What is CME?

Continuing medical education (CME) refers to a range of educational programs provided by trained professionals that helps health care providers to maintain their competence and to learn about new technologies, procedures and developing areas of their field. Content for these programs is developed, reviewed, and delivered by faculty who are experts in their individual clinical areas. 

Similar to the process used in academic journals, any potentially conflicting financial relationships for faculty members must be disclosed and addressed appropriately. The CME Coalition is a collection of health care providers, companies, institutions and academics committed to the pursuit of sensible policies designed to promote responsible CME.

CMS ADOPTS PROPOSAL TO REWARD CME IN PHYSICIAN PAY

In April 2015, President Obama signed into law sweeping physician reform legislation requiring CMS to implement a new two-track payment system for doctors. The two tracks will tie an increased percentage of physicians’ Medicare fee-for-service payments to outcomes through the new Merit-based Incentive Payment System (MIPS) and encourage the adoption of “alternative payment models” (APMs) which move payment away from fee-for-service reimbursement. 

In November 2017, CMS released regulations that include accredited continuing medical education (CME) as an Improvement Activity under MIPS. As detailed in the final rule, CMS determines that “completion of an accredited performance improving medical education program” be included under the list of Improvement Activities under MIPS — one of the key policy changes proposed for the Quality Payment Program Year 2. CME should be included in the Improvement Activity measurement category, as these courses are among the most important ways in which doctors seek to improve their understanding of new treatments and therapies, improve beneficiary outcomes, and ultimately, improve their practice as a whole.

​This initiative led by the CME Coalition began in March of 2016, and included the input of many other stakeholders including ACCME, AAFP, AMA, AOA, CMSS, ACEHP, and others.

Open Payments and CME

In September 2016, the Centers for Medicare and Medicaid Services (CMS) posted an FAQ on its Open Payments website providing specificity with regard to the exclusion of certain CME-related payments from Sunshine Act reporting. While this FAQ is fully consistent with our earlier interpretation of the status of independent CME-related payments when CMS revised the regulations in 2014, as well as the interpretation of other leading stakeholders like the American Medical Association, the revised FAQ now provides even greater clarity to stakeholders.

In the FAQ, CMS says that payments are not reportable "[i]f an applicable manufacturer or group purchasing organization (GPO) provides a payment or transfer of value to a continuing education provider to support a continuing education program, but did not require, instruct, direct or otherwise cause (including, but not limited to, ‘encouraging’ or ‘suggesting’) the continuing education provider to provide payments or transfers of value to a specific or particular physician speaker or faculty." Click here for details on the FAQ.

CME and the Fight Against Opioid Abuse

Nearly 100 million people in the United States, or roughly one-third of the population, experience some form of chronic pain. Meanwhile, prescription opiate abuse and addiction have reached epidemic proportions in the United States, including the widespread illegal diversion of prescription opioids for street use, which in turn can increase the rates of abuse of illegal narcotics. Some clinicians have also prescribed opioids without adequate training surrounding their abuse potential. Many primary-care providers have recently become reluctant to prescribe opioid pain relievers in the context of current public health concerns surrounding addiction, which leads to some chronic pain patients now going without any appropriate treatment. 

​CME has been proven to be a critical in educating physicians about the inherent risks in prescribing opioid medications. Over the course of 39 systematic reviews published between 1977 and 2014, the Accreditation Council for Continuing Medical Education (ACCME) has concluded that CME courses “can more reliably change health professionals’ knowledge and competence than their performance and patient health outcomes.” This video, produced by CME Coalition member Academy for Continued Healthcare Learning (ACHL), provides a sample of a CME activity intended to educate physicians, pharmacists, and other allied-health personnel on the latest guidelines surrounding prescription opioids as well as the latest epidemiological data surrounding addiction management and treatment.​