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Best Practices - Physician Credentialing & Onboarding strategy is crucial to physician satisfaction

Updated: Aug 21, 2020


While there have been several attempts to improve this process and physician experience over the course of the last few years, there is still significant room for improvement. A comprehensive review of the new physician credentialing & onboarding journey must take place to make effective and sustainable improvements.


When investigating best practices, there are several common themes and benchmarks that emerge. Those include (but are not limited to):


  • Clearly defined ownership of the overall on-boarding program (credentialing and payer enrollment. Current regional manager is stepping down to 20 hours and has requested that this team be managed somewhere else)

  • Role clarity and accountability with a sense of urgency among all stakeholders

  • Implementing a project management approach with every new hire (one provider = one project)

  • Setting a standard of 60 to 90 days to carry out all on-boarding functions, including credentialing, health plan contracting, operations assessment and practice/office setup

  • Assigning a physician leader as a mentor

  • Instituting regular (typically quarterly) meetings throughout the first year to focus on new physician orientation and enculturation topics

Gaps in measuring up to these best practices clearly indicate an urgent need for a re-design of our physician experience and the way we sustain our viability as an organization.


Assessment


A review of the current state and improvement opportunities must occur within the context of developing a fully scoped on-boarding and retention program for physicians. Representation from Healthcare Organizations Physicians leadership, physician recruitment, operations, hospital credentialing, payer credentialing, physician relations, marketing, and recently recruited physicians (as advisors) will be required to fully re-design the program. The new physician experience will be a guidepost for decision-making and program development. (Collaborative project management team model)


Key measures of success will include:

  • Achieve 60-90 day target for both hospital and payer credentialing within the first year after full implementation

  • Full payer credentialing to be completed prior to physician start date with a plan in place to manage any payer outliers

  • Improved physician satisfaction

  • Physician outreach & marketing plan with necessary materials in place 2 weeks prior to starting date

  • Practice development roadmap and projections to be met in the first year (quarterly updates)

  • Improved physician retention beyond the first 2 critical years

  • To achieve integration and seamlessness and eliminate redundancies, an appropriate software that allows system-wide sharing must be implemented. Implementation of an electronic solution to manage physician data, credentialing and enrollment along with payer contracts and peer review

  • Physician/Data is shared between team members involved in credentialing & on-boarding to remove redundancies

  • Policies in place for accountability and ownership, with legal review to be in place to support the I deliverables

Recommendations


Physicians are at the heart of the organization’s success. Developing a positive organizational culture coupled with a strong administrative & clinical leadership commitment to providing an exceptional credentialing and onboarding experience is essential.


The immediate next step is to review this comprehensive approach with a group of key leaders & stakeholders for feedback and buy-in/support. It is recommended that with senior leadership endorsement, the following action items are considered and addressed/approved in the appropriate forum(s) and an associated implementation plan is established:

  • Streamline & refine physician recruiting, privileging, credentialing, onboarding and marketing outreach processes – make it easier and simpler for Physician to work

  • Develop & implement a System-Wide Approach to Physician/Provider Credentialing & Data Management by adopting a centralized model. One application for all hospitals

  • A system-wide repository and source of truth for physician data – create a provider “golden record”; Ensures appropriate and accurate data flow to key access (e.g. billing, EMR, physician directory, payer credentialing) as well as other systems

  • Initiate the Onboarding Process within 24 hours of contract signature with a Physician Navigation Specialist to provide physician 1:1 touchpoint throughout their first year

  • Practice Management team to proactively define Physician onboarding infrastructure set up requirements (i.e., IT, Security, Badge, Facilities, etc.) & other requests submitted 6 weeks prior to starting dates

  • Physician to have an onboarding roadmap with mutual expectations to be shared between Physician, Physician Navigations Specialist, Practice Manager, and Medical Leadership 3 weeks in advance of the start date

  • Development of a comprehensive physician outreach and marketing/communication strategy with aligned resources

  • Determine leadership of the onboarding and retention program (new hire = one project)

  • Clarify roles and responsibilities within the interdepartmental/interdisciplinary team

  • Commit to a culture of accountability and responsiveness

  • Initiate a forum for all new Healthcare Organizations Physicians to meet and interact regularly around orientation and enculturation topics, meeting senior leadership, etc.

  • Medical Leadership to conduct quarterly Physician 1:1 touchpoints throughout the first year to ensure high engagement, satisfaction, and retention of our Physicians


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