPS Value Pathways (MVPs), subsets of measures for specific conditions.

The Patient Activation Measure (PAM) measures a patient’s knowledge, skills and confidence to self-manage their health. Insignia Health, a wholly owned subsidiary of Phreesia, is the measure steward of the PAM. Activated patients feel comfortable advocating for themselves and asking for support from their care team to manage their own health. But many patients who feel discouraged and overwhelmed need more targeted support and resources.

“Supporting patients in taking a more active role in their care drives better outcomes, especially for patients who need it most,” said Hilary Hatch, PhD, a clinical psychologist and Phreesia’s Chief Clinical Officer. “It’s incredibly gratifying to see CMS include the Patient Activation Measure Performance Measure in its program as a high priority outcome measure. It’s a real testament to the agency’s commitment to person-centered care and health equity.”

In its 2024 Medicare Physician Fee Schedule published on Nov. 16, CMS said the PAM Performance Measure “ensures capture of the patient voice and experience of care related to the patient's understanding and confidence in the ability to manage their health and be an active partner in their health care journey."

The PAM was developed nearly two decades ago by healthcare services researcher Judith H. Hibbard, DrPH, at the University of Oregon. Since then, a large body of research—more than 800 peer-reviewed research studies—demonstrates the unique value of PAM. Evidence has shown that care teams can use a variety of interventions tailored to patients’ needs to increase PAM scores, improve outcomes, and lower costs. PAM is already used by hundreds of healthcare organizations across the country, and beginning in 2024, MIPS-participating providers can report on gains in patient activation as a new quality measure.