There were seven fewer ACCME-accredited providers in 2011 than in 2010—687, down from 694—continuing a several-year downward slide from the high of 736 in 2007. The industry also lost 58 state-accredited providers, bringing the total to 1,392, or a combined total of 2,079 state- and ACCME-accredited providers last year. While some believe the rising cost of accreditation may be a factor, Kopelow says that external benchmarks say that less than 2 percent of an organization’s expenses should be spent on accreditation, licensing, and other regulatory concerns. If you divide the overall expenses of the CME system with the ACCME’s approximately $5 million budget, it comes out to two-tenths of 1 percent. “The amount the ACCME receives out of the process is very low,” he says.

According to the report, most of those who have voluntarily withdrawn their ACCME accreditation were nonprofit physician membership organizations, publishing/education companies, and hospitals/healthcare delivery systems. Mergers, acquisitions, and other corporate changes were behind most of the reasons they gave to ACCME for leaving. The report also notes that some smaller providers decided to jointly partner with larger accredited organizations rather than remain accredited providers themselves, so there’s no net loss to the physicians and other healthcare professionals looking for opportunities to get accredited CME.

In fact, the number of activities held by ACCME-accredited providers in 2011 has bounced back 8 percent after last year’s 14 percent drop, which capped a trend that began in 2007 when the number of activities offered by accredited providers peaked at 113,000. With more activities come more hours of instruction, not surprisingly: These also were up, though just a scant 1 percent, unlike the number of physician participants, which dropped about 1 percent. While it pales in comparison to the 16 percent increase in nonphysician participants that appeared in the 2010 report, an additional 1 percent of other types of healthcare professionals were attending activities from ACCME-accredited providers.

The most-offered type of activity was courses, followed by online enduring materials, with the bulk of both being provided by publishing/education companies, medical societies, medical schools, and hospitals, though all provider types included these in their 2011 programs. While many believe the future belongs to performance-improvement CME, that future may still be a way off: The number of PI-CME activities did rise, but only from 168 to 252, including both those that were directly and jointly sponsored.

Kopelow points out that the 2011 data also illustrate an ongoing trend toward CME that provides practice-based learning that results in measurable improvements in competence, performance, and patient outcomes, and that it’s being done in the multimodal, multiformat way the literature says is most effective. While courses and regularly scheduled series (live CME activities including lectures) do still dominate, and ACCME does not try to quantify how interactive these courses are,more than half of participants are now engaging in other forms of CME, including live Internet activities and online enduring materials. “People go on a learning journey when they have an issue they want to solve,” says Kopelow. They may begin gathering information by attending large medical congresses and reading journals, but then they move on to the next stage where they interact with colleagues and experts to develop new strategies.

“The accredited provider should reflect on the data that describe the whole enterprise to see if there is a skew toward large-group, synchronous activities that focus on the first stage of learning,” he says, and think about developing more activities in formats that correlate with different stages of change. “As we improve our ability to measure change, I believe we’ll find incremental improvement as learners go through the stages.”

Previous ACCME Data Report Writeups
CME Income Grows Despite Shrinking Commercial Support

Commercial Support Drops Again in 2009

CME Funding Down (2008 Report)

CME Funding Growth Rate Plummets (2007 Data Report)
CME Funding Growth Slows (2006 Data Report)