'Why Bother?'

Compliance programs make much sense. They provide a logical, structured format to identify and implement the company’s best practices, and to fix problems as they arise.

Sure, they cost time and money to create, implement and operate effectively. But the dividends are many and varied. An effective compliance program accomplishes five tasks.

  1. Captures policies and standards of conduct which a company finds important.
  2. Communicates these policies and standards to company personnel. It also ensures that the personnel know how the policies apply to them, as well as what to do when they believe policies are not being followed.
  3. Provides a mechanism to investigate any flagged problems or concerns.
  4. Provides methods for fixing problems and for enforcing program violations.
  5. Includes provisions to audit whether a company is following its policies, and also to monitor whether a company is doing a good job of disseminating information and reporting, investigating and fixing problems.

But, many healthcare providers seem to disagree with me about the importance of compliance programs. I have presented talks and workshops about compliance well over 100 times. I have written or been quoted in hundreds of articles about compliance and compliance programs, over 20 years, and there are thousands more articles in cyberspace.

Despite this overabundance of information about compliance programs, many healthcare organizations—maybe yours, too—have not created an operational, effective compliance program.

Many, many homecare companies, as well as every other variety of healthcare providers, continue to operate with no compliance program in place, or with half-hearted attempts that fail the “effectiveness” test.

Why?  Well, I propose the reason is because of the “Why bother?” questions they ask themselves, but dare not verbalize:

Q: Why bother? After all, effective compliance programs cost too much to establish and operate.
A: Like insurance, they are necessary expenditures. Besides, how much money are you losing to payer audits, claims reviews, records deficiencies and the like?

Q: Why bother? After all, a compliance program will identify problems that will cost me money to correct.
A: Maybe so, but the benefits—financial and otherwise—are well worth the cost.