What I write today, 12/15/09, you will read in the New Year, 2010, a year which may begin with some actual scaffolding for the Country's healthcare reform. There is no point in speculating on what may happen over the next month. Things are changing too quickly. I would like to bring to your attention, however, some of 2009's Medical Society highlights. In October, 2009, the Pennsylvania Medical Society (PMS) published a research brief which was the result of a resolution passed by your peers at the 2008 PMS annual business meeting in Hershey. The resolution directed the PMS to research and report on the cost of health insurance, drug formularies, and reimbursements for E&M codes in PA and in seven surrounding States. It appears that in PA, the average medical plan cost per employee is higher than the national average "for every product except HRA-based consumer-driven health plans." As for average reimbursement levels for commercial health insurance, for new and established patient visits, 99201-99203 and 99211-99213, PA payment levels are 5th-6th lowest. We do a bit better for the higher codes 99204-5 and 99214-5. You can see the full report on the PMS web site. It is interesting to note that IBC in Southeastern PA, at least for smaller doctors' groups without negotiation clout, has come up to a whopping 95% of Medicare. As you all know, also in October, $100 million was transferred from the MCARE fund to the State's General Fund. You should know that all of our County legislators, with one exception, voted against this raid on our money. You should also know that several of them went against their caucus leadership and crossed party lines to support us. Most notably, Rep. Curt Schroder from the 6th District formally challenged the constitutionality of the money transfer and led a forceful effort to block the raid. The challenge unfortunately failed by a vote of 99-98, 99 members of the House voting that the transfer was constitutional! We are extremely grateful to Rep. Schroder for his efforts. The PMS along with HAP has filed a law suit challenging the State's actions. At the 2009 annual business meeting of the PMS, there was also heated debate over the MCARE raid. A resolution passed directing the PMS to investigate the establishment of an escrow fund to hold future payments into MCARE. You will be updated on this in 2010. Also at the meeting, given the excessive requirements of the ACCME's 2006 accreditation criteria and the negative effect these requirements are having on hospital CME programs in Pennsylvania, your colleagues passed a resolution on the floor directing the PMS to work with the AMA to directly intercede with the ACCME to simplify the CME accreditation and reaccreditation process. I would like to point out that CCMS has established that the hospital CME accreditation requirements with which our local hospitals are struggling come from the ACCME and not from the PMS. The PMS has a new President, Dr. James Goodyear who has spear-headed the Institute of Good Medicine, a center of research, State medical resources, volunteer efforts and much more which you can access on the web site. Your CCMS board has grown in 2009. The annual members' meeting, to be held in June of every year, at which time the CCMS members will vote for their CCMS Board Executives will be reinstalled. In the future, we hope this will involve the members more directly in the workings of their Society. Our website is expanding as will the Quarterly Bulletin in 2010. We will bring you more information about the health care network in your County and how your colleagues are contributing. We will be establishing a yearly scholarship which will be awarded at the Annual Meeting to a Chester County student who has presented an exceptional project involved in some aspect of health care. We will be hosting speakers and arranging opportunities for County doctors to meet and talk with their Legislators, particularly as the action on national health care reform unfolds. We will be working to assist our County volunteer clinics. As we move into 2010, I'm looking for the CCMS to become a more meaningful and useful organization, to physicians and to non-physicians alike. Take the voice you bring to your practice groups and to your hospital committees and bring it to the CCMS where as a group we can have some impact on how things get done in Chester County. Wishing you safe and peaceful Holidays. Ruth S. Holland, MD