Oct. 13, 2017
Trump Administration makes major, detrimental decisions about health insurance
The Trump administration made two major decisions yesterday that have the potential to fracture the health insurance market and jeopardize care for millions of patients.
 
The first decision, made by executive order, looks to expand the use of association and short-term health insurance plans. "Expanding association health plans and short-term health insurance without ACA protections will fracture the individual and small group markets," said Insurance Commissioner Marguerite Salazar in a statement. "The limited benefits, the focus on the healthy at the expense of those with pre-existing conditions, and lack of regulatory oversight will cause problems for the health insurance market as a whole."
 
Association plans do not have to follow most insurance regulations and face only limited oversight, especially concerning financial solvency, Salazar said. And cheaper, less comprehensive short-term plans may be able to exclude people with pre-existing conditions and focus on healthy individuals, creating an imbalance in the insurance market.  At this time it appears that the executive order will not impact open enrollment for 2018. Read the full DOI statement here.
 
The second decision, to end cost-sharing reduction (CSR) payments to insurers after December 2017, was announced late last night. CSR payments are used to reduce deductibles and co-payments for low-income enrollees in the marketplace plans created under the Affordable Care Act. The reductions currently cost insurers around $7 billion annually.  The Kaiser Family Foundation estimates that insurers would have to raise premiums for silver plans (for people who make who make between 100% and 250% of the poverty level) by approximately 19 percent to make up for the loss. 

The AMA issued a statement expressing their deep discouragement.  "Republicans and Democrats alike have expressed concern about the affordability of health care coverage under the ACA, and bipartisan efforts have been underway in Congress to provide the specific authorization and funding for CSR payments to address the legal issues involved," said AMA President David O. Barbe, MD. "This most recent action by the Administration creates still more uncertainty in the ACA marketplace just as the abbreviated open enrollment period is about to begin, further undermining the law and threatening access to meaningful health insurance coverage for millions of Americans."
CMS and AMA urge continued flexibility in QPP
Last week the Colorado Medical Society joined the American Medical Association and many other state and national physician organizations in urging Congress to enact legislation to ensure that the Centers for Medicare and Medicaid Services has the flexibility to continue a transitional approach to the implementation of the Quality Payment Program (QPP). 

The organizations praise several helpful provisions to ensure success for physicians. However, two provisions expire after the second year of the MIPS program and they asked Congress to extend these statues for an additional three years. 

This letter was sent to the Committee on Energy and Commerce and the chairs and ranking members of the House Ways and Means and Senate Finance committees. Click here to read the letter.
Free two-part webinar: "The Feds Are Coming! Reducing Physician Risk When Prescribing Pain Medication" - Oct. 17 and Nov. 1, 11 a.m. - 12:15 p.m. MT
Concerns with the opioid crisis are at a fever pitch - understandable given that opioid overdose led to the deaths of 33,000 people in the United States in 2015, almost half of which involved prescription opioids.
 
Governmental and health-related agencies are devoting significant energy and resources to reduce the quantity of controlled substances being prescribed. Concurrently, the DEA and Department of Justice have made enforcement relating to opioid prescribing a top priority by focusing on clinics, pharmacies and prescribing physicians.
 
Practicing physicians need useful guidance in caring for patients for whom the use of prescription pain control is absolutely essential. A free two-part webinar series - The Feds Are Coming! Reducing Physician Risk When Prescribing Pain Medication - will provide practical guidance from health care lawyers at Polsinelli and the physician education experts at the Center for Personalized Education for Physicians (CPEP). The webinars will be held on Oct. 17 and Nov. 1, 11 a.m. - 12:15 p.m. Click here for more information and to register.
Nov. 16 ADEMS/CMS opioid event: Almost everything you know about the opioid epidemic isn't enough
The Arapahoe-Douglas-Elbert Medical Society and Colorado Medical Society invite you to attend "The Opioid Crisis in Colorado & U.S.: Almost everything you know about the opioid epidemic isn't enough" with speaker Robert J. Valuck, PhD, RPh, FNAP. Join us for an open conversation with this leading expert on root causes and a long-term fix.

Thursday, Nov. 16, 2017
6:00 p.m. - Reception; 6:30 p.m. - Dinner / Program
Glenmoor Country Club
110 Glenmoor Dr., Cherry Hills

Why attend?
Physicians are in a direct spotlight when it comes to the opioid epidemic, which has been categorized as one of the greatest challenges facing health care today. While we are not the sole reason for the epidemic's alarming reach that crosses all demographics, physicians have a role in reducing opioid misuse and abuse in our patients.

Dr. Valuck's presentation during the CMS Annual Meeting received glowing feedback:
  • "This was the most amazing, thorough and well organized talk on the opioid epidemic I have ever
    heard. Dr. Rob is outstanding. We should package his talk into several smaller talks to take them
    on the road to our members."
  • Awesome!! Very thorough.
  • This presentation should be available for any CMS member. It really alerted me to the depth of
    problem and since then I have had multiple conversations with many colleagues.

Don't miss your opportunity to see this outstanding presentation. Register now!

Medicaid Alternative Payment Model announcement
Payment for primary care is changing. The Department of Health Care Policy and Financing is implementing an Alternative Payment Model for Primary Care (APM). New resources are available on the department's website.  
 
APM Resources -  The APM Survival Guide is now available on the Department's website   here . The guide provides a good overview of the information providers need to know to begin getting ready for the APM. Here is a link    to detailed resources (measures, code set, timeline, and model) on the department's website. 
 
Implementation Workgroup -  As the department moves forward with the APM, a workgroup is forming to assist with the implementation of the APM.  Similar to the process used to design the APM, the department is looking for representation from primary care physicians, primary care practice coordinators, office managers, and Regional Care Collaborative Organization representatives. The group would provide feedback and input on how best to implement the APM and help the Department understand the impact of operational decisions.   
 
The time commitment would be one 60-90 minute meeting every other month. A kick-off meeting will be held on Nov. 20, 12-1 p.m., and meetings will be scheduled every other month thereafter. There will be a call-in option for those unable to attend in person. 
 
If you are interested in participating in the Implementation Workgroup please send an email to  HCPF_PrimaryCarePaymentReform@state.co.us .
Colorado hits recruitment target for TCPi
The Colorado Transforming Clinical Practice initiative (TCPi), a four-year program run out of the governor's office that is funded by the Centers for Medicare and Medicaid Services, has announced that they have reached their recruitment goal of nearly 2,000 providers. These providers are working on practice transformation activities that enhance the delivery of patient-centered care and help them succeed with alternative payment models. The Colorado Medical Society applauds TCPi in their work to support physician practices. Click here to learn more about TCPi.
AmeriCorps recruitment continues
The Colorado AmeriCorps Community Opioid Response Program (CORP) is still recruiting! CORP is a statewide initiative utilizing 12 AmeriCorps members assigned to six regional Area Health Education Centers (AHECs) who will provide support to local communities that are implementing strategies to reduce the impact of opioid abuse throughout Colorado. This program is a partnership between the Consortium, Rise Above Colorado, Central AHEC, and the AG's Substance Trend and Response Task Force.

Full time positions are still available in Burlington, Holyoke, Colorado Springs, Lamar, Durango, Steamboat Springs, and Grand Junction. Apply at www.ccahec.org/americorpsapp17
Two AMA webinars: MIPS and quality improvement: Oct. 18 and Nov. 29
With many feeling overwhelmed by the complexity of the Quality Payment Program (QPP), physicians struggle to answer one key question - Where do I start? To help assuage this issue, the AMA will hold a webinar on Wednesday, Oct. 18, 11 a.m. - 12 p.m. MT to go through a new customizable resource - the MIPS Action Plan - that breaks down the complexity of the Merit-based Incentive Payment System (MIPS) track of QPP into specific actionable steps. In this one-hour webinar, Thriving Under MIPS - Where to start? Breaking down the complexity of MIPS, attendees will learn how to use this tool to create and/or validate their strategies for MIPS implementation in 2017. Chris Botts, AMA care delivery and payment manager, will be the presenter. Click here to register.
 
Without an understanding of what is really driving poor quality or performance, it is difficult to improve. Root-cause analysis is a critical tool in the quality improvement toolbox that allows professionals to understand what's at the heart of the problem, and then develop improvement ideas that can make a difference. How can you improve if you do not understand the challenge and the contributing factors?
 
In this 1-hour webinar, Root-cause analysis: Digging deep to improve, on Wednesday, Nov. 29, 11 a.m. - 12 p.m. MT, PCPI Director of Quality Improvement Stephen L. Davidow, MBA-HCM, CPHQ, APR, will cover three common forms of root-cause analysis, discuss the advantages of applying these methods to different circumstances and environments, and how root-cause analysis is used as the basis for creating and implementing ideas that lead to robust improvement. Click here to register.
Join CIVHC to learn new insights about how and why health care costs and quality vary across Colorado and the nation
When: Wednesday, Oct. 18, 9 - 11 a.m. MDT
Where: COPIC Mile High Room, 7351 E. Lowry Blvd, Denver, CO 80230 or via Webinar

Join CIVHC and their national partners on Oct. 18 as they reveal initial results of a project aimed at understanding and measuring delivery systems best suited to improve outcomes and lower costs. Preliminary results from Colorado will be shared and they will be looking for input from those in the community to help them shape the remainder of the project and inform some of the initial results.

Click here  to RSVP to join in person.  Click here  for webinar registration.  
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