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Marketing to Compliance, Quality & Risk Leaders in Healthcare

Understanding Their Role

Healthcare is one of the most highly regulated industries in the US.1 There are numerous regulatory agencies that oversee aspects of healthcare, including2 :

 

  • Centers for Medicare and Medicaid Services (CMS) – set standards and specifications to receive reimbursements.
  • Department of Health & Human Services (HHS) – promotes advances in medicine, public health, and social services.
  • Food and Drug Administration (FDA) – regulates drugs, biological products, and medical devices.
  • The Centers for Disease Control and Prevention (CDC) - protect public from disease, injury, and disability.
  • Office for Civil Rights (OCR) – responsible for HIPAA (health information privacy) enforcement.

 

Plus, the Office of the National Coordinator for Health IT (ONC), Agency for Health Research and Quality (AHRQ), Drug Enforcement Agency (DEA), The National Institute for Occupational Safety and Health (NIOSH) and many more. Hospitals must understand and comply with regulations across all of these regulatory bodies or face fines or more serious sanctions.

 

Hospitals have compliance officers to oversee adherence with all of the applicable regulations3, risk managers to protect the hospital from noncompliance4, legal departments to protect against lawsuits and performance management programs.5 Sometimes these functions are combined, but often they operate independently in silos. The overall process for these functions is similar, they must:

 

  • Assess and prioritize areas of high risk, vulnerability and liability.
  • Identify gaps between current and required levels of performance.
  • Implement policies, procedures, technology, programs and training to improve performance and mitigate risk.
  • Establish a formal measurement and documentation plan to track ongoing execution.
  • Conduct reviews and audits to ensure compliance.

 

Regulations change and new challenges arise, so these processes are continuous and leaders must be flexible and adapt to an evolving environment. Government enforcement efforts often review the overall effectiveness of compliance programs, and assess hospitals with strong programs more favorably. 6 In addition to identifying and implementing specific initiatives, healthcare leaders strive to change the overall culture of the hospital to focus more on compliance, safety, performance and risk mitigation.7

 

“I didn't want compliance folks to be looked at as police. I wanted them to be looked at as critical members of our team who help make sure we were following regulations…." - Frank Corvino, former president and CEO of Greenwich Hospital and EVP of Yale New Haven Health System8

1 Gregory, Dan. “Healthy, Wealthy and Wise: The Impact of Regulatory Compliance on Patient Relationships.” Health Management Technology 33, no. 1 (2012): 21. EBSCOhost(71132166).

2 “Agencies & Regulations.” American Nursing Association (ANA). Accessed 12/17/15, available at: http://www.nursingworld.org/Agencies-RegulatoryAff...

3 Herschman, Gary W., and John D. Barry. “Preparing Compliance Program Effectiveness Reports.” Journal of Health Care Compliance 15, no. 6 (2013): 15 – 34. EBSCOhost(93664233).

4 Cole, Sarah A., Raj Chaudhary, and Derek A. Bang. “Sustainable Risk Management for an Evolving Healthcare Arena.” Hfm (Healthcare Financial Management) 68, no. 6 (2014): 110 – 114. EBSCOhost(96249183).

5 Mansour, Rick, and Martha Thorne. “Performance Management Fundamentals.” Health Management Technology 35, no. 9 (2014): 16 – 17. EBSCOhost(97655898).

6 Herschman, Gary W., and John D. Barry. “Preparing Compliance Program Effectiveness Reports.”

7 Griffin, Donald J. Hospitals: What They Are and How They Work. 4th ed. 40 Tall Pine Drive, Sudbury, MA 01776, 978-443-5000, www.jblearning.com: Jones & Bartlett Learning, 2012.

8 Jayanthi, Akanksha. “Effective compliance programs begin with strong CEO-CPO relationship.” Becker's Hospital Review. April 2015. Accessed 12/17/15, available at: http://www.beckershospitalreview.com/healthcare-in...

 

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Copyright © 2016 Fusion Point Research, Inc.

Marketing to Leaders in Healthcare

Healthcare is a complex and highly regulated industry. Healthcare leaders have departments and programs focused on ensuring regulatory compliance, patient safety, strong operational performance and the reduction of risk.
fusion point research Marketing Research Reports
Healthcare is a complex and highly regulated industry. Healthcare leaders have departments and programs focused on ensuring regulatory compliance, patient safety, strong operational performance and the reduction of risk.
  • – set standards and specifications to receive reimbursements.
  • – promotes advances in medicine, public health, and social services.
  • – regulates drugs, biological products, and medical devices.
  • - protect public from disease, injury, and disability.
  • – responsible for HIPAA (health information privacy) enforcement.
  • Assess and prioritize areas of high risk, vulnerability and liability.
  • Identify gaps between current and required levels of performance.
  • Implement policies, procedures, technology, programs and training to improve performance and mitigate risk.
  • Establish a formal measurement and documentation plan to track ongoing execution.
  • Conduct reviews and audits to ensure compliance.