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Gains in Patient Activation Measure (PAM) Scores at 12 Months

CBE ID
2483
1.5 Project
Endorsement Status
E&M Committee Rationale/Justification

When the measure returns for maintenance, the committee would like to see:

  • Progression on electronic health record (EHR) integration
  • Evaluation of bias due to changes in the population over time
1.0 New or Maintenance
Previous Endorsement Cycle
Is Under Review
No
Next Maintenance Cycle
Spring 2029
1.6 Measure Description

The measure is the percentage of patients who achieve a 3-point increase in their Patient Activation Measure® (PAM®) survey score within 12 months. The outcome measure demonstrates how a clinician group performed in providing best care to its patients by quantifying the proportion of patients who had at least a 3-point score change. 

 

The PAM surveys the knowledge, skill, and confidence necessary for self-management on a 0-100 point scale that can be broken down into 4 levels from low activation to high activation. The 13 (or 10) item survey has strong measurement properties and is predictive of most health behaviors, many clinical outcomes, and patient experience. PAM® scores are also predictive of health care costs, with lower scores predictive of higher costs.  

Measure Specs
General Information
1.7 Composite Measure
No
1.3 Electronic Clinical Quality Measure (eCQM)
1.8 Level of Analysis
1.9 Care Setting
1.10 Measure Rationale

The Patient Activation Measure® (PAM®) is a 10- or 13- item questionnaire that assesses an

individual´s knowledge, skills and confidence for managing their health and health care. The measure

assesses individuals on a 0-100 scale that can be converted to one of four levels of activation, from low (1) to high (4). The PAM performance measure (PAM-PM) is the proportion of patients who achieve a 3-point change in the 0-100 scale score on the PAM from baseline to follow-up measurement (CBE #2483). A positive change would mean the patient is gaining in their ability to manage their health. The measure is not disease specific but has been successfully used with a wide variety of chronic conditions, as well as with people with no medical diagnosis.

 

The PAM is predictive of most health outcomes, including such diverse outcomes as how a patient fares after orthopedic surgery; remission of depression over time; the likelihood of hospital re-admission or

ambulatory care sensitive (ACS) utilization; the trajectory of a chronic disease over time; and even the

likelihood of a new chronic disease diagnosis in the coming year. PAM scores are also predictive of

health care costs, with lower scores predictive of higher costs.

 

The PAM is in use both in the US and internationally in research (including more than 850 peer-reviewed

journal articles) as well as clinical settings. It has been translated into more than 30 languages. Because

researchers all over the world use PAM, we have been able to validate the instrument with people of

different racial and ethnic backgrounds, and with people from different socio-economic levels. The

measure has been shown to be valid and reliable in different clinical settings and under different

payment models.

1.25 Data Source Details

The performance measure makes use of PAM survey data to quantify changes in patient activation over time. Administrative data, electronic health records, and/or paper patient medical records may also be used to help identify denominator exceptions and exclusions.