About Us

What is the Bree Collaborative?

In 2011, the Washington State Legislature established the Dr. Robert Bree Collaborative so that public and private health care stakeholders would have the opportunity to identify specific ways to improve health care quality, outcomes, and affordability in Washington State. These stakeholders are appointed by the Governor as Collaborative members and represent public health care purchasers for Washington State, private health care purchasers (employers and union trusts), health plans, physicians and other health care providers, hospitals, and quality improvement organizations.

Our partnership is named in honor of the late Dr. Robert Bree, a pioneer in medical imaging.

Why is the Bree Collaborative necessary?

Washington State, along with the rest of the country, is working to identify and promote strategies that improve patient health outcomes, health care service quality, and the affordability of health care.  Achieving these goals requires collaboration between the many different stakeholders in health care.  We fill this need by providing a setting in which collaboration can be successful.

How does the Bree Collaborative influence the health care system in Washington State?

Each year, our members identify up to three health care services with high variation in the way that care is delivered, that are frequently used but do not lead to better care or patient health, or that have patient safety issues. For most topics, we form an expert workgroup to develop evidence-based recommendations. Recommendations take into account existing quality improvement programs and the work done by other organizations and are then sent to the Washington State Health Care Authority to guide the type of health care provided to Medicaid enrollees, state employees, and other groups.

Which health care services has the Bree Collaborative addressed?

The Bree has worked on the following topics:

Addiction and Dependence Treatment
Bariatric Surgical Bundle and Warranty
Cardiovascular Health
Coronary Artery Disease Bypass Surgery Bundled Payment Model and Warranty

End-of-Life Care
Endorsing the Washington State Agency Medical Directors’ Group Guideline on Prescribing Opioids for Pain
Endorsing hospital membership in Spine SCOAP
Hospital Readmissions
Implementing the Washington State Agency Medical Directors’ Guideline on Prescribing Opioids for Pain
Lumbar Fusion Bundle and Warranty
Low Back Pain
Obstetric (Maternity) Care
Oncology Care
Prostate Cancer Screening
Pediatric Psychotropic Use

Spine Surgery: Lumbar Fusion Bundled Payment Model and Warranty
Total Knee and Total Hip Replacement Surgery Bundled Payment Model and Warranty

What is the Bree Collaborative currently working on?

We are working to develop implementation strategies for our previous recommendations and:


Read our final reports