2017 Credentialing Survey Report Results

2017 Credentialing Survey Report Results

Oct 6, 2017
  • Author:
    Lisa Rothmuller, CPCS
    AVP, Clinical Solutions and CVO Services
    Lisa works with clients and organizations to provide Strategic Account Management and best practice and solution consulting. Lisa has a bachelor's degree in Economics/Finance from Bentley University in Boston, Massachusetts and currently resides in San Diego.

When I started in this industry, customers implemented our solution to move their paper or spreadsheet based process of managing the medical staff providers credentialing information to a computerized system. Completing primary source verification was done via mail, sometimes fax – but never via email or websites. Hospitals were rarely part of health systems, most were stand-alone or part of a small multi-facility group.

Times have changed. Through 20 years of technology advances, automation has enabled mostly real time primary source verification. There have been changes to the industry in non-technological ways as well. Especially over the last few years. Mergers and acquisitions, MACRA, provider enrollment, employed providers, onboarding have all contributed to the changes. Today’s Medical Services Professionals (MSPs) and the departments they staff are significantly different from 20 years ago.

Today’s MSPs have worked very hard to streamline processes, both in technology and human ways. According to our research, approximately 80% feel they have streamlined and reduced their initial and recredentialing time frames. This trend will only continue with future technological innovations.

Today’s MSPs are no longer just completing credentialing for initial and reappointments, but are the source of truth for provider information for many downstream systems within the hospital or health system – approximately 73% have implemented this already. While so many have implemented a source of truth, only 43% have integrated and automated the process for updating downstream systems. Another area MSPs are working on to streamline is automating the downstream updates necessary to maintain the source of truth thus eliminating the human requirement.

Today’s MSPs are working hard towards creating a single online application for their organization to streamline processes for providers as well as for the Credentialing and Privileging applications and Provider Enrollment applications. Approximately 60% have worked on this while many have their sights on this over the coming months.

Integrating Provider Enrollment activities, creating a centralized CVO or Medical Staff Services Department to support multiple facilities, and standardizing privilege criteria across enterprises are lower priorities but gaining in attention in multi-facility systems. Why haven’t some of these activities had more progress and success? Most organizations cite internal resource constraints and competing priorities as the most common impediments to implementation and success. We see this on a regular basis when discussing initiatives and priorities with our clients.