1. Bree Collaborative Cardiology Report: Appropriateness of Percutaneous Cardiac Interventions (PCI) Bree Collaborative Meeting January 31, 2013

2. Purpose of Presentation To re-present Cardiology final report & answer any questions To present and discuss new section, “Implementation Recommendations” Proposed Motion – Adopt Cardiology final report 2

3. Purpose of Report - RECAP A written summary of Bree Collaborative/COAP appropriateness of PCI partnership (“product” of cardiology topic) COAP medical director and staff consulted and edits included in report Next Steps: Upon adoption by Bree, final report will be submitted to HCA administrator for adoption 3

4. Outline of Report – RECAP Executive Summary Bree Collaborative and its Charge Background on Appropriate Use of PCI & National Standards COAP & Appropriateness of PCI Variability of Appropriate Use of PCI in WA Causes of Variability of Appropriate Use of PCI for nonacute indications and insufficient data Bree Collaborative and COAP Bree Collaborative Recommendation – Increase Measurement and Reporting of Appropriate Use of PCI Status of Collaborative Recommendation New Section! Ways Hospitals, Payers, and Purchasers including the State of Washington Can Support Collaborative Recommendation Future efforts to Promote Measurement and Transparency of Cardiac Procedures and Interventions 4

5. Questions/Discussions Any questions on first 9 sections of report? 5

6. Ways Hospitals, Payers, and Purchasers including the State of Washington Can Support Bree Collaborative Recommendation (Page 9) Hospitals: Submit all necessary data requested by COAP for community-wide analyses; and Allow COAP to publish their appropriate use and insufficient information results. Payers and purchasers, including the State of Washington, through contracting, require individual hospitals to: Participate in COAP, a neutral, third-party quality improvement program; Submit complete data requested by COAP for community-wide analyses; Allow COAP to publish their appropriate use and insufficient information results; Demonstrate that they have taken sufficient steps to reduce the amount of insufficient data related to appropriateness of PCI; and Create an action plan if PCI appropriate use and insufficient or “not classified” data exceed benchmark rate. 6

7. Questions/Discussions Any questions on section? 7

8. Proposed Motion Proposed motion: Adopt Cardiology Report 8