Blueprint for success

Tuesday, May 07, 2013 01:22 PM
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CMS supports governor’s vision for health and wellness

Kate Alfano, CMS contributing writer

In the March/April issue of Colorado Medicine, Colorado Gov. John Hickenlooper offered a glimpse into his vision to make Colorado the healthiest state in America. Through the promotion of prevention and wellness, expansion of health care access and capacity, improvement of system integration and quality, and enhancing value and strengthening sustainability, he hopes a collaboration of individuals and public and private partners can improve health outcomes for every Coloradan and improve the quality of life in Colorado communities at the best value – a variation of the “Triple Aim.”

Organizations from around the state, including CMS, were given a first look at the draft plan, “The State of Health: Colorado’s Commitment to Become the Healthiest State,” and an opportunity to provide feedback. CMS CEO Alfred Gilchrist hailed the blueprint as “fertile ground for collaboration among stakeholders” as it reaches beyond the medical aspects of health to include physical, behavioral, oral and environmental health.

Now final, the plan states: “Achieving this vision demands innovation that will reshape our current health care delivery and payment mechanisms to bend the health care cost curve, improve efficiency, achieve higher quality, and drive more value out of the health care dollars we spend. … Addressing social and environmental factors that influence our health is also essential to Colorado becoming the healthiest state.”

Next steps
On March 29, Gilchrist and CMS leaders John Bender, MD, and Dennis Waite, MD, attended the first of a series of meetings with representatives from the governor’s office, major state agencies and hospital systems to discuss the plan and identify each organization’s role going forward. “The governor’s office has earmarked $19 million to be spent in a continuing manner, not just a one-time payout but an increase in the budget, to provide more services and meaningfully coordinate care,” Dr. Bender said.

“If you look at all the things that the governor proposes – administrative simplification, continuity of care in Medicaid, working with the RCCOs (regional care collaborative organizations), understanding the barriers – as an organization we could support those efforts,” Dr. Waite said. “Their points of view are like everyone else’s: we have a problem, we need to have better integration, we need to have better communication.”

“Much of the discussion fell on mental health and the disconnect between public health, behavioral health organizations and primary care, Dr. Waite said. “The concept of supporting behavioral health advancement and modification while integrating it into the patient-centered medical home model supports the mission and values of the Colorado
Medical Society.”

Dr. Bender agreed. “I feel like there are some opportunities for change with primary care and behavioral health that the administration is championing, he said, but he also noted that there are areas that must be addressed in regard to specialty care such as payment for telemedicine in a way to allow access to mental health for at-risk populations in rural areas who may not normally have access.

“The feeling is definitely genuine; $19 million is real money and depending on how it’s leveraged in the budget between the agencies, it has the potential to do some good things,” he added.

Leading by example
As care providers, physicians inherently play a role in encouraging wellness and healthy lifestyles but a group of CMS members said this often does not extend to physicians caring for themselves.

Back in April 2011, CMS conducted an all-member morale survey that revealed only one-half of physician members are able to live a healthy lifestyle in regards to exercise and diet; fewer are satisfied they’re able to find time to relax through activities like yoga or reading. Following the survey, then-CMS President Brent Keeler, MD, appointed an expert panel on physician wellness to advise the board of directors. The panel finalized its recommendations this past February and the board will consider its report for approval in May.

The wellness panel recommends strongly supporting and actively participating in the governor’s vision for health and wellness.

Internally, CMS should:

  • Educate members on the governor’s plan and encourage its support by all elements of organized medicine;
  • Encourage individual physicians to lead by example, promoting prevention and wellness to their patients and the public by living a healthy lifestyle;
  • Provide resources on healthy living and ways physicians can participate in public and patient education, specifically through a specialized section of the CMS website that will be continually shaped by the wellness panel; and
  • Partner with other stakeholders.

Now that we have the final plan, “we would do well to circulate this and get some discussion among ourselves because I think this hits on a lot of the tenets of what we put forth in all of our meetings in regard to wellness of the state, how to work at prevention, how to better integrate care, and better methods of communication like health IT,” said Dr. Waite. “These are all things that are on the horizon.”

Colorado’s commitment to become the healthiest state

Governor Hickenlooper’s vision is to make Colorado the healthiest state through four focus areas where “we can have the greatest impact” and includes targets to track progress over time.

Promoting prevention and wellness

  • Tackle obesity among youth and adults
  • Support improved mental health
  • Support reductions in substance abuse
  • Improve oral health of Coloradans
  • Encourage wellness among state employees

Expanding coverage, access and capacity

  • Expand public and private health insurance coverage
  • Strengthen Colorado’s health workforce
  • Close gaps in access to primary care and other health services

Improving health system integration and quality

  • Expand use of patient-centered medical homes
  • Support access to state information and services
  • Support better behavioral health through integration
  • Improve access to community-based long-term services and supports

Enhancing value and strengthening sustainability

  • Achieve cost containment in Medicaid
  • Advance payment reform in the public and private sectors
  • Invest in health information technology

Read the full report at


Posted in: Colorado Medicine | Initiatives | Physician Wellness


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