Potentially Avoidable Readmissions Workgroup Update

1. Potentially Avoidable Readmissions Workgroup Update Bree Collaborative Meeting August 2, 2012

2. Outline of Presentation • Present initial ideas and approach for potentially avoidable readmissions (PAR) workgroup (summary of 7/31/12 workgroup meeting) • Get feedback from Bree Collaborative members • Approve revised PAR charter

3. Readmissions at 5/31 Bree Meeting: RECAP • Renamed workgroup: “Potentially Avoidable Readmissions” (PAR) workgroup • Approved PAR charter: • Endorsement for current PAR efforts underway in WA state • Measurement, Transparency, Reporting • Exploration of accountable payment structures

4. Readmissions at 5/31 Bree Meeting: RECAP • Recommended Bree chair reconfigure workgroup membership • Did not approve readmissions payment reform subgroup charter • Agreed workgroup should meet first, and the workgroup can create different subgroups (e.g., payment reform) and add experts as necessary to complete work

5. Potentially Avoidable Readmissions (PAR) Workgroup • Bree Chair reconfigured workgroup, with input from WSMA , WSHA, steering committee, and others • Workgroup members • Jodi Joyce, Legacy Health (Chair) • Susie Dade, Puget Sound Health Alliance • Joe Gifford, Regence • Mary Gregg, Swedish • Tony Haftel, Franciscan • Bob Mecklenberg, VMMC • Kerry Schaefer, King County • Peter Valenzuela, PeaceHealth

6. PAR Workgroup met 7/31 • Reviewed and edited charter • Discussed 3 PAR strategies: • How to support and align Bree’s work with existing local PAR initiatives • Measurement, Transparency, and Reporting • Accountable Payment Model • Have not yet defined scope

7. Strategy #1: Support and align Bree’s work with existing local readmissions initiatives • Acknowledgement that many local PAR initiatives exist currently(WSHA, WSMA, Puget Sound Health Alliance) – no need to re-invent the wheel • Workgroup needs a better understanding of existing initiatives • Staff will work with partners and catalogue initiatives

8. Strategy #2: Measurement, Transparency, and Reporting • Transparency of methodologies key • Global metrics first with eye to specific populations later: build a strategy that accommodates both • Leverage technical knowledge of provider groups on this topic • Initial tactic: Ask WSHA to make their readmission data semi-public • Longer-term tactic: Work with the Puget Sound Health Alliance to measure, publish, and report additional PAR measures over time

9. Strategy #3: Accountable Payment Models • Create small group to sketch out “common playbook” – components and structures essential to successful PAR accountable payment model that aligns incentives; will need to address both • Episodic (e.g., knee or hip replacement) and • Chronic (e.g., heart failure) conditions • Not a mandate nor a prescriptive new payment structure • A number of workgroup members expressed interested in working on this issue

10. Next Steps • Schedule next workgroup meetings (~1 per month) • Create and convene accountable payment model subgroup

11. What is Needed from Bree Members • General feedback on the workgroup’s ideas • Subject matter experts to help PAR workgroup scope out work • Skill sets ideas needed for the accountable payment structure subgroup