Associations Between American Board of Internal Medicine Maintenance of Certification Status and Performance on a Set of Healthcare Effectiveness Data and Information Set Process Measures

Gray B, Vandergrift J, Landon B, Reschovsky J, Lipner R. Ann Intern Med. 2018 Jun 12. [Epub ahead of print] [CrossRef] [PubMed]

The authors assessed whether the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) is associated with performance on selected Healthcare Effectiveness Data and Information Set (HEDIS) process measures. 1260 general internists who were initially certified in 1991 were evaluated. 786 maintained their certification from 1991 to 2012 and 474 did not. The percentage of physicians whose diabetic patients completed semiannual hemoglobin A1c, low-density lipoprotein (LDL) cholesterol measurement and biennial eye examinations were examined along with LDL cholesterol testing in patients with coronary heart disease (CAD LDL) and biennial mammography. The results demonstrate that maintaining certification was positively associated with physician performance scores on a set of HEDIS process measures (Figure 1).

Figure 1. Percentage of patients who completed HEDIS process measures.

An accompanying editorial by Lee Goldman points out that the changes are very modest, only mammography was associated with better outcomes (2.4 deaths per 100,000 patient-years) and MOC is expensive ($17,000 per general internist and $5.7 billion in total over 10 years).