Supporting Safer Healthcare

The healthcare industry’s focus on Complimentary and Alternative providers (CAM), also known as AHPs (Allied Health Professionals) is changing the scope of our roles in Medical Staff Administration. These jobs represent fields that are among the fastest growing in healthcare.

In many organizations MSSPs work closely with Human Resources to develop and maintain polices, practices, and guidelines for effective credentialing and quality oversight of these providers. In addition, it is increasingly common for managed care organizations to receive requests to add these providers to their approved payer panels.

A nationwide government survey released in May 2004, states that 36 percent of U.S. adults aged 18 years and over use some form of CAM. CAM is defined as a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine.

Stating that health care should strive to be both comprehensive and evidence-based, a new report from the Institute of Medicine of the National Academies calls for conventional medical treatments and complementary and alternative treatments to be held to the same standards for demonstrating clinical effectiveness.

In a recent update, the Joint Commission issued a statement regarding fair hearing requirements for privileged individuals. A JCAHO FAQ states "The requirement applies to anyone credentialed and privileged through the medical staff process. It would not apply to individuals credentialed and privileged through the alternative process described in standard LD.3.70."

CMS has issued a proposed change in the Medicare Conditions of Participation that would allow H&Ps to be done by a "physician or other qualified individual who has been granted these privileges by the medical staff in accordance with State law."

Joint Commission recently announced that the 2006 Hospital Standards will expand the types of practitioners included under LD.3.70, so watch for details.

Earlier this year, US News & World Report released a special health issue with the provocative cover title "Who Needs Doctors?" and a tag line "Your future physician might not be an M.D., and you might be better off." Whatever your feelings are on that statement, it reinforces the fact that healthcare is changing.

CAM providers create new credentialing and oversight challenges. Their education, background, scope, and practice are exceedingly diverse. Medical Staff Administration must collaborate with both Human Resources and with the CAM/AHP providers themselves in order to develop effective policies and credentialing practices.

These providers offer both risks and benefits to your organization, so it’s good to remember that as NAMSS states, "Patient safety begins here."