Standardization is Needed for Credentialing and Provider Enrollment (Part 2)

April 1, 2021
April 1, 2021

This blog post excerpts an article by Linda Waldorf BS, CPMSM, CPCS; President, Board of Directors,

National Association of Medical Staff Services (NAMSS)/ Director of Centralized Credentialing Office and the Office of Medical Staff Services (OMSS), UNC Health Care System, Chapel Hill, NC in the Q4 2015 issue of PX Advisor, our quarterly magazine designed to bring you thought leadership and best practices for improving the patient experience.

Hospital leaders are increasingly asked to do more with less in regard to ongoing monitoring but are struggling with how to do it. The variation in what can be measured across specialties is enormous; for instance, consider the differences between the practices of a dermatologist versus a neurosurgeon. In addition, some hospitals may maintain 50 different specialties on staff and are trying to find the best way to measure performance and improvement across such varied disciplines. More frequent credentialing is needed to support quality and patient safety—without standardization in the process, this only means more time and money spent.

The Impact of Telemedicine

The emergence of telemedicine is a delivery model that could change healthcare. Healthcare is becoming a global business with capabilities to take medicine to the ends of the earth. Health systems are managing and owning hospitals outside of the US; US citizens are going to Joint Commission-accredited hospitals in other countries; US doctors are living abroad; physicians are treating patients across state lines and national borders; vendors are selling products abroad; and recruiters are recruiting MSPs from hospitals outside of the country. This movement has the potential to extend access to care and more efficiently manage chronic disease by allowing physicians to treat their patients no matter where they are located.

However, paired with these advancements comes the need for new credentialing procedures. Currently, physicians must be licensed by the medical board in the state where the patient lives. This creates a barrier in preventing doctors from practicing, due to the excessive amount of resources required to seek credentialing in multiple states.

The recent Interstate Medical Licensure Compact created by the Federation of State Medical Boards (FSMB) will greatly impact and simplify this administrative process. The FSMB Interstate Compact states, “This model legislation will expedite and streamline the process for physicians to attain licensure in multiple states while preserving standards of care and safety. By simplifying the administrative process for licensure approval, the compact would support the work of Medical Services Professionals (MSPs) in the onboarding and credentialing of physicians. Implementing the compact would allow MSPs to spend less time waiting for licensure approval, significantly shortening the time that it takes for the medical staff to process a new applicant.”

NAMSS stands behind the FSMB compact and supports the efforts to incorporate it into state laws. This compact will remove a barrier preventing advancement in the practice of medicine, help manage the problem of physician shortage, and contribute to the overall movement towards credentialing standardization.

This article also includes:

  • Emerging Disciplines That Demand Support
  • The Desperate Need for Standardization
  • Ideal Credentialing Standards and Best Practice Criteria
  • The Growing Push for Transparency
  • The Complexities of Credentialing
  • The Need for More Frequent Credentialing