Transcript Reducing Costs in the Medical Staff Office

The Cost of Doing Business
BRAINSTORMING DOCUMENT
for NCF
Prepared by Bonnie Conley, CPCS
Director, Medical Staff Services
Trinity Medical Center
MISSION
• The Credentialing Forum emerged from a group of medical societies
who first met in 1995 with the mission of reducing health care costs,
decreasing duplication, simplifying the credentialing process and
improving the efficiency of health care delivery. Their first
accomplishment was the development of the Core Credentials
Verification Tool. As basic work on the tool was completed it was
agreed that the benefit of a national forum to bring together all
organizations interested in credential verification was unique, valuable
and should be continued in some form.
• 14 years later …………THE NCF DISCUSSES AT EACH MEETING
WHAT IS OUR FUTURE. I hope today that I can provide some ideas
for that future.
Problem: Our own industry.
MSSP Industry Standard
–
–
Our own interpretation is one of the problems: When asked
why we verify something I have heard these comments amongst
my peers
EXAMPLES:
• Because we have always done that
• Because that is what the standard says
• Because that is what XYZ hospital does
• I heard it at a conference
• Because a surveyor said so
• Contractual terms with the government
Problem: Accrediting Bodies
• standards are not prescriptive or misinterpretation of the MSP or
National Firms that influence the MSP
– An example of this is follows
EXAMPLE -Standards
Example – this FAQ was on the TJC website regarding work history-Verifying
Work Experience
Q: Is there a time limit as to how far back a practitioner's work experience must
be verified?
A: No. The standards require verification of relevant work experience. The
organization is required to make a reasonable attempt to verify all work
experience that is relevant to the privileges being requested. In many cases
this may be many years ago if the practitioner has been in practice for a
long period of time.
•
•
•
What is the relevance of work history that occurred 10 years ago? Do we have
the luxury of each hospital expending valuable healthcare dollars to find that
one person out of thousands of good physicians that made someone mad 10
years ago and now we have a negative reference and no can even remember
the incident?
Shouldn’t we spend money on assuring that current competence is being
monitored and evaluated not something that happened 10 years ago.
Aren’t other points in the process before they get to our hospital, like board
certification and licensure enough of a screen to put some parameters around
the timeframe of this and other less informative elements?
Another Problem
• There is no exchange of quality information
between hospitals
Problem:
Static Information and use of
Profiles and CVO’s
• This is the key to saving across the board. Every
hospital/healthcare entity verifies medical school and
residency program, information that does not change every
time an applicant applies somewhere new
– The concept of CVO’s and the AMA/AOA profiles are good but
have not been fully embraced by our industry.
• In a perfect world could the medical schools and residency
programs report into a data bank that we could query for
this information. The information will always be fresh and
an evaluation could be put on file at the time of completion
Love OPPE and FPPE
Now let’s eliminate reappointment and really
save some money !!! Or as I heard
yesterday extend to three years.
• There is not enough time or staff to work on what is
important (Implementation of robust OPPE and FPPE
requirements, etc NOT TO MENTION PRIVILEGING.)
because we are chasing the same old paperwork that adds
no value to the decision that needs to be made
Technology
• In line with JC recent Sentinel Alert on the
need for up-to-date technology in patient
care settings. This is true also for the link to
patient safety and the cost savings in
administrative areas of the hospital that can
also be realized through technology. How
can we get that point across ??
Recommendation
Therefore, today I am challenging the NCF to return to their mission and use the
overwhelming expertise that is around the room do something for our industry that will
truly save healthcare dollars and give us a valuable tool..
• I suggest that a position paper be authored in collaboration with all
the industry experts that attend this forum. The paper would be
endorsed by TJC, DNV, CMS and legal counsel
• The position paper would distill all myths from every angle about
what is required to produce a quality credential file that would
document a practitioners ability to join the medical staff and his skill
and ability to perform the privileges requested today
• The NCF could leave their mark on our industry with such a position
position, help to strengthen alliances, could impact legislation and
with all agendas aside make a real difference in cost savings for
every hospital in our nation
• and each of us would return from this meeting to a process that is in
a better place today than when we found it 14 years ago