At a time when hospitals are scrambling to maintain adequate staffing levels, a new headache has emerged — credentialing bottlenecks are costing U.S. hospitals roughly a quarter-billion dollars every month, intensifying an already critical healthcare workforce crisis.
The findings, released Wednesday by the Medical Group Management Association (MGMA), highlight yet another challenge for an already strained healthcare system. The report emerges as hospitals nationwide grapple with staffing shortages and mounting administrative burdens.
"The administrative complexity of bringing on new providers has reached unprecedented levels," said Halee Fischer-Wright, MD, President and CEO of MGMA. "What used to be a straightforward process has become a significant barrier to patient access, particularly in underserved areas."
MOUNTING FINANCIAL PRESSURE
The numbers paint a grim picture. The MGMA study, which looked at 500 hospitals in 45 states, found hospitals losing between $6,000 and $15,000 daily for each delayed provider credential. Rural facilities have it worse, with their credentialing processes taking up to 40% longer than urban hospitals.
According to the American Hospital Association's 2023 workforce report, staffing shortages have forced 60% of hospitals to offer signing bonuses and other incentives to attract healthcare professionals. However, these recruitment efforts often hit a wall when faced with lengthy credentialing processes.
TECHNOLOGY ADOPTION TRENDS
Some organizations are finding ways to adapt through technology solutions. Healthcare technology firm Assured reported significant improvements across their client base, with automated systems reducing processing times by up to 80% while maintaining compliance standards. These improvements come at a crucial time, as providers seek ways to overcome what Fischer-Wright describes as "unprecedented levels" of administrative complexity.
The shift toward digital solutions reflects a broader trend in healthcare administration. The Healthcare Information and Management Systems Society (HIMSS) reports that 76% of healthcare organizations are increasing their investment in digital transformation initiatives, with credentialing and provider management among the top priorities.
REGULATORY LANDSCAPE
The Department of Health and Human Services has taken notice. Officials announced a comprehensive review of federal credentialing requirements, signaling potential changes to streamline the process while maintaining patient safety standards.
Current regulations require healthcare organizations to verify numerous elements of a provider's background, including:
- Medical school education and residency training
- State licensing status
- Board certifications
- Malpractice history
- Work history
- Criminal background checks
- Reference checks
- Drug screening results
IMPACT ON PATIENT CARE
The credentialing bottleneck has far-reaching implications for patient care. According to the National Rural Health Association, rural communities face waiting times up to three times longer for specialty care than urban areas, partly due to credentialing delays for new providers.
The American Medical Association notes that these delays particularly affect:
- Emergency medicine departments
- Critical care units
- Maternal health services
- Mental health facilities
- Primary care practices
INDUSTRY ADAPTATION
Healthcare organizations increasingly turn to centralized verification organizations (CVOs) and digital platforms to address these challenges. The National Association of Medical Staff Services reports that facilities using automated credentialing systems see average processing time reductions of 60%.
The implementation of digital solutions has also led to:
- Reduced paperwork errors
- Better compliance tracking
- Improved provider satisfaction
- Faster onboarding processes
- More efficient ongoing monitoring
FUTURE OUTLOOK
Industry experts predict continued evolution in healthcare credentialing processes. The National Committee for Quality Assurance (NCQA) is developing new standards for digital credentialing, expected to be released next year.
The American Hospital Association projects that by 2025:
- 80% of hospitals will use automated credentialing systems
- Provider onboarding times could decrease by half
- Administrative costs related to credentialing could drop by 40%
CALL FOR REFORM
Healthcare industry leaders are calling for systematic changes to address the credentialing crisis. Key recommendations include:
- Standardization of verification requirements across states
- Implementation of universal digital platforms
- Creation of national provider databases
- Streamlined interstate licensing processes
- Updated federal guidelines for virtual care providers
The Department of Health and Human Services has indicated that regulatory updates may be forthcoming, though many hospital administrators worry help won't come soon enough to address immediate staffing need Media Info,
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