Why Do We Have Less CME Providers, But More With Accreditation With Commendation?

I spent last Friday night reading through the ACCME’s executive summary of its Board of Directors March 2012 meeting and…hold on a second, please…

<weeps softly into hands>

<ponders lack of social life since having children>

<regains composure>

…and curating data from past executive summaries (the last one available online is from November 2007). I did so because I was curious about two trends I’ve noticed in the CME community and wanted to see if my anecdotal observations held true. The first trend is fairly obvious; the second one maybe a little less so. Let’s go to the data!

Trend #1: The amount of CME providers producing certified CME activities continues to decrease

I should warn you before you look at this chart – it’s not pretty. In fact, I recommend using the clip below from Mozart’s Requiem as your soundtrack while reading it.


What I did was review all of the ACCME’s executive summaries back through November ’07 and record the number of ACCME-accredited providers and the number of providers accredited by ACCME Recognized Accreditors (state and regional organizations). The ACCME releases three executive summaries a year, so I had a total of 14 summaries to gather data from. Take a look:

Ugh. Since November 2007, the total amount of ACCME-accredited providers has decreased by 8.5% (64 providers) and the total amount of providers accredited by ACCME Recognized Accreditors has decreased by an amazing (I think it’s amazing anyway. Maybe it’s not. Judge for yourself) 17.5% (291 providers). That means there are 355 fewer organizations today producing CME activities then there were in 2007. That seems like a lot to me. Am I crazy? (Don’t answer that.

Trend #2: The amount of CME providers receiving Accreditation with Commendation is increasing

I found this one to be fascinating. In November ’07, March ’08, and July ’08, the percentage of providers up for reaccreditation receiving A with C (yes, I abbreviated it. I’m lazy.) was 9%, 8%, and 5%, respectively (So, in November ’07, 92 providers were up for reaccreditation; 9% of them received A with C.) The next summary was from November ’08 , which also happens to be when the ACCME officially started using the 2006 updated criteria  for reaccreditations. Watch what happens (reminder: the percentages here are for the percentage of providers in that cohort that received A of C. Got it? Great.) :

That’s…quite an increase. Let’s look at this in a slightly different way. From November ’07 to July ’08, 294 providers were up for reaccreditation; 20 of them (6.8%) received A with C. From July ’11 to March ’12, 155 providers were up for reaccreditation; 53 received A with C (34.2%). Anyway you slice it, there are more CME providers getting A with C.

So, what does all this mean? I have two theories.

Glass Half Full: CME providers unable to adjust to the 2006 ACCME criteria are being weeded out. At the same time, the criteria have been around long enough that the rest of the CME providers have adapted and embraced it. We have fewer providers now, but we have a higher percentage of quality CME providers.

Glass Half Empty: The new ACCME criteria has actually made it easier to get A with C. It has moved from a slightly more subjective “graded” system, to a more objective “pass/fail” system. You no longer have to go “above and beyond” to get A with C; you just have to “pass” (be in compliance) all the criterion.

Do I really believe the Half Glass Empty theory? No, not really. The reaccreditation process is still really frickin’ hard and I congratulate any organization that gets Accreditation with Commendation. It remains a special achievement and by no means am I trying to diminish that. I just find it interesting that both the percentage and total number of providers getting A with C has had such a dramatic increase. Don’t you think that’s interesting? No? Just me? Would you find a video of Cookie Monster lip-synching and dancing to Tom Waits’ “God’s Away On Business” to be interesting? Yes? OK, here you go:

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17 responses to “Why Do We Have Less CME Providers, But More With Accreditation With Commendation?

  1. Nice analysis, Derek. I think the explanation is somewhere in between the two theories you posit (how’s that for going out on a limb?) but leans mostly toward the GHF side. The weeding-out process you mentioned had the effect of creating a “rush to quality” among the surviving/thriving providers. I will be sharing this on my FB page, thanks.

    • Thanks, Chris! Yes, I agree, the explanation is likely somewhere in the middle. Or as an old X-Files fan, maybe I should say: “The truth is out there.”

  2. Derek – thanks for taking the time to sort through and write up your findings and insights! Sounds like a thoroughly stimulating Friday night! A question – any indication about how many, if any, AwC providers were among those who dropped out?

    • I do know how to have a good time! 🙂

      You ask a good question, but it’s one I can’t answer. The only way to do it would be to look at the ACCME’s list of CME providers no longer accredited by the ACCME (which does exist http://bit.ly/IEy9gi) and cross reference it with a historical list of ACCME-accredited providers w/ accreditation status, which does not exist. There is a current list of ACCME-accredited providers, but not one that goes back through the years (at least, not one that is available online).

  3. Pam Beaton (@PSB_CME)

    Great write up.

  4. The pessimist/conspiracy theorist in my wonders if any element of this trend is a product of the accreditation process and/or the personnel (and their affiliations) that administer it?

    • Well, that’s sort of the question, isn’t it? Is it the process, is it the CME providers, or some combination of both? In my heart, I want to believe that it’s because we as a CME community have made the needed adjustments and improvements to better meet the new criteria…

  5. Dereck if you took the time to do that analysis to see f those with A with C dropped off it would really help confirm your half full theory. I tend to be more cynical. I really believe theoritcally it should be harder to get A with C, so there are interesting elements at play

    • I suppose I could ask the ACCME if they would be willing to provide me with an archive of their list of CME providers from past years. Not sure they would give it to me, though…

  6. I’m fairly new to the wonderful world of CME so forgive me if this is a “duh” question. What percentage of providers had A with C before the 2006 criteria were implemented?

    • Not a “duh” question at all, but I can only partially answer it. The new criteria was initiated into the reaccreditation process in the Nov ’08 cohort. There are only 3 publicly available executive summaries that precede that time: November ’07, March ’08, and July ’08. During that period of time, 294 providers were up for reaccreditation; 20 of them (6.8%) received A with C.

  7. I’m going with GHF. I do think a lot of those who were on the fence with being accredited CME providers dropped out, and those left standing are the ones who are really working hard to get that AwC. Also, I have to give credit to the ACCME, which has been educating its little heart out on the new criteria for the past several years. One would hope it’s sinking in by now. If not (plug alert), watch for an article on how you too can achieve AwC in the June issue of Medical Meetings.)

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