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Three Key Trends Identified in the 2018 Annual Medical Staff Credentialing Report

April 1, 2021
April 1, 2021

The following guest blog post from VerityStream was written by Randy Carden, Contract Research Consultant, HealthStream.

In order to explore issues in medical staff credentialing and privileging, a survey was conducted between December 2017 and January 2018 that includes responses from 683 MSPs. This study was conducted independently by VerityStream. A previous study, conducted in 2016 and published in 2017, was performed cooperatively with NAMSS. On a few key issues responses changed from the previous survey to this survey. Here are a few key trends we identified from the responses:

Is Electronic Paperless Credentialing Important?

A resounding yes! Organizations that have implemented electronic processing are able to reduce turn-around times dramatically and reduce the staff that it takes to support credentialing and privileging processes. Another result—admittedly anecdotal, but coming from a number of organizations that have fully embraced electronic processing and decision-making—is that physicians responsible for making credentialing and privileging recommendations are less likely to miss important credentialing information when they review an electronic file.

Huge Opportunities in Automating OPPE

This survey, like the previous one, also identifies that there are huge opportunities in automating OPPE performance profiles (ongoing professional practice evaluation—a Joint Commission requirement) and the peer review process. Only a small percentage of organizations have successfully automated these processes (8.1% for OPPE and 9.3% for peer review). We suspect that MSPs will work on this after they have successfully implemented electronic credentialing and privileging. Success with each of these activities will involve increased engagement with other organizational departments such as those responsible for coordinating/managing quality and peer review. Those functions will need to be integrated with credentialing and privileging processes and will necessitate successful implementation with OPPE. Peer review will likely require a closer, more engaged working relationship between MSPs and their quality department colleagues in the future.

Centralization and Standardization a Trend

Health systems are also more likely these days to centralize not only the credentialing process, but also support for privileging. Although this is not mainstream, it is increasing. In the past, privileging support has come from the MSO in each facility. It is difficult to find MSPs with expertise in privileging—a number of health systems are finding individuals with clinical backgrounds (typically nurses) to support privileging across the system. We anticipate that there will continue to be a focus on standardizing privileges in a health system and that staffing that effort centrally will lead to not only support for credentialing and privileging centrally, but centralized management of credentialing and privileging. That means that instead of a health system having a CVO, and managing only the obtaining of an application and performing primary source verification, that the CVO services will expand to also manage the decision-making process within each facility. Technology now facilitates this process. Standardizing privileges makes it more likely to occur. This will change the role of the MSO in each facility in the future. This will be particularly true of health systems that are made up of critical access hospitals, micro hospitals, etc. In those types of settings, it makes sense to manage credentialing and privileging centrally—i.e., a “physical” MSO may not exist but services will be provided virtually.

 Download the report here.