Report from the CMS Board of Directors - May 17, 2019
Dear Colleague,

You board of directors just completed our bimonthly business meeting. We welcomed the new resident representative on the board, Evan Manning, MD, who won a contested race for this board seat. I hope you will review the meeting outcomes and reply to this email with your perspective. They will be thoughtfully considered, greatly appreciated and acknowledged.

2019 General Assembly outcomes
We celebrated the many legislative accomplishments, most particularly: (a) Maintaining the stability of your liability climate; (b) Successfully fighting off a session-long effort by attorneys that sue physicians to breach the privileged nature of professional review activities; (c) Reforms that will streamline the prior authorization process; and, (d) Important advances in reversing the public health crisis caused by opioid abuse and misuse. This celebration also honored the many physicians and medical students that responded to our calls to action.

CMS General Counsel and Senior Director of Governmental Affairs Susan Koontz, JD, made remarks that all members should understand. They included:

  • The 2018 election cycle produced what many believed to be one of the country's most activist, intense health policy environments in both the legislative and executive branches of state government.
  • We anticipate this environment will continue in the near-term, most particularly relating to cost containment;
  • While the 2019 session outcomes demonstrate that medicine can be successful in this environment, the following two points should be given priority attention:
  1. Can the House of Medicine develop meaningful policy solutions, particularly on cost, so as to be proactive and not reactive?
  2. Can CMS significantly increase physician involvement in legislative advocacy; and, perhaps more importantly in the 2020 election cycle?
  • Politics drive the process that drives policy
  • All politics is local
  • Personal relationships are the most important thing in the body of politics

Click here to review bill summaries and effective date
Cost of Care: Report from the Polis Administration:
Kim Bimestefer, a member of the Governor Polis’s cabinet and executive director of the Colorado Department of Health Care Policy and Financing, made a presentation to the board focusing on why health care is a priority for the Governor, what is being focused upon, and how CMS can plug in as a meaningful participant. She emphasized:
  • Reducing health care costs is a priority because current trend rates are unsustainable. Private health insurance premiums cost 32% of the median Colorado household income. The governor developed and is making progress on a specific plan to save Coloradans money on health care.
  • Hospitals and pharmaceutical drug prices and costs are the current, central focus for the administration. Recent legislation and current and planned initiatives to drive more transparency and accelerate transformations in hospital price and quality will continue. Medicaid spends $1 billion on drugs (before rebates) and certain specialty drugs represent 1.25% of Medicaid prescriptions but account for 40% of costs. Because those trends will increase the department is implementing a series of programs including reimporting drugs from Canada, creating a pharma tool for physicians to enable prescribing based on drug efficacy and quality, and releasing a comprehensive report later this summer that detail rebates, kickbacks and other pricing information. 
  • Partnering with the physician community to help develop and execute these initiatives will be critical. 
Click here to read Ms. Bimestefer’s bio sketch
Click here to review Ms. Bimestefer’s power point presentation
Uniquely Colorado physician wellbeing project approved
The board of directors approved a project recommended by the Committee on Physician Wellbeing that will include: (a) A day-long convening for physicians from different systems and practices who are responsible within their system or practice for assessing burnout and enhancing physician wellbeing and professional satisfaction; (b) Keeping the convening participants connected virtually for a 12-month period for the purpose of an ongoing learning and sharing collaborative; (c) Contracting with a qualified expert in the field of wellbeing to monitor and moderate the virtual platform; (d) Conduct a thorough evaluation at the end of the period detailing lessons learned, impacts, spread, value to CMS and other partners, and opportunities for the future; and (e) In addition to general CMS support, pursue funding from other sponsors and a grant from the Physician Foundation for this initiative.

To meet or not to meet? What do members want?
The board of directors suspended the 2019 Annual Meeting to ensure adequate funding to meet the extraordinary challenges facing physicians and patients in the 2019 legislature and to investigate the best approach to meaningful-in-person member engagement. Today’s discussion focused on the following new inputs from: (a) An all-member survey; (b) Recent experiences from other state medical societies; and, (c) Component medical societies. The polling data sparked a rich discussion about what members want, how to keep physicians engaged and energized, and the organization moving forward. A number of creative ideas were surfaced and a final decision will be made later in the fall. 

Click here to read the new information from other state medical societies and component medical societies.
Central Line policy proposal
The board carefully considered input from physician members like you from across the state when the board took action on the following two proposals: Youth Vaping and Recognition of Pain Medicine Specialists and the American Board of Pain Medicine. You will soon get an email notification from your board member via Central Line about action taken on this proposal. About 30 seconds (and no login required) is all it will take for you to respond and tell us if the board “got it right” on these proposals. If a majority of those voting disagree with the board’s decision, the issue will be reconsidered at the board’s July meeting.

Fiduciary duties of the board
Board governance best practices : In November 2018, CMS engaged Charney Associates to review its current board governance practices and, consistent with literature-based best practices, identify opportunities to enhance the Board’s capacity to optimize its governance strength and leadership for CMS. Tom Keyes, JD, a member of the Charney team, presented some highlights of the report and a lively discussion began which will continue over the summer and conclude in the fall with the implementation of specific recommendations. 
  • Consent calendar: Click here to read minutes from seven meetings and the report from Committee on Wellbeing in this impressive consent calendar.
  • Finance Committee report: The Finance Committee report detailing financial summaries and statements from January 2019 through February 2019 was also approved by the board. It is available upon request. 

With gratitude,
Debra J. Parsons, MD, FACP
President, Colorado Medical Society