Programs such as the Blue Button Initiative, which enables beneficiaries to download their own health records from a website, have the potential to increase patient activation through greater sharing of information. This analysis has several limitations that are worth noting. To start, the purchase Nilotinib cross-sectional nature of the analysis limits inferences regarding temporality when predicting low patient

activation. We cannot deduce from this analysis, for example, whether poor health status predates low patient activation, or is an outcome from it, or if the relationship is multidirectional. This study used self-reported data, and

cost data is only available for the fee-for-service population. Similarly, this study’s generalizability is limited as the survey population was restricted to the non-institutionalized Medicare population that was healthy enough to self-report. All questions in the patient activation scale are weighted equally, when in fact certain questions may be stronger predictors of activation than others. Although the patient activation scale has not been externally validated, survey questions are consistent with previous studies and a sensitivity analysis raised no concerns.

Further research on MCBS patient activation questions could address some of these limitations and also demonstrate any correlation with the PAM. This study demonstrates an underutilized portion of a major Medicare survey that could prove to be of significant value to health services researchers and policy analysts. The MCBS content and sample size are significant and, while this study provides an initial dive into the subject of patient activation, there are many areas pertaining to this topic of research that can be refined and advanced upon by future MCBS users. The MCBS Patient Activation Entinostat Supplement was first introduced as part of the MCBS in Fall 2001 and consists of three domains identified through principal component factor analysis: (1) confidence in their ability to navigate their health care, (2) communication in health care settings, and (3) knowledge-seeking behavior about health. Analyses can be done on individual domains or on a composite measure combining the three domains.