Revisiting the road map

Saturday, March 01, 2014 11:10 AM

CMS Board reviewed strategic plan in January

Kate Alfano, CMS contributing writer

In 2010, after broad membership input and review, the Colorado Medical Society Board of Directors adopted a long-term strategic plan designed to provide a road map for CMS. The plan set a vision for meeting the challenges facing Colorado physicians and it has guided CMS staff and the Board of Directors in program development, budgeting and defining success.

In 2013, the CMS board decided to review the assumptions underpinning the current plan as well as the progress in implementing the plan, and set aside the weekend of Jan. 17-18, 2014 for a strategic plan retreat.

During the retreat, attendees developed a variety of recommendations to enhance CMS’ progress in achieving our strategic goals. These recommendations spanned the areas of governance, advocacy, communications and education. The ideas formulated and vetted by breakout groups included items like expanding the delivery models for professional development, creating new membership units and restructuring representation in the CMS House of Delegates and on the board, and pushing for legislation to create a bill of rights for physicians contracting out their services.

The CMS executive committee has reviewed each idea and provided a recommendation to the board. These recommendations will be presented at the March 14 board meeting and further vetted. The revised strategic plan will be presented to the CMS House of Delegates at the 2014 Annual Meeting in Vail.

Background materials
Several documents provided to the board gave crucial framing to attendees’ work: results of an all-member survey, an environment scan, a list of major CMS accomplishments between 2011 and 2013, and the results of a board questionnaire on CMS’ internal strengths and weaknesses as well as external opportunities and threats.

Analyses of the all-member survey provided comparisons to prior member surveys on key questions. It revealed a decrease in the levels of concern about a number of issues over the past three to five years including the financial viability of small practices, payer issues, payment reform and access to care. Medical malpractice and health care quality and cost remain top priorities. It showed that members continue to look to CMS primarily for communications and advocacy.

The survey administrator concluded that maintaining physician engagement in this time of constant change is an ongoing challenge that the next strategic plan will need to continue to strive to address.

CMS commissioned the Center for Improving Value in Health Care (CIVHC) to conduct the environmental scan, which outlined the changes occurring in Colorado health care, with a particular emphasis on the impact on physician practices in terms of care and economics.

CIVHC noted the following delivery system trends in their report: Integrated primary care and behavioral health can address high-cost patients with chronic conditions; hospital systems are expanding, employing more physicians; increased data availability is affecting care delivery and physician-patient interactions; health information technology is expanding but not universal; patients want full access to medical information, cost transparency and engaged doctors; and doctors are burning out from increased administrative tasks.

“While the future of health care is still uncertain, there are signs that indicate the direction of change and the interdependence of health care delivery and payment is central to innovation,” the authors stated. “Physicians must help lead the movement toward integrated care and outcomes-driven payment. Visible leadership will be a key component to the success of this evolution of care.”

The list of CMS’ major accomplishments included achievements in maintaining a stable liability climate, protecting the physician-patient relationship in the care of injured workers, educating physicians about integrated approaches to care delivery, advancing patient safety, standardizing prior authorization, and many more.

Finally, the pre-questionnaire identified strengths, weaknesses, opportunities and threats. To provide focus to the many thoughts received, attendees of the planning retreat “voted” on what they felt were the top three items in each of the four categories. Examples of CMS’ identified internal strengths were: the size and diversity of our membership, a positive track record, and hard-working CMS staff. Some weaknesses were: the brewing medical “class war” between primary care and other specialties, historical silence on racial and ethnic concerns, and membership diversity challenges including the increasing number of employed physicians.

Respondents identified external opportunities in the economic effects of the Affordable Care Act, the governor’s State of Health program, and the demand for innovative practice models. And they saw as threats hospitals and businesses taking the lead on “integrated” practice rather than physicians, continuing attempts to undermine the ACA, and trial lawyers’ political power and potential for success.

CMS is grateful to all members who contributed to the all-member survey and to the board members for their work at the strategic plan retreat. CMS will keep members updated as the revised strategic plan develops.