-2.png)
The healthcare industry is constantly evolving, with new risks and regulations emerging rapidly that must be addressed without delay. Compliance Officers and their teams are stretched thin as they work to keep up with the high rate of change. Here are the key reasons that your healthcare business needs a compliance consultant to maintain a proactive program:
They save your business money by preventing regulator scrutiny and enforcement. Damage control can be costly, especially in the midst of regulatory investigations which require exclusive time and attention from your staff. Following an investigation, when non-compliance is verified, a regulator may pursue enforcement (fines) which add to overall cost of non-compliance. A compliance consultant can help your business stay ahead of the curve by supporting maintaining a proactive compliance program.
Their services safeguard against reputational harm. Non-compliances by healthcare entities are highlighted in the media daily. When a covered entity experiences a HIPAA Privacy breach affecting 500 or more individuals, the entity is required to notify prominent media outlets serving the State or jurisdiction. Non-compliances, and the media coverage of the violations and enforcement, damages the reputation of healthcare entities. A proactive compliance program can safeguard against the reputational harm that follows regulatory scrutiny and enforcement as a result of non-compliance.
Consultants are experts at simplifying compliance requirements and guidance. Compliance professionals routinely translate complex, lengthy regulatory requirements into concise, simplified and actionable steps to help achieve compliance. An experienced consultant can help eliminate uncertainty and overwhelm and provide clear guidance and actionable steps to strategically achieve compliance.
Protects your consumers and their rights by law. Many of the regulatory requirements healthcare organizations are required to adhere to, impact consumers. The requirements impacting consumers may range from healthcare benefits and cost-sharing to the privacy and security of consumer data. An experienced consultant can support your compliance efforts and ensure healthcare consumers are provided their rights by law, which ultimately affects the reputation of the business.
Your designated Compliance Officer or designee has a full workload. Healthcare organizations of all sizes are subject to a significant volume of legal obligations. In medium to large organizations, compliance teams are responsible for a large volume of daily work, including both proactive activities to prevent and detect compliance issues, and reactive activities to correct compliance issues that are detected. In smaller healthcare businesses, the designated compliance and privacy "contacts", often Practice Managers, are wearing multiple hats and adding to their already full workload. An article published by Management in Practice, reveals that 39% of Practice Managers surveyed were considering leaving their jobs in the next 12 months, and workload was one of the primary factors. (Evans & Roberts, 2024) A compliance consultant can help ensure you maintain a proactive program and workload balance, by leading large proactive activities, such as program assessments, program maintenance, and training, so that your staff can continue to drive the daily work forward without compromise or experiencing burnout.
Compliance consultants have the expertise you need. A consultant is defined as a person who provides expert advice objectively. A compliance consultant can supplement the expertise of your Compliance Officer, Program Manager or designated contact, ensuring that your compliance and privacy program remains current with industry guidance and regulations, and promptly addresses emerging industry risks. A qualified consultant can assist with understanding of complex regulations, and how they apply to your business by bridging the gap between legal jargon and operationalization.
Compliance consultants are independent and objective to your program. The Federal Sentencing Guidelines and the Department of Justice (DOJ), Office of Inspector General (OIG) advise healthcare organizations to periodically assess the effectiveness of their compliance programs. According to the Institute of Internal Auditors (IIA), Independence and objectivity are two critical components of an effective internal audit activity. (Frequently Asked Questions, n.d.) One of the benefits of an external consultant is their independence and objectivity to the program's day-to-day operation.
Compliance consultants are trusted partners who are worth the investment. Maintaining a proactive compliance program requires ongoing effort to maintain the 7 elements of an effective program, and to prevent, detect and correct compliance issues. A consultant provides your practice with expert advice, knowledge and analysis of the most current requirements and guidance, and robust insights into industry best practices. When you partner with a consultant, they can provide their expert advice more quickly if they are already familiar with your organization and the structure of your compliance program. Partnering with a qualified consultant will benefit your business for years to come, as the industry continues to evolve.
At Cultured Compliance Co, LLC, we are passionate about supporting healthcare businesses to ease the burden of achieving and maintaining compliance. Contact us today to schedule a free, no-obligation, consultation and needs assessment. Contact@culturedcomplianceco.com
Evans, R., & Roberts, E. (2024, January 26). Two fifths of practice managers considering quitting – with pay and workload top reasons, says survey. Management in Practice. https://managementinpractice.com/news/two-fifths-of-practice-managers-considering-quitting-with-pay-and-workload-top-reasons-says-survey/
Frequently asked questions. The Institute of Internal Auditors. (n.d.). https://www.theiia.org/en/about-us/advocacy/about-the-profession/faq/#:~:text=Independence%20is%20established%20by%20the,Effectiveness%20and%20efficiency%20of%20operations.
Office of Inspector General (OIG). (2023, November). General Compliance Program Guidance (GCPG). https://oig.hhs.gov/compliance/general-compliance-program-guidance/
Comments