Researchers estimate that the 2015 maintenance-of-certification program from the American Board of Internal Medicine will generate considerable costs, primarily attributed to demands on physician time.
“In 2014, the American Board of Internal Medicine (ABIM) substantially increased the requirements and fees for its maintenance-of-certification (MOC) program. Faced with mounting criticism, the ABIM suspended certain content requirements in February 2015 but retained the increased fees and number of modules,” Alexander T. Sandhu, MD, of the University of California, San Francisco, and colleagues wrote.
To estimate costs for the 2015 version of the MOC program and the incremental cost relative to the 2013 version, researchers developed a discrete-state Markov model of all ABIM-certified internists, hospitalists and internal medicine subspecialists in the United States.
Analyses indicated internists will incur an average of $23,607 (95% CI, $5,380-$66,383) in MOC costs over 10 years, ranging from $16,725 for general internists to $40,495 for hematologists-oncologists.
Ninety percent of MOC costs can be accounted for by time costs, according to researchers. Cumulatively, 2015 MOC will cost $5.7 billion during the next 10 years, $1.2 billion more than 2013 MOC, the researchers reported. This estimate includes $5.1 billion in time costs, resulting from 32.7 million physician-hours spent on MOC, and $561 million in testing costs.
“The MOC program generates considerable annual costs, predominantly due to demands on physician time,” the researchers concluded. “Reform of MOC should focus on decreasing the time required to fulfill MOC requirements and increasing integration with existing continuing education activities.
“A rigorous evaluation of the program’s effect on clinical and economic outcomes is warranted to better balance potential gains in the quality and efficiency of clinical care against the high costs identified in this study.” – by Amanda Oldt
Disclosure: The researchers report no relevant financial disclosures.