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Defining economic credentialing

Compliance Monitor, August 5, 2005

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How would you define economic credentialing?

A: Credentialing is the practice through which physicians and others apply for and gain permission to work in the hospital. Traditional medical staff credentialing has nothing to do with economics. It assesses a physician's competence and professionalism to determine whether he or she is an appropriate addition to the hospital's medical staff. Typically, traditional credentialing involved evaluating qualifications, including education, training, experience, license and certification, and professional competence as measured through malpractice history and prior disciplinary and corrective actions. 

Economic credentialing assesses (as a qualifying factor) the financial impact of accepting a physician onto a hospital's medical staff. Although the American Medical Association defines economic credentialing as an evaluation of economic factors "unrelated to quality or care," this is generally true only in the narrowest sense of the term. In a much broader sense, economic credentialing has everything to do with quality. The driving force behind economic credentialing is that it enables a hospital to obtain control over economic factors that affect the quality and range of services that a hospital can provide.

Todd Sagin, MD, JD, national medical director for The Greeley Company, provided this week's answer. To contact Dr. Sagin directly, e-mail todd_sagin@greeley.com.

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