The means of developing and deploying the positions and policies of our Colorado Medical Society are now in a direct line to you and your colleagues. In this regard, I want to report on the actions of the first of six board of directors meetings I will chair, and ask for your comments and insights. Our main purpose at the meeting today was to prioritize and set the course of our actions for the next 12 months. Accordingly, the adopted priorities are outlined below.
Throughout the year, we will keep you informed as to the status of our efforts, and we will continue to earnestly solicit your perspective. This will include, as circumstances may dictate, asking for your engagement with key public officials. In terms of health care policy, the election outcomes have left us with a target-rich environment, where at times we may indeed be the target.
Notwithstanding our methodical planning and clearly stated goals and objectives, there is, at the risk of understatement, considerable uncertainty as to direction of federal health care policy. The 115th Congress convenes in January and it will likely take actions that could profoundly alter health care finance, coverage and delivery in our state. As those intentions become more clear, your board of directors will be assessing and informing you of our options, at the statehouse, with our congressional delegation in Washington and at the practice level. I urge you to participate in all of our surveys and other outreach in the coming months.
Meanwhile, for your review and comment, our ambitious 2017 scope of work on your behalf was approved at the meeting. The board and I wanted you to get the top lines right away.
Professional Liability and Professional Review: We will fight to maintain and promote Colorado’s proactive patient safety environment and stable liability climate.
Payer Imperatives: We authorized the filing of state legislation to:
- Protect consumers from surprise out-of-network (OON) charges not covered when care is provided at an in-network facility.
- Create appeal rights for providers when they are being de-selected without cause from insurance products.
- Address other network adequacy and access reforms consistent with CMS policies.
We also voted to spend resources on other important payer initiatives, such as:
- Regulation of Payers: We authorized a study on the pros and cons of transitioning the role of the Colorado Commissioner of Insurance from an appointed to an elected, independent position within state government;
- MACRA: We approved a plan to ensure that members can successfully transition to the Medicare Quality Payment Program (QPP) by focusing educational resources on the specific QPP domains in order to provide a structured approach.
- Mega Insurance Mergers (Anthem-CIGNA; Aetna-Humana): We will continue vigorous support of the U.S. Department of Justice lawsuit to block the mega-mergers, and oppose Anthem’s acquisition of CIGNA before the Colorado Division of Insurance if the DOJ lawsuit is not successful.
- UnitedHealth Group’s proposed acquisition of Rocky Mountain Health Plans: In collaboration with Western Slope physician leaders, we will: (1) Examine the acquisition for its real-world impact on physicians; (2) Seek opportunities to enhance the agreement; (3) Expand collaboration with the merged companies if approved by state regulators to ensure meaningful implementation of the agreement.
Prescription Drug Abuse: We will continue our work with the Colorado Consortium for Prescription Drug Abuse Prevention to ensure access to compassionate, evidence-based care for patients who suffer from acute and chronic pain while reducing the potential for medically inappropriate use and diversion of prescribed medications, and partner with stakeholders to reduce illegal drug abuse and addiction to drugs; and,
Member Engagement and Empowerment: We will continue transitioning CMS to a 21st century state medical society by growing member awareness and promoting features, participation and achievements.
In a 10-minute impromptu exercise, we asked directors to imagine what it would mean if burnout among our colleagues were reduced by 50 percent over the next 12 months. You can click here to review the board’s responses and reply to this email with your own answers. I’m going to combine all the responses into one list and get the final copy over to Gov. Hickenlooper, his cabinet, and the budget and health committee chairs before the 2017 General Assembly convenes in January. To start, they can help address a few of the stressors next year by passing our legislative package and properly funding Medicaid.
Click here to access the 2017 operational plan, here to access the Sept. 16, 2016 board minutes, and here to access new board Standards of Conduct.
As we move into the holiday season, please accept my very best wishes, and please contact me anytime on any issue of importance to you.
Katie Lozano, MD, FACR
Colorado Medical Society President