COLORADO MEDICINE
KNOWLEDGE
BEYOND
COVERAGE
COPIC’s premier medical liability insurance offers comprehensive support built on unparalleled expertise and decades of experience. We share our knowledge through meaningful CME/CNE education, an extensive library of resources, in-depth site visits, and more. All of which help you avoid risks, improve practice protocols, and solve urgent issues quickly. That’s Value Beyond Coverage.
COPIC is proud to be the endorsed carrier of the Colorado Medical Society. CMS members may be eligible for a 10% premium discount.
COLORADO MEDICAL SOCIETY
7351 Lowry Boulevard, Suite 110 • Denver, Colorado 80230-6902
720.859.1001 • www.cms.org
OFFICERS,
BOARD MEMBERS, AMA DELEGATES, and STAFF
2023-2024 OFFICERS
Omar Mubarak, MD, MBA
President
Kim Warner, MD President-elect
Patrick Pevoto, MD, MBA
Immediate Past President
Hap Young, MD
Treasurer
Dean Holzkamp Chief Executive Officer
BOARD OF DIRECTORS
Brittany Carver, DO
Elizabeth Cruse, MD, MBA
Kamran Dastoury, MD
Amy Duckro, DO, MPH
Enno F. Heuscher, MD, FAAFP, FACS
Rachelle M. Klammer, MD
Marc Labovich, MD
Chris Linares, MD
Michael Moore, MD
Rhonda Parker, DO
Pritika Parmar, MSC
Lynn Parry, MD
Sean Pauzauskie, MD
Leto Quarles, MD
Hap Young, MD
COLORADO MEDICAL SOCIETY STAFF
Dean Holzkamp
Chief Executive Officer
Dean_Holzkamp@cms.org
Kate Alfano
Director of Communications and Marketing
Kate_Alfano@cms.org
Cindy Austin Director of Membership
Cindy_Austin@cms.org
Virginia "Ginny" Castleberry
Executive Director
Denver Medical Society
Virginia_Castleberry@cms.org
(ISSN-0199-7343)
720-859-1001. Periodicals postage paid at Denver, Colo., and at
80217-0550. Address
Cecilia Comerford-Ames
Executive Director, Colorado Society of Eye Physicians and Surgeons Communications Manager
Cecilia_Comerford@cms.org
Dorcia Dunn Program Manager, Membership Dorcia_Dunn@cms.org
Crystal Goodman Executive Director, Northern Colorado Medical Society
Crystal_Goodman@cms.org
Mihal Sabar Director of Accounting Mihal_Sabar@cms.org
AMA DELGATION
David Downs, MD, FACP
Carolynn Francavilla, MD
Mark Johnson, MD, MPH
Jan Kief, MD
Rachelle Klammer, MD
A. "Lee" Morgan, MD
Tamaan Osbourne-Roberts, MD
Lynn Parry, MD
Brigitta J. Robinson, MD
Michael Volz, MD
AMA PAST PRESIDENT
Jeremy A. Lazarus, MD
Chet Seward Chief Strategy Officer Chet_Seward@cms.org
Kim Vadas Director of Continuing Medical Education and Recognized Accreditor Programs
Kim_Vadas@cms.org
Debra Will Director of Business Development
Debra_Will@cms.org
and
Scribner Creative.
COMBINE PROFESSIONAL GROWTH WITH AN UNFORGETTABLE GETAWAY
YOU’RE INVITED TO THE 154TH COLORADO MEDICAL SOCIETY ANNUAL MEETING
Join the Colorado Medical Society and your peers from around the state in Breckenridge for the 154th CMS Annual Meeting Sept. 13-14. Attendees will experience cutting-edge programming on artificial intelligence, disaster preparedness, risk management and the latest on the evolving liability landscape, plus great food and plenty of opportunities to meet new colleagues and reconnect with old friends. Bring your family and friends along, as guests are welcome for all meals and programs, and we provide free childcare for kids 12 and under with advance registration. With ample free time to explore the stunning fall scenery and optional activities like hiking, sightseeing and fine dining, the CMS Annual Meeting offers a perfect balance of professional and personal. Register now and make this a conference to remember!
AGENDA HIGHLIGHTS
See the full agenda on CMS.org; subject to change
FRIDAY, SEPT. 13
12-5 p.m. Board of Directors lunch and meeting
This is the third quarterly meeting of the CMS Board of Directors in 2024, and will be offered as a hybrid meeting for in-person or virtual participation. All meetings are open to all CMS members to attend.
6-7:30 p.m. Welcome reception with Exhibitors
Don’t miss our opening reception to pick up your registration materials, meet and greet old and new friends, and visit with our exhibitors who keep the conference
fees low and offer great products and services. We will even bring a little tabletop magic from Scott the Magician.
7-8 p.m. Research Poster Competition open for viewing and judging
CMS welcomes all CMS members, especially medical students and residents, to present your research in three categories: primary research, case report and evidence-based review. Posters will be on display Friday and the top researchers will present their research live Saturday. Awards will be given in various categories. More information is available on the event webpage, or email kate_alfano@cms.org. Advance registration for presenters is required by Sept. 1.
SATURDAY, SEPT. 14
7-8 a.m. Buffet breakfast
8 a.m.-12 p.m., 4-8 p.m. Children’s camp
Bring the kids up to age 12 to enjoy arts and crafts, snacks, an evening movie and other activities with professional childcare providers while you participate in the meeting. Free, with kid-friendly food included! Advance registration required by Sept. 1.
8-9:15 a.m. Working Smarter with AI, with Alan Kimura, MD, and Sean Riley, MD, MBS
Explore AI’s role in medicine as panelists discuss how AI can transform evidence-based medicine into intelligence-based practices. 1.25 AMA PRA Category 1 Credits™
9:15-10:15 a.m. Health Care Availability Act Cap Increase: What Does It Mean and What to Expect? with Janel Loud-Mahany, MBA, and Beverly Razon, MBA
Participants will walk away with a good understanding of the changes that occurred, what impact there will be to premiums, and what they might expect over the next five years. 1 AMA PRA Category 1 Credit ™; 1 Copic Point.
10:15-10:45 a.m. Exhibit break
10:45-11:45 a.m. All Hazards Approach; All Population Response with Brian Feist, BSN, RN
Prepare your practice by exploring and applying key components in quality improvement to maximize efficiency in emergency preparedness planning and incorporate a community approach to mitigation, preparation, response and recovery. 1 AMA PRA Category 1 Credit ™
11:45 a.m.-1 p.m. COMPAC lunch featuring Colorado Lt. Gov. Primavera COMPAC hosts lunch on Saturday with a keynote by Lt. Gov. Dianne Primavera, an awards presentation to Rep. Shannon Bird, a brief business meeting to elect members of the COMPAC Board of Directors, and more.
1-1:45 p.m. Live presentations of top research posters
Top research posters from Friday evening's judging will be invited to present live during this afternoon session. 0.75 AMA PRA Category 1 Credit ™
2-3 p.m. AI – The Double Edged Scalpel with David Whitling, MD
Learn all you need to know about new AI tools and AI-powered applications through the lens of risk management and legal considerations. 1 AMA PRA Category 1 Credit ™; 1 Copic Point.
3-3:30 p.m. Final exhibit break with raffle drawings
3:30-5 p.m. Wellness break/free time
Take a break from a busy day to hike, bike or rest, and rejoin the fun for our evening activities.
5-6 p.m. President's Reception
Enjoy a cocktail reception with friends old and new before the President’s Gala.
6-9 p.m. President's Gala
The President’s Gala is the highlight of the weekend, featuring the passing of the gavel from outgoing CMS President Omar Mubarak, MD, MBA, to incoming CMS President Kim Warner, MD. Dress is semi-formal. Enjoy a buffet dinner, dessert, and time with peers.
SUNDAY, SEPT. 15
Open time for fun around Breckenridge
ENJOY BRECKENRIDGE
The Village at Breckenridge – our host hotel at the base of Peak 9 – provides easy access to all Breckenridge has to offer in the fall: beautiful views, hiking, biking, and numerous boutiques and award-winning restaurants along Main Street.
Just a few more ideas for a great weekend:
• Enjoy Breckenridge Oktoberfest – held on Main Street Friday to Sunday with free admission and activities for the whole family.
• Take a scenic drive up French Gulch Road to see the fall colors, the historic Country Boy Mine, the Reiling Dredge and the abandoned Lincoln Townsite.
ACCME ACCREDITATION STATEMENT
The Colorado Medical Society is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
AMA CREDIT DESIGNATION STATEMENT
The Colorado Medical Society designates this live activity for a maximum of 5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
ABS MOC STATEMENT
Successful completion of this CME activity enables the learner to earn credit toward the CME requirement(s) of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABS credit. ■
• Book an adventure through Alpine Activities; their concierge is available to coordinate fun activities for your group, from horseback rides to Jeep tours to zip lines and more. Call 970-262-0374 and see other options at alpineactivities.com. Scan to register
The Colorado Pain Society invites you to our 7th Annual Chronic Pain Conference, Oct. 11-13, 2024, in Vail, Colo., at The Hythe Live-streaming; Live or virtual attendance; No-cost virtual option for Colorado PCPs.
This will be a CME event (up to 16 CME credits), including 5 MATE credits towards DEA license renewal requirements, for physicians of all specialties, advanced practice providers (APPs), psychologists and others interested in pain management. The Colorado Consortium for Prescription Drug Abuse Prevention is sponsoring a virtual primary care attendance opportunity (16 CME credits) at no cost (for PCPs only), working in conjunction with Medical Education Resources and Colorado Pain Society. Virtual streaming will be available for live and virtual attendees including lecture access for 7 days post-conference.
Scan to register Scan to book lodging
Rediscovering friendships: Overcoming loneliness in a demanding medical career
Laura F. Martin, MD, Associate Medical Director, Colorado Physician Health Program (CPHP)
I miss my friends. How I’ve gotten to this place is a story I have heard countless times told by my patients, peers and loved ones. Prior to medicine, my friendships were typically strained due to geographic moves: best friends in high school dispersed across the nation on the way to college, then again to graduate school. As the intensity of medical training and work grew, my friendships became strained due to neglect given my little time and energy left over after long and hard workdays. I made what I thought was a temporary decision to take my energy away from strengthening my social connections to focus on work. Rather than a temporary imbalance, however, my energy remained inordinately focused on my work and family for almost two decades. I’m feeling particularly unbalanced now that my youngest child is leaving for college. This feeling of
imbalance and impending loneliness has prompted me to re-prioritize my social connections to prevent the development of more isolating alternatives such as overwork, alcohol, television or shopping.
Isolation and loneliness have impacts on not only our behavioral health, but also our medical health. Surgeon General Vivek Murthy, MD, has shone a light on our nation’s epidemic of loneliness in his book “Together: The Healing Power of Human Connection in a Sometimes Lonely World.” As a solution, he emphasizes spending undistracted daily time with loved ones, undistracted time with ourselves to understand how we are doing and connect with our world, and being of service to others. His office has made the antidote concrete through the creation of the 5 for 5 Connection Challenge and resources such as the
simple and powerful Made to Connect Cards. If you are in a medical leadership role, please also consider introducing evidence-based practices that can improve wellbeing and social connectedness among employees, such as COMPASS groups (Colleagues Meeting to Promote and Sustain Satisfaction) or other reflection-based groups.
Surgeon General Murthy also notes that receiving help strengthens social bonds. Strong social connections can help the phone feel less heavy when we need to reach out for help. For physicians, however, the phone can feel heavier if they struggle to recognize they need help, minimize their need for help when considering that it might reduce their time to help others, worry about appearing imperfect, can’t find the time, can’t share their stress due to patient privacy concerns, or worry about scaring a loved one with their pain. If this is the case, know that you are not alone and that there are great resources. Physician groups in the workplace or having a work friend for these moments can be a huge help, as can a therapist.
At CPHP we also have the Doc2Doc Wellbeing Consulting program (720-8109131) which is a free and confidential way to connect immediately to one of our clinicians and then have up to three free and confidential sessions with one of our medical directors to talk about anything you wish. We don’t have to wait until something bad happens to us to make a change or to find out how many people love and support us. We only need to pick up that phone to connect.
Thank you so very much for everything you do for others and please find a way to do something to take care of yourself today. ■
And then I cried
Sarah Shortall
Sarah Shortall is a fourth-year medical student at the University of Colorado School of Medicine. She grew up in Centennial, Colo., and has had the great pleasure of staying in Colorado for all of her schooling so far, including the University of Colorado at Boulder for her undergraduate neuroscience degree. She will apply for a residency position in internal medicine in the fall, with the hopes of pursuing training in an urban underserved community and continuing her exploration of humanism in medicine.
Crying is not a rarity for me, so it cannot be used as a marker to gauge the impact of a moment in my life. It is often present in formative experiences, in addition to those that are mundane or trivial. When I reflect on medical school so far, there have been several moments where the tears rose above everything else, where my emotions were so big that my body simply could not contain them. One Friday afternoon at the end of our first year, I had come home after our clerkship continuation ceremony, and a tidal wave washed over me. I suddenly felt overcome by the realization that by embarking on a year in clinical spaces, I would have the honor of witnessing life happen to our patients. We had been told for what felt like forever that we had the power to make a difference, that a medical student’s greatest gift is their time, and that we had a unique opportunity to make an impact on our patient’s care. But in this moment, I just did not believe it. We had just spent an hour listening to older students, faculty and family members tell us about what quality care had looked like for them and how they had found light in the darkness through shared connections. But what these stories all had in common was at the center of it all: a patient, with a whole life of their own, with relationships of their own, with legacies, loves, grievances and worries of their own. A human being whose experience in the hospital or clinic went far beyond what we would experience from our shared space and time. A parent, child, friend or lover who has a
role in our world that can likely never be understood by another person. And yet, I have been tasked with the seemingly impossible job of helping guide them through their journey. How would I do them justice? How could the work I do as a not-even-physician serve them as the distinct individual they are? How could I honor them as I bear witness to life and death simply happening? And so, I cried.
When I was given a patient to follow while on inpatient medicine because of her “interesting” medical history, I came to know her and her family, and these emotions arose in a new way. She was a 21-year-old who, due to Li Fraumeni syndrome, had already survived metastatic colon cancer. She had presented to the emergency department with nausea and vomiting for several days and left the hospital with a new cancer diagnosis. During her stay, I was exposed to the distinct and incredible individual that she is. We had spent several days chasing down a diagnosis, and it was ultimately an ERCP and biopsy that, even before confirmation by pathology, the GI attending was very suspicious meant cholangiocarcinoma. I had returned from this procedure to the workroom to share with the team what we had feared, and the senior resident and I planned to wait to give her the news until she had time to wake up from anesthesia, and for her mom to return. But when we entered the room to check on her, and she burst into tears and said, “it’s bad isn’t it?”, that
plan fell to the wayside. Instead, we sat on the edge of her bed, and we all cried. Because bearing witness to the intricacies and realities of her life in this same world as my own, was such an honor. And because this reality was not the one we had hoped for, but it was truth to her. I often think of her and the gift she has given me, of discovering a part of me that I hope to foster throughout my career. I hope to remember the complexities of the patient in front of me, and to never lose sight of the impact they have on their care.
I don’t have all the answers to the questions that overwhelmed me that first afternoon. But I feel comforted by the fact that the mere pursuit of honoring patients and their lives is worth something. I believe that the humanistic practice of medicine is both anticipating and celebrating real time all that is the human experience in and separate from medicine. Our patients deserve to be known, and their relationships, legacies, loves, grievances and worries deserve to be cared for. I want my practice to be my proof, to myself and to my patients, that this is a goal worth fighting for. I hope for the constant reminder that the unique human experience is one of, if not the single most important part of, the care we provide to our patients. No matter what, I hope to never stop asking myself how I can better serve and honor the individual in front of me. ■
Reflective writing is an important component of the University of Colorado School of Medicine curriculum. Beginning in the first semester, medical students write essays, stories or poetry that reflect what they have seen, heard and felt. The Reflections column was co-founded by Steven Lowenstein, MD, MPH, and Tess Jones, PhD. It is now co-edited by Dr. Lowenstein and Kathryn Rhine, PhD. It is dedicated to the memory of Henry Claman, MD, Distinguished Immunologist and Professor at the University of Colorado, and founder of the Arts and Humanities in Healthcare Program.
their 20 other patients. This unhoused patient was one of tens of thousands of unhoused individuals living in Colorado. There exists a larger systemic problem regarding the limit of health care resources, of which there are few for those without insurance.
As I think about humanism in medicine, I think about my struggles to maintain my own humanistic values of justice and equity as a medical student, and the challenges I will face when I have my own patients, many of whom may be unhoused, uninsured and underserved in a system that has limited resources for these populations. I thought about how I could have served the patient better in the three days that he was admitted in the hospital. Three days in the hospital meant three days in the health care system. As the medical student who saw the patient every day and could suggest treatment plans, it was important that I try to maximize the patient’s time and address what I could address while in the hospital. I could have made sure the patient’s bandages and wound were clean, teach the patient how to care for
his wound, provide diabetes education, work with physical therapy to maximize the patient’s strength, and work with occupational therapy to help the patient maximize his ability to perform activities of daily living while in a wheelchair. There was a lot that could be done for the patient before his discharge. If I worked with the patient while he was there, I realized that it was possible to try to give him the skills and resources needed for when he was outside of the hospital. I acknowledged that I had my own bias of believing that the patient’s health was doomed because of the resources he lacked, instead of thinking about what could be done with the resources he did have.
On a larger scale, I thought about how advocacy within medical organizations could be used to change the larger system. As a medical student who has gotten involved in organized medicine nationally and locally, I have seen the impact that policy can make to change inequitable systems. I knew there were policies that existed that could be used to create community initiatives to serve unhoused patients, like housing-first
initiatives that were already in place in Colorado. However, I could imagine that there were countless other policies that lacked action without consistent advocacy for its implementation and advancement. As a future physician, I think about how staying involved in organized medicine and acting on the injustice that occurs to unhoused patients – and to many others who face similar injustices –is another way I can serve and advocate for a better system for everyone.
The rotation made me realize how medicine does not only exist within the hospital or the clinic. I had to confront my own idealism and recognize how easy it could be to become disillusioned. By integrating my passion for health equity with the reality of the health care system, I realized it was important that I remember what can be done for each patient with the resources available. Health care can be unjust and unfair, but I can control whether it persists within the care I seek to provide. In doing so, I hope to be able to maintain my own humanistic values while providing care that every patient deserves. ■
COMMENT
Copic: Celebrating 40 years of supporting health care
Gerald Zarlengo, MD, Chairman & CEO, Copic Insurance Company
This year marks the 40th anniversary of Copic. It is a milestone we are honored to celebrate and a testament to the purpose that was set forth by our founders. We are still guided by principles that connect back to our early years and remain relevant as we grow and evolve.
While our core business is medical liability insurance, Copic has always strived to do more than traditional carriers and use our role in health care to give back on a broader level:
• We provide medical professional liability insurance at no charge to eligible Colorado physicians who provide uncompensated medical care.
• Copic’s legislative advocacy work is more vital than ever, and our partnerships with organizations such as the Colorado Medical Society and Colorado Hospital Association enable us to monitor and address legislation that impacts health care.
• Our ability to provide education extends into a long-standing medical resident rotation and involvement with medical schools that draws upon our insight to help prepare the next generation of physicians.
• The Copic Medical Foundation continues its goal of being a catalyst for innovative ideas through grant funding and other support that aim to improve health care outcomes
• We believe in using our decades of experience to keep providers and patients safe, proactively. During
my tenure as CEO, I am reminded of this every day and why we do what we do. I also understand that to appreciate what Copic has become, we need to look back at how the company emerged to protect health care in Colorado.
We believe in using our decades of experience to keep providers and patients safe, proactively. During my tenure as CEO, I am reminded of this every day and why we do what we do. I also understand that to appreciate what Copic has become, we need to look back at how the company emerged to protect health care in Colorado.
COPIC’S HISTORY
It was the early 1980s. Malpractice cases across the country had increased in frequency and severity. Awards skyrocketed and national insurance companies began to bail from unprofitable states. The companies that remained raised rates. Copic’s physician founders feared the worst: without affordable liability insurance, doctors would leave Colorado. This would threaten the health and wellbeing of everyone in the state.
With support from the Colorado Medical Society, our founders went to work. They formed a team of business experts who understood their vision. They also challenged the notion that a bunch of doctors could run an insurance company. The founding doctors knew medicine and understood their peers. Business advisors agreed – preventing claims and teaching doctors to practice safely benefited everyone.
But they still needed to sell their idea to the doctors they would insure. So our physician founders went on the road. They drove countless hours to meet Colorado’s 3,200 practicing physicians and shared their desire to make our state a great place to practice medicine. And they asked doctors to pledge $100 to fund this vision. Each $100 bill collected strengthened the medical society’s self-insurance trust. By 1984, and with additional funding from the Colorado Medical Society, this trust became Copic Insurance Company, a fully licensed professional liability insurance company. To this day, the Copic Trust continues to operate in a way the puts the needs of physicians and the medical community first because it is not beholden to the profit motives of shareholders.
COPIC TIMELINE
• 1984: Copic becomes a fully licensed and regulated Colorado insurance company.
• 1985: Copic Financial Service Group is formed to expand the line of insurance and financial products.
• 1988: Copic worked alongside the Colorado Medical Society to support the passage of the Health Care Availability Act, which created critical tort reforms and stability for medical providers.
• Early 1990s: Copic introduces educational seminars and practice reviews conducted by nurses to support improvements.
Mason Howard, MD, first CEO and founder of Copic, with Tom Tucker, an actuary who helped start Copic.
• 1991: Copic Medical Foundation is created as a nonprofit to provide grant funding and other support to the medical community.
• Early 2000s: Medical liability tort reform experiences setbacks when a pair of decisions by the Colorado Supreme Court leads to premium volatility. Copic responds with advocacy efforts that help to reintroduce premium stability.
• 2007: Copic’s 3Rs Program is recognized by The New England Journal of Medicine as part of a national transformation in how medical providers communicate with patients after adverse outcomes.
• 2016: Copic becomes accredited by the Accreditation Council for Continuing Medical Education.
• 2017-2018: Copic earns endorsements from the Iowa Medical Society, Minnesota Medical Association, Utah Medical Association, South Dakota State Medical Association, and North Dakota Medical Association, in addition to long-standing endorsements with the Colorado Hospital Association, Colorado Medical Society, and the Nebraska Medical Association.
• 2019: Copic is part of a coalition that extends the Colorado Professional Review Act, which improves care and promotes patient safety.
• 2022: Copic Medical Foundation hosts the first Grantee Summit so grant recipients can connect and collaborate.
CREATED BY DOCTORS, FOR THEIR PEERS IN MEDICINE
Today, Copic remains physician-directed. Having expanded our regional footprint to become the leading carrier in the Midwest/Rocky Mountain region, we have the strength and stability to support physicians, other health care providers, and facilities. We’re proud of the support we can offer and how this helps to deliver high-quality care for patients. Our success is, in large
part, because we’ve stayed true to our founders’ vision to improve medicine in the communities we serve.
I feel honored to be part of Copic’s history and celebrate how our past has enabled us to continue to serve Colorado’s health care community, now and into the future. ■
Members of Copic’s 2004 Board of Directors
Top row, from left: Dr. Lee Anneberg, Dr. Caroline Reilly, Dr. Jack Berry, Dr. Alethia Morgan, Virginia Berkeley, Dr. John Wolz, Dr. Stewart Greisman, Dr. Robert Bigelow, Dr. Jennifer Roller, Dr. Dick Parker Bottom row, from left: Dr. Roberto Masferrer, Dr. Theodore Clarke, Dr. Jerome Buckley, Steve Rubin, Dr. Barbara Reed
Medicare 2025: Huge changes impact everyone on Medicare
Alexis Pepple, MBA
The Inflation Reduction Act of 2022 has provisions pertaining to Medicare prescription drug coverage. We have seen small changes in 2023 and 2024, but much more significant changes will impact 2025 Medicare plans.
HERE IS A CHART FROM KAISER FAMILY FOUNDATION OUTLINING HOW THE PROVISIONS ROLL OUT:
Requires drug companies to pay rebates if drug prices rise faster than inflation.
Limits insulin copays to $35/month in Part D
Reduces costs and improves coverage for adult vaccines in Medicare Part D, Medicaid & CHIP
Eliminates 5% coinsurance for Part D catastrophic coverage Expands eligibility for Part D Low-Income
Subsidy full benefits up to 150% FPL Adds $2,000 out-of-pocket cap in Part D and other drug benefit changes
In 2025 the $2,000 cap is the maximum amount that Medicare enrollees will pay in drug co-pays beyond the deductible. This provision will benefit only an estimated 4 percent of Medicare enrollees, leaving the remaining 96 percent to feel the negative impacts of this cost reduction for a small portion of Medicare enrollees.
B and Part D drugs
Part B and Part D drugs
Further delays implementation of the Trump Administration's drug rebate rule to 2032
The maximum deductible for 2025 plans is projected to be $590. Many plans may have lower deductibles.
Let’s look at the ramifications for the insurance companies. They can only collect $2,000 + deductible from enrollees regardless of the expense of
the drugs. This will have a huge negative impact on their bottom lines and cause a ripple effect to negatively affect patients.
We anticipate that the insurance companies will respond to this constraint by:
1. Increasing premiums on standalone Rx plans (double or triple!)
2. Further degradation of the Rx formularies
a. Fewer medications covered
b. Tier 3 drugs most likely will go to a 25 percent copay as opposed to a specific dollar amount
3. Decreasing other benefits on Medicare Advantage plans
4. Discontinuing Rx or Medicare Advantage plans
Regarding the discontinuance of Medicare prescription drug plans, we have historic precedence for this scenario. In Colorado, two inexpensive Medicare Rx plans were discontinued from 2020 to 2021. The insurers informed enrollees
of the discontinuance and stated that the enrollee would be automatically transferred to the insurer’s “most comprehensive” Rx plan; in other words: MOST EXPENSIVE! If the enrollee was not paying attention and did not actively enroll in an alternate plan the insurance company automatically moved them into that “most comprehensive” Rx plan, and the enrollee was stuck for the following year.
People who didn’t pay attention woke up in January 2021 to a bill for a Rx plan that went from $19 per month in 2020 to over $80 per month in 2021!
This same strategy is certain to be used for 2025 Rx plans and makes the 6 percent limit on premium increases meaningless because insurers will simply discontinue low-cost plans.
TAKE AWAY
This will be the most important Medicare Annual Enrollment Period (AEP) in decades. All of your patients should
compare their medication regiment to match to the best 2025 plan during AEP which runs from Oct. 15 to Dec. 7.
Patients may want to consider refilling prescriptions in November and December of 2024 if possible. Savvy sourcing is required; compare prices on GoodRx, Cost Plus and other sources with the copays on their Medicare Rx plan.
Pepple Insurance can help your patients as well as provide an educational lunch and learn for your staff.
Mary Jo Heins is a former medical practice manager and past president of Colorado Medical Group Management Association. Now she and her colleagues at Pepple Insurance are totally focused on Medicare. https://www.peppleinsurance. com 720-593-6155
Pepple Insurance is proud to be a Partner in Medicine with the Colorado Medical Society. https://www.cms.org/partners/ Pepple-Insurance. ■
Report from the AMA Annual Meeting
COLORADO PHYSICIANS REPRESENT YOU IN CHICAGO
Kate Alfano, CMS Director of Communications
Your elected delegation of Colorado physicians traveled to Chicago in June to represent you at the American Medical Association House of Delegates meeting and conduct other business on your behalf. We are grateful to these volunteer physician leaders for their time and dedication to organized medicine. Of particular note:
• Carolynn Francavilla Brown, MD, became chair of the AMA’s Private Practice Section. Dr. Francavilla looks forward to amplifying the voice of private practice physicians nationwide in this role.
• AMA Delegates also passed a report supporting the use of appropriately trained virtual assistants in medical practice, and pledged to help create tools to support physicians use of virtual assistants. This policy was created based on a resolution originally offered by Dr. Francavilla.
• Jan Kief, MD, became vice chair of the Council on Long-Range Development and Planning.
• Tamaan Osbourne-Roberts, MD, continued his service as a member of the Council on Science and Public Health.
Colorado medical student leaders also traveled to Chicago to participate in the AMA Medical Student Section Annual Meeting and the AMA House of Delegates meeting.
• Dakota Hitchcock, MS4 at the University of Colorado School of Medicine, presented research on the geospatial impacts on initial melanoma stage, highlighting the health care disparities in rural communities. She also testified in support of opposing capital punishment (which was adopted by the House of Delegates) and in opposition to eliminating the requirements made for the executive vice president position at the AMA (which was not adopted). Hitchcock was also a team lead for the Medical Student Section for RefCom CCB (Committee on Constitution and Bylaws), leading the efforts and testimony from medical students presented in this reference committee.
• Hojin Seo, MS4 at Rocky Vista University, presented her research on a rare case of urinothorax, and created and led programming as part of her work on the Medical Education Committee.
• Sonia Abraham, MS4 at RVU, created and led programing during the MSS Assembly as chair of the AMA’s Medical Student Section Minority Issues Committee.
• Renee Dreher and Marlee Akerson, MS1s at CU, attended their first AMA Meeting and served as the CU AMA chapter delegates to the MSS Assembly.
• Jason Seeley, MS1 at RVU, attended his first AMA Meeting and served as the RVU AMA chapter delegate to the MSS Assembly.
Medical student leaders and members of the Colorado Delegation to the AMA attend the AMA Annual Meeting.
HERE ARE OTHER NATIONAL HIGHLIGHTS:
• Bruce A. Scott, MD, an otolaryngologist and private practice owner from Louisville, Ky., was inaugurated as the 177th President of the AMA, promising to spend his tenure fighting for members, for the profession and for patients. Dr. Scott was the special guest at our 2023 CMS Annual Meeting.
• Bobby Mukkamala, MD, was elected president-elect of the AMA and will be inaugurated at the 2025 AMA Annual Meeting.
• The LGBT+ Caucus was officially elected into Section status, which will allow one Delegate and Alternate to sit in the House of Delegates.
• Medicare pay reform is one of the AMA’s top advocacy priorities, and the AMA is working to advance comprehensive fixes to physician payment for Medicare. One fix would provide physicians with an annual, permanent inflationary update in Medicare tied to the Medicare Economic Index.
The Interim Meeting of the American Medical Association will be held in Buena Vista, Fla., in November, when the Colorado Delegation will again represent you on the national stage. ■
Thank you to the physicians who volunteer their time on the Colorado Delegation to the AMA:
Lee Morgan , MD, AMA Delegation Chair, David Downs , MD, FACP, Carolynn Francavilla , MD, Mark Johnson , MD, MPH, Jan Kief, MD, Rachelle Klammer, MD, Tamaan Osbourne-Roberts, MD, Lynn Parry MSc, MD, Brigitta Robinson , MD, FACS, Michael Volz , MD
Thanks, also, to the medical students who attended this year:
Sonia Abraham, MS4, RVU
Marlee Akerson, MS1, CU
Renee Dreher, MS1, CU
Dakota Hitchcock , MS4, CU
Jason Seeley, MS1, RVU
Hojin Seo, MS4, RVU
Colorado Medical Society Foundation supports medical students through annual scholarships
Cecilia Comerford-Ames, CMS Communications
Every year, the Colorado Medical Society Foundation (CMSF) proudly awards scholarships to promising future physicians. CMSF offers two distinguished scholarships: the Gilchrist Student Leadership Scholarship and the Rural Track Scholarship.
The Rural Track Scholarship financially supports students in good academic standing who are completing their first or second year in a rural medicine track or program of a Colorado medical school. This scholarship aims to encourage and assist those committed to serving rural communities.
The Gilchrist Student Leader Scholarship provides financial assistance to third- and fourth-year medical students who have made significant leadership contributions to organized medicine. This scholarship recognizes their dedication and outstanding achievements.
Below are the scholarship awardees who have already made incredible contributions to benefit their communities and show great promise for the future.
RURAL TRACK SCHOLARS
Roopa Bhat: Witnessing the struggle for health care access in rural New Hampshire, future doctor Roopa Bhat was driven to create When2Go, an app that supports the rural community to know when to make a trip to the hospital. Inspired by personal experiences and as an EMT, she saw the deeper needs of these communities. Now, with a computer science degree from Columbia and further training at the University of Colorado School of Medicine's rural track program, she is dedicated to becoming a physician who brings comprehensive care to underserved areas.
Rebecca Bolen: Growing up in Winter Park, Colo., future doctor Rebecca Bolen witnessed firsthand the challenges of rural health care. Her journey began with an EMS course in high school, sparking a passion for rural medicine. At Rocky Vista University she created Rural Roots: Healthcare Pathways to get more rural high schoolers interested in medicine. Her goal is to return as a dedicated rural doctor, giving back to the community that shaped her.
Isabella Contolini: Future doctor Isabella Contolini is a passionate advocate for rural and wilderness medicine. Growing up in Denver’s suburbs, her love for the outdoors and desire to help others led her to this unique path. Her inspiration for rural medicine was fostered by mission trips to Guatemala and shadowing a physician, and she aims to build close patient relationships and serve her community. Isabella's journey is driven by a deep commitment to Colorado medicine.
Robert Tolson: Future doctor Robert Tolson, a first-year medical student at Rocky Vista University, is passionate about rural and wilderness medicine! Growing up in Fort Morgan, Colo., Robert's childhood and high school experiences at St. Elizabeth Hospital shaped his dedication to rural health care. Inspired by his mother, a devoted lactation consultant and obstetric nurse, Robert values the deep connections formed in tight-knit communities. He is working to become a rural physician who offers not just medical care but also friendship and support. Robert aims to give back to the community that raised him, carrying forward his mother’s legacy.
Conor Wallace: Future doctor Conor Wallace grew up in Eagle County, Colo., where he had firsthand experience with rural health care disparities. After supporting family members through six-hour drives for treatment, late diagnoses, and a shortage of providers, he is committed to helping solve these issues. After training, he will serve rural Colorado communities and make a positive impact on the lives of individuals and families.
GILCHRIST SCHOLARS:
Sonia Abraham: Future doctor Sonia Abraham is a proud Colorado native. Her journey to leadership began with a passion for equity. In high school, she discovered the transformative power of volunteering at an underserved clinic, igniting her commitment to community service. Throughout medical school, she wrote policy for CMS and testified on critical patient and physician issues. As a liaison at CDPHE health equity meetings, she amplified student voices, believing that recognizing community gaps is vital to uplift and safeguard marginalized groups.
Dakota Hitchcock: Since joining CMS, future doctor Dakota Hitchcock has witnessed the power of advocating for communities. Driven to serve underserved populations, with a passion for rural medicine and reducing health care disparities, she saw firsthand the challenges of opioid use disorder in rural Alamosa, Colo. Through AMA advocacy, she helped secure Medicaid funding for essential car rides to treatment. This experience solidified her commitment to advocacy in medicine.
Pritika Parmar: Future doctor Pritika Parmar recognizes the importance of taking health equity issues from research to clinical care, and ultimately to legislation. As a Colorado student delegate to the AMA, she supported policies to combat skin cancer and improve interpreter services for low-English proficiency patients. She is committed to advocacy and aspires to bridge the gap between research, clinical care and policy, ensuring equitable health care for all.
CONTRIBUTE TO THE FOUNDATION
CMSF can’t support the future of medicine without your support. Visit cms.org/ contribute to make a contribution, or add a donation to your annual dues when you receive your 2025 membership invoice in September.
Remembering a CMS and physician leader: James Robert Regan, MD
May 31, 1956 - June 9, 2024
James R. Regan, MD, passed away on June 9, 2024, shortly after his 68th birthday. He is remembered for his empathetic nature and a remarkable career in Internal Medicine spanning over four decades.
Born in Detroit, Mich., Dr. Regan attended Colorado College and Wayne State University, earning his medical degree in 1982. He completed his internship and residency at St. Joseph Hospital in Denver.
Throughout his career, Dr. Regan was deeply involved with the Colorado Medical Society (CMS), starting in 1983. He served as the President of the Denver Medical Society in 2000, in addition to chairing several Task Forces, serving as a Board of Directors member in 2003, and serving as CMS Treasurer from 20062009. He was also recognized as a Fellow by the American College of Physicians, an honor reflecting his excellence in internal medicine.
A GREAT MEMBER BENEFIT
Dr. Regan’s commitment to patient care was evident in his leadership roles as medical director at Good Shepherd, Bethesda, and AbleLight, where he cared for patients with developmental impairment for over 20 years. His practice transitioned through various stages, eventually adopting a boutique style under the MDVIP model to offer highly individualized care. He valued the ability to practice medicine in a way that allowed him to give each patient the amount of time they needed, developing a deep bond with them to support their total care.
He is survived by his wife Nita, his children Page, Stephen and Brett, and his sister Kathy. Dr. Regan's legacy continues through the countless lives he touched as a physician and his lasting impact on the medical community.
Modernizing our dues structure to remain a strong CMS
Hap Young, MD, CMS Treasurer
Over the last several months the Colorado Medical Society’s Board of Directors, working with staff, took action to ensure the continued strength of our organization. This entailed modernizing CMS’s membership categories and dues structure. Our goal, both now and in the future, is to provide greater flexibility and better meet the needs of Colorado’s evolving physician demographics and marketplace.
For the first time in 20 years, CMS will be adjusting our membership dues. Starting in 2025, most dues-paying members will experience a modest $50 increase. This increase is essential for keeping pace with inflation and maintaining the high-quality services and advocacy efforts that our members deserve and expect. The Board has also approved small, inflationary adjustments in the future to ensure the continued viability of CMS. See the full slate of adjustments in the chart below.
A task force comprised of your peers on the CMS Executive and Finance commit-
THANK YOU
to our 2024 Annual Meeting exhibitors and sponsors
• Copic
• Center for Personalized Education for Professionals (CPEP)
• Colorado Physician Health Program (CPHP)
• Cruise Planners
• DEA
• Delta Dental
• Favorite Healthcare Staffing
• Panacea Financial
• PNC Bank
• Revascent
• TCS World Travel
• Tebra/Patient Pop
• Touchstone
• Xyla Health
Read more about the meeting on page 4, and register at CMS.org/events.
tees analyzed market trends, data and strategies to develop the new model. Our top priority was maintaining and building upon the benefits CMS provides; from robust advocacy at the state capitol to accrediting continuing medical education (CME), and from supporting practice viability to keeping you informed with timely publications. Your dues are put to good use, and to continue delivering these and other invaluable services, it was impera -
tive that we align our dues with the current economic landscape.
Of course, your voice matters to us. If you have any questions or concerns about these changes, we encourage you to reach out to membership@cms.org. We are committed to transparency and will gladly discuss how these adjustments will support our mission to serve Colorado’s physicians effectively. ■
Colorado Medical Society Member Categories and Dues Structures
See what’s inside
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