I have three children that play tennis. Everyone who plays the game knows success is based on focusing on where the ball is going to be and not where it is at the moment. I recently attended the National Association of Medical Staff Services (NAMSS) conference in San Francisco. Several new ideas and approaches to credentialing were introduced and I thought it was worth taking a moment to share a brief summary of many hot topics with you as we “keep our eye on the ball”.
Let’s begin with the APP vs. the AHP
The world of credentialing is full of acronyms. An acronym that has been around for some time now but is just now making its way to the majority of us in Kansas is the APP or Advanced Practice Practitioner. This is a subcategory of Allied Health Practitioners or AHPs as we’ve come to know them. APPs are those AHPs that have advanced degrees giving them the opportunity to play a key role in the clinical course of treatment for the patient. Many hospitals are struggling with how to assess the clinical competency on the AHP/APP. The best practice is to request an activity log at the time of initial appointment and reappointment so the hospital can measure that against the clinical privileges being requested. The future credentialing model will treat APPs just as the medical staff members with all the required documentation.
NAMSS recognizes The Joint Commission (TJC) does not require a timeline-credentialing model where all hospital affiliations and work history affiliations are verified. NAMSS does, however, support affiliation verifications and is launching a new service called NAMSS PASS. This service will require voluntary participation of hospitals and physician employers around the country. The end result will be a centralized collection of all physician affiliation documentation (hospitals, work history, academic affiliations). Those entities requiring the information will be charged a fee for access to the NAMSS PASS. This is a great idea in theory but will rely on voluntary participation of hospitals and physician employers around the country. Unlike the verifications we request now where most are free, this verification will come at a price. The Joint Commission is most likely to accept the NAMSS PASS as primary source documentation, although this has yet to be determined. More to come on the NAMSS PASS….
New Credentialing Models
The world of medicine as we know it is ever changing and different credentialing models are necessary to meet the demand. Accountable Care Organizations (ACO) and medical home groups and other physician alignment models are being developed in the country and each will require some type of credentialing response. That response has yet to be determined because the new models will embrace some type of economic credentialing approach (who’s in and who’s out). Economic credentialing has not been popular in the past but will soon become the necessary standard of credentialing in some health care alignments.
MOL, MOC and OCC
Many of us have heard of the Maintenance of Certification (MOC) required by some boards of the American Board of Medical Specialties (ABMS). The MOC has not been fully adopted by all ABMS boards but it does seem to be the path of the future. Maintenance of Licensure (MOL) is a model being developed by the Federation of State Medical Boards (FSMB). This model is similar to the Maintenance of Certification (MOC) and Osteopathic Continuous Certification (OCC) in that it requires a provider to provide proof of continuous competency via classes attended (traditional CME requirements), participation in clinical activities (an expanding area of competency) and other forms of documentation. Although the MOL has not been implemented yet, this strategy of licensure requirements is being fully and aggressively embraced by the FSMBs. If implemented by all state licensure boards, the Kansas State Board of Healing Arts (KSBHA) will be developing the requirements for Kansas. My questions include the following: Will this eliminate the annual licensure renewal as all licensure is continually maintained? When will MOC be required for all boards? So far the American Board of Pediatrics has adopted it in 2010 but no other boards. Several boards are moving toward the MOC model. In any event this is where we are headed in the future.
I hope this summary of what is on the horizon provides an indication of where credentialing paths may lead in the future as we keep our eye on the ball of credentialing. I, like you, have many questions, but I’m confident we can approach these models together as we respond to the documentation needed.