Bree Outcomes - Jason McGill

Expectations of Legislation
Bree Collaborative
Jason T. McGill, JD
Executive Policy Advisor, Health Care
Governor's Office
(360) 902-0448
[email protected]
• A public/private collaborative to improve
health care quality, cost-effectiveness, and
outcomes in Washington state.
• The collaborative shall identify health
care services for which there are
substantial variation in practice patterns
or high utilization trends in Washington
state, without producing better care
outcomes for patients...
Expected Outcome:
By July 2012 develop
at least one impactful
state-wide solution to a
significant health care
problem in our state.
How to select a topic?
• Focus on health care service delivery
issues with safety, efficacy or costeffectiveness concerns.
• Focus on substantial variation in
practice patterns or high utilization
What to do once topic is selected?
• (2) For each health care service identified,
the collaborative shall
▫ (a) Analyze and identify evidence-based
best practice approaches …
▫ (b) Identify data collection and reporting
necessary to develop baseline health
service utilization rates and to measure
the impact of strategies adopted …
What to develop and propose as a solution?
• (c) … Strategies considered should include, but are
not limited to:
▫ Identifying goals for appropriate utilization and
▫ peer-to-peer consultation or second opinions
▫ provider feedback reports
▫ use of patient decision aids
▫ incentives for appropriate use of health care services
▫ centers of excellence or other qualification standards
▫ quality improvement systems
▫ service utilization and outcomes reporting
▫ research to improve care quality and outcomes
Other items to consider
• Consider other efforts (statute: In developing strategies,
the collaborative should strongly consider related efforts of
organizations ...)
• Provide an opportunity for public comment
(statute: The collaborative shall provide an opportunity for public
comment on the strategies chosen before finalizing their
• Engage a clinical committee (statute: The collaborative
shall add members to its membership or establish clinical committees
for each therapy under review by the collaborative for the purpose of
acquiring clinical expertise needed … Each clinical committee shall
include at least two members of the specialty or subspecialty society
most experienced with the health service identified for review.)
Recap: Expected Outcome –
By July 2012 develop
at least one impactful
state-wide solution to a
significant health care
problem in our state.
Next Step: Select a topic
Summary of criteria to consider in selecting topic
• Substantial variation in practice patterns
• High utilization and/or cost growth trends
• A source of waste and inefficiency in care delivery
• Patient safety issues
• 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 avoidable?
▫ Are there proven means/strategies to address this
topic (leverage other opportunities)?

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