Colorado lawmakers not proposing major health care reform bills

Predictions of a flurry of legislation in the wake of the 208 Commission's health care reform report have proven false, with fewer health care bills being filed so far this session of the General Assembly compared to last.

None of the bills deal with major health care reform, which Gov. Bill Ritter recently said should come from the federal government -- not from the states.

"We're waiting for the other shoe to drop," said John Suits, assistant administrator for government affairs at Memorial Health System. "We really thought that after the 208 Commission gave its report, that we'd be inundated with bills related to health care. We thought the legislators were really waiting to hear the report before they presented their own ideas for reform."

Of the 350 bills in the House, only 56 deal with health care. The Senate has introduced 150 bills, with 32 of them related to health care, said Rich Haugh of the Colorado Hospital Association.

"We're expecting quite a bit more," he said. "We think it's going to be an interesting year for health care legislation. Last session, there were at least 130 (bills) introduced."

But while substantial reform proposals have yet to materialize, several bills will affect doctors, hospitals and first responders. The Colorado Hospital Association and the Colorado Medical Society are tracking bills that could affect their constituencies.

Senate Bill 138

Senate Bill 138 could prove to be the most controversial of the session. The bill, sponsored by Republican Steve Johnson of Fort Collins, establishes "acceptable criteria" for use in consumer information programs about doctors.

Critics say the bill is designed to end the trend of medical transparency and will make information about doctors' cost, quality of care and bedside manner more difficult to obtain.

The bill establishes defined criteria for online information services that can result in unfavorable information about a doctor based on skewed or faulty information.

"Conceptually, it's not a bad idea," said Steve Berkshire, a professor at Regis University. "The idea behind it is to give people making decisions information about the doctor. But some of the information -- given in the wrong context -- could prove damaging to the doctor. For instance, just because someone has filed a malpractice claim against a doctor, doesn't mean the claim is justified."

The Colorado Medical Society, which represents the state's physicians negotiating with the insurance industry about the language in the bill. CMS helped draft the bill, and says many insurers experimenting with transparency use information that gauges efficiency based on irrelevant data. Other factors that could influence patients include a star rating. The bill aims to eliminate both the star rating and the message board feedback that has little to do with a doctor's competency, according to CMS.

"Our formal policy is that we want transparency," said Dave Downs, CMS president. "But we want to make sure there are ways to ensure accuracy and usefulness to people. We want to assure that the information is accurate and correct. We want to be assured that doctors can update and provide supplemental information."

The bill requires an evidence-based approach to show how doctors treat and diagnose medical conditions.

Suits said Memorial was watching the bill closely -- and would support the hospital's physicians.

"I think there's some compromise language from New York that will allow the bill to go through," he said. "I think they're going to be working on that language before it leaves committee."

The New York agreement, endorsed by the American Medical Association and the Consumers Union, creates an independent committee to oversee concerns about doctor performance measurement programs.

Nursing bills

The 208 Commission isn't the only task force to have finished its work. The Governor's Task Force on Nursing turned in its report at the end of December. Two bills address changes recommended in that report.

One bill adds nursing measures to the state-mandated Hospital Report Card. The CHA is responsible for gathering information for the report card.

"So far, all the parties are in agreement," Haugh said. "We don't really anticipate a problem with it. The report card will add nurse- sensitive information."

The second bill might prove more difficult -- especially to pay for. It creates a pilot program that would examine model nursing practice inside hospitals.

"They're still working on the language for the pilot program," said Sara Jarrett, a professor at Regis University's nursing program. "As I understand it, the project will demonstrate to show how staffing levels could be enhanced. A good model could be a good idea -- but the financing of that is another story."

Trauma care

Even as legislators await a final report from an independent consultant about Colorado's trauma care, the legislature is considering several bills concerning payment for trauma services.