The American Board of Medical Specialties (ABMS) Multi-Specialty Portfolio Program™ started in 2010 as a pilot designed by three member boards and the Mayo Clinic. The pilot’s goal was to align Maintenance of Certification Improvement in Medical Practice (MOC Part IV) activities with physician and organizational quality improvement (QI) needs. There are health care organizations doing rigorous and meaningful quality QI work and there are physicians in those organizations engaged in such QI efforts—and those doctors deserve Maintenance of Certification (MOC) Part IV credit for their work.
“It seemed logical that if those types of activities were happening at the organization level with physicians who were meaningfully engaged, they should be able to obtain MOC credit for their efforts,” said David W. Price, MD, executive director of the Portfolio Program. “We have 80 different health care organizations participating and, to date, we have had over 9,300 unique physicians earn MOC credit at least once through the Portfolio Program.”
Twenty-one of the 24 ABMS Member Boards participate in the Portfolio Program.
“Organizations that are Portfolio Program sponsors have their finger on the pulse of their gaps in care, and the opportunities for QI for the patients and populations that they serve,” Dr. Price said. “Physicians are engaged in these improvement efforts because they are important and relevant to their practices, as well as their organizations. It really starts at the place where physicians are caring for their patients.”
ABMS’ Portfolio Program allows hospitals and health care organizations to apply for Part IV MOC for individual or team-based, multispecialty projects that physicians are already engaging in at their organizations, reducing duplication of physician efforts. It enables hospitals, health systems and health care organizations to support and engage physicians in systemwide practice improvement activities that are directly related to a physician’s specialty as well as the system’s goals and objectives—all of which serve to help improve the quality of care for their patients.
Portfolio Program sponsors identify and structure opportunities using one or more well established performance improvement methodologies in such a way that they meet the standards of the program. Sponsors submit their QI efforts and the names of physicians who have meaningfully participated in those efforts to the Portfolio Program, which then submits the information to the respective boards.
There are more than 1,800 types of QI activities in areas such as prevention and screening to improvements in disease-specific care processes to cross-cutting activities such as transitions in care, patient-physician communication, patient safety and harm reduction and interdisciplinary team-based care. Many of these MOC activities satisfy other national, state and private-sector QI and reporting activities.
The Portfolio Program is supported by AMA policy that calls for MOC activities that are relevant to clinical practice and that should not be cost prohibitive or present barriers to patient care. The Council on Medical Education is working on behalf of physicians to bring the physician voice to the ABMS member boards to allow multiple and diverse physician educational and quality improvement activities to qualify for MOC.
ABMS is working to incorporate this input as MOC evolves. Recently, several boards have transformed their MOC Part III examination to make it more relevant to clinical practice.
ABMS is constantly evolving the Portfolio Program to fit the needs of the modern practice, and there are two new ways to get involved and earn MOC credit as a physician.
Become a peer reviewer and earn MOC credit. The program engages peer reviewers with expertise working in QI and practice improvement, who help review potential sponsor organization applicants and progress reports from sponsors.
“These physician reviewers provide us very valuable feedback so we can continue to improve the Portfolio Program,” Dr. Price said. “We are continually trying to evolve the Portfolio Program to fit the needs of the modern, evolving practice. Often, these reviewers are also learning things in their role as a reviewer that they turn around and apply in their own practices.”
ABMS offers reviewing physicians the opportunity to earn MOC credit. To sign up to be a physician reviewer, visit the Portfolio Program website and apply.
Test the waters and earn MOC credit. ABMS recently launched a new pre-sponsor pilot, designed to enable Accreditation Council for Continuing Medical Education (ACCME)-accredited CME providers who are not yet prepared or able to become full Portfolio Program sponsors to test and experience the program’s benefits to their physicians and organization.
“We’ve launched this opportunity whereby an organization can submit up to three quality improvement efforts through the pre-sponsor pilot. Physicians who meaningfully participate in those QI activities can earn credit through the Portfolio Program,” Dr. Price said.
“We’re really trying to think outside of the box to make this opportunity as widely available as we can,” Dr. Price said. “We’re trying to balance flexibility with maintaining a degree of rigor in the process as well, so we are engaged in conversations with lots of different people so we can make this as win-win as we can.”
Quality improvement activities are not only the basis for care improvement, but also will be a key aspect of reporting under the new Quality Payment Program (QPP) created by the Medicare Access and CHIP Reauthorization Act (MACRA). The Portfolio Program has already taken this into consideration.
“This is a wonderful opportunity and example of alignment of competing demands,” Dr. Price said. “We know that physicians are feeling overwhelmed by the number of different competing requirements, so we’re looking forward to creating new opportunities.”
“Organizations [that] are Portfolio Program sponsors select the activities that qualify for MOC credit,” he said. “Those organizations can select the activities that also align with the QPP; we encourage them to do so. Physicians can then use their work for QPP reporting as well as their MOC credit.”
Physicians are the key to quality improvement and patient safety, so their input is critical. “We want to engage as many different organizations and as many physicians as possible so more and more physicians have the opportunity to take advantage of this program,” Dr. Price said. “The more physicians that are involved, the more we can learn about different practice circumstances and the more we can then learn about how to make the Portfolio Program more relevant and valuable to physicians and the patients they serve.”