title: Economic credentialing: the propriety of managing physician costs through privileging.
abstract: Hospital executives face the unique task of managing the costs of an institution in which they have no direct managerial authority over the primary cost drivers, namely, the physicians who practice in the hospital. Perhaps the most controversial method of controlling physician costs consists of the application of economic factors to the credentialing process. Using the credentialing process as a technique to exert fiscal control over physicians affords hospital executives and their governing boards a tremendous cost-management opportunity. The legal propriety of economic credentialing remains unsettled. Many commentators, relying on limited case law, conclude that hospitals can engage in economic credentialing. Nevertheless, hospitals should exercise care when employing an economic rationale to restrict privileges lest they stir up legal challenges. Moreover, if hospitals use economic credentialing to limit medicaid patients' access to hospitals by excluding these patients' physicians from the hospital, the federal government may have the last word on the propriety of the practice.
authors.affiliation: University of Iowa, USA.
authors.forename: B A
authors.initials: BA
authors.lastname: Dahl
mesh_terms: D000574:American Medical Association; D003249:Constitution and Bylaws; D003363:Cost Control; D003406:Credentialing / Q000191:economics* / Q000331:legislation & jurisprudence; D007591:Joint Commission on Accreditation of Healthcare Organizations; D007882:Legislation, Hospital; D008504:Medical Staff Privileges / Q000191:economics* / Q000331:legislation & jurisprudence; D016749:National Practitioner Data Bank; D014481:United States