Mike Gawley Comments on Joint Commission’s Extension of Reappointment Process for Medical Staffs

Medical Staff Briefing

Mike Gawley was quoted in the Medical Staff Briefing article “To three-year or two-year, that is the reappointment question.” The article provides an overview of changes to the reappointment process by the Joint Commission and ACHC/HFAP. Healthcare practitioners who hold medical staff appointments or clinical privileges at organizations accredited by the Joint Commission or ACHC/HFAP now have their reappointment process extended from two years to three years.

Commenting on what the thinking behind the change could be, Michael said, “Medical staffs have been reappointing practitioners on two tracks: a two-year cycle for clinical privileges and a three-year cycle for payer enrollment…These inconsistent reappointment cycles have created administrative headaches for medical staff offices. The Joint Commission's recent change gives medical staffs the option to align their reappointment cycle with payer enrollment and thus avoid the redundancies of dual-track credentialing.”

He added that with the changes, the “the substance of credentialing and evaluating members won't change, medical staffs that adopt a three-year cycle should enjoy a smoother process for reappointing physicians.”

Discussing how the new reappointment period doesn’t change law — as some states such as California and New York require two-year reappointment periods — Mike noted, “For what it's worth, the Joint Commission's new reappointment time frame accounts for this and permits a reappointment period ‘not to exceed three years or for the period required by law and regulation if shorter.’”

Regarding how the longer reappointment period might impact maintenance of credentialing records and information updates, Mike said, “Reappointment is a good opportunity for medical staffs to touch base with providers and ensure their records are up to date…Extending the reappointment period creates a longer gap between these formal check-ins and could lead to gaps in appropriate recordkeeping. That said, those who favor a three-year reappointment cycle argue that other mechanisms, like FPPE and OPPE reviews, can address that issue. In practice, hospitals with solid performance evaluation processes will fare better than those with inconsistent or ineffective reviews.”

He closed by offering his thoughts on how the new guidelines could impact patient care, saying, “It can often be difficult for medical staffs to collect appropriate data on substandard physicians in the middle of an appointment cycle. Critics of the three-year reappointment cycle argue that longer gaps in practitioner evaluations will allow problematic physicians to go overlooked, jeopardizing the quality of care…But proponents counter that switching to a three-year cycle will permit more frequent and more meaningful mid-cycle assessments of members, since an aligned credentialing schedule should provide medical staff professionals more time and resources for clinical evaluation. Whether and how the new reappointment cycle impacts patient care remains to be seen.”

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