Rural hospitals’ telemedicine efforts will get a boost from federal regulators’ decision to let hospitals use credentialing and privileging information from the remote location, industry officials say.

 

Having the Centers for Medicare & Medicaid Services recognize the process needed changing is a huge step, said John Matessino, president and chief executive officer of the Louisiana Hospital Association.

 

“I think it is going to lead us to be able to take advantage of some of those new technologies that are out there, especially when it comes to reading things like X-rays and some of the scans,” Matessino said. “They’re done digitally now, and as far as reading them accurately, it doesn’t matter if the person’s in the next room or really on the other side of the globe.”

 

Rural hospitals in Louisiana and throughout the country have a terrible time getting specialists and sub-specialists, Matessino said. Telemedicine helps solve that problem, which is good for the patients and the hospitals.

 

Matessino cited Bunkie General Hospital’s link to Louisiana State University Health Science Center in Shreveport as a success story.

 

Bayou Vista Manor Nursing Center is just down the street, and the nursing home has been able to take patients to the hospital to be seen by LSU’s specialists and sub-specialists, Matessino said.

 

Instead of putting the patients in an ambulance and transporting them to Shreveport, a trip which could take up nearly two days, the nursing home can just take people down the street, Matessino said.

 

“You can imagine what the expense of something like would be versus just bringing them across the street,” Matessino said.

 

Rural hospitals do incur some initial equipment costs, but those can be paid for over time, he said.

 

Rebecca Bradley, LHA director of rural health programs, said CMS’ proposed credentialing process will reduce the burden of paperwork and the trail of paper that hospitals have been required to do.

 

The process is both very cumbersome and very labor-intensive, especially for smaller, rural hospitals, Bradley said. The new regulations will free up some resources for those facilities.

 

The process can take anywhere from days to months, depending on whether the doctor’s information is readily available, she said.

 

Under current regulations, hospitals that use telemedicine services from a remote site must privilege each doctor providing services as if the doctors worked at the hospital. The hospital is responsible for those decisions.

 

CMS said it was revising the Conditions of Participation because it realized the need was urgent for telemedicine services. The current requirements were burdensome for physicians, practitioners and the hospitals, the agency said.

 

Matessino said the current process, which requires the rural hospital to repeat the remote location’s credentialing and privileging efforts, is expensive and time-consuming.

 

“It’s almost a crazy situation to have both facilities if they are certified under the Medicare-Medicaid programs, which means they’ve already been credentialed, to duplicate that,” Matessino said.

 

Under the new guidelines, Bunkie General doesn’t have to go out and have the telemedicine doctors credentialed and privileged, Matessino said. They can accept LSU’s credentialing and privileging.

 

The streamlined regulations will probably encourage some physicians to participate in telemedicine, Matessino said.

 

Physicians who probably would have said they aren’t going to go through all the rigamarole to get credentialed and privileged may change their minds, Matessino said.

 

“Now under a situation like this, the physician may say, ‘OK, I’m already credentialed here. They can accept that. Let’s rock and roll,’” Matessino said.

 

The Hospital Association is also trying to help hospitals with the credentialing process through a joint venture with the New Mexico Hospital Association, Matessino said. The joint venture is called LA Credentials LLC.

 

“One of the things that we’re seeing is because it’s such a labor-intensive program that credentialing companies can do it cheaper than hospitals,” Matessino said.

 

In addition to Medicare and Medicaid, almost every insurance company has its own credentialing forms and process, Matessino said. The process is a little different for private insurers, but the hospitals still have to go through and make sure the physician is who he says he is and has the experience and training he says he has.

 

LA Credentials is the hospital associations’ effort to create a credentialing center, Matessino said.

 

“We’re a ways from that, but one of the things that we’d like to do through this credentialing company that we have is try to really streamline the process,” Matessino said. “Physicians and healthcare professionals need to be credentialed, and we just want to make that as smooth a thing as possible.”

 

It’s also cheaper for hospitals, Matessino said. The cost is around $200 to $300 per physician through the credentialing center, while hospitals can easily spend much more doing it themselves.