Thursday, July 10, 2014

ABIM MOC Failure Rates

Dr Wes' post is important but based only on first time takers of the test.

In case you haven't seen his latest:
http://drwes.blogspot.com/2014/07/examining-maintenance-of-certification.html
Also see this graph from Sermo and the implications for those Recertifying:
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I would suggest the text there indicates that the FIRST time testers are used as the index for pass/failing. This means it is prejudiced against the OLDER group of test takers (now would this be illegal due to the age discrimination?). If you have been continually exposed to the "latest statistics, etc" you will be better able to regurgitate that which is DESIRED (but also not necessarily true as it will fall in 2-5 years when the "new truth" is told).
It looks even worse on closer exam:

3413 total test takers with 65% pass means 1194 total failed of whole group
1867 of these were first time recerts and pass rate of 80% means 373 failed
This leaves 1546 "repeat or non-first time recertification testers" of which 821 failed!
This is a 53% failure rate among that group of second time recertification testers!
This means with every cycle of recertification you stand to get failed increasingly.
Seems like this is intended to weed out old guys/gals and make room for the young ones- AND YET THERE IS SUPPOSED TO BE A SHORTAGE OF PRIMARY CARE!
So it would seem with every "cycle" of 10 years, you are increasingly failing OLDER people, with indexing on the youngest only!

What are your thoughts to this?
I also actually requested CMS DATA on payments for PQRS-MOC in 2011 (the only year available and the results were published in Med economics which you may find useful as factual data:
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Maintenance of Certification must go: One physician's vi...
  The Maintenance of Certification (MOC) program’s expense and time commitments continue to grow, producing greater complexity and more headaches f...
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MOC physician incentives
It is clear not all registered got their money and with 850,000 US docs, with a 2% cut in payments this will be a huge perhaps $2.5 billion cut in CMS payments equal to the "sequester" cuts which cause people to raise hell. This is why I think 2005-6 will be hallmark years for wake-up calls to physicians regarding the MOC extortion and government collusion and I hope results in large numbers dropping medicare and caid as providers-shifting care to Fauxicians.

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