Neil Caesar is president of the Health Law Center (Neil B. Caesar Law Associates, PA), a national health law practice focusing on business opportunities and regulatory issues for health-care providers. He is the author and editor-in-chief of the five-volume Compliance Answer Book series. He can be reached at 864-676-9075 or firstname.lastname@example.org. Learn more at www.healthlawcenter.com.
Throughout 2012 I have used this column to challenge certain conventional views of regulatory compliance programs. Specifically, I have suggested that we acknowledge and demand an answer to the question, “Why should I bother with a compliance program?”
My premise has been this: Any home-care company that does not have a working, effective regulatory compliance program has, in effect, decided not to bother with compliance initiatives. Certainly, the lip service may be there—written policies and procedures may exist. However, the home-care company has decided that the benefits of an effective compliance program are not worth the costs and hassle of true implementation and operation.
Throughout the year we have explored 21 ways in which a compliance program can produce ongoing benefits for your company. In previous columns I offered seven ways an effective compliance program helps home-care companies stay out of trouble with the government, improve the accuracy of their claims and increase reimbursement amounts.
Seven benefits aren’t bad at all, but we can do better. If you are willing to expand your perspective beyond the reimbursement anti-fraud rules, allow me to begin phase two of our list of benefits: Six additional ways an effective compliance program can improve efficiency and employee morale within a home-care company. These are improvements that can help a home-care company nurture a more loyal, efficient and savvy workforce.
Our goal is simple: a home-care company that understands these benefits can maximize its value from compliance systems and protocols. This will allow the company’s compliance initiatives to be used more efficiently and may give the initiatives greater perceived value by senior management. In other words, by maximizing the ways in which a compliance program can be utilized, even exploited, it will be even more difficult to sustain the “Why bother?” attitude.
Let’s begin with the first of these internal operational benefits: An effective compliance program can improve internal communication generally within a home-care company. It must be able to demonstrate to personnel that the home-care company truly intends to learn and follow the rules and investigate possible violations of law and organization standards. This occurs through repeated and consistent communication by management about its efforts, as well as through repeated and consistent examples that demonstrate how the homecare company evaluates and teaches its rules, and visibly seeks to fix problems and answer questions.
In addition, an effective compliance program must establish procedures which encourage personnel to communicate concerns they have about violations or other problems. This occurs by creating ways to report possible problems, by rewarding those who come forward and by demonstrating a strong non-retaliation policy.
Both of these components demonstrate to the home-care company’s employees its commitment to a corporate culture of compliance. They also communicate to personnel that the company welcomes productive feedback from staff, and that it values their opinions. These are huge benefits from an employee’s perspective.
In fact, at its core a compliance program is an internal communication system for reimbursement and fraud rules, for HIPAA and for whatever else the home-care company includes in the program. This internal communications system makes it easier for personnel to communicate compliance problems. It also arguably demonstrates by its very existence that ongoing, effective internal communication is important to the home-care company.
Further, a progressive home-care company can utilize the internal communication system in its compliance program as the foundation for improved internal communication generally. Many home-care companies now seek to incorporate team-building and joint problem-solving into their management and operational structures. A functional internal system for efficient communication is essential to achieving those goals.
The materials in this article have been prepared by the Health Law Center for general informational purposes only. This information does not constitute legal advice. You should not act, or refrain from acting, based upon any information in this presentation. Neither our presentation of such information nor your receipt of it creates nor will create an attorney-client relationship.