Physician credentialing in a consumer-centric world

As managed care responds to the rising tide of consumerism in medicine, it is necessary to reexamine the functions that health plans have performed. Chief among the activities that demand resources but return minimal value is the process of physician credentialing. As consumers are asked to assume more control in their health care decisions and to pay more for their care, the credentialing process must be changed if it is to add value for consumers. This paper discusses the role of credentialing and how it might be reconfigured to become more meaningful to consumers.