Foundation Program Sites

Reproductive Health

Please see information on the Perinatal Behavioral Health Report under the “Behavioral Health” section.

Hysterectomy

Guideline title: Hysterectomy Report and Guidelines

Publication Status: Active

Date of publication: 2018

Date of last evidence search: 2018

Scope: Assessment and medical management; uterine sparing procedures; surgical procedure;  follow-up care; enhanced recovery after surgery protocol; use of a minimally invasive approach.

Methods: Current guidelines and literature review and expert consensus

Description: The workgroup’s goal is to promote appropriate use of hysterectomy, including pre-surgical counseling and evaluation, while recognizing individual variation based on clinical opinion and patient preference. Workgroup members developed the guidelines to encourage clinicians to review guidelines with patients prior to hysterectomy to reduce unnecessary or inappropriate hysterectomies.

Supporting Material:

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

To support health system improvement the Bree Collaborative has created score cards that are designed to help measure progress on the implementation of our guidelines. These were developed in collaboration with subject matter experts and are aligned across audience types (such as state agencies, health plans, providers, community organizations, employers, etc.)

To use our score cards, find the audience type, or types, that is closest to your organization or area of improvement work and download the document. There may be more than one “audience” type that is relevant. For example, large health systems may want to track progress at both the organizational level and the individual practitioner level.

Score cards are also aligned with the Bree Collaboratives’ self-report data collection efforts. Organizations are not required to report, however anyone can submit data to help track system wide progress, measure their progress against others, and to be eligible for implementation awards.

Health Systems

Coming Soon

Health Plans

Health Care Purchasers

Washington State Health Care Authority

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

Obstetrics Care

Guideline title: Obstetrics Care Report and Guideline

Publication Status: Needs minor revisions – to be scheduled

Date of publication: August 2012

Date of last evidence search: 2012

Scope: Elective deliveries, Elective inductions of labor, Primary c-sections

Methods: Current guidelines and literature review and expert consensus

Description: This report aims to to accelerate quality improvement in three areas of OB, which, in turn, will improve the safety, quality, and affordability of patient care for mothers and infants, and decrease costs for the entire community.

Supporting Material:

To support health system improvement the Bree Collaborative has created score cards that are designed to help measure progress on the implementation of our guidelines. These were developed in collaboration with subject matter experts and are aligned across audience types (such as state agencies, health plans, providers, community organizations, employers, etc.)

To use our score cards, find the audience type, or types, that is closest to your organization or area of improvement work and download the document. There may be more than one “audience” type that is relevant. For example, large health systems may want to track progress at both the organizational level and the individual practitioner level.

Score cards are also aligned with the Bree Collaboratives’ self-report data collection efforts. Organizations are not required to report, however anyone can submit data to help track system wide progress, measure their progress against others, and to be eligible for implementation awards.

Score cards for the Obstetrics Care report will be developed during the upcoming guidelines revision process.

Delivery Sites and Health Systems

Health Plans

Washington State Health Care Authority

Health Care Purchasers

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

Guideline title: Perinatal Bundled Payment Model Report and Guidelines

Publication Status: Needs minor revisions – to be secheduled

Date of publication: First published 2019, Revision in 2021

Date of last evidence search: 2021

Scope: This report presents a payment model that includes prenatal care, labor and delivery, postpartum care, and pediatric care along with clinical components for internal quality tracking and performance metrics.

Methods: Current guidelines and literature review and expert consensus

Description: The work group developed a clinical pathway supported by an episode-based payment building on existing perinatal work within Washington State prioritizing health equity, high-quality, and evidence based perinatal and pediatric care.

To support health system improvement the Bree Collaborative has created score cards that are designed to help measure progress on the implementation of our guidelines. These were developed in collaboration with subject matter experts and are aligned across audience types (such as state agencies, health plans, providers, community organizations, employers, etc.)

To use our score cards, find the audience type, or types, that is closest to your organization or area of improvement work and download the document. There may be more than one “audience” type that is relevant. For example, large health systems may want to track progress at both the organizational level and the individual practitioner level.

Score cards are also aligned with the Bree Collaboratives’ self-report data collection efforts. Organizations are not required to report, however anyone can submit data to help track system wide progress, measure their progress against others, and to be eligible for implementation awards.

Score cards for the Perinatal Payment Bundle and guidelines will be developed during the upcoming guidelines revision process.

Delivery Sites and Health Systems

Health Plans

Washington State Health Care Authority

Health Care Purchasers

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

Previous Meeting Materials

Date Materials
October 28 Minutes September 28
September 28 Agenda September 28
Minutes August 24
Primary Care HCA Multipayor Model
August 24 Agenda August 24
Minutes June 1
June 1 Agenda June 1
Minutes January 5
January 5 January 5
Minutes October 27
Public Comments
Draft Perinatal
October 27 Agenda October 27
Minutes September 22
Draft Maternity Bundle w/ Peds
September 22 Agenda 09/22/20
Minutes 08/25/20
Draft Maternity Bundle w/ Peds
August 25 Agenda 08/25/20
Minutes 07/28/20
Draft Maternity Bundle w/ Peds
July 28 Agenda 07/28/20
Maternity Bundle Final
Newborn Care Bree Proposal
Perinatal Bundle Review
January 7 Agenda 01/07/20
Minutes 10/10/19
Draft Maternity Bundle
Minutes 01/07/20
October 10 Agenda October 10
Minutes September 12
Draft Maternity Bundle
ACOG Postpartum Care Plan
September 12  Agenda September 12
Minutes August 8
Draft Maternity Bundle
August 8 Agenda August 8
Minutes July 11
Draft Maternity Bundle
July 11 Agenda July 11
Minutes July 9
Draft Maternity Bundle
June 6 Agenda June 6
Minutes May 9
Draft Maternity Bundle
May 9 Agenda May 9
Minutes April 11
Draft Maternity Bundle
Literature Review
ACOG Optimizing Post Partum Care
April 11 Agenda April 11
Draft Minutes March 14
March 14 Agenda March 14
Draft Minutes February 14
HCP LAN Establishing Maternity Episode Payment Models
February 14 Agenda February 14
Minutes January 8
HCP LAN White Paper Maternity Bundle
January 8 Agenda January 8
Presentation Slides
Maternity Bundle Charter and Roster
Bree Process Infographic
HCP-LAN Maternity Clinical Episode Payment Model
AJMC Bundled Payments for Maternity Care
Conflict of Interest Form
OPMA Training Roster

Reproductive and Sexual Health

Guideline title: Reproductive and Sexual Health Report and Guidelines

Publication Status: Active

Date of publication: 2020

Date of last evidence search: 2020

Scope: Cultural humility; access; person-centered care; appropriate care

Methods: Current guidelines and literature review and expert consensus

Description: These guidelines aim to improve quality, equity, and cultural appropriateness of reproductive and sexual healthcare services across the lifespan in Washington State. The workgroup has expanded on the populations identified in Senate Bill 5602 (2019) to focus on improvement of clinical services for those who are Black, indigenous, people of color, immigrants or refugees, have experienced violence including human trafficking, people with disabilities, and Lesbian, Gay, Bisexual, Transgender, and/or Questioning or Queer (LGBTQ+).

In 2023 the Bree Collaborative introduced a new process of metrics and measures identification that has been embedded into the guideline development process. A framework for evaluation has been created and recommended metrics have been identified by audience (below).

Delivery Sites and Health Systems

Health System Evaluation Score Card

Health Plans

Washington State Health Care Authority

Health Care Purchasers

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)