It is no news that as a trillion-dollar industry saddled with the responsibility of patient care, the healthcare industry is one of the most regulated industries in the United States. This justifies the rapid growth in healthcare compliance within the industry.
The Bureau of Labor and Statistics projects that compliance officer jobs will grow by over 8 percent from 2016 to 2026.
To effectively address ever-evolving healthcare compliance regulations placed by governing bodies, you need to employ compliance professionals and even institute a compliance committee within your healthcare facility.
Healthcare compliance is an ongoing process concerned with meeting and exceeding professional, legal, and ethical standards set by relevant authorities in healthcare. As a result of the nature of the healthcare industry, following rules is everything.
In healthcare, Compliance standards are voluminous and dynamic, I.e., ever-changing and improving. The frequent changes in these rules require operational and workflow changes, internal audits, ongoing educations, health IT compliance updates, etc.
Regulatory compliance requires that your healthcare facility (regardless of the size) develops effective modes of operations, structures, and procedures to enforce appropriate conduct, ensure administrative staff is trained, and adhere to the policies set by compliance entities.
When you take health compliance seriously within your healthcare organization and uphold it as a culture from top to bottom, it will become difficult for government authorities to detect compliance violations and sanction your healthcare facility.
Ultimately, the primary purpose of healthcare compliance is to improve patient care. When appropriate clinical standards are being adhered to, the quality of patient care will improve, complication rates will reduce while avoiding the cost of government sanctions and penalties.
Today, several federal and state agencies regulate healthcare compliance in various categories such as patient information privacy, ensuring quality care, combating fraud, and protecting healthcare staff. Some leading compliance regulators are stated below;
The National Association for Health Quality also (NAHQ) also performs the function of TJC save that its primary focus is credentialing verification organizations and insurance plans.
The Centers for Medicare and Medicaid Services (CMS) and other insurance panels have also brought about quality initiatives to foster high-quality healthcare through accountability.
There are so many regulations that healthcare organizations must adhere to, but some of the most important ones are listed below;
Among other ways to implement an effective healthcare compliance program in your organization, creating a culture of compliance within the facility is crucial. This means making the whole point of the compliance standards ingrained into the core of your organization's mode of conduct.
Based on the OIG's compliance guidelines, an effective compliance program must do the following;
Following this guideline will make it easy to run your healthcare facility without fear of possible violations; you will also develop a solid reputation for your facility, consequently improving your patient retention rate.
Always remember that a compliant organization is a safe one, a confident one, and an empowered one.
Incident reporting improves safety for all healthcare participants. The main reason incident reporting exists is to ensure that everyone interacting with the healthcare facility (patients, staff, community, and facility) can live in a safe environment.