Too Many Rules To Track?

Compliance in Healthcare

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How To Better Manage Your Compliance Efforts

Compliance reporting requirements have ramped up in recent years, making it even more important to create a centralized monitoring system that aggregates and analyzes system-wide metrics. However, many hospitals and health systems experience issues that may slow, muddle, or even halt efforts to maintain compliance.

It’s time to find a way to better manage compliance monitoring – and directly impact how quickly you can address issues or problems or identify opportunities for improvement.

Compliance in Healthcare

You Need To Stay Ahead

If you’re using a program to track, analyze, and report on compliance, you’ve probably run into challenges. Without real-time data and a centralized, system-wide view, you run the risk of repeated mistakes and consistent episodes of noncompliance. To identify problematic trends and patterns that affect your organization, you need to take action before penalties occur.

Besides your reputation on the line, there are serious implications to noncompliance, including imposed operational monitoring by CMS, penalties of up to $25,000 per determination, sanctions, or even contract termination. (A search on CMS.gov shows that, so far in 2016, civil penalties for part C and D enforcement actions average $166,450.1) As penalties mount, there’s additional fallout – such as $10,000/week penalties for uncorrected deficiencies, skewed public opinion, or even staffing issues as professional opinions of your facility shift.

Pressure From Within

Fiduciary responsibility adds layers of accountability to a healthcare organization’s compliance efforts. Because noncompliance means denied reimbursement for claims, it’s a top priority for organizational leadership. But when the inevitable demand for metrics begins, compliance dashboards can slow things down. The operational teams responsible for generating reports must be able to access the information they need quickly and accurately – a common pain point for compliance dashboards.

Find a Partner

Considering the myriad challenges faced by most organizations when it comes to compliance monitoring, it’s comforting to know you’re not on your own. Our CMS Compliance Dashboard is tailored specifically to report to CMS by aggregating and summarizing compliance activities system-wide. By examining tracks such as patient/caregiver experience, preventive health, and care coordination, as well as specific concerns such as observation status, you can diagnose and address noncompliance issues quickly and accurately.

Healthcare organizations use the CMS Compliance Dashboard to visualize compliance details and reimbursement losses on several levels, using multiple dashboards complete with customizable widgets,  and if you have specific compliance issues that aren’t covered by Medicaid and Medicare guidelines, Brandix i3 is equipped to develop a custom dashboard – one that provides a centralized view on the data that you’ve identified as vital. Leading healthcare Business Intelligence solutions such as Infor BI also contains pre-built healthcare solutions to assist the entire organization to improve compliance, give insights and better manage resource.

As an Infor Global Alliance Partner, Brandix i3 is also implementing and supporting Infor’s healthcare Analytics and Business Intelligence solutions for their customers throughout the US. Brandix i3 can capture and manage business, operational or clinical data and provide pre-built or custom created applications, reports and dashboards.

Infor Alliance Partner

These professional services are designed to benefit the entire organization, to help improve compliance performance, to give detailed insights, to better manage resource, and to empower our clients to be a well-trained and proficient healthcare institution.

Far-Reaching Effects

Maintaining compliance isn’t just about avoiding fines, frustration, and C-suite pressure – it’s about streamlining processes to balance costs and deliver high-quality care. Developing and maintaining an effective compliance monitoring program is critical in today’s healthcare landscape. As hospitals and health systems improve processes and monitoring, these organizations can reap the benefits… from better ratings to higher patient satisfaction scores.

 

Citation:

1Part C and Part D Enforcement Actions. (2016, April 7). Retrieved May 19, 2016, from https://www.cms.gov/Medicare/Compliance-and-Audits/Part-C-and-Part-D-Compliance-and-Audits/PartCandPartDEnforcementActions-.html

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