Evolution of the Bree Collaborative’s Work in the

Potentially Avoidable Readmissions (PAR) Topic Area

September 2013

Past

May 31, 2012 ~Bree Collaborative approves PAR workgroup charter

July 31, 2012 ~ Newly convened PAR workgroup identifies three strategies to pursue:

  1. Alignment with local readmissions activities
  2. Measurement, transparency, and reporting
  3. Accountable payment model

November 6, 2012 ~ First meeting of the Accountable Payment Model (APM) subgroup

November 30, 2012 ~ PAR workgroup makes preliminary recommendations about endorsing the

WSHA toolkit and requesting more reporting from Qualis and WSHA; the Bree asks the PAR workgroup to further refine these recommendations

January 31, 2013 ~ Bree Collaborative approves twoPAR workgroup recommendations:

  1. The Collaborative should say that WSHA and its community partners are on the right track of developing a standardized toolkit and process that both hospitals and community providers can use to reduce the rate of readmissions
  2. Steve Hill should send a letter to Qualis and WSHA on behalf of the Bree requesting that they publish 30-day, all-cause readmission results, by hospital, in a semi-public manner, starting with the next Hospital Readmission Report

March 6, 2013 ~ WSHA declines request to publish additional readmission data because

currently available data is not risk-adjusted (new measure expected in July)

May 29, 2013 ~ PAR workgroup reports that it is in hiatus but plans to pursue two tracks:

  1. Wait for the WSHA toolkit to be finalized and pilot results are known and then work on operationalizing it and developing incentives to encourage standardized implementation of it across the state (probably in September)
  2. Payment reform, to be carried out by the APM subgroup

July 9, 2013 ~ Puget Sound Health Alliance hosts a meeting to review CHARS data about 30-

day, all-cause readmissions; group agrees to add sample sizes and confidence intervals to the charts before further distribution

Present

  • No PAR workgroup meetings since March 20th
  • Four members of PAR workgroup have left the Bree, including the chair
  • No data available from WSHA toolkit pilots (process data expected in October/November)
  • APM subgroup has completed draft products for total knee and total hip replacement (TKR/THR) surgery that incorporate components of the WSHA toolkit

(Proposed) Future

  • Formally dissolve the PAR workgroup
  • Share the CHARS data about 30-day, all-cause readmissions (with sample sizes and confidence intervals added)
  • Elevate the APM subgroup to workgroup level (i.e. change the topic area to “Accountable Payment Models”) and encourage it to continue its work beyond TKR/THR
  • Add readmissions to the list of topics that the Bree could consider taking up at a future date
  • Review a summary report about the PAR workgroup at the next Bree meeting (to be drafted by staff and reviewed by remaining PAR workgroup members)

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