Leveraging through strategy

Saturday, September 01, 2012 01:16 PM

CMS physician delegates give direction on policy priorities

Sara Burnett, CMS contributing writer

The Colorado Medical Society’s (CMS) 2012 Annual Meeting focused on leveraging relationships. Defined as the action of a lever or the mechanical advantage gained by it, leveraging can take many forms, outgoing CMS President F. Brent Keeler, MD, told members on the meeting’s opening day.

“A medical group’s size may give it leverage in dealing with hospitals and health plans,” Keeler said. “A physician’s popularity with patients may give her great leverage in dealing with her employer. And CMS uses the respect that policy makers, patients and others have for the organization’s physician members to leverage better public policy.”

That kind of leveraging occurs every day at CMS to help improve patient care. It is rooted in frequent and thorough member input and put into action via strategy sessions with physician leaders and CMS staff.

During the annual meeting, physicians in attendance were able to sit in on one of those strategy sessions and weigh in on pressing issues via live polling (using keypads at their seats) and open microphone discussions.

What follows is the outcome of some of that polling on a series of issues that are either currently before CMS or are considered “emerging issues,” which will be pressing in the months to come.

“It’s about creating a policy consensus that can serve as leverage through a unified physician voice over the coming year,” Keeler said.

Which issues do you think are most important for CMS to spend resources on in the 2013 Legislature?

The top three issues of importance for CMS to spend resources on in the 2013 Legislature are the Medicaid expansion and program improvements to Medicaid, preserving Colorado’s stable liability climate and investigating alternatives to the flawed litigation system through the cerebral palsy demonstration project.

Who’s your daddy? In the next three years, which forces will have the most influence on your practice?

Physicians reported that hospital systems, private sector managed care companies, trial lawyers, Medicare and issues related to the implementation of the Affordable Care Act (aka Obamacare) as the forces that will have the most influence on their practice.

When it comes to advancing patient safety and professional accountability, which approaches do you favor?

Once again, physicians reported that pursuing state legislation to create alternatives to the tort litigation process should be a top priority along with a commitment to work with other physicians, clinics and hospitals on programs that prevent harm and avoid litigation.

In October, CMS and the Colorado Hospital Association are co-hosting a Patient Safety Congress. If you could make one patient safety-related suggestion to hospital management on behalf of your peers, what do you think is most important to emphasize?

Physician sentiment centered around four suggestions they would like to make to hospital management:

1. Better communication with physicians through such ideas as regular cordial meetings with bilateral dialogue instead of edicts and mandates.
2. Recognizing that physicians should guide patient safety.
3. Creating a reporting culture of nonpunitive and open systems that should include a secure hot line to report events to management.
4. Committing to remain focused on reforming the liability climate which still impedes physicians being more proactive and transparent.

What ideas do you think CMS should pursue as a component of health care reform?
This question revealed similar levels of support for the following five ideas.

1. Standardize billing processes among all insurance companies and require participation from all plans.
2. Develop a basic level of safety net coverage provided through insurance companies, backed and funded by the government.
3. Limit and simplify health insurance plan options to three or four standard benefit plans informed consumers can understand, easily compare and choose for themselves.
4. For any standard health insurance offered to Coloradans, include financial incentives to encourage healthy choices (e.g. prenatal care)
5. Create a system of cost transparency for health care facilities, providers and pharmaceutical companies.