Impact of certified CME in atrial fibrillation on administrative claims

Am J Manag Care. 2012 May;18(5):253-60.


Objective: To determine whether changes in physician behavior associated with a continuing medical education (CME) activity on atrial fibrillation (AF) can be measured using an administrative claims database.

Study design: A retrospective, analytical review of physician practice changes and AF patient- related healthcare utilization and costs derived from an administrative claims database was performed on a cohort of Humana health system physicians.

Methods: The Humana physicians participated in a specified CME activity on the management of patients with AF. Treatment patterns of these providers and clinical outcomes of a cohort of established AF patients were compared 6 months before and 6 months after physician participation in the AF CME activity.

Results: Analysis of administrative claims data from Humana providers who participated in an AF CME activity and their patients demonstrated a significant reduction in AF-related healthcare costs and utilization, including decreased length of stay. Humana providers, in addition to the other CME activity participants, demonstrated significant gains in knowledge of evidence-based care strategies when presented with real-world scenarios of patients with AF.

Conclusions: The use of administrative claims data is an innovative way of measuring the effectiveness of CME. These observations support the need for further investigation into the drivers of change in patient outcomes that may be associated with CME activities, as well as the utility of healthcare claims data as a possible valid measure of the impact of CME on physician performance and patient outcomes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Atrial Fibrillation*
  • Clinical Competence / statistics & numerical data
  • Education, Medical, Continuing / statistics & numerical data*
  • Health Knowledge, Attitudes, Practice
  • Health Maintenance Organizations / statistics & numerical data
  • Health Status Indicators
  • Humans
  • Insurance Claim Review / statistics & numerical data*
  • Pilot Projects
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Retrospective Studies
  • Statistics, Nonparametric
  • United States