June 21, 2016
AMA Annual Meeting report
Colorado delegation passes resolution on physician satisfaction
The Colorado delegation to the American Medical Association brought and passed a resolution at the 2016 AMA Annual Meeting of the House of Delegates to add physician work-life balance to provider experience measures for evaluating how well alternative payment models function.

The delegation raised the concern that the "Triple Aim" - a term coined by the Institute for Healthcare Improvement - is "jeopardized by the burnout of physicians and other health care professionals." As originally conceived, the triple aim seeks to improve patient experience of care, health of populations and reduction in per capita costs.

The new AMA policy, which was debated, amended for clarity and purpose, and approved, changes the Triple Aim to the Quadruple Aim. The AMA will ask the Centers for Medicare and Medicaid Services to count physician satisfaction as a Clinical Practice Improvement Activity under the Merit-Based Incentive Payment System (MIPS).

Click here to read the full resolution.

One of the most controversial issues at the AMA meeting concerned a late resolution authored by the Young Physicians Section following the recent mass shooting in Orlando, Fla. The final adopted policy directed the AMA to call gun violence in the United States a public health crisis that requires a comprehensive public health response and solution. Additionally, the AMA resolved to actively lobby Congress to overturn legislation that for 20 years has prohibited the Centers for Disease Control and Prevention from researching gun violence. And the AMA will call for background checks and a waiting period for all firearms purchasers, expanding a previous AMA policy of requiring the same for only handguns.

Other meeting highlights
  • Brandi Ring, MD, in private practice at Mile High OB/GYN in Denver, was elected to the governing council of the AMA Young Physicians Section in the position of the Chair-Elect. It is a three-year position with the first year as chair-elect, the second year as the chair and the third year as immediate past chair.
  • The AMA HOD affirmed a comprehensive update of the nearly 170-year-old AMA Code of Medical Ethics, the conclusion of a meticulous project started eight years ago to ensure that this ethical guidance keeps pace with the demands of the changing world of medical practice.
  • Several new policies were put into place by the HOD addressing factors that are critical to reducing opioid medication misuse, overdose and death, including prescription drug monitoring programs (PDMP), access to naloxone and addiction medicine as a sub-specialty.
  • AMA President Steven Stack, MD, gave his outgoing presidential address, pointing out the "world of contradictions" in which physicians live: It's a profession of rewards and privilege amid the toll of frustration and burnout, borne of administrative hassles and bureaucratic overreach.
  • Incoming AMA President Andrew W. Gurman, MD, an orthopedic hand surgeon in private practice in Altoona, Pa., issued a call to action for physicians to be leaders and advocates for their profession.
  • Andy Slavitt, acting administrator of the Centers for Medicare and Medicaid Services, said that the driving factor behind many of the changes in the new Medicare payment system was physician input. He encouraged physicians to continue to work to improve the system.
Click here to read more on CMS.org.
Register for the 2016 CMS Annual Meeting

Join your colleagues at the re-engineered CMS Annual Meeting in Keystone Sept. 16-18 as we engage some of the top health care policy and political experts in the nation on issues such as universal health care, physician-assisted death, Medicare payment, physician burnout, health plan mega-mergers, politics, and more. We'll have plenty of time for rest, relaxation and rejuvenation, too, for attendees and their families. 

California DOI: Block Anthem-Cigna merger

California Insurance Commissioner Dave Jones recommended blocking the merger of Anthem and Cigna in a 22-page letter to U.S. Attorney General Loretta E. Lynch and Principal Deputy Assistant Attorney General Renata B. Hesse. Jones said that after analysis, the proposed merger "will substantially lessen competition" and will "substantially enhance market power in various geographic and product markets," leading to "increased prices and decreased quality."

"The Anthem and Cigna merger will harm Californians, California's businesses, and our health insurance market," Jones wrote. "Further, I do not believe that partial divestiture or other remedies traditionally used by the Department of Justice will adequately protect consumers or address the adverse consequences of a merger of Anthem and Cigna. Traditional methods to avoid concentration issues will not address poor service qualities, the power to charge excessive rates or the loss of a potential market participant that has the resources to enter into new markets."

Attention Colorado Medicaid and CHP+ Providers - Big changes coming to Provider Portal, MMIS, PBMS

As part of the Colorado Medicaid Management Innovation and Transformation (COMMIT) project, the Department of Health Care Policy and Financing will be launching several new provider-facing systems on Oct. 31, 2016.

Two of these new systems will affect the way providers submit claims and receive payment. These are the Colorado interChange (a new claims processing and eligibility verification system) and the Pharmacy Benefits Management System (a new pharmacy point-of-sale system).

Over the next several months, the department will be working to inform and prepare the Colorado Medicaid and CHP+ provider networks for these changes. In addition to the updates mentioned below, the department will host a series of live webinars to answer any questions you may have. Both webinar and training schedules will be released mid-to-late July 2016.

Get tailored updates that matter to you!
Sign-up for this email distribution list today, and you will receive important information specific to your provider type or business, straight to your email inbox. As physicians, you should (at a minimum) check the following "provider type" boxes when signing up for the email distribution list:

  • Clinic - Practitioner
  • Physician
Other ways to stay informed
The department will keep you informed and help prepare you for the coming changes. Look for general information and updates to be posted in the Provider Bulletins, At a Glance, and on the department's website.
 
Webinar: Learn about the new name for Colorado Medicaid, Health First Colorado

Colorado Medicaid is changing its name to Health First Colorado (Colorado's Medicaid Program) this summer. Join the Colorado Department of Health Care Policy and Financing to learn about why Colorado Medicaid is changing its name, and how this change affects your patients and your practice. They will also direct you to resources to help educate your patients about this change.

There are six dates for the webinar: Wednesday, June 22; Thursday, June 23; Tuesday, June 28; Wednesday, June 29; Wednesday, July 6; and Wednesday, July 13. All are 12 - 1 p.m. except the June 23 webinar, which will be held 12:30 - 1:30 p.m.

Connect for Health Colorado: Apply for new advisory group by Thursday, June 23

Based on direction from HB16-1148 passed during the 2016 legislative session, the Connect for Health Colorado Board of Directors will establish an advisory group that will inform the way Connect for Health Colorado handles high-level policy decisions. Interested members of the public, including but not limited to, enrollment assistors, brokers, carriers, consumer advocacy organizations, health care providers, small business owners, and health policy professionals are invited to apply. The application deadline is June 23. Click here to access the application.

Register to attend an informational webinar on TCPi

TCPi Colorado Practice Transformation Network presents an opportunity for 2,000 clinicians in Colorado to receive practice support as they prepare for new payment models. All physicians -- primary care and specialists -- are encouraged to stay up to date on Medicare payment reform and consider taking advantage of this federally-funded support to help their practice thrive in the evolving health care landscape.

The SIM Office is hosting a series of informational webinars and encourages anyone who is interested in learning more about TCPi to register.

More information on the webinars and links to register can be found online at www.colorado.gov/healthinnovation/tcpi. They are held each Wednesday, alternating between morning and mid-day. Questions? Email [email protected].

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