Author: Vicki Searcy, Vice President of Consulting Services, VerityStream
When I started consulting 25 years ago, an emerging area in credentialing was the development of Credentials Verification Organizations (CVOs). At that time, many of us thought that CVOs would be a component of a medical society or hospital association – and I worked with these types of organizations to establish CVOs across the country. Later, I started working with healthcare organizations to establish CVOs specifically for health systems and this ultimately became the type of CVOs I most often worked with. I surveyed CVOs for several years for NCQA and saw a wide variety of CVOs with different types of operations and scope of services.
Over the past three to five years, there has been an explosion of the development of CVOs in health systems. This is largely due to the proliferation of health systems during the past few years. The VerityStream consulting group is either working in an environment where a new CVO is being established, we are in the process of operationally improving an existing CVO by implementation of various software solutions or we are in an onboarding environment where the “CVO” services are expanded to include involvement with recruiting, contracting, HR, credentialing, provider data management/interfaces and payer enrollment.
Having been involved in the CVO industry for so many years, I’ve seen impressive successes – and, unfortunately, some spectacular failures. I’ve seen boxes of paper files returned to hospitals when a CVO connected with a hospital association failed. I’ve surveyed medical society CVOs where files were several inches thick and it was impossible to identify what data was provided to a specific hospital and when. I’ve been in CVOs so large and so busy that they had individuals who did nothing but verifications of licensure, or DEA registrations, etc. I’ve also worked with health systems where the CVO was functioning so effectively that no one in the hospitals could envision taking back credentialing and doing it facility by facility.
There will, I’m certain, be many changes in how health system CVOs operate in the future. We are already seeing interesting variations related to the scope of services in CVOs based upon technology which is available now or CVOs that focus on onboarding. There are numerous CVOs that provide credentialing and enrollment services. Some CVOs provide support for facility privileging (particularly when privileges are standardized across a health system). It will be interesting to continue to watch the development of CVOs in the coming years.