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How Staffing Firms Can Realize Potential Revenue

 

How Staffing Firms Can Realize Potential RevenueStaffing firms that place healthcare providers have an opportunity to realize additional revenue by eliminating delays associated with credentialing their candidates and ensuring that the healthcare facility grants the candidates privileges.  Delays commonly occur due to inefficient credentialing processes or credentialing re-work requested by the privileging authority because a component of the credentials delivered by the staffing firm is incomplete or inaccurate.  This is especially true when placing a provider in a military setting as the credentialing and privileging requirements governing that process are more rigorous than those of civilian healthcare organizations.

Value Delivered Through Outsourcing

Outsourcing the credentialing and provider management components of clinical staffing allows firms to drive additional expertise into their offerings.  The capabilities that make-up this expertise include supplementary subject matter knowledge, credentialing-specific technology solutions, and mature operating procedures.  While some staffing firms maintain in-house credentialing capabilities, it is often the incremental benefits driven by an outsourced service’s operation that enable more efficient credentialing and therefore the realization of additional revenue.

Measuring the Value Added

It is clear that properly calculating the monetary benefit of an outsourced credentialing service can be complicated as the hard costs and externalities associated with an operational change must be measured.  However, experienced credentialing service providers understand these costs and externalities and can establish ROI analyses that account for a firm’s unique circumstance.

Next Steps

The white paper Improving Competitive Advantage within Contract Clinical Staffing Firms discusses many of the benefits associated with outsourced credentialing and provider management services.  Additionally, the MCS Potential Revenue Calculator provides simple estimates of revenue that may be realized by increasing the efficiency of a firm’s credentialing operation.  Reviewing both provides a strong foundation for determining if an outsourced credentialing service provider can deliver value and create a competitive advantage for your organization. 

 

 

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About the Author

describe the imageAdam Cohen is the Director of Operations for Military Credentialing Solutions.  Adam started his career as a management consultant helping organizations design and implement new operations as well as leading organizational turn-arounds.  His strengths lie in strategy development, organizational leadership, operations analysis and design, and change management. Read more..  

  

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Collaboration Drives Improved Healthcare Quality Assurance

 

Collaboration Data Streamlining Improves Healthcare Recruiting Quality Assurance EffortsAt some point in our lives, we all apply for a job.  Whether we find the opportunity ourselves or go through a third-party, there is some component of recruitment involved.  This recruitment includes multiple steps and interactions with various individuals that require the submission, verification, and discussion of capabilities or competencies. Some industries may emphasize a background check or interview, while others place value on credentials.  This recruitment and vetting process is very similar across industries.  However, focus is placed on the differences in this process rather than encouraging shared-learning and the creation of effective processes for all stakeholders, especially in healthcare.

 

Let’s specifically talk about healthcare provider recruitment.
 

A major component of this activity is credentialing.  Credentialing, in its simplest form, is the process by which a provider’s skills, education, and training are verified.  Unfortunately, this process is often riddled with intricacies, complexities, and lack of standardization.  The good news is this process can be adjusted so that it becomes more streamlined, standardized, and efficient.  One way to do this is by driving collaboration and sharing into the process; a process that requires a variety of different entities to interact with an individual provider.

 

 A sample, yet simple, sequence of events for provider recruitment is outlined below:

 

  • A provider submits a resume to a clinical staffing firm
  • The staffing firm performs an interview and some basic due diligence on their resume (demographics, education, work history)
  • The staffing firm submits the provider’s resume to a healthcare organization’s HR department
  • The healthcare organization’s HR department vets the candidate after their application is completed
  • The HR application is approved and the provider is submitted to medical staff for hiring activities
    • The provider fills out another application
    • The provider submits all necessary credentials and associated documentations
    • The provider completes a privilege request


The scenario above may not fully mimic how your organization operates.  However, it is likely that your process has activities that occur in silos, are repetitive, and do not optimize technology.  Information that is acquired by the staffing firm is often not shared with the HR department, and subsequently, the HR department does not share this information with the medical staff office.  Not to mention the information may still be submitted and processed in paper-form with multiple applications.  The outcomes: lack of sharing and collaboration, poor provider experiences, and an increased credentialing timeframe.


There are a number of solutions that will decrease the recruitment timeframe (a big win for staffing firms) and improve a provider’s satisfaction and credentialing experience (a huge competitive advantage for healthcare organizations) – benefits that will help both entities differentiate themselves in the market.
 

Credentialing, and the broader recruitment process, is related to back-end performance management.
 

The majority of recruitment information, or data, being captured is consistent across industries; a holistic picture that contains an employee’s knowledge, skills, and abilities (KSAs).  With provider recruitment, it’s the process of retrieving and utilizing data that is different.  Performance management in healthcare may reside with the department, instead of HR, and include activities such as peer review, proctoring, FPPE, and OPPE, that are non-existent in other industries but still drive the same goals.

 

The credentialing component of recruitment is actually the front-end of an organization’s ongoing performance management process.  If you focus on items once a provider is on staff, wouldn’t it be important to learn about them in advance?  Imagine a scenario in which a staffing firm finds candidates, credentials candidates, and then submits the candidate along with an electronic record of their credentials, verifications, and KSAs to HR and the medical staff simultaneously.  Both business units have a standard set of data to perform a thorough evaluation on that provider.  If it leads to employment, this same set of data will be the basis for future performance management cycles and other onboarding activities.

 

By collaborating and sharing this standard set of data among stakeholders involved in the recruitment and credentialing process, providers submit their information once and experience a streamlined interaction and great first impression with their new potential employer.  The timeframe is decreased by eliminating the need to capture information multiple times, in varying methods and by different people.  The staffing firm also has higher confidence in candidate selection and placement due to a more comprehensive data set leading to market differentiation with competitors.  

 

This is one model and not the right solution for all organizations.  However, it is important that staffing firms and stakeholders recognize that adjustments to the credentialing component, through collaboration, sharing, and technology, can drastically improve a number of key metrics that guide the success of a healthcare organization.
 

 

 

 

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About the Guest Author

mattseer1Matt Gretczko is a member of the MCS advisory team and a Managing Consultant with Tenon. He has nine years of consulting experience, previously working at Deloitte where he provided global process redesign, technology implementation, workforce analytics, and change management services.

  

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Can You Trust Your Credentialing Information?

 

Can You Trust Your Credentialing InformationEveryone in clinical credentialing understands the importance of the information provided by prime sources.  It is the data that healthcare organizations use to determine whether a provider is clinically competent and worthy of privileges.  However, a recent Wisconsin State Journal report highlights the fact that state medical boards may not be disciplining doctors who make mistakes.  As a result, providers who should be flagged and further vetted may avoid the discerning eyes of credentialing professionals as prime source verifications obtained from the state medical boards do not include adverse information, unless a formal disciplinary action is taken.

Competing Realities

It is clear that state medical boards desire to provide complete and accurate information about the providers they license.  However, limited resources reduce the boards’ ability to thoroughly review all the reports they receive.  Unfortunately, this reality conflicts with the healthcare industry’s general assumption that information from state medical boards is a complete and accurate reflection of the information it holds regarding its licensed providers.

Practical Solutions

Regardless of the information provided by state medical boards, healthcare organizations are responsible for patient safety, in part, through a thorough credentialing process.  As with any data point collected using this process, credentialing professionals must leverage the information available and do their best to analyze a provider’s competency.  Therefore, credentialing professionals must shift their thinking about the information provided by state medical boards.  Rather than taking a “clean” medical board prime source verification as a confirmation of a provider’s effectiveness, credentialing professionals must acknowledge the absence of an adverse action and thoroughly explore other prime sources that may tip them off to potential issues.

Risk Mitigation & Operational Improvement

Healthcare organizations must acknowledge that the information received from prime sources may not be as complete and accurate as previously thought.  As a result, efforts must be made to close the gap and ensure the quality of credentialing outcomes is maintained.
 

One strategy for improving the overall quality of credentialing operations is to leverage an outsourced credentialing service provider.  These organizations specialize in high-quality, customer-focused credentialing operations.  Their expanded subject matter knowledge, credentialing-specific technology solutions, and mature operating procedures allow healthcare organizations to realize a variety of positive outcomes including reduced timelines, increased quality, and expanded recruiting and retention opportunities.  Additionally, the direct costs and positive externalities often result in a net positive financial position for the organization.  

Realities

Healthcare organizations are responsible for the quality of their providers and the effectiveness of the care received by their patients.  These organizations rely on information provided by prime sources to effectively vet providers and confirm clinical competency.  If the completeness of this information is diminished, credentialing professionals must become more diligent in their analysis of a provider’s credentials.  The question is, how do healthcare organizations turn this strategic requirement into an operational reality? 

 

 

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About the Author

describe the imageAdam Cohen is the Director of Operations for Military Credentialing Solutions.  Adam started his career as a management consultant helping organizations design and implement new operations as well as leading organizational turn-arounds.  His strengths lie in strategy development, organizational leadership, operations analysis and design, and change management. Read more..  

  

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What I Learned About Credentialing from an Old College Tradition

 

 

What I Learned About Credentialing from an  Old College Tradition

 

Healthcare quality assurance is a complex industry fraught with nuances, complexities, exceptions, and details.  As a result, significant effort is put forth to master the technical aspects of credentialing, privileging, and provider management.  However, lost in our efforts to master this competency is a skill that significantly improves one’s ability to effectively credential and privilege providers.

The Tradition 

In the early 1920s, a tradition began at my alma mater, the University of Georgia.  Everyone on campus, regardless of whether they’ve been previously introduced, was to greet each other as they passed.  Even a simple hello was acceptable.  It is likely this tradition was implemented in an effort to protect the collegial and friendly atmosphere around campus as the university continued to grow. 

The Lesson

I believe people are naturally friendly.  However, the grind of life and the complexities of business can result in a myopic focus on completing the next task or achieving the next goal.  We forget that effective interpersonal skills and sincere relationship development provide the foundation necessary for us to truly be successful.

 

The 1921 edition of the G Book, a volume distributed to each student that delineates the university’s traditions emphasizes the act of engaging each student as you pass because classmates “cannot afford to be snobbish at Georgia.”  Inherent in this tradition is the understanding that one’s success at the university was, in part, dependent upon effective relationship development.

Applications in Credentialing

Interactions between providers, medical staffs, prime sources, and other stakeholders are often distant.  Each believes the other owes them something (information, documentation, signatures, etc.) that they are entitled to by regulation.  The reality is that this sentiment is correct.  Credentialing is an administrative process required for providers to deliver care and the stakeholders are simply facilitating the completion of this task.

 

However, people fail to realize that the speed and accuracy at which others will complete a requested task is, in part, dependent upon their level of commitment toward you.  The strength of this commitment is a function of the relationship that is established between stakeholders.

 

It is clear to me that if everyone would take that brief moment, exchange pleasantries, and engage each other in a respectful and understanding tone, the entire healthcare quality assurance process would become more efficient.

The Results  

At Military Credentialing Solutions, we focus on providing exceptional customer service to every stakeholder we engage.  Our approach is not complex.  It simply requires each team member to measure their own success by the successes and experiences of our colleagues and clients.

 

By leveraging this strategy, providers submit complete and accurate information more quickly.  Prime sources return our verification requests more quickly and are responsive to any exceptions or reduced timeframes we may require.  And, each step of our credentialing process is more efficient because we’ve earned the trust, confidence, and respect of our stakeholders.  So, as you start your day tomorrow, remember to simply say hello… 

 

 

 

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About the Author

describe the imageAdam Cohen is the Director of Operations for Military Credentialing Solutions.  Adam started his career as a management consultant helping organizations design and implement new operations as well as leading organizational turn-arounds.  His strengths lie in strategy development, organizational leadership, operations analysis and design, and change management. Read more..  

  

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Tips & Tricks for Using CCQAS 2.10

 

CCQASEarlier this year, the Department of Defense launched version 2.10 of the Centralized Credentials Quality Assurance System (CCQAS).  The new version includes many enhancements that stakeholders from across the Military have been anxiously awaiting.

 

With any new process or technology, Military Credentialing Solutions takes diligent notes and works to share insights that may support the great men and women working in healthcare quality assurance across the Military.  The following is a collection of tips and hints that we have collected from our experiences using CCQAS 2.10.  We hope that you will find these insights helpful.

CCQAS 2.10 Hints & Tricks 

  1. 1.  Need a CCQAS Account?  Register at https://ccqas.csd.disa.mil/.  Identify the person responsible for approving the request and send notification of your submission to the POC to ensure timely processing.
  2. 2.  The UIC in CCQAS does not coincide with the UIC typically used by a Unit.   Use the binoculars to the right of the UIC field to help identify the correct selection if you are uncertain.
  3. 3.  In CCQAS, a “Primary” address must be identified in the Contact section prior to sending an electronic application.   
  4. 4.  As of 2JAN13, the information that previously appeared under Affiliations has now moved to the Work History Section of CCQAS.  Organizational Memberships and Academic Affiliations are now listed under Affiliations. 
  5. 5.  When uploading information in the Documents section of CCQAS, double-check that the correct “File Type” is selected.  The default selection indicates “Adverse Privileging Information.”
  6. 6.  As of 2JAN13, an ICTB is generated from the Work History section on the Navigation Bar. Use the arrow to the left of the Active CRED record under the Assignments Tab to open the submenu. Initiate ICTB is one of the options. 
  7. 7.  If an ICTB is prepared using ‘paper’ documents rather than electronic privileging, be sure to change the selection for “Suppress ICTB E-Application” to Yes.  The provider will receive repeating notifications to complete the e-application if this change is not made!
  8. 8.  Completed privileges for electronic applications can be found in the Documents Section of the provider file.  From the Navigation Bar, select Documents.  Next, click on the button for PAR’s/Snapshots. Choose the entry labeled PA Review Complete to view the approved privileges.
  9. 9.  Physician Assistants in the Military are not required to hold a State License. A PA Waiver is automatically generated by CCQAS if the PA’s credentials file meets the qualifications for the waiver.
  10. 10.  To successfully navigate through CCQAS, be sure to check for additional tabs once a selection is made from the Navigation Bar or within the Assignments. 
  11. 11.  When adding a verification that needs to be updated by the Custodian of the Credentials Record, do the following: On the Documents Tab, use the drop down Menu beside Status.  Select “Update of Credentials Record Requested.”  Proceed as normal.  The Custodial UIC will receive the message to update the provider record.

 

 

 

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About the Author

describe the imageAdam Cohen is the Director of Operations for Military Credentialing Solutions.  Adam started his career as a management consultant helping organizations design and implement new operations as well as leading organizational turn-arounds.  His strengths lie in strategy development, organizational leadership, operations analysis and design, and change management. Read more..  

 

  

 

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Brand Differentiation in Contract Clinical Staffing

 

Brand Differentiation in Contract Clinical StaffingThe clinical staffing service industry is highly competitive and many firms are finding it difficult to create a competitive advantage.  Moreover, firms have yet to feel the full impact of market parity as provider shortages fuel industry growth.  Delivering clinical staffing services is becoming a commodity and firms must act quickly to position themselves to take advantage of increasing opportunities in the marketplace.

Brave New World

Clinical staffing firms commonly use price, provider quality, and existing client relationships to differentiate themselves.  However, these opportunities will diminish as the supply of providers shrinks and demand expands.  Commodity pricing will set-in and there will be little room for discounting unless firms employ effective methods to differentiate themselves in the marketplace.  Additionally, competitive advantage through provider quality will shift as sourcing premium providers will become more difficult– further strengthening the commoditization of provider services in mainstream markets.  Finally, the ability to leverage client relationships will wane as healthcare organizations will reduce their tolerance for turnover and will become more loyal to individual providers rather than the staffing firms that place them.  As a result, providers will gain influence and gravitate toward favored staffing firms– bringing the accounts with them.

Enhance Your Operations

It is clear that staffing firms must turn to their own operations to find ways to differentiate themselves in the market.  To enhance their services and maximize operational outcomes, given the current market environment, firms must focus on customer service and provider relationship management.

 

Credentialing is often an afterthought in the staffing industry.  Clients expect providers to be vetted properly and credentialing timelines have become standardized.  As a result, firms invest in credentialing operations infrequently, and seldom think to leverage credentialing as a differentiator.  However, credentialing is a key ingredient in excellent customer service and provider relationship management.

 

Providers likely see credentialing as an administrative burden standing between them and delivering care.  It is true that traditional credentialing processes are often repetitive and require providers to engage in the process for extended periods of time.  However, a high-performing credentialing operation allows for shortened credentialing timelines and continuous maintenance of credentialing data.  As a result, providers simply update their information as new credentials are obtained– never repeating paperwork or resubmitting information. 

 

Appointment timelines are reduced and all parties recognize revenue more quickly.  In addition, high-performing credentialing operations provide concierge-style support to providers throughout the credentialing process.  Providers appreciate the “do-what-it-takes” approach and knowing they have an advocate supporting them throughout the detail-laden process.

 

Clients often require support throughout the privileging process.  The information gathered during the credentialing process is the key data needed to support these efforts.  Firms that use a high-performing credentialing operation that leverages technology to manage this data and highly trained resources to support the client are positioned to exceed client expectations.  Continuous maintenance of this data, along with sanctions monitoring, allow for ongoing support, expanded risk management services, and expedited re-credentialing activities.  As a result, the client can rely on its staffing firm to help ensure the quality of its providers, rectify administrative questions quickly and easily, and ensure re-appointment is as efficient as possible.  By covering all aspects of the credentialing process, firms are able to provide customer service at levels that are rare in the clinical staffing industry.

Making The Change

Specialized credentialing service providers are gaining popularity in the marketplace.  As healthcare organizations recognize that credentialing is much more than an administrative duty, they are outsourcing this function and experiencing uncommon results.  The quality of credentials files is increasing, credentialing timelines are decreasing, stakeholder satisfaction is increasing, and the proper maintenance of credentialing data is enabling efficiencies across the organization.  Furthermore, firms are finding that the savings realized by eliminating inefficiencies is often offsetting the cost of outsourced services, altogether.

 

The whitepaper Improving Competitive Advantage within Contract Clinical Staffing Firms provides detailed information on how staffing firms are leveraging credentialing service providers to enhance their operations and create the competitive advantage needed to capitalize on expanding opportunities in the industry.

 

 

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About the Author

describe the imageAdam Cohen is the Director of Operations for Military Credentialing Solutions.  Adam started his career as a management consultant helping organizations design and implement new operations as well as leading organizational turn-arounds.  His strengths lie in strategy development, organizational leadership, operations analysis and design, and change management. Read more..  

  

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Employees Drive Healthcare Quality Assurance Results

 

happy business peopleIn 2008, we launched Military Credentialing Solutions (MCS) with the goal of creating a service that provides the best value, highest quality, most customer-focused healthcare quality assurance solutions in the world.  Over the past five years, we have experienced huge successes.  Our programs are consistently under budget.  Our error rate is less than one thousandth of one percent.  Our provider compliance rate is 97%. Our program for the Army National Guard was even honored with the Surgeon General’s Excalibur award for healthcare program excellence.
 

We attribute this success to several new strategies that have allowed the firm to exceed industry expectations.  However, we are particularly proud of our employee empowerment strategy.

 

Relationships Are Key 

We believe healthcare quality assurance is a relationship business. Completion of credentialing, privileging, and provider management activities require the successful engagement of providers, prime sources, and employer executives/administrators.  Each stakeholder adds value and key information to the process. In each example, the relationship between the stakeholder and the individuals responsible for facilitating the process are extremely important. The stronger the relationships, the more efficient the process and the more accurate the outputs. The following outlines the benefits of strong stakeholder relationships:
 

  • When providers trust the team managing their credentials they are more forthcoming with sensitive details regarding their history, and feel a stronger sense of responsibility regarding the speedy submission of information and documents
  • When prime sources trust the team obtaining verifications, they release information more freely, respond to inquiries more quickly, and understand the documentation requirements for each client type
  • When employer executives and administrators trust the team facilitating the process, timelines are reduced and rework is limited

Developing Team Members 

A strong relationship is an intangible metric.  It is a bond that two people share resulting in a higher level of dedication and commitment than one would normally afford a different individual in the same situation.  As a result, few policies or procedures result in strong stakeholder relationships.  What is required is hiring exceptional employees and creating a strong corporate culture.
 

At MCS, we select employees that fit a specific personality profile.  While this is a key aspect of amassing a great team, we understand that the culture is key.  That is why we focus on empowering our team members.  This includes encouraging collaboration and problem solving, promoting self-management, enabling decision-making, eliciting constructive criticism of managers and processes, and allowing flexibility throughout all aspects of the business, except when it comes to results.

The Outcomes 

When placed in an ideal work environment employees are more likely to reach their highest potential, love their jobs, and be committed to the success of the firm and its clients.  As a result, employees forge stronger relationships with stakeholders and the overall quality of the company’s services is maximized.

The Experiment is a Success 

Five years ago, we began our employee empowerment initiative with confidence it would translate into exceptional results for our clients.  We’ve proven this to be true, although, it is always difficult to gauge the confidence employees have in such a program.  However, we now have direct unsolicited feedback from the team.  The MCS team, independent of the managers, choose to participate in the 2012 Atlanta Business Chronicle’s Best Places to Work program.  With results based solely on confidential surveys completed by employees, Military Credentialing Solutions was ranked the 15th best place to work among small businesses in Atlanta, from over 650 nominated companies.
 

We are proud that the MCS team has a strong sense of ownership in the business and the services we provide our clients.  It is clear that the commitment of our team members enhances the services we provide to our clients and results in a quality level unattainable without such a culture.  While difficult to quantify, an amazing team and empowering culture are certainly critical success factors for high-performing service providers.

 

 

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About the Author

describe the imageAdam Cohen is the Director of Operations for Military Credentialing Solutions.  Adam started his career as a management consultant helping organizations design and implement new operations as well as leading organizational turn-arounds.  His strengths lie in strategy development, organizational leadership, operations analysis and design, and change management. Read more..  

 

 

 

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Providers! Give Us Your Credentials Information (Part I)

 

Military Credentialing SolutionsWhy is it so difficult to compel your providers to submit complete and accurate credentials information in a timely fashion? All healthcare quality assurance professionals have experience dealing with this situation, and it can often be one of the most stressful aspects of the credentialing process.

 

In this blog series, we will examine why providers struggle to maintain their credentials information with healthcare quality assurance professionals and how organizations can refine their operations to promote the maintenance of complete and accurate credentials information. 

The Problem 

Providers respond to their environment just like everyone else. The following describes key environmental factors that are impeding provider cooperation: 

Lack of Centralization

Providers must replicate their credentials record for each facility at which they work unless some of the organizations have implemented a centralized healthcare quality assurance program. As a result, providers must package this information in slightly different ways and supply it over and over again. We can all agree that this is a very frustrating responsibility. 

Lack of Standardization 

While official credentialing standards, like those set forth by The Joint Commission, NCQA, URAC, and military organizations exist, individual healthcare organizations and facilities interpret these standards differently and then add their own requirements. As a result, providers become familiar with basic requirements (e.g., current license, malpractice insurance, etc.) but often struggle with more specialized requirements (e.g., specialized CV formatting, facility-specific forms, supervisor vs. peer references, etc.) 

Lack of Effective Engagement

Providers are highly educated and often highly compensated. Many have grown accustomed to receiving pragmatic, concierge-style support and extremely high-levels of customer service. Often, the healthcare quality assurance program and service levels established in healthcare organizations aren't designed to maximize the provider's experience. As a result, providers may view the process as ill-conceived and inconvenient. This is especially true if requirements aren't articulated clearly, data isn't maintained effectively requiring providers to repeat steps, or if the process is unnecessarily long. 

Lack of Buy-In

Providers likely chose their profession so they could help people. The reality is, credentialing, while necessary, is a bureaucratic process that stands between the provider and delivering healthcare services. Additionally, providers may not understand why certain aspects of the healthcare quality assurance process are completed the way they are. This "distance" from the process creates a lack of buy-in and support from the provider. As a result, some providers may not focus on delivering complete and accurate credentials information and may actively obstruct the process rather than support its successful completion. 

Lack of Ambiguity 

Most people don't like being examined, which, ironically, happens to be the exact purpose of the credentialing process. Providers must explain employment gaps, malpractice cases, personal health issues, and other sensitive topics. As a result, some providers will, understandably, shy away from cooperating as this information may be embarrassing. 

Focus on the Positive 

While the factors above negatively impact the healthcare quality assurance process, organizations can leverage strategies that mitigate these factors. The highest performing healthcare organizations have found ways to not only minimize these issues but to turn healthcare quality assurance programs into strategic assets that improve provider satisfaction and increase recruiting and retention opportunities.

 

 

In Part II of this series we will examine how healthcare organizations address the issues outlined in this blog entry.

 

 

 

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About the Author

describe the imageAdam Cohen is the Director of Operations for Military Credentialing Solutions.  Adam started his career as a management consultant helping organizations design and implement new operations as well as leading organizational turn-arounds.  His strengths lie in strategy development, organizational leadership, operations analysis and design, and change management. Read more..  

 

 

 

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Does Your Organization Meet The Most Rigorous Credentialing Requirements?

 

drill instructorAnyone with healthcare experience knows that the industry is highly regulated.  There are standards, requirements, regulations, and best practices for almost any task.  This is especially true for healthcare quality assurance.  Credentialing and privileging practices are well defined and healthcare organizations are audited on their ability to consistently meet these standards.

Who Sets the Rules?

In the private sector, a few organizations have emerged as leaders in setting healthcare quality assurance requirements.  These groups audit healthcare organizations to ensure the standards they set are achieved on a consistent basis.  In return, accreditation and/or certification is awarded.  The most common standard setters include:

Hospitals, clinics, healthcare facilities, insurance plans, medical groups, and other healthcare organizations participate in these programs, either by mandate or to formally illustrate competence in healthcare quality assurance.

Military Healthcare Quality Assurance Standards

While the organizations above are widely recognized throughout the industry, few outside the Department of Defense are familiar with military healthcare quality assurance regulations.  These standards (e.g., Army Regulation 40-68, Air Force Instruction 44-119, etc.) outline specific instructions regarding medical policies, processes, and requirements.  Every medical provider in the armed forces and every military healthcare facility around the world is bound by one or more of these regulations.

Few also realize that military regulations are more stringent and rigorous than any other.  As a result, the providers and personnel responsible for managing the credentialing process must go above and beyond what is required by civilian healthcare organizations. Some of these requirements include:

  • Submission of source documents in addition to prime source verifications
  • Extended work histories including all activities beginning with the award of a qualifying degree
  • Submission and verification of all current and expired licenses
  • Maintenance of military privileges in addition to any civilian privileges and affiliations

Credit Where Credit is Due

Military medical stakeholders should be lauded for successfully meeting these standards on an ongoing basis.  This is especially true for reserve component providers.  In addition to their civilian practices, these individuals volunteer to keep our troops healthy and must expand upon their civilian credentials just to qualify for their volunteer military positions.

Completing the Mission

The additional requirements associated with military credentialing are just one of the many reasons it is critically important for military healthcare organizations (e.g., force components, military treatment facilities, staffing companies serving military clients, etc.) to employ a highly efficient healthcare quality assurance program that leverages subject matter expertise and industry leading innovations to complete this work.  Those that do, consistently experience higher quality credentials files, shortened processing timelines, improved provider retention, increased recruiting opportunities, and increased provider satisfaction.

 

 

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About the Author

describe the imageAdam Cohen is the Director of Operations for Military Credentialing Solutions.  Adam started his career as a management consultant helping organizations design and implement new operations as well as leading organizational turn-arounds.  His strengths lie in strategy development, organizational leadership, operations analysis and design, and change management. Read more..  

 

 

 

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Thankful for These 3 Healthcare Quality Assurance Innovations

 

ThanksButtonWith the Thanksgiving holiday winding down, our focus moves from family back to work. Often a holiday break reinvigorates us and we return to the office ready to undertake the next big challenge.  Luckily, for those of us tackling the toughest credentialing and privileging scenarios, there has been a recent flurry of innovations emerging from the healthcare quality assurance industry.

 

Accessions, credentialing, privileging, provider quality management, interfacility credentials transfer brief (ICTB) processing, and risk management are just a few of many healthcare quality assurance processes that have been completed the same way for many years. However, recent advancements in the strategies, service offerings, and technology supporting this work have lead to organizations experiencing improved quality, increased provider satisfaction, shortened processing times, and other enterprise-level externalities. 

Three Industry Changing Innovations 

The following are just a few innovations that are changing the way organizations manage their healthcare quality assurance processes:

 

  • Centralization & Standardization: Inconsistency is a huge problem in healthcare quality assurance.  When organizations rely on local teams to interpret regulations and manage the operation, credentialing standards, policies, and procedures vary wildly. The key to an efficient and high-quality healthcare quality assurance program is ensuring the provider experience, standards, operational strategies, and management practices are consistent at every facility.
  • Customer Service Focus: Providers often find that maintaining their credentials is a tedious task. Employing a team of customer service experts to guide and support providers throughout the credentialing and privileging processes results in more complete and accurate files, shortens processing timelines, and increases provider satisfaction.
  • Continuous Credentials Management: Credentialing inefficiencies often occur because many organizations do not maintain provider data on an ongoing basis (e.g., expirables management, sanctions monitoring). This places a burden on each provider to re-create their credentials file in support of biannual re-credentialing or individual privileging actions.  This re-work is frustrating and time consuming.  Maintaining a provider’s credentials minimizes re-work and reduces the provider’s involvement to simply submitting new credentials information as it is obtained.  As a result, only a few risk management queries are required to complete a credentials file at any point in time.

 

Like any innovation, early adopters are currently leveraging these strategies and re-engineering their operations to take full advantage of the benefits.  Soon, these innovations will become industry standards as organizations use them to create a competitive advantage in the marketplace.

 

We will continue to blog about innovations and success stories from across the industry.  Hopefully, you’ll find this information useful and can leverage this information to enhance your healthcare quality assurance operations.
 

 

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About the Author

describe the imageAdam Cohen is the Director of Operations for Military Credentialing Solutions.  Adam started his career as a management consultant helping organizations design and implement new operations as well as leading organizational turn-arounds.  His strengths lie in strategy development, organizational leadership, operations analysis and design, and change management. Read more..  

 

 

 

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