Our survey of medical staff credentialing professionals occurred December 2017 – January 2018. This survey was conducted independently by VerityStream. The previous survey, conducted in 2016 and published in 2017, was performed cooperatively with NAMSS. Responses changed from the previous survey to this survey. In the current survey, we also added some metrics about the credentialing process that the industry badly needs to understand and has requested.
You’ll see that organizations are still working hard to improve their credentialing processes, but there is still much to be accomplished. VerityStream hopes that the information provided in the report linked to this post will be valuable to healthcare industry leaders and help to determine future directions for their improvement efforts.
KEY FINDINGS 6-10:
6. Implementing a single, master provider database was the activity garnering the most attention in the Provider Data Management Initiative. More than one-third reported they have fully, successfully implemented this activity, while 76.2% said they had either partially or fully successfully implemented a single, master provider database.
Respondents rated the degree to which Provider Data Management Initiatives have been fully and successfully implemented. Slightly over one third (35.5%) indicated that they had fully and successfully implemented a single, master database. Other initiatives trailed substantially behind the implementation of this master database. For example, managing, updating, and validating data was the next most fully implemented initiative at 14.9%. This was followed by the implementation of integrating provider data with downstream applications at 12.5%. The implementation of the creation of new data roles trailed the integration of provider data with other applications at 9.4%. Adding other types of data such as CAHPS and social media information was last at 2.6%.
Furthermore, when considering the partial or full successful implementation of Provider Data Management Initiatives, the order of successful implementation remained nearly the same for each initiative—the percentages of successful implementation, of course, increased. For example, the implementation of a single, master provider database percentage rose to 76.2%. Integrating provider data with downstream applications and managing, updating and validating data were nearly the same at 45.1% and 44.1% respectively. Successful implementation of the creation of new data roles (25.8%) and adding other kinds of data to the provider database (13.5%) rounded out the remainder of the initiatives. The range of percentages identified with unsuccessful implementation was rather narrow. For example, percentages of unsuccessful implementation varied from 5-8% across all provider initiatives. When considering the percentages associated with no attempt at implementation it was found that two initiatives stood out. The percentages associated with creating new data roles and adding other types of data to provider databases were substantially higher than that of the other initiatives at 41.8% and 51.9% respectively.
7. None of the Centralization and Standardization activities have been FULLY, successfully implemented by more than one-third of the medical services professionals participating in the survey. Respondents reported more success in FULLY or PARTIALLY implementing three activities—implementing a single online application, centralizing privileging activities, and updating medical staff by-laws.
When considering the Centralization and Standardization Initiative it was found that two initiatives outpaced the others in regard to full, successful implementation. Implementing a single online application for the entire organization was perceived as being a fully successful endeavor by 33.3% of the respondents. Similarly, 30.3% of respondents indicated that implementing a centralized or regional CVO separate from your MSO was fully successful. Updating medical staff by-laws was seen as the third most successful implementation (25.5%) while implementing a centralized or regional MSO to support multiple facilities (20.2%) was the fourth most successful.
Standardizing privileging criteria and forms and integrating provider enrollment activities were seen as relatively less fully successfully implemented with percentages of 17.3 and 14.4 respectively. When considering respondent ratings when full or partial successful implementation had been accomplished, a slightly different picture was seen. Implementing a single online application was perceived as being successfully implemented (either fully or partially) by 61.9% of respondents. Most were also successful in standardizing privileging criteria and forms along with updating medical staff by-laws (57.6% and 56.2% respectively). Respondents indicated they were less successful at implementing a centralized or regional CVO (46.1%), integrating provider enrollment activities (42.8%), or implementing a centralized or regional MSO (39.2%).
8. As with the other initiatives, most medical services professionals indicated they had not been able to FULLY, successfully implement any of the Service Expansion activities, but more than half have been able to FULLY OR PARTIALLY implement the management of their Provider Directory.
When considering the Service Expansion Initiative, only a little over a quarter of respondents indicated that managing the Provider Directory for “Find the Doctor” functionality and handling delegated credentialing services were fully and successfully implemented. Full and successful implementation of three other initiatives were indicated by percentages ranging in the teens (14-19%)— they were managing the provider enrollment process, providing and tracking CMEs, and developing an integrated provider onboarding process. Percentages of successful implementation for three other initiatives were the lowest of the group and ranged from 8-12%. These were handling network management and managed care responsibilities, managing or coordinating graduate programs, and lastly, non-provider credentialing services.
When combining the ratings of full or partial successful implementation, the percentages went up. Several ranged in the forties to fifties. These included managing the Provider Directory (55.8%), handling delegated credentialing services (49.7%), developing an integrated provider onboarding process (48.8%), and managing the Provider Enrollment process (40.5%). The remainder of the initiatives clustered together with lower levels of success that ranged from 22-38%. The non-provider credentialing services percentage of successful implementation was the lowest of the cluster at 22.1%.The following table displays the full range of percentages of successful implementation of all Service Expansion Initiatives. Ratings of unsuccessful implementation were low ranging from 3.4-10.6%. Developing an integrated provider onboarding process across multiple departments was highest at 10.6%. Percentages of non-attempted initiatives were considerable and ranged from 16.9-45.3%. Nearly half (45.3%) of respondents indicated that the non-provider credentialing services initiative was not attempted. Thirty percent of respondents indicated that two other initiatives were not attempted. These were providing and tracking CMEs for providers and managing or coordinating graduate medical education programs.
9. Compared to 2017, medical services professionals were more likely to say their organization was absorbing an “extremely” or “very significant” impact due to having more employed physicians in 2018.
Almost half of respondents (48.0%) to the 2018 survey reported that increasing numbers of employed physicians were having an extremely or very significant impact on their organization. This percentage is up from the 42.5% who said this in 2017.
10. Just over one-third of medical services professionals reported that the transition to value-based care was having a significant impact on their organization. This percentage remained consistent from 2017-2018.
Some 37.2% of survey respondents said the transition to value-based reimbursement had an extreme or very significant impact on their processes in 2018 compared to 35.4% in 2017.
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