Accredited CME Providers Can Now Help Clinicians Earn Performance Incentives from CMS
New Report Promotes Research in Interprofessional Continuing Education
AMA/ACCME Alignment: Providers Can Now Enter Activities as “Other” in PARS
Tips and Tools
Guidance on the Standards for Commercial Support and International Industry Codes
Compliance Reminder about Identifying and Resolving Conflicts of Interest for CME Planners
CME that Counts for MOC: Updates and Reminders
For Your Reference
Call for Abstracts Due December 19: AAMC 2018 Integrating Quality Conference
Accreditors Target Training Gaps that Contribute to Burnout
Stem the Tide: Addressing the Opioid Epidemic AHA Toolkit
Exploring a Business Case for High-Value Continuing Professional Development: Proceedings of a Workshop
REMS and Continuing Education for Health Care Providers: FDA Feasibility Report
The President’s Commission on Combating Drug Addiction and the Opioid Crisis
In Case You Missed It
Tips and Data Submission Deadline Reminders for CME that Counts for MOC
PARS Enhancements Bring More Functionality and Flexibility
ACCME Seeks New Public Member of the Board of Directors
CME Counts for Improvement Activities in CMS Quality Payment Program
In its final rule, the Centers for Medicare & Medicaid Services (CMS) added accredited CME as an improvement activity in the changes for the Quality Payment Program (QPP). The changes take effect on January 1, 2018, the second year of the QPP, as part of the Medicare Access and Chip Reauthorization Act of 2015 (MACRA).
This rule now gives accredited providers in the ACCME System the opportunity to help clinicians meet CMS expectations, which can prevent financial penalties and offer financial incentives to clinicians who engage in quality and performance improvement activities. The elements of the new rule provide flexibility and freedom for educators to engage with clinicians in improvement activities that are meaningful for those learners. The rule outlines a process that can be used across specialties and practice types, can apply to a broad range of content areas, and utilize a range of outcome measures. The inclusion of accredited CME reflects recommendations from the ACCME and others that CMS develop a process that allows accredited providers flexibility and permission to meet clinician needs. Read the ACCME’s letter to CMS here.
To meet the criteria for improvement activities in the Merit-Based Incentive Payment System (MIPS) of QPP, accredited CME providers need to implement activities that:
- address a quality or safety gap that is supported by a needs assessment or problem analysis, or support the completion of such a needs assessment as part of the activity;
- have specific, measurable aim(s) for improvement;
- include interventions intended to result in improvement;
- include data collection and analysis of performance data to assess the impact of the interventions; and
- define meaningful clinician participation in their activity, describe the mechanism for identifying clinicians who meet the requirements, and provide participant completion information.
You can find the criteria described above in the PDF of the final rule on page 624.
Opportunities for Accredited CME Providers
The inclusion of accredited CME in MIPS offers an opportunity for providers to demonstrate the value of CME in promoting clinician engagement in efforts to improve performance, quality, and safety. Accredited CME providers can support their clinician learners in several ways: you can help clinicians understand how to identify improvement activities, facilitate those activities, and then assist clinicians in attesting to their participation; and you can plan and present CME activities that will count as improvement activities.
We’ve provided a list of resources below that can enhance your understanding of MIPS and that you can share with your clinician learners to support their participation.
CME that Counts for MIPS
You’ll see that the MIPS improvement activity criteria are well-aligned with the ACCME Accreditation Criteria and may align with your CME mission and program. You may already be delivering activities that will fulfill the criteria. Delivering CME that counts for MIPS within the already existing framework of a clinician’s educational home could streamline and demystify the process for clinician participation.
CME + MOC + MIPS: You’ll see that the MIPS criteria are also aligned with the American Board of Internal Medicine (ABIM) Practice Assessment Maintenance of Certification (MOC) requirements. This offers another opportunity for CME providers to ease the burden on clinicians by delivering activities that meet multiple expectations. Providers can offer activities that enable clinicians to earn CME credits and ABIM Practice Assessment MOC points—and those same activities can count for MIPS. More information about CME that Counts for ABIM MOC is available here.
We suggest that accredited providers:
- Review the MIPS improvement activity criteria described in the bulleted list above.
- Review the letter ACCME sent to CMS about how accredited CME can support MIPS goals. The letter includes a few examples of accredited CME activities that focus on quality and performance improvement and appear to meet MIPS expectations.
- Identify activities that you are designing to change performance or patient outcomes. (ACCME Accreditation Criterion 3)
- Identify activities that will be part of a quality improvement initiative for individual clinicians or for small or large groups.
- Identify activities that will be offered for ABIM Practice Assessment MOC points.
- Consider teaching clinicians how to implement quality measures into their practice and supporting them in implementing these performance improvement programs.
Providing Guidance for Clinicians
- 2017 Improvement Activities: Data submission for 2017 begins January 2, 2018 and ends on March 31, 2018. More information is available here. Note: the new process outlined above does not apply to 2017 Improvement Activities.
- 2018 Improvement Activities: Clinicians can report their participation in accredited CME activities that meet the MIPS criteria beginning in 2018. You can help clinicians identify CME activities and other activities that meet MIPS criteria and educate them about how to attest to their participation and report their activities. More information about MIPS is available in the resources listed below.
Next Steps for Accredited CME
The ACCME is working with CMS to obtain specific guidance about how clinicians should attest once they have completed the activity. In addition, we anticipate collaborating with the CME community and CMS to identify a simple, nimble mechanism for reporting clinician engagement that will relieve the burden on clinicians.
As more information becomes available we will share it with the CME community and we will continue to provide guidance about how accredited CME providers can implement activities that count for MIPS improvement activities.
If you have questions, please contact us at email@example.com.
The following resources are available on the CMS website:
- MIPS Improvement Activities Fact Sheet: Overview that includes guidance for submitting improvement activities
- Quality Payment Program Fact Sheet: Overview of Quality Payment Program Year 2 Final Rule
- Quality Payment Program Resource Library: Resources including specific information about MIPS measures by clinician profession
- Merit-based Incentive Payment System: 3 Ways to Participate in 2017: Infographic that summarizes three ways to participate in 2017 and includes links to additional resources
- Quality Payment Program website: Overview of eligibility and participation guidelines, with links to additional resources
The American Academy of Family Physicians (AAFP) published a list of acronyms and definitions on its website: MACRAnyms: Acronyms and Terms Related to MACRA.
A new report, Promoting Research across the Continuum of Health Professions Education: Making Patient Care Better, explores recommendations for advancing research on the effectiveness of interprofessional continuing education (IPCE) in improving healthcare team performance and patient care.
The report summarizes the 2017 Joint Accreditation for Interprofessional Continuing Education Leadership Summit, which brought together continuing education (CE) leaders from 30 institutions across the country including hospitals, health systems, medical schools, specialty societies, and education companies. Participants shared strategies, best practices, and case studies for conducting and disseminating research that shows how IPCE programs contribute to measurable improvements in team care and patient outcomes.
This report serves as an addendum to the 2016 report, By the Team for the Team: Evolving Interprofessional Continuing Education™ for Optimal Patient Care-Report from the 2016 Joint Accreditation Leadership Summit.
The Leadership Summits and reports were supported (in part) by the Josiah Macy Jr. Foundation. They were produced by the three collaborating accreditors in Joint Accreditation: the ACCME®, the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC).
Click here to read the full news release.
As part of our collaborative efforts with the American Medical Association (AMA) to simplify and align expectations, we’ve modified the Program and Activity Reporting System (PARS), enabling providers to choose “other” as the activity format for blended, new, or other approaches that do not fall into one of the established format categories. Providers also need to identify these activities as “other” in the AMA credit designation statement, as well as include a brief description of the learning format in PARS, in the credit designation statement, and in documentation given to learners (certificates, transcripts, etc.).
We are using the label “other” because we do not want to imply any restrictions on this category and to encourage providers to develop new, creative, and blended educational approaches that abide by AMA and ACCME requirements. As providers design and describe innovative approaches to education, we expect to identify a descriptor that better represents the evolution of CME.
For more information about the AMA/ACCME alignment and links to resources, including FAQ, the AMA PRA booklet, and a shared glossary, please visit the AMA/ACCME Alignment webpage.
Upcoming Educational Opportunities
Join us April 16-19, 2018 in Chicago as we seek—together—to elevate the impact of accredited CME to transform practice and care. Using collaboration, interactive sessions, and multi-format discussions, the ACCME 2018 Meeting will provide numerous opportunities to engage with ACCME staff, expert faculty, and colleagues as you develop strategies to propel your CME Program forward.
New to our 2018 Meeting is the Leadership Track, a one-day workshop for accredited providers’ executive leadership. We have designed the first full day of the conference as an opportunity for you and your leadership to learn together about the full potential for accredited CME to address mission-focused priorities for your healthcare organization. Invite your leadership to join you as you roll up your sleeves—together—to create an education plan for the year ahead through multi-format sessions. One day rates are available to qualifying registrants.
Another new opportunity this year is the Public Health Summit: Collaborating to Address the Opioid Crisis, a focused, two-hour, multi-disciplinary seminar for educators looking to improve the impact of their education to address the opioid crisis. This Public Health Fair is your opportunity to engage with public health experts about crosscutting health imperatives that have significant impact for the communities that your CME Program serves. There is no special registration for the Public Health Fair; it is included in your registration and available to all attendees of the ACCME 2018 Meeting.
Don’t delay! Register by January 12th to get the Early Bird Rate. For more information and to register, visit www.accme2018.org.
In 2018, we are continuing our popular series of bimonthly webinars to discuss strategies for planning CME that Counts for MOC and to answer provider questions. In response to provider requests, we are now offering webinars for providers beginning to plan CME for MOC and providers with more experience. Join us for the next "CME for MOC: Ask Your Questions" webinars on January 30 for beginners and March 20 for experienced providers. Stay tuned to the events section of our website, where we will post registration information as it becomes available.
For more information about CME that Counts for MOC, visit our webpage.
Learn more about CME that counts for MOC during a session at the Alliance for Continuing Education in the Health Professions Annual Meeting in Orlando, Florida from January 20-23, 2018. ACCME senior staff and representatives from the American Board of Anesthesiology (ABA), the American Board of Internal Medicine (ABIM), and the American Board of Pediatrics (ABP) will provide a brief-overview of their collaboration, then dedicate the majority of the session to answering questions from attendees about how to register CME activities for MOC points. “CME for MOC: How to Register Accredited CME Activities for Maintenance of Certification Using ACCME's Program and Activity Reporting System (PARS)” will be held on Monday, January 22 at 3:30 PM (ET).
The ACCME is also presenting at two other sessions:
- “ACCME Update — Promoting Engagement, Opportunity and Strategic Value Through Accredited CME”: Graham McMahon, MD, MMSc, ACCME President and CEO, will address ACCME’s Criteria for Accreditation with Commendation, CME for MOC, the American Medical Association (AMA) and ACCME alignment, and engagement of institutional leadership to nurture an education home. This session will be held on Sunday, January 21 from 1:30 PM - 2:30 PM (ET).
- “Nurturing Effective Teams: Creating an Educational Home Where Together is Better”: Steve Singer, PhD, ACCME VP of Education and Outreach, and Dion Richetti, DC, ACCME Vice President of Accreditation and Recognition will focus on the value of interprofessional continuing education, faculty development, patient/public engagement, and engagement of health professions students as key stakeholders in innovative and effective learning. This session will be held on Sunday, January 21 from 11:00 AM - 12:00 PM (ET).
For more information on the meeting and to see a full schedule of sessions, visit http://www.acehp.org/annual.
Tips and Tools
The ACCME is aware of the changes to the codes of conduct that have been introduced by MedTech Europe, AdvaMed, and APACMed, organizations that represent the device manufacturing industry. Beginning in 2018, the expectations of the revised codes require member manufacturers to discontinue direct payments to clinicians to fund attendance by these clinicians at professional development activities. The manufacturers may continue to support the engagement of clinicians in professional development activities through grants given to health systems/employers, and through grants to accredited CME providers.
The ACCME applauds the changes the associations have introduced in the codes of ethical business practices since they bring industry standards in closer alignment with those that have existed here in the United States since 1992, and in doing so support greater transparency and independence in global medical education. Many of the principles espoused in the revised codes are aligned with the ACCME's Standards for Commercial Support: Standards to Ensure Independence in CME ActivitiesSM. These standards have been recognized internationally as a benchmark for independent medical education, and have been adopted by numerous other healthcare continuing education accreditors in the United States and around the world.
Standards for Commercial Support Apply Internationally
As has always been the case, organizations accredited in the ACCME System can accept financial support for their educational activities from commercial entities such as device manufacturers under the revised codes and successfully maintain independence from industry by adhering to ACCME’s Standard 3: Appropriate Use of Commercial Support. The ACCME’s Standard 3 allows accredited organizations to accept funds from commercial interests, with the express understanding that the accredited organization will:
- Make all decisions regarding the use of the support independent of any company or companies
- Have a signed written agreement with the company that includes the specific terms and conditions of the support
- Use the funds only for the educational activity and to offset the cost of participation to the learners as a whole
- Not pay for travel, lodging, honoraria, or personal expenses for non-teacher or non-author participants of the supported educational activity
- Disclose to learners the source and (if in-kind) the nature of the commercial support
- These expectations apply to any activities that an accredited provider offers, regardless of where the activity is held.
Alignment between the revised codes and ACCME requirements can be achieved by ensuring that funds received from companies by organizations accredited in the ACCME System are not used to pay for travel, lodging, honoraria, or personal expenses for non-teacher or non-author participants of the supported educational activity. This expectation to follow ACCME standards also applies to organizations that are acting as agents of the accredited organization offering the activity, such as firms that provide meeting planning services, nonaccredited joint providers, or other stakeholders in an educational event.
The intent of this component of the Standards is to ensure that the accredited organization does not act as an intermediary to establish a relationship between an ACCME-defined commercial interest and learners in an accredited activity, and help ensure that clinicians’ prescribing or device usage patterns are not influenced inappropriately through accredited education.
If an international learner receives funding from his/her hospital or some other entity, not affiliated with the organization accredited in the ACCME System, to participate in the education and those funds come from a commercial interest, the accredited organization is not prohibited from accepting that learner’s registration/participation in the education.
As always, accredited providers who have additional questions about meeting ACCME standards and expectations can contact us at firstname.lastname@example.org.
You can find the codes at the following links:
Over the course of several review cycles, the ACCME has observed that some providers are not applying appropriate mechanisms to identify and resolve conflicts of interest for individuals who are engaged in planning CME activities (for example, CME committee members, course directors).
In the ACCME Standards for Commercial Support: Standards to Ensure Independence in CME Activities℠, Standard 2.3 says that “the provider must have implemented a mechanism to identify and resolve all conflicts of interest prior to the education activity being delivered to learners.” This standard applies to all those in control of content — including those who plan the activity. We set that expectation because planners have the opportunity to influence the selection of topics and faculty, and therefore it is critical to make sure that any conflicts of interest they may have are identified and resolved. It is important to initiate this process as you begin planning the activity, to ensure that decisions made during the planning process are independent of commercial influence.
The ACCME expects that accredited providers:
- obtain information from planners about relevant financial relationships;
- resolve any conflicts of interest of those planners;
- disclose the relevant relationships of planners to learners (or inform the learners if the planners have no relevant relationships); and
- be able to show that conflicts of interest were identified and resolved, and disclosure was made to learners for planners.
There are a few key points for accredited providers about obtaining information about relevant financial relationships:
- Information about relevant financial relationships should be sought from all those in control of content, including course directors, committee members, and other planners – as well as faculty, authors, and teachers.
- The information form planners should include relationships from the previous 12 months.
- Accredited providers should ensure that planners are presented with the correct definitions of commercial interest and relevant financial relationships before they are asked to disclose so that they can provide appropriate information back to the provider.
- Providers are not required to use forms to obtain information about relevant financial relationships; however, they must be able to provide the form, tool, or mechanism used to identify relevant financial relationships of the planners, and the information obtained for each individual.
- Employees of ACCME-defined commercial interests cannot have roles as planners in accredited CME, except in very specific circumstances outlined here.
Here are several examples of actions that would meet ACCME’s expectations. Please keep in mind that these are only suggested mechanisms. Each provider should implement mechanisms that work best for its program.
- The planner is recused from planning content related to his/her financial relationship(s).
- The decisions of a planner with a conflict of interest are subject to review by a reviewer who has no conflict of interest and who has sufficient expertise to plan the activity. Accredited providers should be sensitive about relationships that may exist between a reviewer and a planner that could impede an objective review.
- The planner divests him/herself of the relationship.
In addition to obtaining information about relevant financial relationships and resolving these conflicts of interest, providers must ensure that the relationships of planners are disclosed to learners, even if these relationships have been resolved.
- Do I need to use different approaches to resolve conflicts of interest for planners than I use for other persons in control of content, such as authors, speakers and reviewers?
- Flowchart for the Identification and Resolution of Personal Conflicts of Interest
- Using ACCME’s Flowchart for Identifying and Resolving Personal Conflicts of Interest
- Examples of Compliance and Noncompliance
We’re happy to report that more than 350 accredited CME providers have registered over 14,000 activities that count for the Maintenance of Certification (MOC) programs of the American Board of Anesthesiology (ABA), American Board of Internal Medicine (ABIM), and American Board of Pediatrics (ABP) in ACCME’s Program and Activity Reporting System (PARS). Providers and diplomates can search for the more than 6,000 currently available CME activities that count for MOC by visiting CME Finder.
Coming in January 2018: New ABIM ID Webpage
In early January, ABIM will make it easier for CME providers and physician learners to search for ABIM IDs by the learner’s name or NPI number. To find a physician’s ABIM ID, go to http://www.abim.org/verify-physician.aspx. Providers should update any language within their existing activities, websites, and promotional materials to point learners to this tool. The old “Find Your ABIM ID” tool that you have been using will remain live for several months and will redirect users to the new tool.
Upcoming Deadlines: Participant Completion Data Submission Due by December 31
ABA and ABIM: Participant completion data for CME that Counts for ABA and ABIM MOC should be submitted to PARS by December 31, 2017. These deadlines are set so that credit can be applied for physicians who are required to complete MOC activities by the end of the year. We encourage CME providers to submit participant completion data as soon as possible after an activity is completed so that points can be applied to physicians’ records.
Collaboration and Engagement
The ACCME created a commitment statement for the National Academy of Medicine’s recently launched action collaborative on clinician well-being and resilience, a network of more than 50 organizations, including the ACCME, committed to reversing trends in clinician burnout.
Our commitment statement says, in part: “Healthcare professionals flourish when they can practice at the top of their ability, witness the positive results of their efforts, and work in a conducive environment among supportive colleagues. Leaders and educators can foster continuous improvement by investing in their human capital, thus strengthening the role of healthcare professionals as healers. The Accreditation Council for Continuing Medical Education (ACCME) affirms the role of continuous professional development in supporting safe and effective patient care and the power of education to convene colleagues, create a collaborative culture, and address the isolation, disempowerment, and despair that lead to burnout. The ACCME continues to promote the implementation of specific strategies that demonstrate our commitment to clinician well-being and support our community of accredited educators who share these values.”
In September, the American Board of Medical Specialties (ABMS) and its 24 member organizations launched an initiative, called the Continuing Board Certification: Vision for the Future (Commission), to collaborate to re-evaluate how physicians are certified for continued practice. The initiative will bring together key stakeholders with the goal of creating a system of continuing board certification that is meaningful, relevant, and of value.
In order to establish this Commission, a Planning Committee has been identified. Graham McMahon, MD, MMSc, ACCME President and CEO, will serve on the planning committee, along with representatives from the public, the Accreditation Council for Graduate Medical Education (ACGME), the Coalition for Physician Accountability, Council of Medical Specialty Societies (CMSS), and Council on Medical Education (CME) of the American Medical Association (AMA) as well as ABMS.
Having completed the criteria for potential Commission members, the Planning Committee is now seeking nominations. The deadline for nominations is 9:00 PM CST on January 8, 2018. For more information on the Vision Initiative, the Commission or to submit a nomination, visit http://visioninitiative.org/.
Reminders for Accredited Providers
ACCME-Accredited Providers: We sent invoices for the 2018 ACCME annual accreditation fee on December 4, 2017. Payment is due by January 31, 2018. The fee for 2018 is $5,700 per provider. The invoices will be addressed to the person designated by your organization as the billing contact. Please log in to the Program and Activity Reporting System (PARS) to view the billing contact for your organization.
Please note: This information applies only to ACCME-accredited providers, not to providers accredited by a state medical society. Intrastate providers should check with their accreditor for information regarding accreditation fees.
To meet your year-end reporting requirements, you must enter data for your 2017 activities and your 2017 program summary in the ACCME’s Program and Activity Reporting System (PARS). PARS is always open and we encourage you to start entering 2017 activity data now in anticipation of the year-end reporting deadline. You are welcome to enter basic information about an activity before it has taken place and complete the entry after the activity.
For more information and links to educational resources, please visit our About PARS webpage.
For Your Reference
- Call for Abstracts for Association of American Medical Colleges (AAMC) 2018 Integrating Quality Conference: AAMC is seeking proposals for posters, interactive workshops, and presentations in healthcare quality, patient safety, and high-value care with an emphasis on successful strategies in care delivery, health professions education, and research in health professions schools, teaching hospitals, and healthcare systems. Proposals should aim to enhance attendees’ knowledge, skills, and/ or abilities. The deadline for submissions is Friday, December 19, 2017 at 11:59 PM (ET).
- Accreditors Target Training Gaps that Contribute to Burnout: Tom Nasca, MD, CEO of the Accreditation Council for Graduate Medical Education (ACGME) and Graham McMahon, MD, MMSc, President and CEO, ACCME, discuss how accreditors can work more closely together to support clinicians across the continuum of medical education.
- Stem the Tide: Addressing the Opioid Epidemic AHA Toolkit: The American Hospital Association (AHA) released a new toolkit to provide guidance to hospitals and health systems on how they can work with their patients, clinicians, and communities to stem the opioid epidemic.
- Exploring a Business Case for High-Value Continuing Professional Development: Proceedings of a Workshop: Proceedings from the Global Forum on Innovation in Health Professional Education, including a summary of the presentation by Kate Regnier, MA, MBA, Executive Vice President, ACCME, on the role of CME and interprofessional continuing education (IPCE) as a catalyst for healthcare improvement.
- REMS and Continuing Education for Health Care Providers: FDA Feasibility Report: This report details the Food and Drug Administration‘s (FDA) analysis and conclusion that accredited CE can be a useful method for delivering clinician education under Risk Evaluation and Mitigation Strategies (REMS). The report includes lessons learned about leveraging accredited CE to deliver education under the Extended-Release and Long-Acting Opioids Analgesics REMS. For more information, visit CME in Support of REMS.
- The President’s Commission on Combating Drug Addiction and the Opioid Crisis: This report includes recommendations for the role of education in addressing the opioid crisis, such as developing a national curriculum and standard of care for opioid prescribers and mandating CME for prescribers seeking relicensure from the Drug Enforcement Administration (DEA).
In Case You Missed It