ABIM’s MOC Changes How to Deliver the Message to ACC’s Members and Constituents

1. Developed for members of ACC Boards, Committees, Councils and Other “Messengers” December 2013 ABIM’s MOC ChangesHow to Deliver the Message to ACC’s Members and Constituents

2. Disclosures Joseph P. Drozda, Jr., MD, F.A.C.C. Director, Outcomes Research Mercy Center for Innovative Care, Sisters of Mercy Health System Commercial Interest : Family member is a sales representative for Boston Scientific Rhythm Management Relationship Category : Salary Relationship Level : Significant (>= $10,000) Richard J. Kovacs, MD, FACC Professor of Clinical Medicine Associate Dean For Clinical Research, Indiana University School of Medicine Clinical Director, Krannert Institute of Cardiology Commercial Interest : Insight Pharmaceuticals Relationship Category : Consultant Fees/Honoraria* Relationship Level : Modest (< $10,000)

3. Webinar Goals Our goal is to provide information about ABIM’s new MOC program so that you, ACC’s member leaders, can: • Communicate the changes to ABIM’s MOC program to your constituents and colleagues; • Explain how the changes will impact different categories of ABIM diplomates; • Know when to refer a cardiologist to ABIM for an explanation of how the new certification requirements apply to them; • Understand the challenges of delivering this message and have answers to the questions that might be asked; • Know where to locate tools and resources to help with your presentations

4. Challenges • Many changes to the MOC program • Complexity of new approach • ACC does not have all the answers because: • some elements of the new MOC program are still in development by ABIM; • some information from ABIM seems to conflict and/or is not clear.

5. Presentation Content • Evolution of Certification Process • 2014 Changes to MOC • What the Changes Mean for Cardiologists • What Our Members Think • What ACC is Doing to Support its Members • Role of the Messengers • Tips for Messengers

6. Section 1 Introduction

7. ABMS & ABIM • All 24 of the medical boards that comprise the American Board of Medical Specialties (ABMS) are in the process of implementing a more continuous approach to Maintenance of Certification • To meet new requirements outlined by ABMS, the American Board of Internal Medicine (ABIM) is changing its MOC program. • ABMS and ABIM believe that a more continuous MOC program helps you keep pace with the changes in the science of medicine and assessment.

8. ACC’s Role • Interpret ABIM’s materials that describe their new MOC program and communicate the key themes to our members. • Provide educational products and other support that help our members: • Study for ABIM’s Cardiovascular Disease MOC exam (“the Boards”) • Secure Self-Evaluation of Medical Knowledge credits (MOC Part II) • Undertake Self-Evaluation of Practice Assessment modules (MOC Part IV)

9. When it comes to ABIM’s MOC program… ACC does not: • Review • Edit • Comment • Vote …on certification or recertification requirements.

10. Section 2 Evolution of Certification Processes

11. Certification • Recertification Certification Process Up to 2006 Pre- 1990 • Secure exam after completing fellowship • Lifetime certification with NO end date • Secure exam after completing fellowship • Time-limited certification WITH an end date • Recertification exam every 10 years 1990- 2006

12. Maintenance of Certification (MOC) Certification Process 2006 - 2013 2006-2013 • Secure exam after completing fellowship • Time-limited certification with an end date • Maintenance of Certification exam every 10 years • Completion of: • Self-Evaluation of Medical Knowledge Modules • Self-Evaluation of Practice Performance Modules

13. Components of Maintenance of Certification 2006 - 2013

14. Maintenance of Certification Points 2006 - 2013 100 Points Every 10 years Part II = Self-Evaluation of Medical Knowledge modules Part IV = Self-Evaluation of Practice Assessment modules

15. Section 3 2014 Changes to MOCWhat We Know and Don’t Know

16. Maintenance of Certification Changes Certification Process 2014 and Beyond 2014- Two Separate Designations: • Board Certified • Meeting MOC Requirements • Certification represents passing initial exam • Meeting MOC Requirements is a new and separate obligation

17. Summary of What Will be New in 2014 • MOC now applies to all diplomates (including grandparents); • 100 MOC points now have to be secured on a 5 year cycle with some activity required every 2 years • Patient Safety & Patient Survey requirements • 20 MOC points awarded for every first exam attempt within each specialty

18. Maintenance of Certification 2014: Points and Cycle Changes Complete an MOC activity every 2 years Part II = Self-Evaluation of Medical Knowledge modules Part III = MOC secure exam Part IV = Self-Evaluation of Practice Assessment modules

19. New Patient Safety & Patient Survey Requirements • Patient Safety • Some ABIM MOC modules currently meet this requirement • ABIM will be adding more options in the future • ABIM is developing a process so that diplomates can use patient safety activities at their institution to meet this requirement • Patient Survey • Some of ABIM’s existing Performance Improvement Modules (PIMs) [Part IV activities] include patient surveys • ABIM will offer options to meet requirement without doing a full PIM • ABIM is developing a process so that diplomates can use patient survey activities at their institution to meet this requirement

20. Section 4 What the Changes Mean for Cardiologists

21. Those Who Certified Prior to 1990 (“Grandparents”) • Starting January 2014 new MOC requirements apply to you. • To be reported as “Meeting MOC Requirements”: • Enroll in the MOC program by March 31, 2014 • Complete an MOC activity to earn MOC points every 2 years • Earn 100 MOC points every 5 years • Complete patient survey & patient safety modules every 5 years • Pass ABIM’s Cardiovascular Disease MOC Examination (“the Boards”) by December 31, 2023 (10 years) • Your initial certification in Cardiovascular Disease does not expire. You will remain certified whether or not you are “Meeting MOC requirements.” However, if you choose not to undertake all required MOC activity, you will be reported as “Certified. Not Meeting MOC Requirements.”

22. Those in 10-year MOC cycles • Starting January 2014 new MOC requirements apply to you. • Finish out your individual 10-year MOC cycles for Parts II & IV, and the MOC exam. Any points earned after January 2014 will apply both to those you need to earn to maintain your existing certification and to be “Meeting MOC Requirements”. • To be reported as “Meeting MOC Requirements”: • Enroll in the MOC program (if not currently enrolled in MOC) by March 31, 2014 • Complete an MOC activity to earn MOC points every 2 years • Earn 100 MOC points every 5 years • Complete patient survey & patient safety requirements every 5 years

23. Those Newly Certified after January 2014 • Starting January 1, 2014 the new MOC requirements apply to you. • To be reported as “Meeting MOC Requirements”: • Activate your MOC program by March 31, 2014 • Complete an MOC activity to earn MOC points every 2 years • Earn 100 MOC points every 5 years • Complete patient survey & patient safety requirements every 5 years • Pass the ABIM Cardiovascular Disease MOC Examination (“The Boards”) every 10 years

24. Sub-Specialty Certification As in previous years, diplomates must still hold a current, valid ABIM certification in Cardiovascular Disease to be eligible for renewal of certification in: • Advanced Heart Failure and Transplant Cardiology • Clinical Cardiac Electrophysiology • Interventional Cardiology If you have more than one ABIM certification, all MOC points earned will apply to all certificationsyou are actively maintaining. If you are maintaining certification in Interventional Cardiology, you will need to continue to attest to meeting additional program-specific requirements. You will receive 20 MOC points for completion of one MOC exam per certification area being maintained.

25. ABIM/ABMS Reciprocal Credit for Dual-Boarded Diplomates • ABIM-certified physicians who are maintaining certification through another of the the ABMS’s 24 member boards (e.g. the American Board of Pediatrics) may be eligible to receive points for Self-Evaluation of Medical Knowledge and Self-Evaluation of Practice Assessment. • To receive credit, ABIM diplomates will need to attest that they are current and participating in the other Board’s MOC program. • For more information, please call ABIM at 1-800-441-ABIM.

26. Doctors of Osteopathy (D.O.s) • D.O.s must certify with the American Osteopathic Board of Internal Medicine (AOBIM) which introduced new Osteopathic Continuous Certification (OCC) January 1, 2013.

27. What We Don’t Know • When a diplomate could be reported as “Not Certified” • ABIM staff has suggested that certain categories of diplomates might lose their certification if they do not secure the required MOC points within the required timeline. • The ways in which an ABIM diplomate can be reported as “Not Meeting MOC Requirements” by ABIM • This seems to depend on each diplomate’s specific certification situation (year certified, multiple specialty certification, dual-boarded) • What the Patient Survey and Patient Safety modules requirements will be when they are finalized • Precisely how dual-boarded MOC attestation must be done by diplomates.

28. Section 5 What Our Members Think

29. ACC Member Surveys: Main Themes • Over half are not aware of the 2014 changes to MOC. • Although most are enrolled, cardiologists do not find value in MOC. • Cardiologists are divided on the impact of the MOC changes with many believing it will affect their practice negatively. • Although half say that the MOC changes will not affect future plans to continue practicing, two-fifths are either unsure or say that their plans have been affected.

30. Awareness of ABIM MOC Changes

31. MOC is 5th Highest Challenge to Practicing Medicine • Reimbursement /payment cuts/Medicare issues (69%) • Work-life balance/extensive workload/work hours (35%) • Costs/rising costs (31%) • Government regulations (28%) • MOC/certification/training (23%)

32. Section 6 What ACC is Doing to Support its Members

33. Communications Plan In order to address member concerns, an initiative has been launched by ACC to communicate a consistent message about the MOC changes to members. This initiative is designed to: • Inform membership about ABIM’s MOC changes and explain that they were not initiated by ACC. • Highlight the variety of educational and quality improvement opportunities that ACC makes available to its members to assist with securing MOC points (Parts II, III and IV). • Establish a forum to gather member feedback on the ABIM’s MOC changes and advocate to ABIM on members’ behalf.

34. Three Complementary Communication Strategies

35. “One Voice” ACC will build awareness among its domestic members about the new requirements, with a special focus on “Grandparents”. This will include: • Informing members clearly and concisely about the new ABIM requirements and the fact that these are not ACC requirements • Providing presentations, webinars, web pages, articles, mail, emails, editorials, exhibits, events, and social media resources which address ABIM’s MOC changes. • ACC will become a comprehensive and credible source of information on the changes

36. “Easy Button” ACC will highlight its educational and performance improvement opportunities that are available to assist memberswith the new MOC requirements. • Dedicated ACC web pages addressing the ABIM’s changes to MOC and the impact on diplomates’ MOC point requirements (www.cardiosource.org/MOC) • An ACC MOC Changes Resource Kit including a Glossary, FAQs and Talking Points (in production) • List of ACC’s MOC Part II (Self-Evaluation of Medical Knowledge) educational modules (www.cardiosource.org/MOCEducation) • List of ACC’s MOC Part IV (Self-Evaluation of Practice Assessment) performance improvement modules (www.cardiosource.org/MOCEducation) • Step-by-step instructions for ABIM’s MOC Part IV Self-Directed PIM and use of NCDR data (www.cardiosource.org/SelfDirectedPIM)

37. “We Hear You” ACC will work to establish an online forum for gathering member feedback on issues critical to the MOC change initiative that will serve as a foundation for ACC’s advocating to ABIM on its members’behalf. • ACC will provide mechanisms to systematically gather information from members – “Listening tour” • ACC will advocate to ABIM on members’ behalf making recommendations for process improvements

38. Section 7 Role of the Messengers

39. “One Voice” - Getting the Message Out

40. Messengers Inform the Members

41. Objectives For Messengers Communicate details of ABIM’s MOC changes to domestic physician members in your constituencies. • Informmembers clearly and concisely about the details of the new requirements and share “Important Dates” and “Calls to Action” (following two slides) • Reinforce the fact that these are not ACC requirements • Describe ACC resources that help members obtain MOC credit • Provide answers to general questions where possible, or direct those with specific questions to ABIM (www.abim.org)

42. Important Dates • March 31, 2014: If ACC members are not already enrolled in MOC, they should enroll on the ABIM website by March 31, 2014 to become an ABIM diplomate and be “Meeting MOC Requirements” • December 31, 2015: By December 31, 2015, ABIM diplomates should complete an MOC activity to earn ABIM MOC points to continue to be reported as“Meeting MOC Requirements” • December 31, 2018: • By December 31, 2018, ABIM diplomates should earn a total of 100 MOC points in a mix of Self- Evaluation of Medical Knowledge & Self-Evaluation of Practice Assessment • By December 31, 2018, complete the new patient safety and patient surveyrequirements

43. Calls to Action Find educational activities that provide MOC points, as well as CME credits, at: ACC • http://cardiosource.org/MOCEducation • Table and web links to ACC’s Part II and Part IV activities ABIM • http://www.abim.org/maintenance-of-certification/medical-knowledge.aspx • Links to ABIM’s Part II activities • http://www.abim.org/moc/earning-points.aspx • Links to ABIM’s Part IV activities

44. Section 8 Tips for “Messengers”

45. Messenger Action Familiarize yourself with these resources: • JACC article and companion piece • http://moc2014.abim.org/ • http://www.cardiosource.org/MOC • http://www.cardiosource.org/MOCEducation • ACC’s MOC FAQs, Talking Points & Glossary (in production for publication in January 2014)

46. Delivering the Message • Direct participants to supplementary materials and other resources • MOC Resource Kit content (consider bringing hand outs for the audience) • ACC and ABIM websites, emails and phone numbers • Tailor content to the audience • Not every audience will require the same level of detail. • Adapt your pace and content as appropriate

47. Responding to Audience Questions Redirect questions about “Why?” • All questions about “Why” should be made by the audience member directly to ABIM. • Focus on what we know so far: • What is staying the same • What is changing • How and When cardiologists need to act

48. Responding to Audience Questions (cont.) Don’t try to explain how the rules apply in specific cases (e.g. sub-specialty certification, dual boarded, multiple expiration dates) • It is ACC’s role to communicate the upcoming changes but not to interpret them for individual cardiologists • Refer all questions about specific application of the new rules to ABIM at • 510 Walnut Street, Suite 1700Philadelphia, PA 19106 • Phone: 1-800-441-ABIM Mon - Fri 8:30 a.m. - 8 p.m. ETSat 9 a.m. - 12 p.m. ET • E-mail: MOC2014@abim.org

49. Responding to Audience Questions (cont.) Know the portfolio of education products that ACC and ABIM provide for diplomates to pass the Boards, and secure Medical Knowledge and Practice Assessment (Part II, III and Part IV) MOC points. • ABIM website (See “Resources” slide) • ACC website (See “Resources” slide) • ACC PIM Support Line (1-800-253-4636 x.5404)

50. Questions? Contact: • The Master Trainers • Ellen Cohen, Director of Certification and Accreditation, ACC • ecohen@acc.org; (202) 375-6526 • Melanie Stephens-Lyman, Associate Director of MOC Part IV Products, ACC • mstephenslyman@acc.org; (202) 375-6427