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Case Study

Integrating Credentialing

A large regional health system was in a period of expansion, and had recently acquired a new hospital, with plans to acquire more. Our client needed to incorporate provider and payer credentialing activities for the new hospital into the existing centralized credentialing group. This included merging two workforces while maintaining two locations, technology systems, and credentialing processes.

The Challenge

A large regional health system was in a period of expansion, and had recently acquired a new hospital, with plans to acquire more. Our client needed to incorporate provider and payer credentialing activities for the new hospital into the existing centralized credentialing group. This included merging two workforces while maintaining two locations, technology systems, and credentialing processes.

Our Approach

Our team partnered with the centralized credentialing group to:

  • Conduct a current state and gap analysis across both organizations, identifying where differences in process and policy existed
  • Thoroughly document all roles and responsibilities, identifying which activities should be conducted at each location
  • Define the future state and develop a detailed plan to integrate staff, implement new technology, and align processes across the two organizations; including the definition of new roles and processes where necessary
  • Create a communications plan to engage leadership and support employees through the change journey

These four critical factors ensured successful program execution:

Active Listening

When interviewing staff, it is critical to truly listen and take the time to form relationships; it’s the only way to understand how processes really work in the current state versus what’s “on paper”

Mind The Gap

Identifying gaps is not enough to define a future state. Our team worked with leadership to define criteria to size the importance and impact of variances, helping them prioritize the right areas and co-create solutions with the highest impact

Plan For A Playbook

Vynamic’s role was to help the health system integrate one hospital’s credentialing system into the centralized function, but it was clear that other hospitals would follow.  By clearly documenting templates and approach, the health system can leverage this work multiple times in the future

Communication Is Key

An implementation plan means nothing if stakeholders are not aligned to the future state and what needs to happen to get there

The Results

The health system successfully integrated the new hospital’s credentialing group into the centralized function, with a projected savings of over $500K annually. As new hospitals join the health system, they continue to leverage Vynamic’s expertise and documentation to integrate and enhance credentialing operations.

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