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Credentialing 2018
Options Abound

author - Tanya Egbert
Author
Tanya Egbert
 
April 17, 2018 | Read Time: 5  minutes

As healthcare organizations merge, acquire, and consolidate in greater numbers, KLAS has observed a marked increase in the number of CIOs and other executives looking for information on the credentialing options available to them. In this inaugural credentialing study, KLAS interviewed over 100 executives and medical staff offices and found vast differences in customer experiences, from decreased turnaround times and improved workflows to frustration with outdated solutions and negative ROIs.


This report represents the first time KLAS has measured medical staff credentialing. The goal of this report is to establish what options are available to provider organizations and to measure vendors’ performance.

KLAS plans to publish a follow-up report during the second half of 2019 that will identify whether software, services, or a mix of approaches best prepares customers for success as well as which solutions best optimize payer enrollment and professional practice evaluations. In the meantime, KLAS will continue to publish real-time ratings for those solutions most relevant to provider organizations at KLASresearch.com.

KLAS invites all vendors to engage with full transparency. ASM (MD-Staff), Modio Health, and Verge Health participated with full transparency in this research. Those vendors that chose not to participate include IntelliSoft Group, Morrisey (HealthStream), and symplr (Cactus).


automating primary source verification and privileging management

Verge Health, MD-Staff, and Modio Health Lead in Primary-Source Verification & Task Management


Options abound for healthcare organizations looking for software or services to help automate their credentialing and privileging workflows. Modio Health and Verge Health lead all other vendors in user satisfaction with primary-source verification and expiring-records management. Verge, with a model that prioritizes managed services over standalone software, has been described by customers as a CVO+. Respondents praise Verge’s alert functionality and reliable, monthly reports. Modio is separated because they serve primarily ambulatory practices and medical groups (though 5 different acute care organizations are currently using Modio, and KLAS validated one with satisfaction similar to Modio's ambulatory customers). Modio’s customers speak highly of Modio’s side-by-side comparison of old, expired records and newer records.

ASM’s MD-Staff solution, HealthStream’s Morrisey and Echo solutions, and symplr’s Cactus solution have the largest market share and highest name recognition in the industry. While no solution yet offers 100% automation, users suggest MD-Staff automates about 90% of the web-crawling process, and satisfaction is almost universally high. While respondents rate Morrisey low relative to other vendors, satisfaction with Morrisey’s task-management functionality is high. This reflects the positive impact the solution has had on workflows when compared to more manual Excel workflows. Frustration with Morrisey’s consistently unreliable help desk and complicated fee structure drags down satisfaction. Customers who are not using the most current release of symplr’s Cactus Provider Management Platform report having to manually manage expiring records, and under half are utilizing Cactus for task management. The few Echo customers with whom KLAS spoke are generally satisfied with the solution’s web-crawling functionality; 5 of 7 are not using the solution for task management.


Payer Enrollment & OPPE/FPPE

Rarely were respondents able to provide feedback on their credentialing solution’s ability to automate payer enrollment or ongoing/focused professional practice evaluations, either because they haven’t investigated automating the process yet, the work is being carried out by a different department, or the modules are too expensive or not advanced enough to be cost effective. Refer to the Expanded Insights section of the full report for additional details.

helping to automate the payer enrollment process

Morrisey Allows Data Quality, Efficiency Tracking; Missing Functionality Haunts Cactus Users


High satisfaction with Modio Health’s training, ease of use, accessibility, and updates supports a perception that Modio is innovative and confidence that Modio will continue to develop new technology to meet clients’ future needs. Users report that Verge Health's solution is easy to implement, learn, and use, but Verge’s primary strength is the relationships they maintain with their clients. Quality control can be an issue in some cases, with a few users describing data errors and critical misses. Provider organizations utilizing MD-Staff (ASM) report the solution to be extremely user friendly, though a few alluded to a learning curve during and immediately after implementation. Satisfaction with the company’s support is also relatively high, and multiple respondents described the company as innovative. Morrisey users are particularly pleased with their ability to track and manage data quality and measure efficiency, something not mentioned about other solutions. KLAS received multiple reports of occasional system issues with images that don’t upload or web crawling that stops functioning, but this was described most often as rare and does not have a significantly negative effect on user satisfaction with the solution. Missing functionality is a sore spot for Cactus (symplr) users. Over half of the Cactus customers KLAS surveyed said that the solution’s task management functionality is having no impact on their workflow, often because they are not using it. A number of respondents said this is because it’s not available in their version of the software, with the biggest obstacles being cost, time, and labor required to upgrade to the newest release of symplr’s Cactus Provider Management Platform. Neither respondents using EchoCredentialing nor those using EchoOneApp described the solutions as user friendly. Users described the IntelliSoft Group solution as “cumbersome,” expressed irritation with the solution’s lack of speed (even in the cloud), and often resort to doing manually what they imagined they’d be able to automate with IntelliSoft.

product functionality and new technology

MD-Staff High Value; Nickel-And-Diming Inhibits Morrisey, symplr Customer Success


MD-Staff (ASM) customers report a higher money’s worth or value score than customers of any other solution, leading 100% of surveyed MD-Staff customers to report that the solution is part of their go-forward plans. Modio Health customers are near unanimous in their assessment that Modio’s software has a high value-to-cost ratio and spoke frequently about how much time and money Modio’s software has saved them. While respondents are generally satisfied with Verge Health’s cost-to-value ratio, a few complained of exorbitant costs outside of their yearly contract renewals, including extra charges for expedited files and other à la carte services. Morrisey customers are more frustrated with their vendor’s propensity to nickel-and-dime them than customers of any other measured vendor, and by a sales process that forces customers to make uninformed choices. Customers tend to prefer sales models in which they are charged by the number of providers they credential rather than having to worry about hidden costs and pay tens of thousands of dollars every time they integrate a hospital. Due to Cactus’ (symplr) initial cost and subsequent nickel-and-diming, customers report Cactus to offer less value than any other measured solution.

satisfaction with value and cost structure
author - Jess Wallace-Simpson
Designer
Jess Wallace-Simpson
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This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2024 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.