Advancing Credentialing: Insights from the 2024 National Forum

Lisa Rothmuller and Tawna Knight

We’re back from the National Credentialing Forum (NCF), and what an informative event it was! In case you aren’t familiar, the NCF is an annual event that brings together organizations and individuals who contribute to the credentialing and verification processes.  Attendees share information over two days each February and discuss strategies and initiatives to improve the credentials verification process. This year’s event saw the participation of esteemed organizations like the American Board of Medical Specialties (ABMS), American Medical Association (AMA), Det Norske Veritas (DNV), The Joint Commission (TJC), and many others. HealthStream was honored to be included among the invitees. 

Many discussions during the event focused on the topic of Artificial Intelligence (AI), including AI integration, standards development, and utilizing AI to improve efficiency in credentialing processes. Additionally, there was a notable emphasis on fostering provider well-being through application adjustments and wellness initiatives.

Here is a quick roundup of the updates provided by various organizations that attended the event:

• The American Medical Association (AMA) delved into AI technology and the results of a survey they conducted. They provided an overview of their "Principles for Augmented Intelligence Development, Deployment, and Use" and plans for a credentialing wallet to streamline application processes.
• The American Osteopathic Association (AOA) focused on data-driven opportunities involving technology infrastructure, interoperability, and AI tools.
• The Council for Affordable Quality Healthcare (CAQH) discussed their transition to a new CEO, multi-payer alignment efforts, and developments around a universal group delegated roster. A press release with additional information is available here.
• Det Norske Veritas (DNV) addressed CMS-approved standards revisions for Professional Practice Evaluation and how cyber security and AI impact medical staff and credentialing.
• Federation of State Medical Boards (FSMB) showcased automation advancements that reduce cycle times and upcoming products like a member service portal and revamped application processes.
• The National Committee for Quality Assurance (NCQA) provided updates on proposed standards revisions. The proposed standards revisions included transitioning certification from 2 years to 3 years, combining CR and CVO standards, and system controls will be changed. The final revisions will be released in July, and the changes will be put into effect one year later.
• National Association Medical Staff Services (NAMSS) highlighted resources available to members, including credentialing by proxy content, a job description builder, a provider enrollment glossary and several new tool kits.
• National Practitioner Data Bank (NPDB) underscored security measures and the transition to mandatory multi-factor authentication for all users.
• The Joint Commission (TJC) emphasized the importance of ongoing Professional Practice Evaluations and peer learning networks.
• The Utilization Review Accreditation Commission (URAC) discussed how dental plans have incorporated credentialing into their processes, and specialty networks for pharmacy are the next area of focus.
• The Accreditation Commission for Health Care (ACHS) shared revisions in professional practice evaluations and their focus on tackling challenges like keeping current on application information, engaging medical staff in ongoing professional practice evaluations, and ensuring compliance with accrediting organizations and state regulations.
• The American Board of Medical Specialties (ABMS) outlined plans to expand certification statuses and implement consistent language across boards. They also highlighted a consumer campaign aimed at explaining certification and why it matters.

Summary

Each organization that presented and participated in this year’s NCF represents a piece of the credentialing puzzle for credentialed and privileged providers. Their forward-thinking approaches around topics like AI and workforce wellness will ultimately help improve the quality of healthcare. Our industry’s commitment to the provider experience, process improvement and patient care is inspiring, and we at HealthStream fully embrace it.

We look forward to continuing to work with these industry leaders and participating in the National Credentialing Forum in 2025.  Have questions? Get in touch.