Vendor credentialing compliance best practices for health systems

Nov. 11, 2021

COVID-19 has increased the need for enhanced compliance and safety across healthcare providers, yet GHX data from a 2020 survey shows most hospital and healthcare systems regularly fail to reach their vendor credentialing compliance goals due to limited resources, insufficient investment and conflicting priorities for organizational leadership.

Driving consistent vendor credentialing compliance will help create safer environments for patients, healthcare staff and hospital vendors, in support of improving the overall quality of patient care, according to a GHX press release. In conjunction with the Health Care Compliance Association’s (HCCA) annual Corporate Compliance & Ethics Week, November 7-13, 2021, GHX Vendormate has outlined five best practices healthcare leaders should adopt to encourage organization-wide vendor credentialing compliance:

  • Create a Culture of Compliance Starting from the Top A successful compliance program requires key organizational stakeholders, especially those in the C-suite, to focus on its criticality. Proactively and consistently communicating the value of compliance from the top down will help build a culture of compliance. This includes creating well documented credentialing processes that can be extended beyond the four walls of the hospital to external vendors. This strategy strengthens vendor compliance initiatives by ensuring the stakeholders in an organization’s ecosystem have clarity on policies and procedures to help ensure adherence.
  • Become Familiar with and Embrace Shifting Rules Without question, it’s challenging for healthcare leaders to remain familiar with ever-changing compliance regulations. Hospitals and health systems must comply with no fewer than 629 discrete regulatory requirements across nine domains, and data shows organizations spend nearly $39 billion a year solely on the administrative activities related to regulatory compliance in these nine domains, according to the American Hospital Association’s Regulatory Overload Report.
  • Create Measurable Programs Healthcare organizations can’t manage what they can’t measure and creating an effective compliance program includes defining actionable steps to measure success. Vendor credentialing compliance programs should include actionable checklists to help ensure vendors and representatives are held accountable and meet key vendor credentialing standards. Checklists should include items such as facility registration requirements, federal/multi-state exclusions and sanctions lists, background screenings, acknowledgements, immunizations/vaccinations, education and training. HCCA-OIG outlines important guiding principles for compliance measurements.
  • Embrace the Power of Technology Healthcare organizations can’t build scalable and sustainable compliance programs using paper-based processes alone. Healthcare organizations can leverage technology to help manage different aspects of vendor credentialing compliance. Examples include online dashboards, mobile vendor credentialing apps, self check-in kiosks and digital data repositories that help providers automate and streamline once-manual vendor credentialing processes to help improve vendor credentialing compliance.
  • Strive to Maintain and Improve Compliance is never “once and done.” It is a process that continually evolves and must become part of an organization’s DNA to succeed. Healthcare leaders should strive to meet shifting compliance standards by not only monitoring regulatory changes but adjusting associated compliance policies and procedures to reflect changing industry and public health circumstances. Ongoing vendor credentialing compliance takes a village, so it’s also vital to invest in staff training. Organizations should also empower staff to identify areas of non-compliance (such as individuals in a facility without proper badging) and bring issues to the attention of management.

GHX press release