The Bree Collaborative is proud of our work in 2019 and thankful for our dedicated Bree Collaborative members and our many workgroup members who have donated countless hours to improve health care quality, outcomes, and affordability in Washington State.

This last year we developed recommendations for palliative care, shared decision making, those at risk of violence to others, maternity care, and on our recommendations for those who have been prescribed long-term opioid therapy. We believe that palliative care should be offered alongside curative treatment at any age or stage of serious illness to address unmet patient needs. We propose a common definition for palliative care, clinical standards, and a reimbursement mechanism. A common definition also serves to guide our work within shared decision making for which we propose ten priority clinical areas, a framework for adoption, and documentation, coding, and reimbursement guidance. Revising reimbursement structure is also a key component of our perinatal bundled payment model. We outline a bundle that includes prenatal care, labor and delivery, and postpartum care along with clinical components for internal quality tracking and performance metrics.

Bree was also asked to develop standards for clinicians to address patients who may be at a risk of violence to others. Our recommendations stress that while clinicians can assess and monitor an individual’s risk factors for violence and use clinical decision-making aimed to mitigate risk of violence, they cannot predict violent acts with certainty. We developed a clinical pathway moving from identification, assessment, and management of increased risk of violence to protection of third parties.

We have four workgroups on our docket for 2020 as well as completing our long-term opioid therapy recommendations. In January we will be holding meetings for reproductive health as outlined in Senate Bill 5602, chemotherapy and inpatient care, colorectal cancer, and for primary care. The full Bree Collaborative will continue to meet every other month.

See our Year in Review for more information!