Primary Method Used to Evidence Compliance Program Effectiveness
Results from the 2025 Compliance Benchmark Survey
The survey conducted by SAI Global and Strategic Management Services, LLC offers valuable insights into the status and progress of compliance program development within the healthcare sector, as well as suggestions for improvements. One challenge for Compliance Officers is providing credible evidence of compliance program effectiveness both within their organization and for external authorities, if challenged. Nearly two thirds of respondents reported that their primary method for evidencing their compliance program effectiveness was through internal assessments, with only one in five citing independent compliance program evaluations. While keeping track of compliance process outputs and metrics is important and meets the obligation of ongoing program monitoring, effectiveness ultimately relates to the outcome of the processes, not the outputs alone. For evidence to be credible to both external authorities internal stakeholders – such as executive leadership and boards – it is far more convincing when it comes from independent audits, surveys, and evaluations. Notably, a reduction in claims errors is considered independent evidence. The statistical results were as follows: (1) Internal Audits/Assessments, 63%; (2) Independent Compliance Program Evaluations, 18%; (3) Training Test Results, 9%; (4) Employee Survey Results, 7%; (5) Reduction in Claim Processing Error Rates, 3%; and (6) Arrangements Reviews, <1%.
Results of all the questions in the Survey can be obtained without charge at compliance.com after the complementary webinar reviewing the findings. The webinar was held on Thursday, April 17th at 1pm Eastern Time.
For more information on this topic, contact Richard Kusserow ([email protected]). You can also keep up-to-date with Strategic Management Services by following us on LinkedIn.
