March 10, 2017
Your board of directors met today and covered the following topics for your review and insights. I welcome your comments.
1. Colorado’s Opioid Crisis: Lt. Gov. Donna Lynne asked CMS to conduct a short-notice, hurry-up exercise to identify and recommend additional solutions to accelerate current efforts to combat Colorado’s opioid crisis. The lieutenant governor’s request resulted from her tour of 54 rural counties where opioid misuse and abuse were routinely identified as a crisis issue. Fortunately, our Committee on Prescription Drug Abuse convened almost immediately in response to her request. A wide range of specialty societies participated in the meeting, as did the AMA; the state’s CMO, Larry Wolk, MD; the chair of the Colorado Consortium for Prescription Drug Abuse Prevention; and Gov. Hickenlooper’s top health care policy adviser. In response, the board of directors approved the following recommendations:
- Support the concept of Schedule II Controlled Substance partial prescription fills.
- Ensure insurance industry compliance with the Substance Use Disorders Essential Health Benefits (EHB) Provision of the Affordable Care Act.
- Advocate in the 2017 General Assembly and, in coordination with the Executive Branch, to help identify and appropriate the necessary funds to upgrade the Prescription Drug Monitoring Program (PDMP) into a highly functional clinical tool.
- Achieve the following opioid prescribing continuing medical education goals in 2017: Partner with the Colorado Consortium for Prescription Drug Abuse Prevention, COPIC, CU School of Public Health, CPMG, CPEP, Pinnacol Assurance, specialty societies and others to accelerate responsible opioid prescribing CME courses to Colorado physicians. And dedicate the September-October issue of Colorado Medicine to Colorado’s opioid misuse and abuse crisis and provide practical “to do’s” for readers.
Click here to read the recommendations in full.
2. Federal Health Care Reform: There are three important takeaways from our meeting to share with you.
a. CMS elected leaders were on Capitol Hill in Washington last week and met personally with both of Colorado’s U.S. senators and all but two House members. We made the following points in these meetings:
- Only repeal the Affordable Care Act and related federal health policies with a clearly identified and carefully considered replacement plan. Colorado physicians would like to give their perspective on any plan before it passes.
- Colorado’s uninsured rate has dropped from 15.8 percent in 2011 to 6.7 percent in 2015, a record low. Protecting those gains in coverage, as well as the corresponding benefits of improved access for consumers and sustainability for health care providers, is a priority.
- Colorado physicians would like nothing more than for a new coverage scheme to lower Colorado’s uninsured rate even further.
- Protection of patients who have benefitted from the Medicaid expansion is vital.
- There is deep dysfunction in the current multi-payer system that can be addressed by reducing administrative burdens, providing clarity about what consumers are actually getting for their health care dollar, and leveling the playing field between mega-health plans and physicians.
Click here to read a congressional briefing document that helped prepare us for the congressional meetings.
The American Health Care Act: House Republican leadership, with the strong backing of President Trump, unveiled their plan to repeal and replace the 2010 Affordable Care on March 6. CMS policy experts are currently preparing an analysis of the bill and we will continue to stay in close contact with the Colorado Congressional Delegation. Largely due to the decline in health insurance coverage the bill would likely cause, the AMA announced that it is unable to support the bill as drafted. I released a statement on March 8 to the Denver Post explaining that while we are critically analyzing the bill at this time, its ultimate elimination of the Medicaid expansion does not provide a clear pathway for these Coloradans to maintain coverage, and causes us great concern.
c. The board of directors approved new CMS policy supporting adequate Medicaid funding provided by the state and federal government. CMS supports the Medicaid expansion under the terms of the Affordable Care Act. CMS President Katie Lozano, MD, will appoint an advisory group of physician members to compare proposed federal Medicaid proposals, such as block grants or per capita caps, against current state of Colorado Medicaid for the purpose of advising the board of directors and the Colorado Congressional delegation.
With best regards,
Central Line Policy Proposals: Members continued to use our nationally unique grassroots policy engagement tool by submitting three policy proposals since the January meeting – reimbursement for prior authorization, Medicaid block grants and pharmaceutical pricing. Once again, the response was tremendous. If you were one of the 366 unique voters who cast some of the 800 total votes on these policy proposals, thank you. The board carefully considered that input when it took action on these proposals during the meeting. In keeping with the purpose of Central Line to enable you to help set Colorado Medical Society policy, you will soon get an email notification from your board member via Central Line about these actions. About 30 seconds (and no login required) is all it will take for you to tell us if the board “got it right” on these proposals. Please vote, and if you have not yet designated your Central Line “Interest Area(s),” then click here to sign up and join the conversation on issues important to you.
Credential Verification Member Benefit: CMS will soon be announcing an innovative credentialing and enrollment platform designed to consolidate credential verification functions into a centralized process to reduce administrative cost and burden for our members. This service will be provided through a member benefit agreement with 3WON, a health information technology company specializing in credentialing and enrollment management services for hospitals and health systems, medical groups, independent physicians and health insurance plans. 3WON was founded by health care executives with considerable experience in the managed care industry who were responsible for credentialing hundreds of thousands of medical professionals associated with PPO and HMO networks.
3WON will collect data from participating CMS members, maintain their data real-time, and distribute that data to any authorized entity on behalf of the physician or practice as required for appointment or enrollment processes. Physicians who participate will deal with only one entity, in this case 3WON, as opposed to many, thereby reducing the cost and administrative burden of credentialing.
Click here to learn more about 3WON.
5. Governance: Fulfilling its fiduciary duty to maintain and grow a sustainable and prosperous organization, the board of directors:
- Appointed director Brandi Ring, MD, as the Medical Student Component Advisor;
- Adopted a strategic planning timeline;
- Approved the January minutes and financial report; and,
- Approved nominations for elections of AMA delegates and CMS President-elect.
Thank you very much for taking time to read this report and for providing me your comments.
Katie Lozano, MD, FACR, President
Colorado Medical Society