Some providers of CME are getting better at complying with accreditation criteria, several years’ worth of data show, yet many still struggle to meet a stricter set of requirements.

The proportion of CME outfits achieving accreditation with commendation has increased, from 3% of providers in the November 2008 cohort to 28% in the July 2013 cohort, according to data which were discussed at ACCME’s July board meeting and released in late August.

Accreditation with commendation confers a six-year term; baseline is four years. The fact that roughly 17 providers out of 60 in the 2013 cohort scored the top-level accreditation suggests overall improvement.

“It shows that by putting these new criteria in place, [ACCME] is pushing providers to be better educators, and the numbers are showing it’s working,” said Lawrence Sherman, SVP, educational strategy, Prova Education, an accredited shop. In some cases, organizations are simply getting better at filing the necessary documentation, he added. 

Better compliance trends were also seen in the proportion of CME outfits receiving accreditation with a progress report—necessary when a provider is found not in compliance with an individual criterion. That number has dropped from the 51% seen in the November 2008 cohort to 16 providers (27%) in the July 2013 cohort (out of the 31 that received basic accreditation).

Still, nine other providers (15%) were placed on probation and are required to submit progress reports. 

The stricter standards have also had a Darwinian effect on the CME universe. As of August 2013, there are 677 ACCME-accredited providers, down from 702 last year and 751 in 2007.

Almost all ACCME-accredited providers (838, to date) have been reviewed under the tougher 2006 criteria, the ACCME said. Accreditation, or reaccreditation, requires compliance with 15 out of 22 possible criteria. For commendation, providers need compliance with all 22.

“Harder” and “more involved” is how Sherman described the requirements, updated seven years ago. “It makes providers demonstrate that they’re really working with an educational framework [and] that the education they’re developing really meets the needs of those who are practicing in the environment in which they practice.” 

The ACCME also said it is finding that some providers may not have incorporated the expanded definition of a “commercial interest” (i.e., an entity ineligible for accreditation) into their processes. 

This definition was expanded in 2007 to include companies that market drugs and devices as well as those that manufacture, resell or distribute them. At the time, the expansion forced medical education and communications companies owned by marketing firms to separate from their parents or lose accreditation. 

“Some providers have not added ‘marketing, re-selling, or distributing’ to their processes and tools,” ACCME said, a failure which could result in partnering with an ACCME-defined commercial interest, or to collect incomplete information related to relevant financial relationships of those in control of content.

ACCME said it has notified some providers of its concerns.