Every so often the Bree Collaborative is asked to talk about our work to other states or at national events. In May, Bree Collaborative member, Dr. Jeanne Rupert, presented on our Hysterectomy recommendations to the Michigan Surgical Quality Collaborative and in August, I presented to the National Academy for State Health Policy (NASHP) on our Palliative Care recommendations.

From Dr. Rupert, “Like the Bree Collaborative, The Michigan Surgical Quality Collaborative is interested in identifying and reducing variations in cost and quality of surgical care in their state.  In May, they held a daylong workshop and conference for stakeholders around the topic of hysterectomy care. They reached out to the Bree Collaborative for input, and invited us to send a speaker.  As Chair of our recent Hysterectomy Workgroup (2017), I was delighted to attend, share and learn.

The essential message from our Hysterectomy Workgroup that I conveyed was the importance of being patient-centered at all steps of the process.  We benefited from having a patient representative on our group, and strove to organize our final report around the patient’s experience at each stage of the hysterectomy pathway.  We have great examples in Washington state of health systems and providers who emphasize patient education and shared decision-making, and I was proud to discuss our approach with the Michigan attendees.

I gained some new understanding of our mutual work as well. One point that struck me, as I listened to the various discussions that day, was how setting statewide standards has the potential to profoundly reorganize health care.  We have touched upon this issue during Bree meetings as well. If a rural hospital hopes to provide local, personal and comprehensive care, but standards would be hard to meet with the volume they have, how do we balance those considerations?  I realized that day in Michigan that this will likely be a topic of debate and discussion for years to come.”

NASHP, with a grant from The John A. Hartford Foundation, held a daylong summit in Chicago this August to convene state policymakers with the collective goal of improving access to and quality of palliative care services in their states. The summit is now being followed by ongoing support. We were invited to attend and present on our work to develop statewide standards this last year.

I learned that access to palliative care is an issue across our country, echoing what we have heard from the clinical community throughout our workgroup’s convening. Like Dr. Rupert discusses above, considering access to palliative care services in rural areas is especially important. We learned how California is changing payment for palliative care through legislation, how Blue Shield of California is making this change a reality, how New York is using its Medicaid waiver to define and spread palliative care, among many other great examples.

Washington is not alone on this heath care transformation journey and we have much to learn and also much to share. The Bree Collaborative is proud to be seen as a leader nationally.

Jeanne Rupert, DO, PhD
Provider, One Medical
Member, Bree Collaborative

Ginny Weir, MPH
Director, Bree Collaborative