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  • Under the Magnifying Glass: MOC Changes Increase Transparency, Streamline Certification

    September 01, 2012

    The ABMS has begun a reporting initiative that will impact all of its member boards, including the ABR.

    As part of a broader movement to increase transparency throughout healthcare, the American Board of Medical Specialties (ABMS) has begun a reporting initiative that will impact all of its member boards, including the American Board of Radiology (ABR).

    Since August 2011, ABMS has reported on its public website, certificationmatters.org, whether physicians certified by seven of its 24 member boards are meeting ABMS Maintenance of Certification® (ABMS MOC) program requirements. In the near future, ABR-certified diagnostic radiologists, radiation oncologists and medical physicists also will be reported on the ABMS website as "meeting requirements of MOC," "not meeting requirements of MOC" or "not required to participate in MOC."

    In tandem with the public reporting initiative, ABR has implemented a new MOC status verification system that will ensure that diplomates remain current in their requirements for certification. Under the new "Continuous Certification" process, certificates will no longer display an end date but will instead state that ongoing certification is contingent on meeting MOC requirements. Lifetime certificate holders are not required to participate in Continuous Certification but are encouraged to do so on a voluntary basis.

    ABR has been working on a number of fronts to get the word out about these changes and to implement them seamlessly. "ABR is determined to make this transition as facile and easy as possible," said Milton J. Guiberteau, M.D., ABR president-elect and an ABR trustee. "We would like diplomates to understand that although this is a change, it's a change for the better and with their best interests in mind."

    Public Demand Fuels Need for Website

    Public reporting has been a long time in coming. Much as public demand for transparency has fueled consumer sites like Angie's List, patients hungry for information on their own healthcare are pushing for increased accountability from providers.

    "Healthcare has been poised for this type of change for some time," Dr. Guiberteau said. "Public accountability has become part of the national consciousness and healthcare is fast becoming a part of that. It is the duty of our member boards to report this information in a way that is accurate, helpful and most beneficial to our patients." Public reporting has already taken hold in many areas of healthcare, said ABR Executive Director Gary J. Becker, M.D. "Report cards on physicians, hospitals, nursing homes and health plans abound," added Dr. Becker, who served as RSNA president in 2009.

    Along with offering transparency, public reporting simplifies the process for consumers who can check a physician's certification status from one centralized database for all 24 ABMS boards. Dr. Becker stressed that ABR diplomates are responsible for making sure the information on their ABR Personal Databases (PDBs) is accurate and up-to-date. Diplomates may log on at www.abronline.org.

    "We need diplomates to go to their PDBs and to the ABMS website and verify their information is displayed correctly and to let us know immediately if there are any discrepancies," Dr. Becker said. An added incentive to stay on top of MOC certification status: A recent ABMS survey found that 95 percent of Americans say it's important that their doctors participate in a program to maintain their board certification, while nearly half (45 percent) would look for a new doctor if they learned theirs was not participating in such a program.

    Diagram of survey findings
    A recent American Board of Medical Specialties survey (ABMS) found that 95 percent of Americans say it's important that their doctors participate in a program to maintain their board certification, while nearly half would look for a new doctor if they learned theirs was not participating in such a program. Above: Board-certified physicians have completed specialty training beyond the state licensure basic competency requirements to practice medicine.

    Continuous Certification Aligns MOC Process

    Linking public reporting and continuous certification is critical to standardizing the MOC process that has been something of a patchwork since it was created 12 years ago, ABR leaders said. Because each of the 24 ABMS member boards had separate MOC programs, adopting common standards was necessary to ensure consistency of use for participants and the public.

    "With Continuous Certification, every person's MOC status is more manageable, fewer mistakes are made and the process is streamlined," said David Laszakovits, ABR's director of certification services. "This will be especially important as MOC continues to evolve."

    Along with keeping reporting clear and preventing unanticipated changes to the certification status of someone who has fallen behind in requirements, Continuous Certification aligns reporting more closely with programs of the U.S. Centers for Medicare and Medicaid Services (CMS), the Joint Commission, state licensing boards and other institutions.

    Instead of the 10-year, time-limited certification for meeting MOC requirements, Continuous Certification uses a look-back period to evaluate all four MOC components and render a diplomate's participation status. This annual look-back will encompass a yearly check of licensure; a rolling three-year check of CME, SAMs and PQI project completion; and a rolling 10-year check of exam status. All new and maintained certificates will move to the new model this year, while the "valid through" dates on existing certificates will continue to be recognized. The underlying MOC requirements will not change.

    ABR leaders say Continuous Certification has a number of benefits, including:

    • Two or more time-limited certificates can be synchronized into one MOC cycle.
    • Unlimited number of CME credits and SAMs that can be counted per year. Anyone can have an off year or even two, in which it is difficult to complete the required CME, SAMs, and PQI. This new process enables diplomates to compensate by completing more of their requirements in a single year in order to achieve the three-year totals they need.
    • MOC exam may be taken at any time, as long as the most recent initial certification or MOC exam was passed no more than 10 years ago.
    • During the transition to Continuous Certification, diplomates who have taken and passed the MOC exam will be given a one-time "break" because the date of their exam passage will be attributed to the last day of their 10-year cycle.
    • If the annual look-back finds a diplomate not meeting requirements (including passing the MOC exam), a built-in "catch-up" period of one year allows time to make up requirements while still being classified as "certified, not meeting the requirements" of MOC.
    • ABR will send automatic reminders to help participants avoid the perils of procrastination and the stress of trying to meet 10 years' worth of requirements in a short period.
    • Lifetime-certified diplomates will not relinquish their original certification upon enrolling but will receive credit for MOC participation as soon as they complete the application process. When they meet their first rolling three-year look-back requirements for CME, SAMs, and PQI at the beginning of their fourth year, they will be issued an MOC certificate. Their first look-back for passing the examination is in their tenth year.

    Additionally, the changes will optimize the MOC program's potential by eliminating redundant efforts, minimizing busywork and aligning with other external requirements and incentives.

    Physicians Should Prepare for More Robust Reporting

    RSNA education leaders emphasize the Society's role in ensuring all members fulfill their MOC requirements and stress the ongoing commitment to supporting RSNA members in maintaining board certification.

    "The important work of the RSNA Content Advisory Panel has helped RSNA significantly increase the number of SAMs available online and the RSNA Quality Improvement Committee is working to double by the end of 2012 the size of its library of ABR-qualified PQI projects for use by members in meeting their Part 4 requirements," said Richard L. Baron, M.D., RSNA Board Liaison for Education. "These resources are all designed to support RSNA members in efficiently fulfilling their MOC requirements and optimizing their personal learning and professional development."

    Web Extras

    • Access the American Board of Medical Specialties (ABMS) public website at certificationmatters.org.
    • To read the article, "Is Public Reporting Valuable? Show Me the Evidence!" by Gary J. Becker, M.D., American Board of Radiology (ABR) Executive Director, in the ABR Newsletter, The Beam, click here.
    • ABR representatives will discuss MOC changes as part of the Bistro RSNA table discussions during lunch hours Monday–Wednesday at RSNA 2012. For more information on RSNA 2012, go to RSNA.org/Annual_Meeting.aspx.

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    Photo of Dr. Guiberteau
    Photo of Dr. Becker
    Photo of Dr. Laszakovits
    Cover image for September 2012
    Public reporting of physicians' MOC status is part of a larger movement to increase transparency in healthcare.
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