Colorado Medical Society

President’s letter: Reflecting on a year of advocacy

Thursday, September 01, 2016 12:05 PM

On Sept. 18 I will hand over the leadership of CMS to president-elect Katie Lozano, MD, FACR. It would be cliché to say it has been an incredible year. Steering the vessel of the medical society was much like being an explorer in the Age of Discovery, and my treasure found was the rich landscape of physician advocacy, health policy, member engagement, and the transition of a nonprofit to a more transparent and connected medical society.

As I expected when I took the helm last September, much of my presidential year has been devoted to our advocacy on network adequacy and bringing the physician’s voice to state and federal regulators on the proposed mega-mergers of Anthem-Cigna and Aetna-Humana. Not uncharted territory, but certainly challenging terrain, we have devoted countless hours and energy to resolving the barriers to good care that physicians are facing with commercial health plans, and this level of commitment will be maintained for the remainder of the decade.

There are many opportunities in Colorado for our profession to step up in an effort to improve interactions between health plans and physicians. One promising venue has been through a special Physician Advisory Group convened by the Colorado Division of Insurance Commissioner Marguerite Salazar. Starting in April and continuing through the summer and fall, the advisory committee has been meeting with the commissioner and working through a variety of issues, such as network adequacy standards, provider directories, continuity of care and provider complaints. We are grateful that she heard our voice and is taking the time to understand the complexities of the interactions between physicians and health insurers in greater detail.

This issue’s cover story details the latest action in the health industry merger story – the lawsuit filed by the U.S. Department of Justice to block these consolidations. CMS has taken an aggressive stand since last summer when the mergers were announced, first by urging state and federal investigators to carefully scrutinize the mergers, and then in March of this year announcing opposition along with the American Medical Association and 16 additional state medical associations. And speaking of the AMA, it was so gratifying to watch as they coordinated the efforts of 17 state medical associations and provided each with scholarly legal and market analysis support. Nearly 600 CMS members completed our merger survey provided by the AMA, with many of the outcomes on full display in the DOJ’s lawsuit to stop the Anthem-Cigna merger (read more here).

CMS governance and communications are rapidly transitioning from an emeritus to a millennial model. The New CMS gives members multiple new ways to engage with our society, stay informed on key issues, share opinions and concerns, and feel empowered to get involved. We’ll soon roll out Central Line, an innovative, first-in-the-nation electronic policy system conceptualized by physicians active with CMS. Central Line will provide members with the unique, easy and powerful opportunity to participate in the policymaking process, often without attending a single in-person meeting. As a CMS member, you can use Central Line to advise the board of directors on subjects that are important to you via your computer, tablet or smartphone 24 hours a day, seven days a week, and provide input to the board of directors on policy decisions before and after they vote. This brings unprecedented grassroots member engagement to CMS and a more balanced approach to governing that splits the difference between a total top-down and total bottom-up model. CMS will be a stronger, more responsive medical society as a result.

I have also traveled around the state meeting physicians in every specialty and practice setting at The New CMS regional forums. It is inspiring to meet these physicians and lead dialogue on governance changes and Colorado’s most pressing public policy issues. Dr. Lozano will continue our enhanced tradition of listening through these in-person meetings and Central Line.

Throughout this busy year, I have been impressed by your passion and involvement on public policy issues. This is best illustrated by the tremendous response to our all-member surveys on the insurance mergers, physician-assisted death and ColoradoCare/Amendment 69. Our bond may have begun in medicine but it continues as we put our patients and communities first through advocacy.

Thank you for the role you have played in steering the ship; it takes all of us to stay on course. And thank you for entrusting the leadership of the medical society to me this past year. I am humbled and grateful for this valuable experience.