Taking the Pulse of Provider Credentialing: Where is the Industry Focusing?

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

Medical Services Professionals strive to streamline processes when it comes to the credentialing of physicians and other healthcare providers. For many, the process continues to be paper-based and inefficient. Organizations may not have designated a master provider database that is a single source of truth, resulting in incorrect or redundant data sources. Credentialing is not usually integrated with other key data, and entities throughout an enterprise may all be using different forms and processes. With such inefficiency, it can be difficult to impossible to analyze and improve the results of the existing credentialing process.

In order to develop an accurate picture of where things stand in the credentialing industry, the National Association Medical Staff Services (NAMSS) agreed to allow VerityStream to survey the NAMSS membership, comprised of over 5,800 medical services professionals. Members were asked to rate the importance of four key initiatives and to indicate their level of success in addressing various activities within each initiative. In October 2016, 915 NAMSS members responded to the survey. The four initiatives explored in detail in this study include:

  • Process Improvement
  • Provider Data Management
  • Centralization & Standardization
  • Service Expansion

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April 1, 2021