Internists earn extra credit for certification data

A partnership of health plans and a medical specialty board is designed to improve quality of care.

By Damon Adams, AMNews staff. Sept. 11, 2006.

The American Board of Internal Medicine is partnering with health plans so that physicians can use maintenance of certification to get credit in health plan performance and quality programs.

Under the program, internists complete a practice improvement module as part of the recertification process, then participating health plans accept those data for use in quality recognition programs. ABIM and health plan officials say the initiative reduces redundancy for physicians and promotes quality improvement.

The effort will allow more than 100,000 internists and subspecialists to qualify more easily for recognition and pay-for-performance rewards, the ABIM said.

"Our reason for doing this is to make the doctor's life easier," said Christine K. Cassel, MD, ABIM president and CEO.

Physicians must be enrolled in the ABIM's maintenance-of-certification program and finish a PIM, an Internet-based, self-evaluation tool that doctors complete to maintain certification. When a doctor completes a PIM, he or she may opt to authorize the ABIM to send information from the completed PIM to health plans, the ABIM said.

In March 2006, Blue Cross and Blue Shield of Nebraska became the first health plan to partner with the ABIM on the initiative. Other participating health plans include UnitedHealthcare, Aetna and Horizon Blue Cross Blue Shield of New Jersey.

Starting this fall, Aetna's Mid-Atlantic Region will accept completion of the ABIM's diabetes PIM in place of the diabetes chart review now required for primary care internists in Aetna's Delaware Valley pay-for-performance program, Aetna officials said. That area covers 2,000 internists in Delaware, southeastern Pennsylvania and southern New Jersey.