Expectations of Legislation Bree Collaborative

Jason T. McGill, JDExecutive Policy Advisor, Health CareGovernor's Office

(360) 902-0448Jason.McGill@gov.wa.gov

Purpose•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 cost-effectiveness concerns.

•Focus on substantial variation in practice patterns or high utilization trends.

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 variation; ▫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 recommendations.)

•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 topicSummary 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)?