Statement of Tamaan Osbourne-Roberts, MD, President, Colorado Medical Society

Commissioner Salazars news that insurance premium increases will rise at a slower rate
in the coming year is certainly welcome; it is also good news (inferred from decreased
premiums) that more of Colorado's health care system has become better integrated and
coordinated. The more physicians, hospitals, and other caregivers are coordinating with
each other, the more costs will fall due to less redundant, higher quality care.

However, we know from long experience that simply cutting reimbursements without
regard to value has the potential to cause havoc in the delivery system. Inevitably, the
volume of services increases to offset such losses; additionally, good care is priced out of
the marketplace, leaving behind large gaps in services, longer wait times, increased
overuse of the emergency room as a high-cost primary care alternative, and care delays
that convert simple problems to acute emergencies. In addition, physicians and medical
students, rationally, begin to avoid service lines that are not economically sustainable,
exacerbating physician shortages.

When health insurers began asking physicians to participate in products sold on the new
health insurance exchange, CMS did hear that some of the companies would offer rates
that were lower than other, existing commercial products. More than a few CMS
members raised concerns specific to the narrowing of the networks for these products. It
is our understanding that at least two of the companies who implemented these products
have indicated that the narrow network products will not just be offered to consumers on
the exchange but also will be part of their larger marketing strategy going forward. While
we believe that these reports should be confirmed through interviews with the health
insurance companies, the CMS House of Delegates, just last Saturday, passed policy
affirming that as networks are narrowed, stronger transparency requirements are
necessary to ensure that such networks are built on criteria that account for cost and
quality.

CMS strongly supports additional collaboration between health plans and providers, and
looks forward to our continued work bringing high-quality, low cost health care to all
Coloradans.