Credentialing & Privileging | 11.17.20
Understanding Reporting to the National Practitioner Data Bank for Communication and Resolution Programs
By Patricia Folcarelli, RN, MA, PhD; Lauge Sokol-Hessner, MD; and Melinda Van Niel, MBA, CPHRM
Communication and Resolution Programs (CRPs) have developed as a patient- and clinician-centered approach to resolving adverse events in healthcare settings. CRPs differ from traditional settlements or judgments in that they require the physician(s) involved to be honest and transparent about any adverse event that occurred, express empathy for the consequences of the event, and engage in improving systems of care in response to the root cause analysis following the event to prevent recurrence. The benefits of CRPs are numerous, including improved patient safety, more efficient resolution, and preservation or repair of the clinician-patient relationship.
As credentialing services staff are well aware, any payment made in response to a written claim on behalf of an individual physician must be reported to the National Practitioner Data Bank (NPDB). Although CRP resolutions may meet these criteria for a report, the traditional reporting options do not adequately acknowledge the efforts clinicians who participate in CRPs have made to respectfully, quickly, and fairly resolve the event for the patient and family. For this reason, the Massachusetts Alliance for Communication and Resolution (MACRMI) and the Collaborative for Accountability and Improvement (CAI) have been working with the NPDB to add an option to their reporting form to help clarify that a payment made to a patient through a CRP is not a settlement or award resulting from litigation.
As of June 2020, the NPDB has made changes to their reporting form in light of the prevalence of CRPs. On page 6, the “Payment Result of:” section now has an “Other” option, instead of the “Settlement Judgement or Payment Prior to Settlement” options which existed previously. Now, “Other” should be selected when a payment has been made on behalf of a physician through a CRP.
Patricia Folcarelli, RN, MA, PhD; Lauge Sokol-Hessner, MD; and Melinda Van Niel, MBA, CPHRM