The rate of decrease in industry’s budget for continuing medical education (CME) slowed last year.

After pulling back on grants for five years in a row—four of them double-digit percentage cutbacks—commercial support for ACCME-accredited providers fell only 1.9% in 2013 vs. the 2012 level, to $649.5 million. Funding from pharma and device firms now accounts for 26.9% of total CME income, according to ACCME data released yesterday.

“The data analyzes CME with and without commercial support, showing that 83% of activities did not receive commercial support, accounting for approximately 80% of participants,” said Murray Kopelow, MD, president and CEO of the ACCME.

It’s a far cry from the mid-2000s, when such funding comprised half of total CME income and, despite standards designed to prevent influence, prompted a crackdown on the grant-making process by the Senate Finance Committee.

Despite the declining trend, in June grant-giving was suddenly thrust into the spotlight again, when a report in Modern Healthcare speculated that pharma and device companies could start shifting their promotional budgets toward CME, and away from direct promotional programs, as a way to evade disclosure under the Sunshine law.

The relatively small 2% decrease in commercial funding for CME, following 2012’s 10% decline, may or may not lend credence to that theory. Now, however, the exemption for CME under the Sunshine law appears to be in jeopardy. The Centers for Medicare and Medicaid Services (CMS), just prior to the July 4 holiday weekend, announced that it intended to eliminate the exemption for CME payments to “create a more consistent reporting requirement.”

The 2013 commercial support figure does not include in-kind support, which providers have not been required to report since 2011. It’s still way down from its 2007 high of 50% of total CME income.

Meanwhile, total CME income rose 3.2% to $2.4 billion—outpacing a 1.2% increase in expenses to $1.8 billion—thanks to a 6% rise ($82 million) in other income such that received from registration fees, government grants and allocations from the accredited provider’s parent organization or other internal departments to pay for the CME unit’s expenses. That’s despite a 2.5% drop in advertising and exhibit income reported by these providers.

The Annual Report data also show the number of physician participants in activities produced by ACCME-accredited providers decreased 4.3% vs. the 2012 report, to 11.5 million, while non-physician participants rose 5.2% to about 8.9 million.

Kopelow also highlighted participation in various activity types. “Individualized, self-directed CME such as internet searching and learning is flourishing,” he said. “ACCME-accredited CME is not all lectures.”