Colorado Medical Society and Health Care Reform

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Colorado Medical Societyand Health Care Reform

• Understanding the
• Winning Strategy
• -
• from Sonnenalp
• to Bill Signing

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• Acknowledgements

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This Mornings Task

• 1) Six Components of CMS strategy on Health Care
  Reform

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Six Components of CMSstrategy on Health Care
Reform

• 1. Support Policies that Work
• 2. Legislative Engagement at the Grassroots
• 3. Build Alliances and Work in Coalitions

• 4. Full Contact Lobbying
• 5. The Right Message, and the Right Messengers
• 6. The Longer View

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This Mornings Task

• Six Components of CMSs strategy on Health Care
  Reform
• Two Components of CMSs physician input and
  outreach over the next 8 months

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Two Components of CMSs physician input and
outreach

• 1. Broad physician input to create our Colorado
  Medicine Gold Standard for Health Care Reform
• 2. Local meetings with our legislators to inform
  them of this Gold Standard

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Six Components of CMSstrategy on Health Care
Reform

• 1. Support Policies that Work
• 2. Legislative Engagement at the Grassroots
• 3. Build Alliances and Work in Coalitions

• 4. Full Contact Lobbying
• 5. The Right Message, and the Right Messengers
• 6. The Longer View

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CMS Annual MeetingSeptember 2005

• Do physicians support comprehensive health care
  reform?
• Yes91
• No9

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CMS Congress on Health Care Reform

• Membership
• Broad-based
• Geography
• Specialty
• Affiliation

• Meets every 6 weeks
• Typically 30-40 doctors

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CMS Congress on Health Care Reform

• Worked closely with 208 Commission
• Developed mechanism for all physicians to
  participate in setting our Gold Standard
• Raised 12,000 in voluntary contributions from
  Colorado Physicians to purchase policy expertise
• Created a set of guiding principles

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CMS Congress on Health Care Reform

• Define Comprehensive Health Care Reform
• Create and recommend a set of guiding principles

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IOMs Insuring America's Health Principles and
Recommendations

• Universal.
• Continuous.
• Affordable to individuals and families.
• Affordable and sustainable for society.
• Enhance health and well-being by promoting access
  to high-quality care that is effective,
  efficient, safe, timely, patient-centered and
  equitable

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CMS Principles of Health Care Reform
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CMS Principles of Health Care Reform

• Guiding Principles
• Coverage
• Benefits
• Delivery System
• Administration Governance
• Financing

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CMS Principles of Health Care Reform

• Guiding Principles
• Those who deliver health care
• Improve health care quality and safety in order
  to assure optimal outcomes.

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CMS Principles of Health Care Reform

• Guiding Principles
• Those that fund health care
• Interventions should be patient-oriented,
  quality-driven and community-centric.

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CMS Principles of Health Care Reform

• Guiding Principles
• Those that deliver, finance and utilize health
  care
• Share stewardship of finite resources.

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CMS Principles of Health Care Reform

• Guiding Principles
• Coverage
• Benefits
• Delivery System
• Administration Governance
• Financing

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CMS Principles of Health Care Reform

• Guiding Principles
• Coverage
• Health care coverage for Coloradans should be
  universal, continuous, portable and mandatory.
• Benefits
• Delivery System
• Administration Governance
• Financing

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CMS Principles of Health Care Reform

• Guiding Principles
• Coverage
• Benefits
• An essential benefits package should be uniform,
  with the option to obtain additional benefits.
• Delivery System
• Administration Governance
• Financing

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CMS Principles of Health Care Reform

• Guiding Principles
• Coverage
• Benefits
• Delivery System
• The system must ensure choice of physician and
  preserve patient/physician relationships. The
  system must focus on providing care that is safe,
  timely, efficient, effective, patient-centered
  and equitable.
• Administration Governance
• Financing

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CMS Principles of Health Care Reform

• Guiding Principles
• Coverage
• Benefits
• Delivery System
• Administration Governance
• The system must be simple, transparent,
  accountable, efficient and effective in order to
  reduce administrative costs and maximize funding
  for patient care. The system should be overseen
  by a governing body that includes regulatory
  agencies, payers, consumers and care givers, and
  is accountable to the citizens.
• Financing

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CMS Principles of Health Care Reform

• Guiding Principles
• Coverage
• Benefits
• Delivery System
• Administration Governance
• Financing
• Health care coverage should be equitable,
  affordable and sustainable. The financing
  strategy should strive for simplicity,
  transparency and efficiency. It should emphasize
  personal responsibility as well as societal
  obligations, due to the limited nature of
  resources available for health care.

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CMS Principles of Health Care Reform

• Guiding Principles
• Also called Reactor Principles

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Broad-based Feedback

• Annual House of Delegates meeting 2005
• Annual House of Delegates meeting 2006
• Guiding Principles approved
• Every other month CMS Board of Directors meeting
• Spring Meeting at Sonnenalp 2007
• Summer survey tool
• Annual House of Delegates meeting 2007

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Senate Bill 208

• PURPOSE to study and establish health care
  reform models to expand health care coverage and
  to decrease health care costs for Colorado
  residents.

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Governor Bill Ritter

• Colorado Promise
• Convening all stakeholders and establishing a
  Colorado Health Plan, with legislation to be
  introduced in the 2008 session of the General
  Assembly. The goal to improve health-care
  access, affordability, and quality.

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Convergence

• CMS 91-9 Mandate For Comprehensive Health Care
  Reform
• CMS Ratification of Guiding Principles
• SB 208
• Expand health care coverage and decrease health
  care costs
• Gov. Ritters Colorado Promise
• Improve health-care access, affordability, and
  quality

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Convergence

• Health Care Reform will occur in Colorado
• Maybe later, maybe sooner
• Maybe not so comprehensive at first

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Convergence

• Health Care Reform will occur in Colorado
• CMS will be at that table where reform gets
  decided
• CMS will reliably and confidently assess and
  suggest revisions to proposals

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The Evaluation Matrix The Gold Standard

• The statement of the Colorado Medical Societys
  policy on what we think Health Care Reform should
  look like.

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The Evaluation Matrix The Gold Standard

• Guiding Principles Theoretical
• Evaluation Matrix Practical

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The Evaluation Matrix The Gold Standard

• By which we will measure all health care reform
  proposals
• The 208 Commission
• All Other Sources
• Consistently and reliably compare proposals to
  one another
• Identify strengths and weaknesses

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The Evaluation Matrix The Gold Standard

• Physicians Congress focuswhere physicians
  voices bring greatest value to debate
• Improving Quality of care
• Improving Cost-effectiveness
• Improving Patient safety

Gov. Ritters Colorado Promise Improve
health-care access, affordability, and quality.
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The Evaluation Matrix The Gold Standard

• Rinse the matrix through membership
• or
• How I Will Spend My Summer
• This meeting at the Sonnenalp
• Web based tool
• Meeting in a bag
• Outside expertise as needed

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The Evaluation Matrix The Gold Standard

• CMS 2007 Annual Meeting
• Steamboat Springs
• Sept 7-9
• House of Delegates Approval of Matrix

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The Evaluation Matrix The Gold Standard

• Web-Based Tool
• Carol Carlson

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The Evaluation Matrix The Gold Standard

• Meeting in a Bag
• Diana Protopapa

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Six Components of CMSstrategy on Health Care
Reform

• 1. Support Policies that Work
• 2. Legislative Engagement at the Grassroots
• 3. Build Alliances and Work in Coalitions

• 4. Full Contact Lobbying
• 5. The Right Message, and the Right Messengers
• 6. The Longer View

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Six Components of CMSstrategy on Health Care
Reform

• 1. Support Policies that Work
• 2. Legislative Engagement at the Grassroots
• 3. Build Alliances and Work in Coalitions

• 4. Full Contact Lobbying
• 5. The Right Message, and the Right Messengers
• 6. The Longer View

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Six Components of CMSstrategy on Health Care
Reform

• 1. Support Policies that Work
• 2. Legislative Engagement at the Grassroots
• 3. Build Alliances and Work in Coalitions

• 4. Full Contact Lobbying
• 5. The Right Message, and the Right Messengers
• 6. The Longer View

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Six Components of CMSstrategy on Health Care
Reform

• 1. Support Policies that Work
• 2. Legislative Engagement at the Grassroots
• 3. Build Alliances and Work in Coalitions

• 4. Full Contact Lobbying
• 5. The Right Message, and the Right Messengers
• 6. The Longer View

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Six Components of CMSstrategy on Health Care
Reform

• 1. Support Policies that Work
• 2. Legislative Engagement at the Grassroots
• 3. Build Alliances and Work in Coalitions

• 4. Full Contact Lobbying
• 5. The Right Message, and the Right Messengers
• 6. The Longer View

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