Patient Safety | 12.06.21
Top 4 Process Improvement Priorities from the 2021 Annual Report on Provider Enrollment
by Vicki Searcy, Vice President of Consulting Services, VerityStream
The following article is sponsored by VerityStream.
Every year, the VerityStream team puts together a comprehensive report on provider enrollment based on survey results from ~500 provider enrollment professionals. The 2021 Annual Report on Provider Enrollment makes it crystal clear that today's provider enrollment professionals are not content to rest on their laurels. You’re on a mission to continuously improve, and our survey results indicate that your top priorities include:
1. Reducing time to enroll providers.
2. Reducing required resources and administrative costs through automation and process simplification.
3. Implementing process efficiencies to improve financial results related to employing physicians and/or owning physician practices.
4. Improving provider satisfaction with the credentialing and enrollment process.
Let’s take a look at the trends surrounding these goals and discuss some of the initiatives you can undertake to achieve them.
Trend #1: Reduce time to enroll providers
This year’s Annual Report on Provider Enrollment found that, similar to previous years, “reduce time to enroll providers” was the single highest rated item, with 88.2 percent of respondents listing it as “very important.” When enrolling a single provider can take anywhere between 30 to 120 days, it’s not surprising that provider enrollment professionals and providers alike want to see a change.
Trend #2: Reduce required resources and administrative cost
Results showed the initiative “reduce required resources and administrative cost through automation and process simplification” increased from 70.2 percent in 2020 to 75.7 percent in 2021. This goes hand in hand with reducing the time it takes to enroll providers, as automation can expedite many of the processes necessary to complete provider enrollment.
Trend #3: Implement process efficiencies to improve financial results
64 percent of survey respondents indicated that “implementing process efficiencies to improve the financial results related to employing physicians and/or owning physician practices” was very important, and it makes sense. If a busy provider bills approximately $10,122/day and it takes 90 days to enroll a provider, you’re at risk of losing around $900,000+ in revenue, a less than ideal scenario.
Trend #4: Improve provider satisfaction with the credentialing and enrollment process
The Association of American Medical Colleges (AAMC) indicates the U.S. could see an estimated shortage of between 37,800 and 124,000 physicians by 2034. Recruiting and retaining providers is more important than ever before and this showed in our survey. When asked about the importance of improving provider satisfaction with the credentialing and enrollment process, 66.7 percent of surveyors listed it as a high priority.
Methods to Improve Provider Enrollment Processes
Perhaps what was clearest of all from our 2021 Annual Survey on Provider Enrollment is that provider enrollment professionals know what must be done to achieve these goals, and it all starts with process simplification made possible through automation and the integration of different solutions. Some ways this is being achieved include:
- Standard applications: The results of this year’s survey shows that 90.9 percent of respondents have a standard application in place that is used to collect information for credentialing, enrollment, and health plans processes.
- Centralized operations: 62.4 percent of respondents stated the same department completes both credentialing and enrollment which reduces required resources and administrative costs.
- Data sharing: Information collected during enrollment can be used to feed other functions, like billing, onboard recruiting, database systems, health system data warehouses, public facing directories, and much more. 52.5 percent of respondents reported they both receive and provide data to other applications, and we’re hopeful this trend will continue to rise.
- A single solution for credentialing and enrollment: Having one software platform streamlines eliminates redundancies, improves efficiency and increases provider satisfaction. This year’s results indicate that 72.7 percent of respondents have commercial software in place that manages both their credentialing and enrollment.
Provider enrollment professionals are committed to realizing process improvements, and are taking action to garner results. We’re grateful to all those who provided insight to our 2021 Annual Report on Provider Enrollment, your responses help us plan for a better tomorrow. For access to the full report, you can download it here at any time.
As VP of Consulting Services for VerityStream, Vicki and her team support customers through implementation. Before joining VerityStream in 2008, Vicki managed several credentialing and privileging practices, led a national healthcare accreditation and compliance consulting practice for a prominent firm, and was a surveyor for the National Committee on Quality Assurance and president of the National Association Medical Staff Services.