Ten Reasons Why Everyone in Healthcare Must Receive Compliance Training

Without a solid base in education and training, t he modern healthcare system as we know it would simply not exist. The importance of knowledge, experience and professionalism required to further the practice and delivery of health care and protect the public’s health and safety cannot be overstated.

It is unfortunate that compliance in healthcare is not talked about much. How much thought have you and colleagues in your organization given to achieving and maintaining compliance training in healthcare?

David Silva, CHC, CPHQ Chief Compliance Officer

David Silva, CHC, CPHQ Chief Compliance Officer

To remedy the situation, here are 10 reasons why all of us in healthcare must train in compliance.

1. Reliance on assurance versus mere hope

Working blindly or lacking the details that show your team can easily demonstrate competence in compliance with healthcare industry standards means that you are counting on intangible hope. But assurance beyond mere hope that you actually ARE doing the right thing — is the key to success. This is a lesson that is especially important for brand new radiology practices to keep in mind.

2. Minimize reputational risk

The reputation of your company, which has taken so much time and energy to develop, is at stake if you are not meeting obligations in healthcare compliance. It is easy to understand that if a client sees that you have had some regulatory difficulties, they will want to go with a competitor with less baggage and fewer problems.

From the viewpoint of potential patients, the thought process could go like this:  An entity that doesn’t meet objective standards in one area might be deficient in other areas of healthcare delivery too, so why should we take a risk in working with them? That is precisely how the reasoning would play out, so you need to consider how valuable your reputation is to your ongoing success, let alone growth.

3. Lower the possibility of client loss

If your organization fails to meet compliance standards, you not only run the risk of losing clients to competitors that follow healthcare industry best practices, you also can anticipate that it will be much harder to attract new clients going forward. Preserving the integrity of your institution will be harder without dedication to understanding and meeting compliance requirements. It will be that much more difficult if you are now trying to grow the business further.

4. Reduce the risk of loss of revenue

When you must shut your doors temporarily to address deficiencies in employee compliance training, there is a definite risk of losing planned revenue. It makes much more sense to spend money now on training, including if staff needs to take some time out to work with consultants to bring their knowledge up to standards.

Otherwise, you stand to lose out on future revenue. You will also, of course need to deal with the attendant problems of making back the lost time to restore your bottom line, if overtime pay will be a prudent option, for instance.

5. Minimize the potential of government scrutiny

We should welcome normal government oversight, but no one wants to be subject to strict government scrutiny after failing to meet healthcare regulations and standards. After all, Healthcare compliance also aids healthcare organizations and providers in avoiding trouble with government authorities. An effective healthcare compliance program can identify problems and find solutions to those problems before a government agency finds the problem.

6. Cut down the burden of government-imposed fines

Whatever the size of your operating budget, chances are you cannot easily take a hit in the form of government fines. Consider the ramifications to your bottom line. For example, “Olympus Medical Systems found themselves in the spotlight for a failure to file adverse reports regarding bacterial infections and will pay a hefty $85 million fine as a result” according to a report from Stetson Law.

This report also threw light on the issue of protecting patient privacy: “In 2017, Aetna was in the news for revealing 12,000 members’ HIV status through visible envelope windows. While the fine has not yet been released, it will likely correspond to the severity of the breach.”

By heightening awareness of potential pitfalls, Compliance training will naturally reduce such issues leading to fines.

7. Avoid the risk of government-imposed sanctions

It is an all-hands-on-deck situation when it comes to compliance. To avoid sanctions from the government, make sure everyone knows their duty. As The Health Law Firm put it, “Every individual in the healthcare organization is responsible for the success of the compliance program because failures in the compliance program can impact every member of the organization.”

The firm went on to state that “the imposition of sanctions in the millions of dollars is common, and even large organizations are affected by those sanctions.”

8. Minimize the risk of regulators imposing a requirement of punitive reporting

You do not want to get involved in a fight with regulators. Once officials have learned they must investigate a compliance failure situation that stemmed from lack of knowledge, you can assume there will be massive paperwork accompanying the reporting. Non-punitive reporting allows for better outcomes because individuals do not feel threatened when creating and submitting vital reports.

9. Avoid the risk of incurring the excess cost of independent reviewers and overhead

The last thing your accountants will want to hear is that you must allocate money in the budget to pay for unanticipated independent reviewers and the attendant overhead costs involved. You might have to choose, retain, and pay for a costly Independent Review Organization to meet your obligations. Doing so will naturally result in more expenses, including overhead.

10. Allows senior leadership to proceed with operational plans

The upper management in your organization will rest easy, knowing that they don’t have to worry about non-compliance issues leading to their operations being derailed; it means senior leadership can focus on the big picture. Working toward meeting the next milestone on time rather than devoting resources to fending off regulatory monitoring means your organization will work more efficiently, productively, and profitably.

How is your organization doing in terms of compliance training? Hopefully, this list of reasons will encourage colleagues to give more thought to the importance of compliance, particularly considering how much it helps you avoid so much needless risk.

Author: David Silva, CHC, CPHQ, Chief Compliance Officer at Collaborative Imaging