We are introducing "The Sounding Block", a new form of keeping CMS delegates up-to-date throughout the year, not just at the Annual Meeting. Please let us hear from you on any of the items in this newsletter. Your comments are important to us - CMS Speaker Robert Yakely, MD and Vice-Speaker Brigitta Robinson, MD.

The CMS Board of Directors met Friday, Nov. 16. Here are the highlights.

• Click here to review a high-level summary of the 2012-2013 board's work plan.
• Click here to read a summary of legislation the board voted to endorse that will provide care coordination and resource coordination, as well as material resources presently not always available to families of children with birth-related cerebral palsy.
• Click here to read a breakout discussion document on employed physicians written by the board's work group on Membership, Unity, and Relevance. Other breakouts included further streamlining of the HOD (more on this in a future communication), and public policy and practice evolution.
• Katie Lozano, MD, was elected treasurer. We are grateful to Dr. Lozano for her outstanding work as Treasurer in 2012.

We are extremely pleased that the Colorado Medicaid Accountable Care Collaborative (ACC) program, incubated with the help of CMS, is producing positive results after one year of operation as detailed in a report released late October by the Colorado Department of Health Care Policy and Financing. The collaborative is a central component to the state's strategy to reform the Medicaid program through the use of local control, changes in payment policies and delivery systems to reward for value versus volume, and providing information technology support to drive informed decision-making.

The report notes that the ACC has achieved important performance improvement results by reducing inpatient hospital readmissions, preventable hospitalizations for patients with asthma and diabetes, emergency room utilization, and utilization of high cost imaging services. The report also shows an approximate $30 million program savings, surpassing the forecasted gross program savings of approximately $20 million for FY2011-2012. Find the complete report at: http://tinyurl.com/bh5m4qo.

The Colorado Supreme Court has agreed to review a Colorado Court of Appeals decision, granting a petition for certiorari (only one in 40 requests are granted), supported through an amicus brief jointly filed by the Colorado Medical Society, AMA, Colorado Chapter of the American College of Emergency Physicians, Colorado Society of Anesthesiologists, Colorado Radiological Society, and the Regents of the University of Colorado and financially supported by the AMA Litigation Center.

The Colorado Supreme Court will decide "whether the Court of Appeals erred in concluding that statements to a physician and other hearsay evidence...was inadmissible under the rules of evidence in a medical malpractice case in which the parties disputed the cause of the patient's complications following a medical procedure."

For example, if a third party, say a family member, tells a treating physician about the patient's prior use of illegal substances and the treating physician is subsequently sued, the information from the family member that the patient had abused illegal substances should be admissible in the physician's defense as to the cause of harm.

President Obama carried Colorado 51-46 percent. The democrats will maintain control of the Colorado Senate and have gained control of the state House. The translation our political professionals provided is:

• There will be greater political viability for a much broader range of health care issues in the 2013 and 2014 legislatures.
• This dynamic will be welcome on some issues and a major challenge on others.
• It will be more to difficult stop bills opposed by medicine in committees - resulting in more votes on the floor of the two chambers.
• There will be more issues for physicians to engage in and more opportunities for legislators to take a stand on medicine's issues.
• Increased vulnerability on liability and peer review.
• There will be greater opportunities on Medicaid, public health, transparency, and delivery system reforms.
• There will be a higher probability that we will ask our membership to make their voices heard on key issues during this legislative session and beyond.

Please be looking for communications from COMPAC on ways to get involved.

Based on HOD direction, the Council on Legislation and the Committee on Physician Practice Evolution are working to develop CMS policy on the Medicaid expansion to present to the board in January. The two groups had a robust discussion in October and again in November in joint meetings around program improvements that CMS should consider promoting as state officials debate whether or not to opt Colorado into the expansion. These improvements included reimbursement, liability protections, administrative simplification, and patient responsibility. A special meeting of the Council on Legislation and the Committee on Physician Practice Evolution is scheduled for December 12.

There were 270 attendees at the 2012 Annual Meeting. Of those, 104 participants completed the online evaluation (available upon request) and 69 CME certificates were awarded. The respondents rated the overall quality of the conference an average of 4.27 out of 5, with 5 being excellent and 1 being poor. The quality of the setting (facility/location) rated a 4.40 out of 5. Several comments indicated the conference facility was too spread out, there was poor sound and acoustics, and there were few things to do. Some positive comments on the quality of the food were also received, as well as the beauty of the area, which probably accounts for the high rating, even though a different venue/location is recommended.

Forty-four respondents made remarks in an open-ended question seeking general comments about the conference overall. These comments are grouped accordingly:

• General - There were many general positive comments - "great," "overall good," "well done," etc.
• HOD Closing Session on Sunday-There were many comments about this session. The respondents felt that it was too long, there was lots of "quibbling" over verbiage, and that the attendees need to be more prepared prior to the meeting. There was one request for the reference committee to be held when most people can attend, and another request for the online information to be downloadable in a PDF format.
• Educational Sessions - There were several positive comments specifically about the program and breakout sessions; "timely," "stimulating," "enjoyable," "well done," etc.
• Observations/Recommendations
• Change venue
• Restructure process for reference committee and HOD sessions
• Strengthen the process for developing performance-based learning objectives. (What do we want the physicians to do as a result of the sessions? What are our desired results?)