BREE

ROBERT&BREE&COLLABORATIVE

VISION&&&MISSIONTo#provide#a#mechanism#through#which#public#and#private#health#care#stakeholders#can#work#together#to#improve#quality,#health#outcomes,#and#cost#effec;veness#of#care#in#

Washington#State.PURP

OSE

Increase&the&use&of&evidence@based&pracCces&by:Goals#for#appropriate#u;liza;on;

PeerDtoDpeer#consulta;on;Provider#feedback#reports;Use#of#pa;ent#decision#aids;

Incen;ves#for#the#appropriate#use#of#health#services;Centers#of#Excellence#or#other#provider#qualifica;on#standards;

Quality#improvement#systems;#and#Service#u;liza;on#or#outcome#repor;ng.

STRA

TEGIC&GOALS

IMPR

OVE

MEN

T&AC

TIVITIES

SPINE&/&LOW&BACK&PAINPa;ent#outcomes

Inappropriate/unnecessary#care

OBSTETRICS&CAREPa;ent#outcomes

Varia;on

CARDIOLOGY&PCIData#collec;on/repor;ng

POTENTIALLY&AVOIDABLE&READMISSIONSReadmissions

ACCOUNTABLE&PAYMENT&MODELS&(THR/TKR)Pa;ent#safety

General#care/quality#improvement:#inappropriate#careCost#reduc;on

END&OF&LIFE&/&ADVANCED&PLANNINGCost#reduc;on

BREE&IMPLEMENTATION&TEAM&(BIT)General#care/quality#improvement

ADDICTION&/&DEPENDENCE&TREATMENTEvidenceDbased#prac;ce

Varia;on

BREE

No#formal#partnerships

Workgroup#includes#PSHA,)WSMA/WSMGMA,#King#County,#Costco,#Overlake#Hospital,#Virginia#Mason,#Providence,#Qualis#Health,#Regence,#and#Premera

HCAHealth#plansPurchasersProviders

Developing#a#"common#playbook"#for#episodes#of#care.#The#first#episode#selected#was#total#knee#and#total#hip#replacement#(TKR/THP).#Team#has#developed#both#a#TKR/THP#warranty#and#bundle#document#through#an#evidenceMbased#process#and#public#comment#period.

ACCO

UNTA

BLE

PAYM

ENT)MODELS Hold#providers#

accountable#for#ensuring#that#TKR/THP#care#is#safe,#highMquality,#appropriate,#and#affordable#

DESCRIPTION AUDIENCE PARTNERS OUTCOMESSP

INE)/)LO

W)BAC

K)PA

IN FHCQ#(Spine#SCOAP)

Workgroup#includes#Regence,#Virginia#Mason,#L&I,#Group#Health,#First#Choice#Health,#and#EvereW#Clinic

HCAHospitalsClinicsProvidersDOHL&IPurchasersHealth#plans

Improving#outcomes#for#low#back#pain#(LBP)#paYents#through#two#acYviYes:#developing#recommendaYons#for#prevenYng#the#transiYon#of#acute#pain#to#chronic#pain#and#recommending#that#all#hospitals#parYcipate#in#the#Spine#SCOAP#to#improve#surgical#outcomes#for#chronic#LBP#paYents.

Improve#outcomes#for#acute#and#chronic#LBP#paYents#

Reduce#unnecessary#inappropriate,#costly#care

No#formal#partnerships,#but#significant#involvement#with#WSHA#on#toolkit

Workgroup#includes#PSHA,#Qualis#Health,#and#Virginia#Mason

HCAHospitalsClinicsProvidersPurchasersPaYents

Pursuing#three#strategies:M#Alignment#with#exisYng#efforts#to#reduce#readmission#ratesM#Measurement,#transparency#and#reporYngM#Accountable#payment#models#Also#focusing#on#WSHA#Toolkit#and#the#availability#of#unblinded#30Mday,#allMcause#readmission#data.

POTE

NTIALLY)AV

OIDABL

ERE

ADMISSIONS

Reduce#readmission#rates

No#formal#partnershipsHospitalsProvidersHCA/MedicaidDOHPEBBPurchasersHealth#plans

IdenYfying#areas#in#which#OB#pracYce#variaYon#can#be#reduced#and#outcomes#improved#through#three#strategies:M#Eliminate#elecYve#deliveries#before#the#39th#weekM#Decrease#elecYve#inducYons#of#labor#between#39#and#41#weeksM#Decrease#unsupported#variaYon#among#hospitals#in#the#primary##CMsecYon#rate

OBS

TETR

ICS)CA

RE

Improve#outcomes#in#obstetrics#care#

Reduce#unsupported#variaYon#in#provider#pracYces

FHCQ#(COAP)HospitalsProvidersHCA/othersHealth#plans

Helping#document#and#disclose#data#to#determine#appropriateness#of#percutaneous#coronary#intervenYons#(PCI)#in#nonMacute#cases.#

PCI

Improve#data#documentaYon#to#determine#appropriate#PCI#care

BREE

To#be#determined;#workgroup#to#be#

convened

HCA

Health#plans

Purchasers

Providers

Convening#an#End#of#Life#(EOL)#

workgroup#focused#on#the#intensity#

of#services#at#the#end#of#life.#Report#

and#recommendaEons#expected#in#

June#2014.

END&OF&LIFE&/&

ADVA

NCE

D&PLA

NNING Reduce#cost#of#care

Promote#greater#

implementaEon#of#

advanced#planning#

for#paEents#so#that#

care#is#carried#out#in#

accordance#with#

paEent#wishes.

DESCRIPTION AUDIENCE PARTNERS OUTCOMES

BREE

&IMPL

EMEN

TATION

TEAM&(B

IT)

No#formal#partnerships

Workgroup#includes#FHCQ,&HCA,&PSHA,&WSHA,&Sport#ReacEon#Center,#Public#HealthPSeaQle#and#King#

County,#University#of#Washington,#

Governor's#Office,#Carpenters#Trusts#

of#Western#Washington,#Regence,#

Mercer,#Coordinated#Care,#and#

Point#B#

Health#plans

Purchasers

Providers

Designing#and#implemenEng#

strategies#to#achieve#the#

recommendaEons#developed#by#the#

CollaboraEve#topic#area#workgroups.#

ImplemenEng#the#evaluaEon#

framework#developed#by#

workgroups,#including#intended#

outcomes,#targets,#metrics#and#data#

collecEon#for#recommendaEons.

Design#strategies#

that#encourage#

stakeholders#to#

implement#the#

recommendaEons#

by#topic#area#

workgroups

To#be#determined;#workgroup#to#be#

convened

HCA

Health#plans

Providers

Purchasers

Convening#an#AddicEon/

Dependence#Treatment#workgroup#

focused#on#the#management#of#

chronic#pain/opioids#and#treatment#

opEons.

ADDICTION&/&DEP

ENDEN

CE&

TREA

TMEN

T

Define#evidenceP

based#standards#for#

treatment#and#

payment

Decrease#variability#

in#treatment

Increase#diagnosis