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Archive Surgical Construction 2004

6 Steps to Combat Economic Credentialing

Hospitals are increasingly basing their credentialing decisions on physicians' business interests - but there are ways to fight back.

Lorin Patterson, Esq.


Ed Stevens, Esq.


Instead of focusing on clinical competence when issuing credentials, hospitals are more often taking into account a physician's business interests. Does he have privileges at a competing hospital? Is he employed by or otherwise affiliated with a competing hospital or health system? Does he have an ownership interest in a competing facility, such as an imaging center, ambulatory surgery center or specialty hospital? A physician looking to start or invest in another facility may encounter these common economic-credentialing actions taken by hospitals:

  • requiring physicians to disclose in writing all interests owned in other facilities;
  • revoking or restricting medical staff privileges for physicians who compete with the hospital by investing in another facility;
  • imposing moratoriums on new medical-staff privileges for physicians who are affiliated with competing facilities;
  • establishing high patient-admission standards for active medical staff status; and
  • limiting competitive physicians to lesser privilege categories (for example, courtesy staff privileges, which often come with practice limitations and may preclude participation in managed-care networks that require active privileges at a hospital).

Hospitals are also restricting competition by securing exclusive participation agreements with local payers, exerting influence over referral sources friendly to the hospital and recruiting physicians in the same specialty who will be directly employed by the hospital. Your response to any economic-credentialing actions will be driven by your particular situation; here are six actions you may want to consider.

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