Becker's Hospital Review

59 Executive Briefing: Strengthening the Medical Staff Services Department Sponsored by: H istorically, the medical staff services department has oper- ated behind the scenes in healthcare organizations, with few hospital workers outside the department fully under- standing the extent of its responsibilities. However, the MSSD is truly the nucleus of the hospital, as it is responsible for everything from credentialing and privileging practitioners and meeting per- tinent accreditation requirements to playing a critical role in infor- mation management and interactions between hospital leaders, physicians, board members and other key stakeholders. Increasingly, the MSSD's ability to successfully manage and ex- ecute its duties directly impact hospital revenue, cost, quality, compliance and physician satisfaction. As hospitals and health systems prepare to adopt value-based and population health-ori- ented systems of care, the stakes of these outcomes are higher than ever before. "In today's world, the MSSD must propel its medical staff leaders into achieving a more accountable medical staff and expand their focus beyond credentialing and compliance," says Sally J. Pelle- tier, CPMSM, CPCS, advisory consultant and chief credentialing officer at the Greeley Company, a healthcare consulting and pro- fessional services firm. "They must become a part of the solution for improving quality while reducing costs." The foundation of how to effectively manage the MSSD's various functions is embedded in the construction, implementation and maintenance of governance documents and associated policies and procedures, according to Ms. Pelletier. Unfortunately, many hospitals' internal MSSDs are ill-equipped — either understaffed or lacking necessary skill sets — to handle such responsibilities. One solution for healthcare organizations with struggling MS- SDs is outsourcing its functions to a specialty service company. According to The Greeley Company's research, outsourcing the MSSD can be an effective strategy for hospitals and health sys- tems seeking to control spending while preparing for significant changes in their practitioner relationships, such as a growing number of employed physicians, an increasing number of ad- vanced practice professionals or a shift to global contracting. Challenges MSSDs commonly face — and the consequences of suboptimal perfor- mance According to Ms. Pelletier, the challenges healthcare organizations with understaffed or under-resourced MSSDs face can be arranged into three main categories: staffing, resources and processes. Staffing. Medical service professionals can be scarce in certain geographic regions, and there is often wide variation in these professionals' skill sets. Inexperience, and importantly, a lack of knowledge and understanding of regulatory and accreditation re- quirements, can result in an increased compliance risk. Some long-tenured MSPs impede efficiencies through their wari- ness to depart from old, outdated practices and adopt automation. "Some folks who have been doing this for 20 years are afraid too much automation will mean losing their job, but if they hold on to that they will be a dinosaur," says Ms. Pelletier. "Automation allows you to focus on the more important analysis of a practitio- ner's qualifications than just licensure." Resources. A lack of available resources to create and sustain an optimally functioning MSSD can be a significant detriment to the department. According to Ms. Pelletier, insufficient resourc- es could mean there are not enough full-time equivalents in the department, inadequate technology or managers who lack the right project management skills to create a sustainable, effective workflow. This is often exacerbated when the department faces increased demands to support the "growing pains" of the hospi- tal or health system during mergers, acquisitions or medical staff expansions without recognizing the depth of resources needed for the correlating expansion of credentialing activities such as provider enrollment and delegated arrangements with payers. Process. MSSDs also face difficulties in creating functional econ- omies of scale and eliminating duplication as a result of dispa- rate documentation, lack of standardization and a siloed mentality between departments, according to Ms. Pelletier. Without proper information sharing processes, organizations that intend to coor- dinate decision making do not have equal access to important quality performance information on physicians. According to The Greeley Company, combined, these primary chal- lenges can result in poor service levels and outcomes, such as: • Redundant and unnecessarily complicated application pro- cedures that contribute to physician dissatisfaction and in- creased cost; • Inefficient credentialing and privileging that slows physician onboarding; • Inconsistent practices among medical staff across depart- ments within the same organization; • Increased compliance risk; and • A disconnect between key stakeholders across the system, which often leads to delays in processing credentials files and a frenzied rush to get physicians credentialed. Outsourcing as a Solution to Your Credentialing Woes

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