Oregon to Streamline Provider Credentialing

Jacqueline Fellows, for HealthLeaders Media , August 22, 2013

One reason for the setback, at least in recent years, was the focus on implementing the Patient Protection and Affordable Care Act, says Tom Holt, director of government affairs for Regence BlueCross BlueShield in Oregon. Holt says Regence BCBS supports the pending mandate.

"The problem has been on the radar for several years," says Holt. "It was stuck because most of the key players were, over the last two years, very much involved in Oregon's Medicaid reforms and now the [health insurance] exchange. So, projects like this got set aside."

State Senator Alan Bates, MD, a practicing physician, resurrected the initiative, which passed unanimously in both the state house and senate.

Steinberg is optimistic because Oregon's lawmakers took the significant step of making its system mandatory instead of voluntary, which is the case in the neighboring state of Washington.

"When you don't require something, and it doesn't get used, you're not really making a difference," she says.

Steinberg says her counterparts who participate in Washington's electronic credentialing system complain about the software program used to run it. That detail is one Steinberg hopes Oregon will get right.

"That's where the key lies here with us in Oregon… to get the best electronic system," says Steinberg.

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4 comments on "Oregon to Streamline Provider Credentialing"

Kendra (8/30/2013 at 4:05 PM)
Arkansas has had a mandate to for all hospitals, insurance companies, and other facilities to use CCVS(Centralized Credentialing Verification Service)since January 1,2002. I'm glad to hear other states are doing the same.

Elizabeth (8/28/2013 at 5:19 PM)
bettynoyes: Credentialing isn't something that is subject to commentary or opinions. The credentialing process has to do with validating a professionals, credentials. Whether or not their license is valid does not require commentary. There are other parts to the process of, say, hospital medical staff appointment and privileging which DO take into account peer references, clinical peer review data, practitioner's health and ability to play nice with others, etc. Those somewhat more ephemeral qualities would probably not be part of a credentialing database. Then there are other aspects that are investigative and somewhat subjective. Criminal background check, NPDB check, Google check and on and on. Maggie: I'm with you, I'm very curious about the particulars of this database. I live and do credentialing in TX so only a matter of interest to me. Oregon may start a trend.

Maggie (8/27/2013 at 2:39 PM)
I'm happy to see the legislature involved those who acutally perform the work...the Medical Services Profession (CPCS/CPMSM). I'm wondering if this similar to the CAHQ application ~ a central repository for data ONLY and the credentialing (PSV) would still be performed by each organization. Or will it be data AND PSV documents? Who validates the data or updates it? What about the organizations that spent tens of thousands of dollars on their own software? Will the data interface and what is the cost? I guess I have a lot of questions don't I? (even that was a question =) I'll go read the bill.




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