Thank you, Delegates, for your hard work at the 2013 Annual Meeting this past weekend. Your participation is critical to the ongoing success of the Colorado Medical Society. The final disposition of resolutions and reports is available on the CMS website. I encourage you to click here to view this important document.

As we've done in other Sounding Block e-newsletters, well provide an update on the latest CMS Board of Directors meeting. The board met on Friday, Sept. 20, to hear updates on and discuss a variety of issues including health information exchange, patient safety and professional accountability, and the drivers of health care costs. See more on these items below.

They also addressed organizational matters, approving minutes from the July 12, 2013 meeting, the Finance Committee report, and a consent calendar. A written update of the Board work plan was provided to the Board in writing. All of these materials are available upon request.

Please contact us about any of the items in this newsletter. Your comments are important to us!

Jack Westfall, MD, CMO of Colorado HealthOP, told the board about the nonprofit health insurance cooperative and how it will benefit patients and physicians by providing an alternative to traditional health insurance and a more engaged experience.

Colorado HealthOP is an independent health insurance plan governed and operated by members. Under the CO-OP structure, members have a voice in operations including deciding what is covered under benefit plans. Members can be elected to the CO-OP's board of directors and when revenues exceed costs, the surplus will go back to members through lower premiums, expanded benefits and quality improvements.

Representatives from the Quality Health Network (QHN) - the health information exchange (HIE) that connects much of the western slope - and the Colorado Regional Health Information Organization (CORHIO) - the HIE that connects the rest of the state - spoke to the board about their efforts to improve the electronic exchange of health information of hospitals, physician practices and other facilities.

Larry Wolk, MD, immediate past CEO of CORHIO and the new director of the Colorado Department of Public Health and Environment, likened the process of HIEs to the development of the cell phone. He reminded board members that we're in the "large, bag phone" stage of HIE development and to be patient as they work out technological issues. But all those involved - Dr. Wolk, QHN CEO Dick Thompson, CORHIO Interim CEO Kelly Joines, and CORHIO Director of Products and Services Jeff Messner - are positive about their progress.

The board discussed the case of the Colorado Medical Board v. The Office of Administrative Courts before the Colorado Supreme Court. CMS, COPIC and the Colorado Association of Defense Counsel filed Amicus Curiae briefs at the request of the Office of the Attorney General, which is representing the Colorado Medical Board. This type of brief is filed by a third party when it is not directly involved in the litigation but believes the court's decision may affect its interest.

As background, a physician applying for a Colorado medical license was denied licensure by the CMB for self-reported past alcohol use. The physician appealed this denial and, as part of the discovery process, the administrative law judge ordered the CMB to produce confidential letters of concern issued to doctors over the past five years for alcohol-related or candor-related issues. The CMB objected and the judge entered a protective order, interpreting an act that prohibits discovery of peer review materials by subpoena or discovery only in civil actions.

CMS believes it's important for the CMB to be able to monitor, mentor and educate its licensees with absolute confidentiality. Without it, the CMB's ability to educate and instruct physicians about its expectations and how to prevent the recurrence of concerning situations will be impaired. An exception to this would have a chilling effect on self-reporting and frank communication of physicians.

The CMS board decided to direct the Council on Legislation and CMS general counsel to update them as soon as a ruling by the Supreme Court is issued, analyze the need to prepare 2014 legislation or institute rulemaking in the case of an adverse ruling, and provide them with an assessment of the chances of passage of legislation in 2014 and of successful rulemaking in the case of an adverse ruling.

The Colorado Hospital Association asked CMS to weigh in on legislation they are considering for the 2014 legislative session to designate a slot on the Colorado Medical Board for a hospital trustee. The reason for the legislation, CHA says, is because CMB routinely interacts with Colorado hospitals on professional review and hospital trustees are "uniquely qualified" to provide input to the CMB.

The board decided to table the issue until the November board meeting.

Legal representatives from the California Medical Association updated the board on the current standing of the MICRA ballot initiative. This is the effort by trial lawyers to lift the state's $250,000 medical malpractice cap, which they say is insufficient to cover the prolonged effects of doctor negligence.

If passed, the measure would go before the voters as a ballot measure in 2014. It would raise the ceiling for pain and suffering damages payments to about $1.1 million and allow the ceiling to continue rising with inflation. The measure would also mandate random drug and alcohol testing for physicians who practice in hospitals and surgery centers and would mandate use of a prescription drug monitoring database.

CMA opposes the legislation and has been working with their physician members to raise awareness and unify their message. The CMS board will continue to follow this issue.

The board began an internal discussion on the debate likely to emerge in Colorado on the price versus the cost versus the value of health care, and where CMS should position ourselves in this debate. This discussion comes after Steven Brill spoke at a Sept. 4 event hosted by the IMA Foundation. Steven wrote the TIME magazine article "The Bitter Pill," which raised awareness of the high cost of health care and the lack of transparency in health care costs.

Board members agree that there is massive waste in health care but that cost drivers represent an extremely complex issue. They voted to table the issue until the November meeting.

• Oct. 12, 2013 - Regional Campaign and Grassroots Seminar - Denver, Colo.
• Nov. 16-19, 2013 - AMA Interim Meeting - National Harbor, Md.
• May 2-4, 2014 - CMS Spring Conference - Vail, Colo.
• June 7-11 - AMA Annual Meeting - Chicago, Ill.
• Sept. 19-21, 2014 - CMS Annual Meeting - Vail, Colo.