4 Key Takeaways from the 2017 Annual Report on Medical Staff Credentialing

4 Key Takeaways from the 2017 Annual Report on Medical Staff Credentialing
Marketing Manager

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.

MSPs strive to streamline and become more efficient when it comes to the credentialing of physicians and other healthcare providers. However, for many, the process continues to be paper-based and inefficient; organizations may not have designated a “master” database that is a single source of truth, resulting in incorrect or redundant data sources; and credentialing is often not integrated with other key data, so entities throughout an organization may all be using different forms and processes. With this inefficiency, it can be difficult or even impossible to analyze and improve the results of the current credentialing process.

To gain a better understanding of today’s credentialing landscape, HealthStream conducted a study that surveyed 5,800 MSPs who are active members of the National Association of Medical Staff Services (NAMSS) to rate the importance of the following four key initiatives and to indicate their level of success in addressing various activities within each initiatives. Here’s what the report uncovers:

1. The Process Improvement Initiative

Only 20% - 30% of organizations have successfully implemented most of the standard Medical Services/Credentialing activities monitored that would create an automated, paperless credentialing workflow.

Some medical staff services departments still rely on paper files to keep track of licenses and certificates. These paper sysems are outdated and can introduce risk into your system. Marshall Baker, who works as a Business Consultant for physcians and is an Educator with the Accreditation Association for Ambulatory Health Care, suggests automating processes and record keeping and setting up notifications when licenses and certifications are near expiration. Also, Baker recommends assembling easy-to-follow checklists for different positions and departments.

2. The Provider Data Management Initiative

More than 36% of respondents say they’ve successfully implemented a master provider database that is the single source of truth for provider data.

BJC Healthcare, one of the largest nonprofits in the U.S., stands out among other large healthcare organizations in that their data management organization operations are incredibly advanced. They operate a single “master” system that allows them to manage outcomes better than most organizations, excel in provider data communication, and set trends in data governance.

3. The Centralization and Standardization Initiative

Roughly 20% - 30% of organizations have made progress in terms of developing a single online application, updating by-laws, and standardizing privileging criteria.

Currently, credentialing, onboarding, and enrollment processes are treated as three separate functions within most healthcare organizations—wasting countless resources as doctors and administrators file redundant contracts between providers and health plans.

In order to improve this process, increased integration of these three processes must be made, states Linda Waldorf BS, CPMSM, CPCS, President and Board of Directors at NAMSS. In addition, significant improvements in technology for reporting and data solutions are needed and most importantly, standardization must be achieved, Waldorf states.

4. The Service Expansion Initiative

Currently, only 28% of respondents said they’ve fully completed the Provider Directory functionality for their website; 22% said they’ve delegated credentialing services; and 21% said they’ve provided and tracked Continuing Medical Education (CMEs) for providers.

This initiative has seen somewhat less effort from organizations compared to the previous three. Activities such as managing provider enrollment, integrating onboarding across multiple departments, and providing credentialing for non-physicians have not been initiated by a third of respondents.

Although MSPs are committed to ensuring quality care and patient safety, this research shows that medical staff services departments are struggling to complete activities that survey respondents know are required and will be highly beneficial in the long term. How has your healthcare organization addressed these issues? Please share; we’d love to hear from you in the comments section below.

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