New provision in health care bill ensures physicians’ participation in PQRI program

A provision in the health care reform measure passed by the House of Representatives Sunday and signed into law today by President Barack Obama includes participation in the American Board of Medical Specialties Maintenance of Certification^® (ABMS MOC^®) as an option for the nation’s physicians to fulfill requirements of the Centers for Medicare and Medicaid Services (CMS) Physician Quality Reporting Initiative (PQRI).

The bill enhances PQRI by opening up an additional pathway for physician participation in quality reporting starting in 2011, and provides an increased incentive payment beyond the PQRI bonus to physicians who choose to voluntarily participate. It represents the first time MOC is an option within the Federal accountability framework.

“ABMS MOC was developed to ensure physician commitment to lifelong learning and competency in his or her specialty and/or subspecialty”

“ABMS MOC was developed to ensure physician commitment to lifelong learning and competency in his or her specialty and/or subspecialty,” said Kevin B. Weiss, MD, ABMS president and CEO. “MOC reporting will give patients, health plans and others the information they need to choose physicians based on performance and other key qualifications, including diagnostic acumen, clinical reasoning and medical knowledge. This bill’s approval is a significant step forward in recognizing the value of MOC in advancing health care quality for the benefit of patients.”

Now celebrating its 10^th anniversary, MOC was enacted by ABMS and its 24 Member Boards to enhance the physician certification process, moving from once in a lifetime, or once every six to 10 years, to an ongoing commitment to continuous maintenance of high quality clinical competencies. ABMS MOC ensures that a participating physician is committed to lifelong learning and ongoing self-assessment in six areas of competency. While measurement of these competencies may vary according to the medical specialty, this multi-faceted assessment is carried out by all 24 Member Boards using a four-part process, including practice-based learning and improvement.

“Practice performance assessment required by ABMS MOC involves real-world evaluation of clinical practice and quality improvement,” said Christine Cassel, MD, president and CEO of the American Board of Internal Medicine (ABIM), a Member Board of ABMS. In MOC, physicians must perform a quality improvement intervention, a process that, by its very nature, calls for continuous improvement for the benefit of patients, physician practices and the broader health care community.

PQRI is a physician quality reporting system established by the CMS. The program includes an incentive payment for physicians who satisfactorily report data on quality measures for professional services provided to Medicare beneficiaries.

Each of ABMS’ 24 Member Boards will now determine if and how to participate within the PQRI program leveraging this new MOC pathway.