1. Potentially Avoidable Readmissions Workgroup Update Bree Collaborative Meeting August 2, 2012

2. Outline of Presentation Present initial ideas and approach for potentially avoidable readmissions (PAR) workgroup (summary of 7/31/12 workgroup meeting) Get feedback from Bree Collaborative members Approve revised PAR charter

3. Readmissions at 5/31 Bree Meeting: RECAP Renamed workgroup: “Potentially Avoidable Readmissions” (PAR) workgroup Approved PAR charter: ▫Endorsement for current PAR efforts underway in WA state ▫Measurement, Transparency, Reporting ▫Exploration of accountable payment structures

4. Readmissions at 5/31 Bree Meeting: RECAP Recommended Bree chair reconfigure workgroup membership Did not approve readmissions payment reform subgroup charter Agreed workgroup should meet first, and the workgroup can create different subgroups (e.g., payment reform) and add experts as necessary to complete work

5. Potentially Avoidable Readmissions (PAR) Workgroup Bree Chair reconfigured workgroup, with input from WSMA, WSHA, steering committee, and others Workgroup members ▫Jodi Joyce, Legacy Health (Chair) ▫Susie Dade, Puget Sound Health Alliance ▫Joe Gifford, Regence ▫Mary Gregg, Swedish ▫Tony Haftel, Franciscan ▫Bob Mecklenberg, VMMC ▫Kerry Schaefer, King County ▫Peter Valenzuela, PeaceHealth

6. PAR Workgroup met 7/31 Reviewed and edited charter Discussed 3 PAR strategies: 1)How to support and align Bree’s work with existing local PAR initiatives 2)Measurement, Transparency, and Reporting 3)Accountable Payment Model Have not yet defined scope

7. Strategy #1: Support and align Bree’s work with existing local readmissions initiatives Acknowledgement that many local PAR initiatives exist currently (WSHA, WSMA, Puget Sound Health Alliance) – no need to re-invent the wheel Workgroup needs a better understanding of existing initiatives Staff will work with partners and catalogue initiatives

8. Strategy #2: Measurement, Transparency, and Reporting Transparency of methodologies key Global metrics first with eye to specific populations later: build a strategy that accommodates both Leverage technical knowledge of provider groups on this topic Initial tactic: Ask WSHA to make their readmission data semi-public Longer-term tactic: Work with the Puget Sound Health Alliance to measure, publish, and report additional PAR measures over time

9. Strategy #3: Accountable Payment Models Create small group to sketch out “common playbook” – components and structures essential to successful PAR accountable payment model that aligns incentives; will need to address both ▫Episodic (e.g., knee or hip replacement) and ▫Chronic (e.g., heart failure) conditions Not a mandate nor a prescriptive new payment structure A number of workgroup members expressed interested in working on this issue

10. Next Steps Schedule next workgroup meetings (~1 per month) Create and convene accountable payment model subgroup

11. What is Needed from Bree Members General feedback on the workgroup’s ideas Subject matter experts to help PAR workgroup scope out work Skill sets ideas needed for the accountable payment structure subgroup