Read our Recommendation Summary

People who have chronic pain often experience frustrating, disjointed care. This can be hard for clinicians too because of barriers in referring to other types of providers and lack of support within an organization. For the past year, our workgroup has looked at the different ways that chronic pain is treated in Washington State and developed a collaborative care model to support patients, providers, and our health care system. We are pleased to present our Report and Recommendations that were adopted at the January Bree Collaborative meeting.

Our research shows us that a collaborative or team-based approach to managing complex is associated with better patient outcomes when compared to traditional, siloed care. This helps address the gaps in care that patients experience. We developed recommendations for collaborative care specific to chronic pain with life activity impacts and decided on the term “life activity impacts” due to the need for an emphasis on patient-centered, individualized care focused on patient-identified goals for resuming affected life activities.  Other policy and white papers may use the term high-impact chronic pain.

Our recommendations are built on supporting patient self-management in the context of a biopsychosocial model and focus on primary care as the medical home for acute and chronic pain treatment and management through a systems-based approach. The recommendations focus on goals of improved function, increased quality of life, and greater patient autonomy rather than a primary focus on pain relief. We also include recognizing and limiting the transition from acute and subacute pain to chronic pain.

The workgroup defined areas within collaborative care unique to chronic pain with life activity impacts including minimum standards of care for:

  • – Patient identification and population management,
  • – A care team,
  • – A care management function,
  • – Basing treatments in evidence-informed care, and
  • – Patient-centered supported self-management.


Additionally, our workgroup acknowledges the need for substantial change from current practice, especially within primary care and therefore encourages the health care systems to take incremental steps toward evidence-informed, optimal, whole-person care. The workgroup recommends supporting this model of care through adequate reimbursement including value-based or alternative payment models.

Thank you to our workgroup members and the many community members who came together to make these recommendations the type of care experience I would want to have.

Read our Report and Recommendations!

Ginny Weir, MPH
Director, Bree Collaborative