PQI - The American Board of Radiology

Trustee, American Board of Radiology
Chair, MOC Coordinating Committee

MOC:
Special Programs
1. Residents and Fellows
2. Practice Groups
3. Whole Practices

RESIDENTS & FELLOWS
MOC FEE DEFERRAL
• Eligible Participants
• Residents entering into Fellowship or practice
• Conditions:
• Timely enrollment required
• 1st Year of MOC after obtaining certification
• Deferment:
• On arrival of 1 st MOC Fee Invoice (January)
• May elect to defer payment until March 1 of the next year
• No late fees or other charges will apply
• Effective: January 2012

GROUP PRACTICE MOC
ADMINISTRATIVE PARTICIPATION TOOL
Creates an easy system for tracking MOC requirements for
individual diplomates in a group practice
Single Administrator given diplomates’ approval for online
access for PDB data entry and tracking of radiologist’s
compliance with MOC milestones
Ready access to group PQI (MOC Part IV) Online Tools
- Group-Wide, Systems Improvement
Piloting in March 2012
Full launch later in 2012

WHOLE PRACTICE MOC
PARTICIPATION DISCOUNT
• Group Definition
• 2 or more Radiologists, Radiation Oncologists, or Medical
Physicists
• Requirements
• All members of the group practice must participate in MOC
• Including Lifetime Certificate Holders
• Annual Fees must be paid in aggregate
• Discount: 10% of the Total Fees Due
• Effective: 2013 Billing Cycle

MOC:
Special Programs
Professional Organizations

AMA PRA CATEGORY I CME
SELF ASSESSMENT REQUIREMENT
• AMA PRA Cat. 1 CME Changes (July 1, 2011)
• Enduring CME Activities Require:
• Assessment of Participant Learning (~test)
• Definition of Success in meeting Activity Goal
Meet s of a SA-CME (SAM)
• ABR Opportunity
• Step closer to Cat. 1 CME ~ ABR “SAM”
• Grant ABR approval of Self-Assessment CME (SAMs)
will less granular oversight

SAM – SELF ASSESSMENT CME
DEEMED STATUS FOR ORGANIZATIONS
• Allows Societies to create and deploy SAMs
without submitting each one for approval
• To qualify, a Society or Organization must:
• Have a track record of success in qualifying ABR SAMs
• Provide a designated staff contact to interface with ABR
• Agree to follow ABR Definitions and Processes
• Submit to ABR audit q 3 years
• Society can claim ABR compliance of their SAMs
• Preserve inherent ABR concept of SAM
• Alleviate staff/volunteer burden for Societies

MOC:
Focused Practice
Recognition
of
Subspecialty Expertise

ABR/ABMS
FOCUSED PRACTICE
• Professional growth does not end with Residencies
or Fellowships
• Technology & practice paradigms evolve throughout
our careers
• We can & do develop new expertise in clinical
practice
• Need for mechanism to recognize this expertise in
those practicing emerging subspecialties &
technologies

MOC:
Focused Practice
through MOC
Recognition in Cardiac CT
Recognition in Brachytherapy

FOCUSED PRACTICE
CARDIAC CT - QUALIFICATIONS
For those DR certified & participating in MOC
• PRACTICE: at least 1 year post residency
• EXPERIENCE: 150 gated, enhanced Cardiac
CT’s in last 3 years (75 w/ primary
responsibility)
• CME: 50 AMA Cat. 1 Credits in Cardiac CT
• PQI: at least ONE PQI project in Cardiac CT

FOCUSED PRACTICE
CARDIAC CT - ACHIEVEMENT
• Apply to ABR
• Passing Score on the ACR’s Cardiac CT
Advanced Proficiency Examination
• Maintain MOC requirements in
Cardiac CT

FOCUSED PRACTICE
CARDIAC CT - RECOGNITION
• Recognized on ABR MOC-status
website as a FPR-CCT Diplomate
• Recognition available to patients,
peers, referring physicians,
credentialers, payers & other
interested stakeholders

MOC Part IV
- PQI
Practice Quality
Improvement

RECOMMENDED HEALTH CARE
ABOUT 1/2 IS DELIVERED
Only about
50-54% of care
that Americans
receive…
…meets
quality
standards
McGlynn EA, Asch SM, Adams J, et al. The quality of health care delivered to adults in the United States. N Engl J Med 2003;348:2635-45.

PQI: Positioned for the Future
• PQI is designed as a platform to
demonstrate physician commitment to
practice assessment, translating practice
improvement into Quality of Care.

MOC:
New Tools
for
PQI Participation

MOC Part IV - PQI
The “Heart & Soul” of MOC
• I don’t understand what it is.
• Explain to me why I am doing
this.
• Tell me what you want me to do.
• Show me how to do it.

MOC: “PQI 2012”
Detailed Diplomate
Instructions
for Performing PQI

PQI BASICS:
THE QUALITY IMPROVEMENT CYCLE
• Identify area
needing
improvement
• Devise a
measure
• Set a goal Plan Do
• Carry out the
Measurement
Plan
• Collect data
• Develop an
Improvement
Plan
• Implement for
cycle #2
Act
Study
• Analyze the
data
• Compare to
Goal
• Root Causes

ABR
Group & Individual PQI
Checklist
&
Summary Record
Tools*
*Templates include steps
to comply with ABR
Meaningful Participation
Standards

PQI ATTESTATION ON MY ABR

Improved PDA PQI Attestation

MOC: “PQI 2012”
Performing PQI
in a Group

GROUP PQI CRITERIA
• Group Consists of 2 or more Diplomates
• Group Project Team Leader
• Team organization, meetings and record keeping
• Must document team member participation
• Project may be group designed, society-sponsored,
or involve a registry
• Requires at least 3 team meetings: Project
organization, data and root cause analysis,
improvement plan development, etc.

GROUP PQI: INDIVIDUAL CREDIT
MEANINGFUL PARTICIPATION
• Individual diplomate MOC PQI credit requires:
• Documented attendance at 3 or more team
meetings
• Preparation of a personal self-reflection statement
describing the positive impact of the project on the
group practice or patient care
• Access to project records in the event of an ABR
audit
• Attestation on ABR Personal Database (PDB) to
in-progress participation and/or project completion

ABR MOC:
Relevance
to
National Quality Initiatives

PQRS
PHYSICIAN QUALITY REPORTING SYSTEM
2007
• Physicians successfully reporting quality measures
to CMS
• Incentive Bonus as a % of all their Medicare Billings
• Quality Measures chosen from a list offered by CMS
• Rules are complex, but now quite achievable

HEALTH CARE REFORM LEGISLATION
MARCH 2010

HEALTH CARE REFORM LAW
MARCH 2010
• Recognition of MOC (PQI) by CMS as Evidence
of Physician Quality and Commitment to
Continuous Quality Improvement
• Physician Quality Reporting System (PQRS)
• Incentive Payments could be enhanced if also
participating in MOC
• Enhances Incentive Payments in 2012 by
0.5%
• 2012 Participation Details on ABR Website

PQRS-MOC: Reason to Participate
PQRS-MOC bonus & penalty
2011 1.0 percent if no MOC, 1.5 percent if MOC
2012 0.5 percent if no MOC, 1.0 percent if MOC
2013 0.5 percent if no MOC, 1.0 percent if MOC
2014 0.5 percent if no MOC, 1.0 percent if MOC
2015 -1.5 percent (98.5 % of Fee Schedule Payment Due)
2016 -2.0 percent (98% of Fee Schedule Payment Due)

MOC: “PQI 2012”
PQI Project Measures
Developed by ABR for
Radiologists

PQI PROJECT MEASURES
ABR/ABMS-ACR-AMA/PCPI
• 5 Organizations working for 2 years to
develop Radiology Quality Measures
• Address National Quality & Safety Imperatives
• “Radiation Dose Optimization in Imaging”
• Multi-purposed
• Part IV MOC – PQI
• CMS Quality Reporting Initiatives
• Pay-for-Reporting (PQRS)
• Other Payer/Regulatory Quality Initiatives
• Tested in 2012

MOC:
THE ROAD AHEAD

Health Care Quality/Accountability Demands
Insurers HC-
Plans CMS
Purchasers (Government,
Employers, Leapfrog)
Quality
NCQA
Hospital
JOINT
COMMISSION
Pharma
Laboratory
FSMB
Consultant
Physician
PQI
ABMS/ABR
Care
Management
QIOs
HIT Vendors
Consumer Advocates
Specialty
Societies
Research (RWJ,
RAND, AHRQ)
Academic
Entities
ACGME
ACCME
AQA/NQF
Measures

Health Care
Plans
Consumer
Groups
Government
Agencies
PQI/MOC
Quality
Organizations
Credentialing
Business
Coalitions

MOC:
Making MOC Work for You
& your Practice

Communicating Quality
MOC Support Hotline
(520) 519-2152
abrmocp@theabr.org