RT Journal
A1 Freed GL, Dunham KM, Singer D
T1 HEalth plan use of board certification and recertification of surgeons and nonsurgical subspecialists in contracting policies
JF Archives of Surgery
JO Archives of Surgery
YR 2009
FD August 14
VO 144
IS 8
SP 753
OP 758
DO 10.1001/archsurg.2009.128
UL http://dx.doi.org/10.1001/archsurg.2009.128
AB Objectives 
    To characterize the role of board certification in general surgeon, surgical specialist, and nonsurgical subspecialist credentialing and contracting policies and to examine possible variation among different types of health plans.Design 
    Telephone survey conducted from October 27, 2006, through March 30, 2007.Setting 
    Health plans across the United States.Participants 
    Health plan credentialing personnel from a random sample of 223 health plans stratified by enrollment size, plan type, Medicaid enrollment, and tax status.Main Outcome Measures 
    Proportion of health plans that require specialty board certification at initial contract or at some point during association with the plan and health plan requirements for recertification.Results 
    Of 223 health plans, 9 were ineligible, and credentialing personnel completed the telephone survey in 176, which resulted in an overall response rate of 82%. More than 60% of the health plans in this study did not require surgical specialists, general surgeons, or nonsurgical subspecialists ever to be board certified to contract with the plan. Approximately two-thirds of respondents reported that they did not require surgeons (65%) or nonsurgical subspecialists (63%) with time-limited board certification to recertify in their specialty. More than half of the health plans reported that they made exceptions to their board certification policies based on geographic or network need.Conclusions 
    Most health plans did not use specialty board certification to assess surgeon and nonsurgical subspecialist competence.