From Measurement to Action: Rethinking the Patient Activation Measure in a Patient Engagement Era
Jennifer Woodruff, MHA
Founder, Patient Better® | Creator of MAPS - Today’s Pre-Quality Measurement Tools for Healthcare Professionals to Assess and Report Patients’ Interest in Participating in Their Care
First, the bottom line: The Patient Activation Measure (PAM) tells us how confident patients feel about managing their care — but it doesn’t tell us whether they can actually do it.
As healthcare professionals, we’re encouraged to use PAM as a benchmark for patient engagement — especially for Medicare populations. It’s even tied to reimbursement through MIPS (Measure 503). But here’s the critical truth: PAM doesn’t measure health literacy or functional self-management. It’s a belief-based tool.
And beliefs don’t always translate into behaviors.
The Problem with Measuring Activation Alone
PAM is a 13-item survey that scores patients on a 0–100 scale, categorizing them into four levels of “activation.” While it gives us valuable insight into a patient’s mindset, it doesn't show us what a patient knows how to do.
A person can score well on PAM and still:
Struggle to navigate a patient portal
Forget to bring their medication list to an appointment
Not know how to formulate a chief complaint
Rely heavily on caregivers without a system to organize their care
PAM identifies awareness. It doesn’t assess capability.
Rethinking Health Literacy Measurement
Traditional health literacy tools — like TOFHLA or NVS — focus on word recognition or understanding a prescription label. PAM took this further by assessing confidence and perceived engagement. But what we still don’t have is a standardized, functional measurement of applied health literacy in a modern care setting.
This is where our industry is at a crossroads.
We need to move from measuring what patients say they can do — to equipping them with the structure and knowledge to actually do it.
Bridging the Gap with Patient Better
That’s the model we’ve built with Patient Better. It starts with a screening tool (the Healthcare Proficiency Challenge), followed by a self-paced education program that teaches people how to:
Access and use their digital records
Prepare for appointments with documentation and questions
Record key takeaways during visits
Follow through with care instructions
Track their conditions over time
All of these are the real-world behaviors that patient engagement, health literacy, and care quality hinge on.
Why This Matters
If we want to see better health outcomes, fewer readmissions, and higher-quality encounters — we have to stop assuming patient belief = patient behavior.
PAM is a starting point. Patient Better is the path forward.
Let’s stop measuring patient engagement in theory — and start supporting it in practice.
🗓 Ready to See It in Action?
If you're looking for a practical, patient-friendly solution that bridges the gap between activation scores and real-world engagement, let’s talk.
Book a discovery demo to see how Patient Better can complement your practice's patient engagement goals — and help your patients do more than just score well.
Executive Director & Founder, Patient Voices Matter Foundation | Rural Patient Advocate | Social Worker
5moThat is why it is so important to have a patient advocate or the patient be educated in how to do self-patient advocacy.