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Introduction to AAHIVM Credentialing

October 2002


About the Academy

The American Academy of HIV Medicine (AAHIVM) is an independent organization of HIV Specialists and others dedicated to promoting excellence in HIV/AIDS care. Through advocacy and education, the Academy is committed to supporting health care providers in HIV medicine and to ensuring better care for those living with AIDS and HIV disease.

As of October 2002, our 1,500 members provide direct care to more than 275,000 HIV patients. This is more than half of the patients in active treatment for HIV disease. The Academy has a diverse membership, primarily composed of I.D., I.M., F.P. and G.P. specialists. In addition, 10 percent of the Academy's primary voting members are frontline N.P.s and P.A.s.


Credentialing

The Academy started a credentialing process in December of 2001 using the Academy's definition of an HIV Specialist.* In this short time, more than 1,000 providers have obtained the HIV Specialist designation.

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The Academy established the credentialing process independent of membership and continues to provide the process as a free service to both members and non-members. To ensure the credentialing process is accurate and supportable, approximately 10 percent of the applications are randomly selected for audit by the Academy.

* The Academy's current definition of an HIV Specialist can be found below.


Credentialed Providers (as of August 2002)

The majority of the more than 1,000 AAHIVM credentialed providers care for less than 150 HIV patients. Only 14 percent care for 300 or more HIV patients. Providers credentialed by the Academy also are a professionally diverse group including I.D., I.M., F.P., G.P., N.P. and P.A. providers.


Credentialed Providers


AAHIVM Credentialing Frequently Asked Questions

Will credentialing reduce the number of physicians providing HIV treatment in rural areas?

During the development of the Academy's definition of an HIV Specialist, rural physicians told the Academy that they are accustomed to practicing general medicine and co-managing many diseases with a specialist in a neighboring city. This is a common HIV treatment situation in rural areas, and consistent with many of the current definitions of an HIV Specialist, a rural physician usually does not see enough patients to qualify as a specialist. The Academy's definition and credentialing of HIV Specialists will assist rural physicians by identifying experienced HIV physicians in their geographical area. With the referral database available at the AAHIVM Web site (www.aahivm.org), a rural physician can quickly locate an HIV Specialist to co-manage specific cases.

Is the American Board of Medical Specialists (ABMS) intending to certify HIV Specialists? If so, how would the Academy's process differ?

Several organizations, including the Academy, have had discussions with ABMS concerning that organization's possible development of a subspecialty in HIV medicine. This process should take several years at a minimum. At this time, it is unclear what the credentialing process might look like if and when it would happen. The ABMS process, though, could require a one- to two-year fellowship program and a proctored certification board exam every ten years. The process also could exclude N.P.s, P.A.s and non-board-certified physicians.

The Academy's credentialing process is open to, and inclusive of all current frontline HIV providers. It has always been the Academy's mission to lower entry barriers into the field of HIV heath care. To this end, the Academy has kept its credentialing process accessible by offering it as a free service. In addition, the Academy requires a recurrent credentialing process to ensure that providers maintain up-to-date knowledge in the ever-changing arena of HIV care.

Do I have to be a member of the Academy to be credentialed as an HIV Specialist?

No. The Academy offers the HIV Specialist credentialing process to increase the quality of HIV-related care and to help identify those practitioners who are keeping up-to-date on HIV treatment knowledge. Recruiting new members is not the purpose of the credentialing process. You do not have to become a member of the Academy to be certified as an HIV Specialist, nor do you have to earn certification to become a member. Membership is open to anyone who is interested in assisting the Academy in reaching its mission of promoting excellence in HIV/AIDS care. Credentialing is available to anyone who wishes to qualify as an HIV Specialist.

What are the benefits of credentialing as an HIV Specialist?

A credential on a practitioner's wall from the Academy will communicate to patients and health plans that the practitioner has gone the extra step to keep up-to-date in HIV treatment knowledge. It also demonstrates support for the development of appropriate national standards. This will become increasingly important as clinics, AIDS organizations, government agencies and especially patients continue to learn more about credentialing.

In addition, the Academy maintains a national listing of HIV Specialists at its Web site. Credentialed providers are listed to link patients and service providers to qualified specialists.

I'm an Infectious Disease Specialist. Why should I credential? Why should I have to use the same process as a General Internist or Family Practitioner?

Given the rapid change in clinically relevant information, the Academy agrees with the position of the Infectious Disease Society of America (IDSA) posted on its Web site. According to the IDSA Web site, "board certification in infectious diseases and pediatric infectious diseases does not guarantee sufficient knowledge to assure that an I.D. specialist will remain an expert in HIV disease over time."

HIV patients have many noninfectious complications from their disease and the medicines used to treat the virus. According to a July 26, 2002 open letter to the California Department of Managed Health Care, IDSA's HIVMA believes I.D. doctors should have to satisfy different criteria to receive an HIV Specialist designation, regardless of a provider's background (whether Infectious Disease, Immunology, Metabolic Disorders, etc.). The Academy believes each should be held to the same standard.

Taking care of the wide range of complications of HIV (infectious, immunologic, renal, neurological, pulmonary, etc.) requires a large fund of general knowledge from practitioners and the coordination of care between multiple subspecialties. The Academy has attempted to develop an appropriate credentialing process that helps providers identify and understand the necessary, specific HIV care knowledge. Accordingly, all providers active in providing HIV/AIDS treatment should consider qualifying for the HIV Specialist credential, regardless of any other specialty or practice area.

I thought I had an option to complete 30 hours of HIV-related CME credits to qualify as an HIV Specialist. What happened?

In September 2002, the Academy chose to simplify the definition of an HIV Specialist to one option to demonstrate professional development so that the definition included the three essential elements: experience, education and external validation.

As stated in the above answer, the Academy believes that passing the I.D. Boards should not qualify someone as an HIV Specialist. In addition, the Academy believes acquiring 30 hours of HIV CME does not meet the standards of external validation as the education may not include up-to-date changes in HIV care.

The Academy's definition of an HIV Specialist recently changed. Will this affect the processing of the completed credentialing kit I just sent the Academy?

The Academy will continue to accept credentialing applications that meet the standards of the Academy's old definition of an HIV Specialist through December 31, 2002. Applicants sending in completed kits before the end of the 2002 will be credentialed through December 31, 2003. The final scoring date for the HIV Medicine Credentialing Exam in 2002 will be November 30. Completed exams must be received by the Academy before this date to be scored.

In early 2003, the Academy will mail new credentialing kits. As a result of member feedback, the Academy will begin credentialing on a bi-annual basis in 2004. This means those applying for a credential using the kits mailed out in 2003 will be credentialed through December 31, 2005.

How do I become credentialed as an HIV Specialist?

The Academy's credentialing process is relatively simple and is offered without charge to encourage as many qualified practitioners as possible to seek and meet the current professional knowledge standards represented by the AAHIVM HIV Specialist credential. To apply, you may download a credentialing application kit by visiting the Academy homepage at www.aahivm.org and click on "credentialing" found on the left-hand side of the screen. If you would like to receive a complete credentialing kit by mail, please call the Academy at 310-278-6380 or toll-free at 866-241-9601.


Definition of an HIV Specialist -- Experience, Education and External Validation

Over the years, several definitions of an HIV Specialist have been proposed. Most of these definitions incorporate some combination of Continuing Medical Education (CME) units and clinical experience as the key criteria in evaluating knowledge and clinical competency. The Academy's definition of the HIV Specialist incorporates both of these components and requires that frontline providers who wish to be considered HIV Specialists meet these qualifications on a recurrent basis. As a result of member feedback, the Academy will begin credentialing on a bi-annual basis in 2004.

In addition, The Academy's definition uniquely incorporates a component for external validation through our take-at-home exam. This exam is 70 percent based on the Most Recent Learning Objectives of the AAHIVM Core Curriculum and evaluates a provider's up-to-date knowledge on HIV care.

The Academy's full requirements for an HIV Specialist are as follows:

  • Maintain current and valid M.D., D.O., P.A. or N.P. state licensure.

  • Provide direct, continuous, ongoing care to at least 20 HIV patients over the past two years.

  • Complete at least 30 hours of HIV-related CME Category 1* credits over the past two years.

  • Successfully complete the AAHIVM exam at time of application.

* Any accredited training program over the past year will substitute for CME.




  
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This article was provided by American Academy of HIV Medicine.
 

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