Continuing medical education provides great benefit to the learners, and there are outcome studies that show it also leads to improvement in patient care. But two questions still remained: How does CME affect the overall cost of care? Can increasing quality of care also reduce the cost?
Recently, a study was published in the Journal of Outcome Measurement in Continuing Healthcare Education that helps further prove the benefit of CME. It shows that CME actually prevented over $20 million in HIV-related healthcare costs. The study was a collaboration between HealthHIV, Bristol-Myers Squibb, Medscape, and CMEology.
Estimating the Economic Impact for HIV in Primary Care
The study estimated the economic impact that happens when physicians and healthcare providers applied learning from a CME activity to recognize and treat HIV earlier. A series of live and online CME courses were developed to enhance knowledge and competence in how to test for, and treat, HIV in a clinical or primary care setting.
The CME activity, “HIV in the Primary Care Setting: Screening, Access to Expert Care, and Treatment Initiation,” was conducted to apply recommendations and procedures for primary care practice treatment teams in screening, diagnosing, counseling, and treating patients with HIV; develop integrated systems for linking patients with newly diagnosed HIV/AIDS to an appropriate care setting; describe recommendations in current HIV treatment guidelines for initiating therapy and monitoring patients who are on an initial regimen; and evaluate important factors in the decision to become an expert HIV caregiver.
The study used a mathematical model to estimate decreased transmission of HIV from an increased awareness of the infection and from an earlier initiation of antiretroviral therapy. An increased awareness of the infection helps to control infection rates because someone who is known to have HIV is less likely to take actions that would transmit the virus to others.
According to the study, estimated costs averted were $10,731,517 when testing-related awareness led to decreased transmission rates. Earlier initiation of antiretroviral therapy (351-500 CD4 cells/uL versus 201-350 CD4 cells/uL) was estimated to have prevented nearly $11,685,686 in healthcare costs. Initiating antiretroviral therapy at 351-500 CD4 cells/UL instead of <200 resulted in a cost savings of a staggering $39,521,676.
Participants in the CME workshops were primarily primary care physicians and nurses. Participants who completed both the pre-activity and the post-activity case vignettes showed a significant increase in answering questions correctly and demonstrating an improved competence in the goals of the activity.
Derek Dietze, MA, FACEHP, CHCP, president of Improve CME, LLC and editor in chief of The Journal of Outcome Measurement in Continuing Healthcare Education, said in a recent Yahoo Finance article, "Estimated costs averted from decreased transmission (based on early testing) and from earlier antiretroviral therapy demonstrated a very substantial impact of the education. Studies on the economic impact of continuing medical education are few and far between, yet results and the analysis reported in this issue suggest tremendous potential."
While little is known about the economic impact of continuing medical education in the HIV setting, this recent study solidifies the value CME provides to internal and external stakeholders, policymakers, and society. By modeling the economic outcomes, this study showed that when learning is implemented, substantial cost savings could be expected to result. The data and results of the study suggest that CME-related learning has a strong influence on even a small number of learners, leading to a considerable impact on the economic aspects of HIV care by saving costs that are related to healthcare utilization.
Other HIV Courses
A relatively recent survey found that 34 percent of primary care providers are not aware of Pre-Exposure Prophylaxis (PrEP) as a way to prevent HIV. The FDA approved PrEP in 2012 and the CDC issued a formal guidance on how to properly use it in 2014.
As a "highly effective" prevention strategy, it is important that healthcare providers know about it and know how to properly use it. Given that CME has such an excellent effect on providers and their knowledge of HIV-related treatment, perhaps more CME courses should be developed that focus on HIV prevention in addition to treatment.
In the future, expect to see more studies on the economic impact of education.