Increasingly, stakeholders throughout the healthcare system are challenging educators, continuing medical education providers, and commercial supporters to prove that CME lowers healthcare costs and benefits society. Until recently though, it has been difficult to prove the actual dollar value attached to CME outcomes. Our new computer model is changing that. According to a recent study we conducted, CME can lead to millions in healthcare savings, even when only a modest number of participants change their behavior as a result of the activity.
Where’s the Data?
There have been very few studies on the economic impact of CME, which is remarkable considering that, according to the Accreditation Council of CME’s 2012 Annual Report, more than $2 billion is spent annually on accredited CME. One possible reason may be that collecting and analyzing patient-level economic data is cost-prohibitive, time-consuming, labor-intensive—and often unrealistic given shrinking CME budgets.
Recognizing that economic outcomes should be reported routinely, CMEology researched ways to measure cost savings associated with CME. The goal was to bring economic measures within reach while meeting the high standards expected for outcomes measures and policy decision-making.
The CMEology team turned to existing health economic models that have served as the basis for policy making and expenditure allocations. Adapting these approaches to the needs of CME, the group developed a computer model. The approach, called outcomes impact analysis, or OIA, estimates costs averted when CME activity participants return to their practices and apply what they learned to change the health outcomes of their patients. Using state-of-the-art statistical and probability methodology, the mathematical model provides a reliable estimate of cost savings. One of the strengths of OIA is that it uses probabilistic sensitivity analysis that simultaneously considers the impact of all the real-life ranges of the different variables in the model. The result is a robust range of the estimated cost savings within which the true value is highly likely to fall.
Cost Savings From a CME Activity
In a recent example, CMEology modeled the cost savings associated with an activity for cardiothoracic surgeons that promoted prevention of bleeding-related complications and reoperation for bleeding. Following a live, certified CME symposiumheld in conjunction with the annual meeting of the Society of Thoracic Surgeons in January 2012, the group analyzed the outcomes using immediate post-activity commitment to change, survey data, and follow-up data collected one year after the activity.
They modeled the potential costs avoided when only three in 10 participants returned to practice and prevented bleeding complications in 1.5 percent to 2 percent of their annual surgeries. The researchers were surprised to find that even with a modest impact on behavior, savings estimates ranged from $1.5 million to $2.7 million. The following year, the faculty asked to present the results to an audience at a similar symposium. After the activity, 84 percent of participants said the economic data would be pivotal in their decision to incorporate what they learned into their practice.
In this age of constrained resources, it is likely that economic impact data will have an impact on learners as well as payers. The data from the research was presented at the 2013 meeting of the International Society for Pharmacoeconomics and Outcomes Research. The poster is available for download.
A Versatile and Practical Approach
While the culmination of extensive research, the OIA model is designed to be practical and applied, requiring only off-the-shelf software. The approach can be used for any therapeutic area or educational design for which cost data are available. In addition to outcomes, the model can help decision makers by evaluating the economic impact of different activities before they are initiated. The team hopes these developments will foster greater discussion of economics in CME, as costs are a universally understood language that complement educational outcomes to effectively communicate the value of CME.
Rob Lowney is principal/managing director of CMEology, a West Hartford, Conn.–based medical education company that includes outcomes research in its offerings.