Full Circle of Care at Circle Health Services & The Centers for Families and Children

About the Customer

Circle Health Services is a Federally Qualified Health Center and The Centers is a Community Behavioral Health Center jointly serving more than 23,000 people annually in northeastern Ohio. CredentialStream provided these organizations with a multi-functional credentialing, privileging, and enrollment solution that took them from paper to electronic. The scalable solution also enabled them to meet and exceed HRSA site visit and CARF accreditation survey compliance requirements quickly.

Overview

The Centers and Circle Health Services operate under a shared leadership structure as one, unified front moving towards a common goal: creating life changing solutions for people in Northeast Ohio to lead healthier and more successful lives. Together, the organizations are leading the way in providing an innovative and integrated model that coordinates health and wellness services, including primary care for children and adults, psychiatry, behavioral health care, addiction services, HIV treatment and an in-house pharmacy with family support programs, including early childhood development, job training and workplace and workforce development. The organization is one of the oldest and largest nonprofit organizations in Northeast Ohio, serving more than 23,000 people annually.

• Circle Health Services is a Federally Qualified Health Center (FQHC) that provides primary, addiction, and mental health care, a pharmacy, and trauma recovery services. They serve everyone who comes to see them, regardless of ability to pay.
• The Centers is a Community Behavioral Health Center that provides early learning, essential mental health care, and training and employment services to people who would otherwise not have access.

As the second poorest large city in the United States where more than 50 percent of children live in poverty, the demand for accessible healthcare in Cleveland and its surrounding areas is high. Circle Health and The Centers needed a credentialing, privileging, and enrollment solution that could help them keep pace with the evolving needs of an underserved community.

Key Challenges

Demand — More pressure to meet growing community needs
With a system under pressure to serve more than 23,000 people each year with a wide variety of medical needs, The Centers and Circle Health needed a flexible and efficient system to support the onboarding, credentialing, and privileging of providers across an array of specialties.

Excessive Paperwork — Paper-based credentialing and privileging processes led to delays
The Centers and Circle Health managed their credentialing, privileging, and enrollment process with a mix of paper and excel spreadsheets. Data was spread out over multiple locations and often had to be manually scanned to be shared. Reports had to be manually created for each individual request.

Meeting Industry Requirements — A site visit and accreditation survey meant the need for improvement
As an FQHC that receives funding from the HRSA Health Center Program, Circle Health must meet a stringent set of requirements to remain compliant. A pending HRSA site visit and a CARF accreditation survey for their behavioral health team meant the organization needed to quickly identify and implement a credentialing, privileging, and enrollment that would enable them to pass with flying colors.

Solution Selection Process

With an HRSA site visit and a CARF accreditation survey for their behavioral health team on the horizon, The Centers and Circle Health needed to find and implement a comprehensive and scalable solution quickly. The team initially began investigating solutions that managed credentialing and privileging. When they had the chance to demo CredentialStream and realized that a single solution could handle credentialing, privileging, and enrollment, they were sold.

On top of having a multi-functional solution, the team also liked CredentialStream’s ability to autofill enrollment applications, as this would tremendously decrease the time it took to complete applications. Other desirable functionality included the ability to easily run monthly OIG checks (which is required of all FQHCs), store provider data electronically in a single location, and integrate with EPIC.

The Centers and Circle Health deployed CredentialStream’s Apply, Validate, Enroll, Appoint, and Privilege. From the beginning, they committed to utilizing the solution’s platform, content and data out of the box, with only a few minor modifications and have found that CredentialStream syncs perfectly with their needs.

Results

Time Savings
CredentialStream saves all the OIG/SAM information in the provider record, which means The Centers and Circle Health no longer need to spend time pulling provider data manually. In fact, the need to manually check licenses has largely been eliminated, and better yet, the organization went from having a monthly credentialing meeting to only once a quarter. That’s a lot of valuable reclaimed time.

Streamlined Privileging
HealthStream's library of continuously updated, best-practice, evidence-based, specialty-specific privilege forms eliminates the need to conduct time-consuming research on new procedures and update privilege forms accordingly. Best of all? CMO and providers are also pleased with the system—everyone wins.

Increased Staff Productivity Levels
With less time spent working through a hybrid system and working manual processes, medical staff is able to accomplish more in a shorter amount of time.

Accelerated Application Processing & Improved Provider Satisfaction
With full automation, The Centers and Circle Health is able to provide accurate reports fast, whenever needed. Pair that with the ability to turn enrollment applications around quickly to get providers to work and you have happy patients and providers.

Looking Ahead

The Centers and Circle Health have become more efficient and can provide better patient care. They left an almost 40-year old model for one that can scale with them as they grow. Next up, they plan to:

• Become proficient using Bolt
• Continue taking advantage of training opportunities to learn the entire system, especially the payer contracts section