Late summer/early fall and back to school season seems like a good time to perform annual checkups and check-ins. After all, you get a yearly physical to remain healthy—and your credentialing or payer enrollment function could use a tuneup at least once a year, too.  Below we offer a comparison chart between your very special human qualities and what those might equate to if your office operations were a person in need of a little TLC.


Your provider checks your:
The office
equivalent is:
Succession planning: A look toward the future and sharp focus on the horizon is essential in order for your organization to handle what the coming years will bring.   NAMSS and HCPro surveys show that about 25% of credentialers and MSPs plan to retire in the near future. Furthermore, credentialing and PE are highly specialized occupations facing shortages in many areas of the country. Leaders must develop robust plans for attracting new talent to replace retiring staff. Strong succession plans seek talent in areas where qualified job seekers search, and provide an extremely strong training program that sets new staff up for success from day one. (How many of you learned “on the job” with no formal job description, zero orientation, and no ongoing training?) Often, succession planning gets pushed off, veterans are leery of being pushed out early and resist fully participating, or there is insufficient support in general for new hires. Leaders must address all facets of staff planning and allow for the professional growth of the employees they value and want to keep.
The communication/feedback loop for internal and external customers requires an ear to the ground and multiple and different channels so you can meet customers where they will best be heard. There’s nothing good about letting problems fester because of insufficient opportunity or means to address issues earlier. On the flip side: If your department or staff is rocking it, don’t you want to get/give credit where it’s due? Credentialers’ internal customers are providers, and its no secret that their time is squeezed now more than ever. There are ways to solicit feedback that aren’t onerous or annoying.  Fit it into already scheduled meetings; send a short, concise survey to get only the data you really need (and include an incentive of any kind); or go old school and put out a suggestion box. It doesn’t matter how you find success in getting responses. The effort to do so shows that your office desires to achieve ongoing improvement.
Blood pressure & heart function
Balance of resources for the number of providers covered (physician and advanced practice professionals) should be checked regularly. The circulation of your MSO/PE office, and its output, is the heart of the organization’s ability to function. No providers, no patient care, no revenue. There’s no one-size-fits-all solution for resource staffing, even in “like” facilities and organizations, even with similar numbers of providers to process. Consider your unique workflows today and in the future. Base predictions on well-vetted and researched provider growth rate expectations to determine necessary manpower. The consequences of not doing so include staff burnout, constant office turnover, and inability to keep up with growth in provider numbers, which affects the whole organization’s profitability. Keep in mind growth potential of APP numbers and their expanding scopes as well as growth of employed or contracted physicians. And is a CVO in use or in the plan? Consider that too.
Weight maintenance
Lean methodology is the act of reducing waste and adding customer defined value to products and services. Lean means doing more with less while doing it better. Reducing waste and streamlining can take an endless number of shapes—going paperless, revising your professional reference questionnaire,  integrating credentialing and enrollment, revising P&Ps and bylaws documents—and on and on. All actions start with close examination of what you already have, what you truly need/will need, making the changes, and making them stick long term. A few places to start: What departments, people, or functions touch the area to “lean?” What are the forms of technology (software or other) that will enable you to reduce currently wasted resources? What documentation exists? What staff or departments must be made aware of the coming changes and/or participate in the project and rollout?
Exercise regimen
The deployment, ongoing support, and effectiveness measures of any initiative is akin to your daily, weekly, and yearly exercise goals—and it takes stamina to keep it up. Technology is the best and often only way to effectively track any initiative on a large scale, across facilities, and over time. Your credentialing software might even have a component that you can use for project management. Try the “basic 3” method for ongoing measurement:

1.       Efficiency –  Relates to rate of speed and availability of [x]. It could affect factors like cost, resource use, time to fulfillment.

2.       Effectiveness – Measures how well [x] initiative is helping the department or organization achieve predetermined outcomes. These vary depending on the goals.

3.       Impact – To show the link between what you did and the effects on the organization’s ability to gain and sustain a competitive advantage, you need reportable metrics (qualitative or quantitative).