happy national - capanet.org · physician assistants • american colleges of: emergency physicians...

CAPA Conference 2015

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Greg P. Thomas, PA, MPHDirector of External Relations

Happy National

Disclosure Information

Financial Relationship:

NCCPA Contractor


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Presentation Outline

• About NCCPA

• The Certification Maintenance Process

• A Few Words about the Physician AssistantNational Recertifying Exam (PANRE)

• Specialty Certificate of Added Qualifications(CAQ) Program

About NCCPA

• Only national certifying body for PAs

• Certifying PAs since 1975

• Passionate about PAs and thepatients you serve

– Promote qualifications and roles ofcertified PAs to various audiences(physicians, employers, state medicalboards, public, etc.)

Celebrating40 years

of the PA-C!

Our Board of Directors

10 PAs, 7 physicians and 2 public members, includingnominees from...

• American Medical Association

• American OsteopathicAssociation

• Association of AmericanMedical Colleges

• Federation of State MedicalBoards

• PA Education Association

• US Department of VeteransAffairs

• American Academies of:

─ Family Physicians

─ Pediatrics

─ Physician Assistants

• American Colleges of:

─ Emergency Physicians

─ Physicians


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• Approximately 102,000 currently certified PAs

• Approximately 7,435 new PAs certified last year

• PAs are a young profession; 52% are under the ageof 40

*As of December 2014

33%

67%

About Certified PAs *

PAs in California

Data California U.S.

Number of certified PAs 8,180 101,977

Rate per 100,000population

21.1(ranked 44th in the US)

31.8

Average salary $107,024 $98,387

Average number of hoursworking per week

39.3 40.6

26.4%

19.5%

13.8%

5.4% 5.2%

19.7% 19.5%

13.8%

4.4%7.6%

FamilyMedicine/General

Practice

Surgical Subspecialty Emergency Medicine Dermatology Internal Medicine-Subspecialty

Top PA Practice Areas California and U.S.

California U.S.

Changes to theCertificationMaintenance

Process


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New CertificationMaintenance Process

• PANRE every 6 years

• 100 CME credits every two years

– Still 50 Category 1 credits

– 20 of the Category 1 credits must be designated asself-assessment and/or performance improvement

Directed CME Defined

100 Credit CME Requirement (every 2 years)

Category 1or 2(50 credits)

Category 1(50 credits)

20 Category 1 CME credits designatedas self-assessment and/orperformance improvement

Certification Maintenance Illustrated

1st CME Cycle

2nd CME Cycle

3rd CME Cycle

4th CME Cycle

5th CME Cycle

During each cycle, earn 100 CMEcredits including 50 Category 1credits with 20 earned throughself-assessment and/or PI-CMEactivities.

By the end of the 4th CME cycle,you must have 40 Category 1 CMEcredits through SA activities and 40Category 1 CME credits through PIactivities.

Earn 100 CME credits including 50Category 1 and pass PANRE


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When Do I Start the New Process?

• After you pass PANCE or PANRE, you will beginthe 10-year cycle.

• Sign in to your record at www.nccpa.net tofind out when you transition.

Why Self-Assessment (SA)?

X ??Things youknow

Things youknow youdon’t know

Things youdon’t know youdon’t know

Self-assessment is the process of conducting a systematic review of one’sown performance, knowledge base or skill set for the purpose of improvingfuture performance, expanding knowledge, or honing skills.


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Why Self-Assessment (SA)?

• 2012 study concluded that more than 20% ofcore information guiding clinical practice ischanged within one year based on new evidenceor guidelines.

• Self-assessment makes CME more meaningfuland practical to one’s practice

• It requires active engagement in the learningprocess


NCCPA has no financial or otherrelationship with the following

organizations or products.

They are included here asexamples only.

• Content covers: Cardiology, Dermatology,Endocrinology and Metabolism, Gastroenterology andHepatology, General Internal Medicine, Hematology andOncology, Infectious Disease, Nephrology, Neurology,Pulmonary and Critical Care Medicine, Rheumatologyand Hospital Medicine is covered across all specialtyareas

• 1,200 Multiple Choice Questions, hundreds of figuresand charts

• Digital format - iPad, smart phone compatible

• Total of 174 CME credits available, minimum of 20 AAPACategory 1 Credits™ Self Assessment CME credits perspecialty section

• Cost: Special AAPA pricing of $369


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• 4 sections of the program:

1. Self-Assessment – 60 pre-test questions

2. Study and Practice – There are 24 categories from whichto choose (i.e. GI disorders, cardiovascular disorders,musculoskeletal disorders, etc…)

3. Post-Test – Take the full 450-question Post-Test. You haveto score 75% or better to get the CME credit certificate.

4. Evaluation – Before you can claim your CME and printyour certificate, you'll have to answer a few evaluationquestions.

• Earn up to 55 AAPA Category 1 Self-Assessment CMEcredits

• Cost: $199 for ACEP members; $299 fornon-members

• 400 clinical vignette based questions

• Topics derived from the NCCPA Content Blueprint

• Comprehensive explanation of the correct and incorrectanswer choices

• A follow up One Step Further question to reinforce thecontent just tested

• Performance analysis to track strengths and weaknesses

• Cumulative 50% correct to receive credit

• Approved for 20 AAPA Category 1 Self-Assessment CMEcredits

• Cost: $79

AAPA’s Learning Central


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Self-Assessment OpportunitiesThrough AAPA

Currently:260+ Self-AssessmentCME examples in manydifferent specialty areas(with more under review)

Prices range fromFREE to $400 dependingon the sponsor and thenumber of credits offered.Ongoing efforts to ensurelowest cost possible

Self-Assessment OpportunitiesThrough AAPA

Currently approved Self-Assessment CME activitiesinclude topics in:

• Rheumatology• OB/GYN• Dermatology• Hospital medicine• Endocrinology• Critical care medicine• Psychiatry• Hematology• Allergy and immunology• Surgical oncology• Pediatric surgery• Hand surgery

• General medicine• Orthopaedic surgery• Neurology• Hospice and palliative

medicine• Pediatrics• Cardiology• Emergency medicine• Gastroenterology• Nephrology• Urology• Neurosurgery

Why PerformanceImprovement (PI) CME?

PI-CME is a process of active learning andthe application of learning to improveyour practice and ultimately to enhancepatient care


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What is PerformanceImprovement (PI) CME?

• A traditional, approved PI-CME activity includesthree stages for which you can earn CME credit:

– Stage A - Identify evidence-based measure andassess practice (5 PI-CME credits)

– Stage B - Intervention(s) (5 PI-CME credits)

– Stage C - Re-measure; document improvement (5PI-CME credits)

• Completing all 3 stages (bonus of 5 PI-CMEcredits)


NCCPA has no financial or otherrelationship with the following

organizations or products.

They are included here asexamples only.

• METRIC is offered by the American Academy ofFamily Physicians

• Can be completed individually or as group

• Modules available in

– Diabetes

– Asthma

– Hypertension

– Geriatrics

• Each module = 20 PI-CME credits

• Cost: $125 for PA non-members


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• EQIPP is offered by the American Academy ofPediatrics

• Can be completed individually or as group

• Modules available in– Asthma

– Immunizations

– Diabetes care

– Newborn screening

– Oral health

– GERD

– Growth surveillance

– Tobacco use and exposure

• Each module = 20 PI-CME credits

• Cost: free for AAP members; $199 for PAnon-members

• The first module is applicable to virtually allsurgical specialties

• Other PI and SA modules to follow in 2015

• Module will be approved for 20 PI-CME credits

• Cost: $199 for AAPA members; $299 for non-members

Surgical Timeout

AAPA’s Learning Central


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PI-CME OpportunitiesThrough AAPA

Currently:Over 55 PI-CMEexamples in manydifferent specialtyareas (with moreunder review)

Prices range fromFREE to $400depending on thesponsor. Ongoingefforts to ensurelowest cost possible

PI-CME OpportunitiesThrough AAPA

• Currently approved PI-CME activities includetopics in:– General medicine– Neurology– Pediatrics– Emergency medicine– Rheumatology– Nephrology– Dermatology– Psychiatry– Allergy and immunology

• Non-practicing PAs– Patient safety– Interprofessional education competencies (for PA

educators and administrators)

More on PerformanceImprovement (PI) CME

• Can be done in partnership with PAs, physicians,and others in your practice

– Board-certified physicians also have this requirement

• Where can I find these programs

– A traditional PI CME activity (like METRIC or EQIPP)

– An activity or project that has been developed by anemployer or institution and approved by AAPA (e.g.Cleveland Clinic, MD Anderson) –- could also be a QIactivity that a PA is already doing

– An activity or project that has been developed by anindividual PA or group of PAs and approved by AAPA(coming in early 2016)


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Hospital and Health SystemQuality Improvement

• Will allow PAs to organize QI activities in their ownpractice settings, or formalize their involvement inexisting QI projects and receive PI-CME credits

• Will require official involvement with organization’sQI Department

– Define project goals and quality measures used

– Define team and resources

– Define criteria for meaningful participation

– Submit data package in specified format

• Separate application type on AAPA CME applicationsite

• Once approved, multiple PAs may receive credit

Coming Soon!

Self-Directed PI-CME Model

• Will allow an individual PA to customize her/hisown PI-CME module by selecting clinical measuresfrom a library

• Process facilitated online

• Projected availability: early 2016

Common Myths About PI-CME

• PI-CME takes more time than traditional CME

– Completed over a longer period of time, but notnecessary requiring more actual time

• PI-CME is just another QI or research project

– No final “paper” to get credit, there is value inthe process itself

• PI-CME requires Institutional Review Board (IRB)approval

– Not intended to generate scientific knowledgeor be applied beyond your specific practice

– In 2011, IOM developed “common rule”supporting PI-CME exemption from IRB review


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Another Myth About PI-CME

I can’t complete a PI-CME activity because Idon’t have continuity of care

• Requires practice level data related to a processthat impacts patient care

– e.g. time to provider, handoffs, timeouts, prescribingpractices

• Process measures focus on repetitive activities, notindividual patient outcomes

Positive Implications for PAs

• Proactively addresses elevated expectations– FSMB has recommended that states implement a

“maintenance of licensure” process for physiciansthat requires just this sort of activity

– Follows ABMS MOC process for physicians

• Elevates the relevance of CME activities

• Focus more on performance as related to patientand community health

• PI-CME aligns with Pay for Reporting (P4R) andPay for Performance (P4P)

• Fewer exams

A Few Wordsabout PANRE


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Recertification Decisions

1. Year 5 or year 6 (9 or 10)?

– 2 opportunities in both years topass the PANRE

– Taking the exam in year 5 (9)gives you more opportunities topass and doesn’t change youroverall cycle

2. Which version of PANRE to take?

– Surgery

– Primary care

– Adult medicine

NCCPA Practice Exams

• Available online for bothPANCE and PANRE

– 4 exams available

– 120 questions takenfrom NCCPA testquestion bank

– Just $35!

– Great way to see how you shouldfocus your preparation

– Get more details and registeronline at www.nccpa.net

Format of Practice Exam Feedback


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Specialty CAQProgram

Key Principles of theSpecialty CAQ Program

• PA-C is still the primary credential for all PAs.

• The CAQ program is voluntary.

• The program has been developed to be asinclusive as possible, recognizing the individualdifferences among and within specialties.

• The CAQ is an added credential that does notreplace the PA-C, hence the name.

What Specialties?

• Cardiovascular & Thoracic Surgery

• Emergency Medicine

• Hospital Medicine

• Nephrology

• Orthopaedic Surgery

• Pediatrics

• Psychiatry


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Specialty CAQ Process

CMEExperienceCases and/orProcedures

Pass SpecialtyExam

Prerequisite:

• License

• PA-C

6 years to finish

1. 2. 3.

CAQ Exams

• 120 questions

– Targeted to certified PAs working in the specialty

– All questions available for scoring if they meet ourperformance standards

• 2-hour exam

• Specialty exams are administered nationwideonce a year at Pearson VUE testing centers.

• Cost $250 plus a $100 administrative fee paidwhen you start the CAQ process

Contact:[email protected]

www.nccpa.net

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