Credentialing

An entire healthcare organization can benefit when medical staff services and HR align.

A medical staff services office comprises medical staff professionals (MSPs) and credentialing specialists. They are responsible for credentialing and privileging medical staff members, keeping up with medical staff bylaws, and more.

In contrast, HR managers and employees are often responsible for promoting employee hiring and retention initiatives, managing financial matters such as payroll, and making sure healthcare regulations are followed.

During the pandemic, the Centers for Medicare & Medicaid Services expanded access to telehealth. In early 2022, that expansion is set to become permanent. While increased access to telehealth opens opportunities for reaching more patients, it also poses additional challenges for long-term hiring practices.

The COVID pandemic disrupted healthcare as we knew it. But healthcare systems are taking advantage of the pandemic-driven upheaval to accelerate changes to the way they work. According to a report from Deloitte, only 9% of healthcare employees indicated that employers were innovating new ways of working before COVID-19, compared with 78% since the pandemic began.

Background screening is vital for meeting regulatory and accreditation standards in healthcare, but because background checks are triggered at the time of offer, they are largely considered a necessary evil of the pre-employment process. Once an employer decides to hire an individual, they have been through requisition creation, multiple interviews, and even pre-hire assessments, all before an offer is made. This puts tremendous pressure on the background screening partner and the entire onboarding process to ensure that the new hire is making it into the earliest orientation possible.

Many healthcare organizations adopted telemedicine for the first time during COVID-19, introducing a wave of process changes. Assessing healthcare providers’ competencies and licenses without meeting them in person was new to many, but a wider adoption of credentialing by proxy makes the process more accessible.

Shortages among physicians and other healthcare professionals are impacting healthcare organizations across the nation. But that doesn’t mean that healthcare organizations have to sacrifice quality of care. Credentialing cements a physician or other healthcare provider’s knowledge and skills so a healthcare organization can make the right personnel and hiring decisions. In the face of these staffing shortages, medical services professionals (MSPs) often stand between uncredentialed physicians and other healthcare workers and patient safety.

Maintaining a healthcare compliance program can be challenging for compliance officers as they guide their organizations through an increasingly complex landscape, but developing partnerships can help.

“Getting other departments involved is the best way to ensure compliance becomes part of the culture of the organization,” says David Sims, Managing Partner at Security First IT, an IT security and support firm that specializes in healthcare.

Hospitals can be drawn into lawsuits involving physician negligence with “negligent credentialing” claims and the results can be costly for any healthcare organization. Attorney fees and the costs of settling a negligent credentialing case can exceed $100 million, as in the 2012 case of Jane Doe v. Bradley, for example.

Medical Services Professionals (MSPs) are the gatekeepers of patient safety for healthcare organizations. In the last few years, their roles have expanded beyond credentialing to include provider enrollment, onboarding, ongoing and focused professional practice evaluation (OPPE/FPPE), and standardization across health systems and other entities.

In recent years, healthcare organizations have experienced an expansion of physician employment. The healthcare landscape is changing compared to what it looked like ten years ago, but what does this mean for Medical Staff Services?