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Health Care Compliance

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How do Compliance Officers remain effective in today’s regulatory and competitive business environment? Compliance experts with years of experience in building, managing, evaluating and enhancing compliance programs have a multitude of suggestions. A common notion does arise, however, from much of the expert advice; the Compliance Officer is the sales agent for the entity’s compliance program. Accordingly, Compliance Officers should embrace this perspective in their efforts to develop and maintain strong compliance programs.

Compliance Officers may use the following best practice strategies to be effective in their roles:

  1. Build and Repair Communication Bridges.
  • When communication channels are ineffective, the Compliance Officer is also viewed as being ineffective. Broken communication channels with all stakeholders including the organization’s executive leadership, the Board, program managers and employees can lead to dysfunctional compliance programs. Ultimately, such problems may lead to the departure of the current Compliance Officer. To bring the compliance program back on track, repairing and building new communication bridges should become the first priority. Compliance Officers should aim to communicate meaningfully with all stakeholders.
  1. Cultivate sound working relationships with other organizational functions that overlap with compliance.
  • Compliance Officers should cultivate sound working relationships with other functions including Human Resources, HIPAA Privacy and Security Officers, Legal Counsel, and Internal Audit.  If these functions operate at cross purposes, it can overshadow the positive contributions of the Compliance Officer. Further, this can diminish the leadership’s perception of the Compliance Officer’s effectiveness in their role. The starting point for cooperation and coordination among an organization’s functions is to establish protocols (policy documents) that define working relationships and methods of cooperative effort.
  1. “Sell” the benefits of a successful compliance program.
  • Compliance Officers should operate in “selling mode” when communicating the benefits of a successful compliance program to the board of directors and executive leadership. Once these leaders are on board, the selling approach should continue in compliance communications with managers, first line supervisors, and with the organization’s employees, physicians and medical staff.
  1. Start with the Board of Directors.
  • Experts view the organization’s board of directors/trustees as the main “sales” target regarding compliance program operations. Once the board is sold, executive leadership will follow suit to empower and support the Compliance Officer. To accomplish this goal, compliance officers should educate the board on what enforcement and regulatory agencies expect from them and the personal risks in ignoring their fiduciary compliance oversight responsibilities. The OIG white papers provide a great resource in this regard. The white paper, “Practical Guidance for Health Care Governing Boards on Compliance Oversight”, is the most recent example.  Compliance Officers should also note that the OIG is now incorporating this guidance into mandates for many Corporate Integrity Agreements.
  1. Personally discuss compliance with first line supervisors and managers.
  • While top-down support is required, a Compliance Officer’s success depends on the entity’s first line managers carrying the compliance message to their subordinates through their word and example. Compliance experts find that compliance programs are strongest when an entity’s first line managers support and carry the compliance message directly to their staff. The first line manager’s endorsement and support is more powerful than pronouncements from the Compliance Officer or the executive leadership. Accordingly, effective Compliance Officers will sell compliance by engaging with the organization’s supervisors and managers about the compliance program.
  1. Promote compliance communication channels for employees.
  • Effective Compliance Officers are successful in promoting employee compliance communication channels, particularly hotlines that ensure complaints and allegations are promptly investigated and resolved professionally. If the workforce perceives that the organization is not receptive to their concerns and input, the compliance officer and program will never be fully effective.  In addition, the Compliance Officer should be visible and available to hear employee concerns.  Compliance Officers should circulate around the organization and be available to talk with staff about their jobs, thoughts, concerns, etc.
  1. Maintain ongoing metrics to benchmark the progress of the compliance program.
  • Effective Compliance Officers will use ongoing compliance program metrics and benchmarking to reassure the Board and executive leadership that they are effectively protecting the organization from liabilities. One of the most useful means of benchmarking is through the use of an independent and professionally developed and administered Compliance Knowledge survey that evidences employee understanding of the program. The best surveys are anchored in a large database to permit comparison with other health care entities. Benchmarking compliance program progress can further evidence Compliance Officer effectiveness.
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