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In the dark about exclusive contracts

Credentialing Resource Center Connection, March 6, 2008

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Sally J. Pelletier, CPMSM, CPCS, is a consultant with The Greeley Company, a division of HCPro, Inc. specializing in the areas of credentialing and privileging.

Dear credentialing colleague:
 
Paul Levy, president and CEO of Beth Israel Deaconess Medical Center in Boston, writes on his blog that sunshine is the best disinfectant. Although this is a positive guiding principal for a hospital to have, not all organizations are that enthusiastic about disclosing information. For example, medical staff offices (MSO) are "in the dark" regarding exclusive contract arrangements. Hospitals frequently enter such contracts with particular specialty groups that provide services to the facility. Typically, these contracts are for hospital-based specialties like emergency medicine, anesthesia, pathology, and radiology, but they are becoming more common in other specialties as well.

You would think that informing the MSO about these exclusive contracts would be guaranteed, particularly since their existence ultimately affects who may apply for privileges in the areas the contracts cover. However, I am finding that it is not at all unusual to hear instances of hospitals failing to inform their MSO about these contracts. Often, it seems that many hospitals do not understand, or even consider, why it is crucial that they communicate this information to MSPs.

When developing privileging criteria and/or a privileging system, exclusive contract arrangements should always be part of the picture. No other individual or group may apply for privileges in an area that is covered by an exclusive contract, and it is imperative that your organization communicates this to all potential applicants, preferably right upfront on the privilege form. Communicating it can alleviate any embarrassment for a practitioner who may not be privy to the exclusive contract, and is told after applying for the privilege that he or she is ineligible. 

The inability of that practitioner to apply for the privilege has nothing to do with whether or not he or she is competent, or even whether he or she meets your existing criteria for that particular privilege or procedure. The hospital simply should not accept applications for those clinical privileges that are exclusive to practitioners included in this type of contract. Likewise, a practitioner is not automatically granted privileges if he or she is a part of an existing contract arrangement. The practitioner must request the privilege and meet the qualifications defined by the hospital in order to be considered for those privileges.

Remember, credentialing has no other master than the patient.

That's all for this week.

All the best,

Sally J. Pelletier, CPMSM, CPCS
http://www.greeley.com/consulting.cfm

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