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Reproductive Health

Hysterectomy

Read our Reports and Recommendations

(Adopted January 2018)

Hysterectomy is one of the most commonly performed procedures with rates that are highly variable based on location rather than patient population. The workgroup met from March 2017 to January 2018 to develop to promote appropriate use of hysterectomy, including pre-surgical counseling and evaluation, while recognizing individual variation based on clinical opinion and patient preference from assessment and medical management, uterine sparing procedures, and if indicated, surgical procedures including follow-up care emphasizing the enhanced recovery after surgery protocol and use of a minimally invasive approach.

Supporting Materials

Letter from the Health Care Authority Accepting Hysterectomy Recommendations
Hysterectomy Charter and Roster

Workgroup Members

Name Title Organization
Pat Kulpa, MD, MBA Medical Director Regence BlueShield
Sharon Kwan, MD, MS Interventional Radiologist University of Washington Medical Center
John Lenihan, MD Medical Director of Robotics and Minimally Invasive Surgery MultiCare Health System
Jennie Mao, MD Clinical Assistant Professor, Department of Obstetrics and Gynecology University of Washington Medical Center
Rachelle McCarty, MPH Patient Advocate
Sarah Prager, MD Chair Washington State Section of ACOG
Kevin Pieper, MD Chief, Women’s and Children’s Providence Regional Medical Center Everett
Kristin Riley, MD, FACOG Assistant Professor, Department of Obstetrics and Gynecology University of Washington Medical Center
Jeanne Rupert, DO, PhD (Chair)  Family Physician One Medical
Anita Showalter, DO, FACOOG Associate Professor and Chair, Women’s Health Pacific Northwest University of Health Sciences
Susan Warwick, MD Obstetrics and Gynecology Kaiser Permanente

Obstetric (Maternity) Care

Award winners for Best Practices in Obstetrics Care:

Read our Report and Recommendations 

Cesarean sections (C-sections) show wide variation and overuse nationally and also in Washington State. This workgroup met from December 2011 to July 2012 and developed three primary goals:

  • Eliminate all elective deliveries before the 39th week of pregnancy (for which there is no appropriate documentation of medical necessity).
  • Decrease elective inductions of labor between 39 and up to 41 weeks.
  • Decrease unsupported variation among Washington hospitals in the C-section rate for women who have never had a C-section.

Supporting Materials

Letter from Health Care Authority Accepting Obstetrics Care Report

Workgroup Members

Member Title Organization
Theresa Helle Manager, Health Care Quality & Efficiency Initiatives The Boeing Company
Ellen Kauffman, MD OB-COAP Medical Director Foundation for Health Care Quality
Robert Mecklenburg, MD Medical Director, Center for Health Care Solutions Virginia Mason Medical Center
Carl Olden, MD (Chair) Family Physician Pacific Crest Family Medicine, Yakima
Mary Kay O’Neill, MD, MBA Executive Medical Director Regence Blue Shield
Dale Reisner, MD Obstetrician/Gynecologist Swedish Hospital Perinatologist
Terry Rogers, MD Chief Executive Officer Foundation for Health Care Quality
Roger Rowles, MD Obstetrician/Gynecologist Yakima Memorial OB-GYN

Perinatal Bundled Payment Model

Read our Report and Recommendations 

The United States has a high maternal mortality rate with high racial disparities. Bundled payment models, one payment for multiple clinical services such as for obstetrics and pediatric care, are being used to address preventable complications and increase coordination of care. Our workgroup met through 2019 and reconvened in 2020 and again in 2021 to develop clinical pathways for prenatal care, labor and delivery, postpartum care, and pediatric care supported by a bundled reimbursement model to improve the care delivery and therefore outcomes. Our fist version was finalized in 2020, pediatric care added in 2021, and the workgroup reconvened to define a pathway to extend maternity care to twelve months through 2021.

Workgroup Members

Member Title Organization
Carl Olden, MD (Chair) Family Physician  Pacific Crest Family Medicine
Andrew Castrodale, MD Family Physician Coulee Medical Center
Angela Chien, MD Obstetrics and Gynecology Evergreen Health
Neva Gerke, LM President Midwives Association of Washington
Molly Firth, MPH Patient Advocate
Lisa Humes-Schulz, MPA/
Lisa Pepperdine, MD		 Director of Strategic Initiatives/ Director of Clinical Services Planned Parenthood of the Great Northwest and Hawaiian Islands
Rita Hsu, MD, FACOG Obstetrics and Gynecology Confluence Health
Dale Reisner, MD Obstetrics and Gynecology Swedish Medical Center
Janine Reisinger, MPH Director, Maternal-Infant Health Initiatives Washington State Hospital Association
Mark Schemmel, MD Obstetrics and Gynecology Spokane Obstetrics and Gynecology, Providence Health and Services
Vivienne Souter, MD Research Director Obstetrics Clinical Outcomes Assessment Program
Judy Zerzan, MD Chief Medical Officer Washington State Health Care Authority

Reproductive and Sexual Health

Award winners for Best Practices in Reproductive and Sexual Health:

Read our Report and Recommendations 

Minority populations often experience higher rates of unintended pregnancy, sexually transmitted diseases, less frequent screening for common cancers such as cervical cancer, and often also less person-centered care. This workgroup met from January to November 2020 and developed evidence-informed guidelines for culturally sensitive mechanisms to improve the standard of reproductive and sexual health care especially for people of color, immigrants and refugees, victims and survivors of violence, and people with disabilities.

Read Our Charter

Workgroup Members

Name Title Organization
Charissa Fotinos, MD (Chair) Deputy Chief Medical Officer Washington State Health Care Authority
Trish Anderson, MBA Senior Director, Safety and Quality Washington State Hospital Association
Janet Cady, ARNP Medical Director, School Based Program Neighborcare
Angela Chien, MD Obstetrics and Gynecology Evergreen Health
Paul Dillon/Lili Navarrete Latinx Outreach & Organizing Program Planned Parenthood of Greater Washington and North Idaho
Colin D. Fields, MD Chief, Gender Health Program Kaiser Permanente Washington
Leo Gaeta Vice President of Programs
The Columbia Basin Health Association
Cynthia Harris, PhD Family Planning Program Manager Department of Health
Leigh Hofheimer Program Coordinator Washington State Coalition Against Domestic Violence
Rita Hsu, MD, FACOG Obstetrics and Gynecology Confluence Health
Heather Maisen, MPH, MSW Family Planning Program Manager Public Health – Seattle & King County
Adrianne Moore Deputy Director of Quality Improvement Upstream
Ivanova Smith Patient Advocate UW LEND Faculty
Mandy Weeks-Green Senior Health Policy Analyst Officer of the Insurance Commissioner
Catherine West, JD Staff Attorney Legal Voice (formerly Northwest Women’s Law Center)
Giselle Zapata-García Co-Director Latinos Promoting Good Health (also Latinx Health Board, Executive Committee Co-Chair)
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