Becker's ASC Review

33 EXECUTIVE BRIEFING SPONSORED BY Why it's time to move provider credentialing into the 21st century: Insights from Modio Health CEO Dr. Kirk Heath P hysician shortages are a major concern for healthcare organizations. Yet, it can take as long as four months for a physician to get privileges at a hospital due to manual, outmoded credentialing processes. Becker's Hospital Review recently spoke with Kirk Heath, MD, CEO and founder of Modio Health, A CHG Company, about the need for more streamlined healthcare employment processes and how technology can help. Question: It's no secret healthcare is experiencing a workforce crisis that is likely to persist for years. How are healthcare organizations managing this crisis in the near term? What about planning for long-term solutions? Kirk Heath: The shortage of providers has been worsening for a number of years and was present even when I finished residency. The crisis is real and COVID only made it worse. According to the Association of American Medical Colleges, the U.S. could see a shortage of as many as 139,000 physicians by 2033. In the near-term, healthcare organizations have increased their usage of locum providers to provide the necessary care. It is estimated that 88% of healthcare organizations who provide medical services utilize temporary, or locum, providers. It was common for the usage of locum providers to carry a negative perception, which I feel was mostly because it was contrary to the traditional medical group. Healthcare services have changed over time, with groups no longer being independent, so staffing solutions need to continue to change. Flex pools are utilized in other areas of medical care, so utilizing locums and flex pools are becoming more common. It will require an investment of time and creativity with creating and sustaining these models that include temporary providers, but the result is a 'covered' patient population. Locum providers can relieve much of the causes of burnout, listed as a top reason why providers are leaving medicine. In the long term, healthcare organizations need to make themselves attractive places to work. Everyone wants to feel valued and part of a team, no matter what job they have. Some hospitals and systems perform that better than others, but there is a large gap among the entire population of organizations. When a group is short-staffed, providers will cover the gap, taking more call and covering patients in the office, but this leads to burnout. It is all too often that a group is left short- handed, relying on the remaining providers for coverage, because it is difficult to find a replacement. This is where locums and temporary staffing come in. When good organizations have a staffing shortage, they pull in locum tenens physicians, temporary staffing or flex pool employees. That makes life more manageable. Benefits, a positive workplace environment, and that sense of value plays an extremely important role in creating long term relationships with the workforce and low attrition. Q: Can you talk more about why it's so important to streamline the clinician credentialing process in the current healthcare environment? KH: Credentialing is highly inefficient and hasn't changed for decades. There are many reasons for this, ranging from fear of litigation to the way healthcare organizations are set up. When I practiced as a surgeon, I was credentialed at three hospitals, with three separate medical staffs and three separate credentialing committees. I had state licenses and was credentialed with around 20 payers. They all used the same data for credentialing, but their processes were all slightly different. A lot of redundant work goes on. In addition to the repetitive nature of credentialing, it's also done manually. Since it takes 90 to 120 days on average to complete the credentialing process, physicians can't work in a hospital for three or four months. If it's painful for physicians to become credentialed, the likelihood they will get an extra license or take a locum tenens assignment in a new hospital is pretty small. The extra income simply may not be worth the hassle. In rural areas, this issue is particularly acute. There may not be, for example, a general surgeon or an endoscopist in the community. If it takes 120 days for physicians to get credentialed, the patients who need care have to wait too. It's imperative we credential quickly to improve patient outcomes and the quality of life for providers. Q: Physicians with multi-state credentials used to be somewhat rare. Is this changing? Is there an easier way to standardize credentialing across states and hospitals? KH: Licensure across state lines is extremely important and telemedicine has definitely shined a light on this. The amount of time required to get a license varies dramatically by state. It could be six months in one place and two months in another. The Interstate Medical Licensure Compact model works well. Unfortunately, the Drug Enforcement Administration doesn't have an interstate compact, so physicians still need a DEA license in every state where they practice. I think we're moving toward a central physician licensing organization, but it's an uphill battle. When we look for solutions, everyone needs to keep an open mind and focus on the greater good. Q: What role does technology play in the credentialing process? How might technology be used to support more streamlined credentialing in the future? KH: I left my practice to start Modio Health because I saw a need in this area. In most places, credentialing is still manual, whether that's at critical access hospitals, ASCs, provider groups, multispecialty groups or health systems. We timed it and it takes an hour and a half to manually complete a typical state credentialing application with common provider data. What if all my data was in a central place, I could push a button and the information was sent to the form? That would reduce the process from an hour and half to five minutes. The amount of time, the hassle factor and the labor costs would all be dramatically reduced. It's imperative we use technology across all the components of the credentialing process. That's why we started Modio Health.n

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