Today’s medical staff services professionals (MSPs) wear more hats than ever, and the critical provider data they handle affects compliance, safety, and a system’s financial health. But they wage a daily battle to expertly credential ever-more providers, using fewer resources, amid a growing list of priorities tied to reimbursement.
A snowball effect on revenue that starts with credentialing
Providers are the main source of patient revenue. In hospitals, physician net revenue attributed to credentialing delays totals $9,000 per provider per day. For this reason, health systems continue to acquire more physicians, even as margins decline. So, at healthcare organizations of all types and sizes, credentialing backlogs continue to grow, delaying physician onboarding, which slows revenue cycles. This has a potential domino effect on patient leakage. When providers are idle as they wait for the credentialing process to wrap up, patients may decide to go to another system for care.
Hospitals are facing unprecedented financial pressure. In fact, 40% of health system chief information officers (CIOs) say that financial pressure is the top threat to their organizations, according to the 2022 symplr Compass Survey. This means cost containment is a key objective, and they are looking to squeeze as much from their existing infrastructure as they can.
Staff and clinician challenges affect credentialing, too
According to a new Bain & Company/KLAS Research report, 31.1% of health system CIOs say clinician burnout and staffing shortages are a main concern. How is this tied to the medical staff services department? Consider that under-resourcing the teams responsible for onboarding qualified clinicians contributes to the problem. Health systems must balance resources and create processes for credentialing workflows that are sustainable. Shortages of credentialing and enrollment personnel can leave a health system unable to manage spikes in credentialing or recredentialing, which can weaken physician acquisition and merger and acquisition strategies.
Further, credentialing and enrollment resource allocation should align with an organization’s overall workforce growth strategy. When a hospital can immediately adjust its resources to support MSPs without financial penalty, as it can with a credentials verification organization (CVO), it’s an ideal arrangement. It also avoids the disruption of having to constantly find and train new staff.
”When plans to launch a national program were escalated in response to COVID, the symplr team helped us meet the demand by obtaining 150 new licenses for our project in one year. They assisted with license requirements research and contributed to improving our internal licensing process, remaining attentive, professional, and flexible in response to shifting priorities along the way.”
—Christine Haass, credentialing manager, Airrosti Rehab Centers
As financial and workforce pressures grow, health systems need new strategies to avoid leaving money on the table and ensure they're not stuck using an inefficient credentialing workflow. The path to faster reimbursement begins with accelerating the primary source verification, credentialing, payer enrollment, and licensure processes. For more healthcare organizations, the way forward is partnering with a well-established CVO.
Using a CVO as a flex-up, flex-down strategy
Health systems have a few options to optimize their credentialing process:
- Hire more full-time credentialers
- Add new technology, which may require more staff to manage it
- Hand off some or all the credentialing workload to a CVO
- Pair credentialing software with CVO services to scale capacity as needed
Consider a CVO as a flexible support team that can assist in the time-consuming process of verifying credentials while also freeing up MSPs to focus on process improvements—once qualified practitioners are in the door and generating revenue. By streamlining the credentialing and enrollment processes, hospitals can more efficiently use their resources and reduce the ongoing burden on staff.
Take our 15-second credentialing analysis
Step 1 on the way forward is to evaluate how well your credentialing workflows address the organization’s current and future provider onboarding needs. Start with key questions answerable in 15 seconds:
- Are your primary source verification processes longer than industry average? YES / NO
- Are your provider enrollment processes longer than industry average? YES / NO
- Does your credentialing technology enable accountability and provide stakeholders with visibility? YES / NO
- Does your process include sending regular status reports and updates on providers? YES / NO
- Do you have a growing backlog of credentialing or enrollment files? YES / NO
- Do you experience staffing shortages on your medical staff services team? YES / NO
Build a business case for CVO services with our help
If the self-evaluation identifies the need to change your credentialing workflows, Step 2 is to build a business case. Investing in a CVO is a significant financial decision, requiring a business case to prioritize the decision and set expectations on the anticipated return on your investment (ROI).
symplr recently partnered with Hobson & Company, a value consulting firm with over 20 years of experience, to build a custom ROI tool for this purpose. It is the result of independent validation of “sources of value” across symplr customers and identifies specific outcomes they achieved by leveraging symplr CVO.
Impact 8 key credentialing objectives and outcomes
Our research identified eight benefits across three business objectives for symplr customers:
Streamline verification processes
1. Automate and accelerate the verification of credentials such as degrees, licenses, and certifications, moving past manual, error-prone tactics.2. Use a centralized, unified, and secure platform for storing and accessing verified credentials.
Strengthen compliance efforts
3. Ensure only qualified and currently competent providers are allowed to practice, thereby improving patient safety.4. Avoid errors and inconsistencies in the credentialing process, which can result in fines, penalties, or damage to the organization’s reputation.
5. Use a solution that fosters accountability and transparency into your credentialing processes.
Grow and protect revenue
6. Adjust your resource needs instantly by using a customizable CVO services package that best fit your organization’s needs.
7. Enable your healthcare organization to serve more patients and generate more revenue through increased efficiency and productivity of credentialing processes.
8. Enhance the reputation of and trust in your healthcare organization among providers by achieving fast turnaround times that put them in front of patients faster.
Once you've received your personalized value calculation from symplr, Step 3 is to connect with us. At symplr we have been working with healthcare organizations for over 30 years, navigating change while helping customers deliver outcomes. We will consult with your organization to make a strategic plan to create a CVO approach that delivers financial, compliance, and operational outcomes.
