The Bree Collaborative: One Year Later Update & Future Planning Discussion

1. The Bree Collaborative: One Year Later Update & Future Planning Discussion Bree Collaborative Meeting October 1, 2012

2. Purpose of Presentation • Review “A Year in Review” • Review the current landscape • Start to discuss Bree Collaborative members’ expectations/outcomes for Year 2 (fall 2012-2013)

3. Outcome of Presentation • Gain a shared understanding of the path BreeCollaborative has traveled and basic agreement on the path ahead (next few months) • Spur Bree Collaborative members to start thinking about goals and expected outcomes for Year 2

4. First Bree Collaborative meeting held on 9/30/11…366 days ago Expected outcome/goal set by Governor Gregoire: By July 2012 develop at least one impactful state-wide solution to a significant health care problem in our state.

5. Accomplishments – many! • 24 clinical and quality experts agreed to come and work together to decrease variation and improve quality in WA State • Exceeded legislative mandate - Selected 4 topics • Achieved expected outcome/goal - Completion of OB report & COAP transparency agreement • Movement towards transparency of inappropriate PCI cardiac procedures • Work underway to improve Potentially Avoidable Readmissions • Agreement to start work on acute low back pain and readmission payment reform

6. The Evolution of the Bree Collaborative • Bree legislation provided a foundation - a “roadmap” • Bree voted on topics/priorities last September 2011 to position Bree to have many wins (see handout in packet) Along with its achievements the Bree Collaborative has grown, and is no longer a new organization… • Policies and procedures (bylaws) needed • Work and strategic plans needed so work matches resources and priorities …while acknowledging huge uncertainties with CMMI grant and change in Governor leadership

7. Bree Collaborative: Next 7 Months Red denotes high resource intensity; Orange denotes medium resource intensity; Yellow denotes low resource intensity (monitoring)

8. New Topic Selection/Development • Solicited Bree Collaborative members’ input on new topics via email 9/4/12 • Sent Bree member survey results from Sept 2011 • Low response rate • Some Bree members question taking on new topics now • Right now Recap • 4 active topics (including OB implementation activities) • 3 active or soon-to-be active subgroups • Resources (1 FTE) at maximum capacity Idea : Hold off new topic selection discussion until November 30th or January meeting

9. What’s next? What’s our vision for Bree? • What are Bree Collaborative members’ expectations? • Y2 Goal ideas for the Bree Collaborative? • Strawman goal: By July 2013 develop at least two impactful state-wide solutions to significant health care problems in our state. Continue this discussion and vote on goal/expected outcomes for YR 2 at November or January Bree meetings

10. Preparation for New Topic Selection & Strategic Planning Discussion in November or January • What type of information do Collaborative members need in advance? • Hire a facilitator? • Topic Selection Discussion • Use last year survey results as starting point? • Select or prioritize a mix of topics that address all or one QI strategies – transparency, public reporting, payment reform? • Leverage existing efforts – COAP? Choosing Wisely? • What guidance or criteria is needed beyond current topic selection criteria (next slide)? • Other Ideas for Strategic Planning Discussion?

11. Current Topic Selection Criteria (from Bree legislation) • Substantial variation in practice patterns • High utilization and/or cost growth trends in Washington State without better outcomes • A source of waste and inefficiency in care delivery • Patient Safety issues In addition, consider the following questions about the topic: • What data are available to support that there is waste, variation, high utilization, excess costs? • Are the waste and quality aspects of this topic avoidable? • Are there proven means/strategies to address this topic?