will require an entirely different set of services than those family physicians in smaller, independent practices, but our responsibility as their advocate doesn't change.
“While we work to assist our members in understanding what the PPACA means to them and their patients,” Saputelli said, “we still fight the pre-PPACA battle of moving from a procedural-based system to one that is more value-based. We are continually retooling and refocusing our efforts to provide service as a clearinghouse for information and as a trusted resource for education — and that education must meet the ever-increasing burden of time faced by our members.”
With the move from private to group practice already under way, American Medical Group Association (AMGA) Director of Education and Meetings Andi Eberly said that her association is “positioned perfectly to address the vast majority of the concerns” of its members. AMGA's 2013 Annual Conference, which took place last month, featured “content directly relevant to the changes taking place in health care, as our conference speakers are the frontline physicians and leadership of the major multispecialty medical groups,” Eberly said. AMGA attendees are “speaking to each other about what they're experiencing first-hand and learning from each other on how to handle the flow of changes coming at them due to the Affordable Care Act. Our format is on point for what they need currently. Our attendance continues to climb.”
‘This year, we are offering additional sessions related to practice transformation and PPACA implementation, which will be eligible for 1-A CME credit. We are also offering dually accredited CME, which we see as added value for attendees.’ -Deirdre Irwin Ross
The U.S. & Canadian Academy of Pathology (USCAP), on the other hand, hasn't yet found it critical to educate its members about the possible impact of the PPACA. “We've had nominal conversations, very nominal conversations,” about offering programming that deals directly with the Affordable Care Act, said Kerry Crockett, CAE, CMP, USCAP's executive director. “Typically, the education that we put forth is really more about the diagnosis of biopsy, etc. Our members don't necessarily have direct patient contact. For us, it does not seem to be as big [a concern] as for some of our colleagues who are in different medical societies.
“A lot of our educational content comes from outside faculty — it is driven from the community, so to speak,” Crockett said. “We haven't really seen any discussion about [the PPACA] in terms of ‘I think we need to start educating about it.’ Internally, we are having some of those conversations about when it hits, are we going to be ready and are we going to be able to meet the needs of our members? We are really looking to our pathologists that are on our education committee to guide us in terms of what programming is going to be.”
How CME Will Change
One thing seems certain: the nature of CME education will have to evolve as a result of the PPACA. “From a CME perspective, a piece of it is the education around what are the evidence-based best practices for population management for caring for patients in teams and so on,” NPA's Scott said. “Which is a little different than what we see in CME, which is what's the contemporary management of diabetes, or something like that. If you think about it, there's evidence-based medicine and then there's evidence-based delivery of care. I'd say from a subject-matter perspective, it may be a bit of a change” in terms of the programming that's offered at conferences.
The ACO model is “basically about getting together with a group of providers to provide cost-effective, high-value care,” Scott said. As the number of ACOs grows, that “may influence the revenue stream of some high-end specialties. So I'd say those are the ones who are the most concerned — you know, radiology, orthopedics, some of those kind of specialties; cardiology has already seen a pretty big hit. And some of them are going to be thinking about CME. They may be a little tighter with their budgets because they're going to start seeing their income shrinking, potentially.
“They're going to need to learn how to kind of cope with the changes that are coming, which are potentially not so much in their favor,” Scott said. “And so from a CME perspective, again, gearing up with learning how to kind of manage your way through the change and if there are changes you need to make, the way you're going to need to collaborate with people — and how much credit you're going to be able to get for that kind of stuff.”
As physicians join hospitals, academic institutions, and other practice groups, Scott said, they probably get a CME allowance, as opposed to having to pay for conferences and CME out of their own pocket. “So from that perspective, I'd say that's probably good news [for medical meetings,] because [for] doctors [it will be] use or lose it,” he said. However, physicians employed by larger entities — group hospitals or group practices — are likely to have less of a choice about what conferences they would like to attend, Scott said, and probably will be “pushed into conferences that the organization deems are going to help move a larger agenda along.
“That's the other big thing that I think your industry should be thinking about,” Scott continued. “That group may have an agenda — like, ‘these are the six things we're trying to improve this year.’ Then they're going to want to have directed CME focused on educating their doctors and getting them on board with these particular improvement efforts. There's a need for CME — like, this is the latest new development in rheumatology or cardiology or whatever it is — and then there's, how do I actually bring that back to my institution and get it implemented in less than a decade? And that's the disconnect we've had for a long time, in my view, with CME.”
No Time at All
Not only will lack of choice become an issue as the Affordable Care Act unfolds, but so will increased time constraints, according to Kathleen Flood, CEO of the American Society of Nuclear Cardiology (ASNC). “As physicians merge into larger groups and/or become hospital employees, their ability to attend conferences will be challenged since they will have a discrete number of days for these activities,” she said. “It is my opinion that this trend will continue to grow. The more senior physicians now that have led the negotiations have some leverage, but this will wane over time with the younger physicians. We are planning a deep dive into our annual meeting to understand how it must change in both content and format. We need to be more strategic about developing easily accessible and very relevant CME offerings that bring education to the point of service.”
Likewise, AOA “understands that being out of the office for a stretch of several days can be difficult,” Ross said. “DOs working in an independent practice may worry about who will cover their patients and that time out of the office is time that could be spent on new administrative duties like quality reporting. If a DO works for a hospital or a large medical center, they might have to convince their bosses to give them the time off.”
One way that AOA is addressing that concern is by starting OMED, its annual Osteopathic Medical Conference & Exhibition, on a Saturday instead of a Sunday, beginning next year — “thus requiring attendees to take one less weekday out of the office,” Ross said. AOA is also “trying to make it easier for DOs to earn CME credit, while being mindful of their time restrictions,