In the August issue of Compliance Today, I read a great interview with Donnetta Horseman. She spoke about her career in healthcare compliance.
When asked about challenges in the industry today, Donnetta said two things that resonated strongly with me.
1. “Demonstrating the value of the compliance program is definitely at the top of my list of challenges. We don’t generate revenue, and it is often hard to quantify the money we save the organization by avoiding fines and penalties or mitigating risk.”
2. “Another challenge is staying abreast of the regulatory environment that applies to your organization.”
This may surprise you, but these two challenges offer an opportunity to create significant value across the organization.
Clinical and administrative healthcare leaders try to comply
Dealing with regulatory challenges isn’t new to you. It is part of the job leading compliance to deal with complex regulatory changes and challenges.
For your clinical and administrative colleagues, it is different. We know that you, like your clinical counterparts, strive to deliver value to your organization and improve patient outcomes. But the head of Pharmacy or Nursing thinks nonstop about improving patient outcomes. They didn’t choose a career in healthcare delivery to spend time with regulatory changes and complexity.
And yet, in most healthcare organizations, the responsibility to comply with these new regulations falls to clinical and administrative employees. Their ambivalence or sense of overwhelm is understandable. The scale and pace of regulatory changes is staggering. Our team of Expert Compliance Professionals (ECPs) just reviewed a new CMS regulation related to lab improvements. It is 31 pages long, with three columns per page.
A Process to comply with new or changing healthcare regulations
To stay ahead of relevant regulations, your colleagues must:
- Monitor a series of regulators
- Read new regs to gauge which department they apply to
- Figure out what the new reg requires if it applies to your organization
- Write any policy and/or procedural changes to adequately address the requirement
- Distribute the changes to everyone in the organization affected by the changes
- Ensure the changes are put into place and followed
- Be able to prove the regulatory change is adequately addressed when asked
Some hospitals have developed an internal process to support this effort. After five years of talking to healthcare compliance professionals, I can confidently tell you that every department head would say it’s not enough.
This problem presents an opportunity to create value
Western Maryland Health System (now part of a large national healthcare provider) was struggling with this exact challenge.
Like many of you, their compliance department was one person. He turned to YouCompli to simplify and streamline the process of managing regulatory changes across the organization.
Every department in the hospital heard the same value-proposition: “You will be able to comply with all new healthcare regulations without having to read them!”
Each department will be notified if (and only if) a new regulatory requirement pertains to their particular department. Without reading it, they can quickly decide if the regulation applies to them. If it does, now they access procedures translated into easy-to-understand business requirements. With the solution, they distribute and track the tasks required for completion in a single system of record.
Think about telling the head of Revenue Cycle they don’t have to read any more regulations (including LCDs).
Simplify the process to stay in compliance
When there’s a new regulation, your organization must comply and continue to comply as regulations change. The organization is at much higher risk if regulatory change management is not managed effectively. And patient care and financial returns can suffer.
Many healthcare organizations rely on automated feeds of regulatory content; this just isn’t enough. To create value, you need a repeatable, scalable process instead of a continuous stream of regulatory changes. Establishing a standard approach to implementation makes it easier to comply with new regulations and updates as they come in. Translating complex regulatory modifications or identifying a simple coding change will help your colleagues know what to do and when.
Consider ways to automate, enhance, and track your change management process. Look at the internal processes your team executes to manage new or changed regulations. Can your colleagues outside of compliance effectively keep up with regulatory change currently? Can you help them remain focused on patient care?
Solve the top industry challenges Donetta mentions: keeping up with changes and demonstrating value. With an effective regulatory change management process, you can simplify the process to share regulatory changes with each department. And tell them, in simple language, the requirements they must address to meet the rule.
Demonstrate the value
Healthcare compliance officers know the value their work and regulatory change management bring to their organization. The challenge is quantifying that value and demonstrating it to leadership. Read more about how compliance delivers value across healthcare organizations in “Five ways to show how healthcare Compliance delivers value“.
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Jerry Shafran
Jerry Shafran is the founder and CEO of YouCompli. He is a serial entrepreneur who builds on a solid foundation of information technology and network solutions. Jerry has founded, managed, and sold software and content solutions that simplify complex work. His innovations enable professionals to focus on their core business priorities.
