A presidential result that surprised even the most accurate pollsters sent a clear message that repudiates the Washington establishment and demonstrates that Americans were yearning for a "change" candidate this year. Both houses of the U.S. Congress are also now Republican-controlled, and all of the incumbents in the Colorado congressional delegation are headed back to the capitol.

On the state level, the political climate did not change much. The Senate Republicans held the majority by one seat (18-17), while the House Democrats also kept the majority, gaining three seats (37-28). Since the Governor wasn't up for election this cycle, state politics should remain fairly consistent with the last two sessions. Leadership for all four caucuses were elected yesterday, Nov. 10. See the leaders in the extended story here. 

Colorado voters approved the ballot initiative to allow for physician-assisted death and the amendment to make it more difficult to alter the state constitution, while defeating the proposed tax increase on tobacco products and the amendment to create a health care cooperative to replace most other health insurance.

COMPAC-endorsed candidates fared very well in the election. This is largely in part to a candidate briefing and interview process that is a model for professional and trade associations.

Local physicians, working with CMS and component society staff, brief candidates on medicine's priority issues. Candidates receive a "Candidate Briefing Document" well before the interview that lays out the background on each issue: Colorado's stable liability climate, health care reform, managed care, scope of practice, etc. The CMS lobby team is available to answer questions about the issues, and local physicians conduct the interview in the candidates' district.

This process provides for two-way dialogue. Physicians and lobbyists get to hear how a candidate thinks about issues. The candidate learns about the passion that physicians have for issues affecting patients and practice.

After the interview of both candidates is complete, physicians vote to recommend the endorsement of one of them to the COMPAC board. Occasionally, the local physicians recommend staying out of the race.

During the election cycle just completed, COMPAC endorsed 82 federal and state candidates; 77 were elected. COMPAC's goal is to help them all know or get to know better their local medical community leaders, and understand that physicians in the community care and are engaged.

COMPAC needs your support to continue its work. Donate to COMPAC or the Small Donor Committee online at www.cms.org/contribute.

Practices that have concerns about whether they will be subject to 2017 payment penalties associated with the Physician Quality Reporting Program have until Nov. 30 to file for an informal review of their data.

Find instructions on requesting an informal review here in the PQRS "Informal Review Made Simple" document; the steps are outlined on pages 4-5.

The penalties stem from policies in effect prior to the enactment of the Medicare Access and CHIP Reauthorization Act. Failure to successfully complete required PQRS reporting will result in a 2 percent penalty. Value Modifier penalties can range from 1 percent to 4 percent depending on the size of the practice and its performance on cost and quality measures. PQRS penalties will be communicated to physicians by mail as well as in the PQRS feedback reports posted on the CMS website. Value Modifier penalties and bonuses can be found in Quality and Resource Use Reports (QRURs) posted on the website only.

Additional information on accessing the reports and filing for an informal review can be found here and here. Those who have questions, even if they are uncertain about penalty status, are urged to submit a request for informal review. Although in most cases a successful PQRS review will trigger an automatic review of related VM penalties, program officials say the safest course is to file requests for review of both PQRS and VM data.

Last week the Centers for Medicare and Medicaid Services issued the final Medicare Physician Fee Schedule for 2017. The agency finalized a number of new policies that will improve Medicare payment for those services provided by primary care physicians for patients with multiple chronic conditions, mental and behavioral health issues, and cognitive impairment conditions.

The final rule addresses other topics related to the Medicare program such as release of certain Medicare Advantage bid data and Part C and Part D medical loss ratio data, enrollment requirements for providers and suppliers in Medicare Advantage, and the Medicare Diabetes Prevention Program expanded model.

Read more here. The final rule can be found at the Federal Register website here.

Through comment letters and conversations with the agency, the American Medical Association recommended many changes to create a more flexible transition to the updated Medicare program, and they report that the federal CMS has adopted a majority of those recommendations in the final rule.

"There is still work to be done to improve the QPP, but it appears that we are off to a strong start," said AMA President Andrew W. Gurman, MD, in an email. "CMS' revisions will allow for a reasonably paced progression into the program so that physician practices can learn and adjust over time."

The Department of Health Care Policy and Financing has printed materials available to help health care providers and others spread the word about Health First Colorado, the new name for Colorado's Medicaid program.

Supported by the Colorado Health Foundation, posters in English and Spanish, and quick fact cards are available and may be picked up from the Department's main office at 1570 Grant St., Denver, 80203 during regular business hours, Monday-Friday, 8 a.m.-5 p.m. They are unable to mail materials.

Electronic versions of these printed materials, as well as web banners in multiple sizes, audio messages and sample social media and blog posts, are available online.

Questions about the materials? Contact Debbie Fimple, Health First Colorado grant manager, at debbie.fimple@state.co.us or (303) 866-6346. Visit the Health First Colorado stakeholder webpage for more information about the name change.