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Tune in on Thursday

admin01_11184880When CMS seems to want one thing and accreditors want something else, you need to cut through the confusion. Fortunately, there’s still time to join us for Verify and Comply: Meet Your Top Credentialing Challenges! Tune in on Thursday, September 4, from 1:00 to 2:30 p.m. Eastern Time for this 90-minute webcast. Carol S. Cairns, CPMSM, CPCS, will help clarify the differences among CMS and accreditors, and their expectations for medical staffs. In addition to specific requirements, best practices in credentials verification will be highlighted.

We will also identify and solve several common problematic credentialing standards that can plague your organization.

After this program, participants will be able to:

  • Describe credentialing best practices
  • Identify the similarities and differences among regulators and accreditors (including CMS, The Joint Commission, DNV, HFAP, and NCQA)
  • Differentiate current requirements from old medical staff standards language and “urban legends”
  • Clarify vague standards and unclear terminology
  • Know what must be done to ensure compliance, what is actually being done, and how to do it better

Click here to learn more about this webcast.


Take a break?

Beach picI thought about work while I was on vacation last week: I wondered, “When CRC readers get a break, what do they do?”

Our most recent MSP Salary Survey found that 50% of respondents handle credentialing and privileging for as many as 400 practitioners, and 21% reported that their department credentialed 1,000 or more. In interviews this year I’ve spoken with MSPs who handled all or most of the credentialing and privileging for multiple facilities—all while keeping MEC meetings on track, keeping their part of hospital operations as survey-ready as possible, and putting out the myriad little fires that go with the territory.

So, as we head into a three-day weekend, what will you do to unwind? Will you think about work? Let me know.

Happy Labor Day and thanks for reading!

Help (really!) wanted

HelpWantedSign[1]Is your organization looking for family medicine practitioners or internal medicine physicians? Wondering why the search is taking so long? The 2014 Merritt Hawkins Review Of Physician and Advanced Practitioner Recruiting Incentives spots some interesting trends that might already be affecting your organization.

The annual review is based on the demand for the physician search and consulting firm’s services. During the 12 months from April 1, 2013 to March 31, 2014, Merritt Hawkins/AMN Healthcare conducted or were engaged to conduct 3,158 permanent physician or advanced practice professional (APP) search assignments.

The review indicates which types of physicians are in the greatest demand and which are the most challenging to recruit. Notable among the Merritt Hawkins’ most recent findings: Family medicine, internal medicine, and hospitalists were the most in-demand specialties among the company’s clients. Psychiatry landed was the fourth most sought-after.

APPs—nurse practitioners (NP) and physician assistants (PA)—made the survey’s top five for the first time

Prior to 2011, there were “few” requests to recruit APPs, Merritt Hawkins reported. Since then, however, APP demand has come on strong. Last year, NPs and PAs made the list of the company’s top 20 most requested search assignments for the first time. “In the 2014 survey, NPs and PAs combined rank as our fifth most requested search. The number of search assignments Merritt Hawkins conducted for NPs and PAs grew 320% from 2011/12 to 2013/14.”

Supply and demand

A familiar trend driving the physician shortage is the graying of the workforce. More than 40% of active physicians are 55 years old or older, which means “a major wave” of physician retirement during the next five to 10 years, according to the company. However, the review also cited a couple of less-mentioned factors behind the physician shortage.

  1. Evolution of physician practice styles. Physician productivity is decreasing as more physicians choose employment and opt for controllable schedules. According to a separate survey conducted by Merritt Hawkins for The Physicians Foundation, physicians worked 6% fewer hours in 2012 than in 2008, a drop in productivity equivalent to the loss of 46,000 full-time equivalent (FTE) physicians from the workforce.
  2. The emergence of aligned care delivery models. These include Accountable Care Organizations (ACOs), primary care medical homes/integrated delivery systems, and others. Organizations are recruiting or acquiring physicians en masse, rather than on an ad hoc basis, as was common in the past, Merritt Hawkins reported. This change in recruiting has evolved to meet ACO staffing requirements, to manage the health of large population groups, and to secure market share.

Is your medical staff dealing with these issues? How scarce are family practitioners in your area? Has your organization hired a recruiter to find NPs, PAs, or physicians? Tell me at

And thanks for reading!


Meet your credentialing challenges

shutterstock_139733149 (2)There’s still time to register for our webcasts, Verify and Comply: Meet Your Top Credentialing Challenges, on Tuesday, September 4, from 1:00 to 2:30 p.m. Eastern Time.

Join Carol Cairns, CPMSM, CPCS, for this webcast if you’re struggling to understand what CMS, The Joint Commission or other accrediting bodies are looking for, or if you’re just striving to develop the best practices for credentialing and privileging.

After this program, participants will be able to:

  • Describe credentialing best practices
  • Identify the similarities and differences among regulators and accreditors (including CMS, The Joint Commission, DNV, HFAP, and NCQA)
  • Differentiate old medical staff standards language and “urban legends” versus current requirements
  • Clarify vague standards and unclear terminology
  • Distinguish between what must be done to ensure compliance, what is actually being done, and best practices

Click here for more information or to register.

Thanks for reading!

Son Hoang, associate editor, Credentialing & Peer Review Legal Insider

An insider’s view of a practitioner turf conflict

Jack Cox, MD, MMM, one of the authors of Resolve Practitioner Turf Conflicts: Medical Staff, AHP, and Offsite Disputes, sat down with HCPro to share his personal experience with turf conflicts as both a physician and physician executive:

It seems like a small issue, but sometimes what appears on the surface as an inconsequential turf battle among well-meaning physicians trying to maintain market share can result in everyone losing.

Recently we had an issue that has not fully played out, but I can speculate on the outcomes if we don’t resolve it. In developing a comprehensive cancer program for melanoma, we have run into an issue of different specialties all claiming expertise in the field, especially in the area of surgical intervention. The health system is looking to invest heavily in this new comprehensive program, and success—which it has had in other areas like breast and GI cancer—would mean an increase in patient volumes for all the affiliated physicians.

But back to the issue: The general surgeons, the plastic surgeons, the dermatologists and even an ENT physician all claim to have expertise with melanoma surgical excision. We recently recruited a fellowship-trained melanoma/sarcoma surgeon who is willing to help train others, but the turf lines have been drawn.

The challenge is, of course, the short-sighted nature of everyone wanting to protect their “slice of the pie” when the focus should be on how to increase the size of the pie. This is not an uncommon scenario, especially in this time of major healthcare transformation, when everything feels unstable and we regress to protecting what we can see today. Strategic thinking is out.

Now more than ever, we need to anticipate potential turf conflicts, be willing to view solutions in a different way, and think of a more strategic outcome that will be better for all. Otherwise, we all suffer the consequences of holding onto our preconceived notions of what is fair. Preparation and developing a process in advance, as well as having the right people at the table, goes a long way in avoiding the above scenario.

Mark your calendars for ICD-10

calendarThe U.S. Department of Health and Human Services formally has set October 15, 2015 as the new implementation date for ICD-10. By this date, healthcare providers, plans, and clearinghouses must transition to the new medical classification system.

ICD-10 implementation in the U.S. has been previously delayed twice. Most recently the date was set for October 1, 2014, until President Obama signed a bill into law on April 1 delaying implementation for a year.

The final rule, Administration Simplification: Change to the Compliance Date for the International Classification of Disease, 10th Revision (ICD-10-CM and ICD-10-PCS) Medical Data Code Sets, is scheduled to be published in the Federal Register on August 4.

Monday memo: Plan for September

TIPAllegations of physician misconduct and negligence. “Assistant physicians” in Missouri. Expanding NP practices in Kentucky. This week’s Credentialing Resource Center Insider news roundup showcases several potential credentialing challenges. Learn how to handle some of the toughest issues your department will face by tuning in to Verify and Comply: Meet Your Top Credentialing Challenges, a webcast slated for September 4, from 1:00 to 2:30 p.m. Presenter Carol S. Cairns, CPMSM, CPCS will help you cut through the confusion when CMS seems to want one thing for medical staffs and accreditors want something else.

I know you’re probably not ready to think about September, but if you put this web presentation on your radar, you could start fall with a better understanding of credentialing best practices.

Thanks for reading!

Mary Stevens, editor, Credentialing Resource Center Insider

Monday memo: Register for Wednesday’s webcast

TIPWith the changing demographics of the hospital medical staff comes growing challenges to collecting and assessing information on physician competence. When physician leaders do have this information, they often don’t know what to do with it. What steps should they be taking with this information? Can they work with the physician to help him or her improve (collegial intervention) or should they suspend/limit the physician’s privileges (corrective action)? This program will walk medical staff leaders through the steps of collegial intervention through corrective action and discuss how to do so while protecting patients, the physician, and the organization.

After this program, participants will be able to:

  • Identify why the change in demographics will eventually create an increase of issues with physician competency
  • Comprehend the range of assessment tools for evaluating the competence of clinically suspect practitioners
  • Understand the full range of disciplinary tools available to problem physicians
  • Conduct peer review while minimizing legal liability

Click here to learn more about this webcast.

CPRLI readers, we want to hear from you

Medical-LawWhat would you change in Credentialing and Peer Review Legal Insider? What should we keep on doing? We’re asking CPRLI readers to take a short survey to help make this publication an even more valuable asset for medical staff services departments, medical staff leaders, and legal teams in healthcare organizations.

Please take a few minutes to complete this short survey. Click here to get started or type in your browser. Respondents can be included in a drawing to win a copy of “Resolve Practitioner Turf Conflicts: Medical Staff, AHP, and Offsite Disputes,” by Jack Cox, MD, MMM; Rosemary Dragon, CPMSM, CPCS; and Christine Hearst, CPMSM.

Thanks for reading!

Monday memo: Know what data can show

TIPProPublica’s analysis of recently released Medicare data has gleaned some interesting findings—a significant number of physicians with “unusual” Medicare billing patterns have been disciplined by their state medical boards or have had challenges to their licenses. The article sheds light on the challenges of using data to identify potentially suspect physicians.

If physician leaders in your organization have collected data, assessed physician competence information, and found issues, what should their next steps be? Tune in Wednesday, July 9, 1:00-2:30 p.m. Eastern for Assessing and Managing Clinically Suspect Practitioners: From Collegial Intervention to Corrective Action, a webcast presented by Todd Sagin, MD, JD, former vice president and national medical director of The Greeley Company, Inc.

This program will walk the audience through steps for handling clinically suspect practitioners while protecting patients, the physician, and the organization. Audience members will learn to identify when working with the physician to help him or her improve (collegial intervention) is the best option, and when they should suspend or limit the physician’s privileges (corrective action).

Click here to register or learn more about this webcast.

Thanks for reading!