In 2016, over half of the payments to Colorado doctors and hospitals by commercial health insurance payers contained incentives to improve the quality of care that patients receive, according to the Center for Improving Value in Health Care (CIVHC). Surpassing national trends, 54% percent of payments in Colorado's Medicaid market were also tied to value in that same year. These are among the findings of  The Colorado Scorecards on Payment Reform  released by  CIVHC and  Catalyst for Payment Reform  (CPR) .

The most common form of value-oriented payment in the commercial market was shared savings (26.5%), which typically creates, on top of traditional fee-for-service payment, an upside-only financial incentive for providers to reduce unnecessary health care spending for a defined population of patients, or for an episode of care, by offering providers a percentage of any realized net savings, if first they meet certain quality standards. In the Medicaid market, pay-for-performance, which is typically traditional fee-for-service payment with a bonus for meeting quality or efficiency goals, along with payments for non-visit functions like care coordination, case management or health IT infrastructure, were the most common forms of value-oriented payment, each representing 16.4% of total payments.

Read the full news release for more findings.

• Pain, Suffering, and Addiction - Corey Waller, MD will discuss the neurobiology of addiction and the psychosocial aspects of pain.
• Making Changes and Changing Lives - Cristen Bates from OBH will highlight best practices and lessons learned from the previous STR grant year and opportunities to participate in the new SOR grant.
• Policy to Practice - Joshua Ewing, CHA associate vice president of legislative affairs, will discuss current and potential legislation relating to opioids that will affect hospitals.
• Changing Attitudes: Psychology, Medicine, and Addiction - Brent Van Dorsten, PhD, will discuss pain management in the hospital setting, including appropriate treatments for patients already on MAT or who suffer from chronic pain.

In the 2019 proposed rule on the Medicare Physician Fee Schedule (PFS), the Centers for Medicare and Medicaid Services (CMS) proposed revisions to the E/M documentation guidelines intended to reduce administrative burden on physicians. In addition, the federal CMS proposed coding and payment changes to new and established office visit services. The AMA led the development of a joint comment letter from 170 physician and other health professional organizations calling for the agency to finalize several proposed changes to E/M documentation guidelines for CY2019.

"The AMA is pleased to report that the federal CMS is implementing the documentation policies, which will significantly reduce administrative burden and allow all physicians to spend more time with their patients," the AMA stated.

The agency has also acknowledged the work of the AMA's CPT/RUC Workgroup on E/M and has postponed any coding and payment-related changes for E/M office visit services until CY2021. This delay in implementation will allow the CPT Editorial Panel to consider the workgroup's proposal in February 2019 prior to prompt consideration by the AMA/Specialty Society RVS Update Committee (RUC).

On page 584 of the rule, the federal CMS states:

"We recognize that many commenters, including the AMA, the RUC, and specialties that participate as members in those committees, have stated intentions of the AMA and the CPT Editorial Panel to revisit coding for E/M office/outpatient services in the immediate future. We note that the two-year delay in implementation will provide the opportunity for us to respond to the work done by the AMA and the CPT Editorial Panel, as well as other stakeholders. We will consider any changes that are made to CPT coding for E/M services, and recommendations regarding appropriate valuation of new or revised codes."

Click here for a summary of the rule from the AMA. The Colorado Medical Society continues to coordinate with the AMA.

With more than 38,000 Americans dying from firearm-related injuries each year and an estimated 85,000 people surviving non-fatal firearm injuries, the American Medical Association released a new online continuing medical education module to help prepare physicians to counsel their patients on firearm safety. The module is designed to assist physicians, particularly those who specialize in primary care and emergency medicine, in recognizing risk factors that increase the potential for firearm injury and death, identifying barriers to communicating with patients about firearm safety, and effectively communicating with patients to reduce the risk of firearm injury and death.