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Tuesday
Apr212015

Mike Scher hangs out with healthcare compliance pros

I've been attending the HCCA's 19th Annual Compliance Institute this week in Lake Buena Vista, Florida.

The Health Care Compliance Association is a non-profit membership group for compliance professionals in the healthcare-provider field. Roy Snell founded the HCCA in 1996 and serves as its CEO. The group now has more than 10,000 members. And like its sister organization the SCCE, the HCCA is also headquartered in Minneapolis, Minnesota.

There are over 2,000 compliance professionals at this year's annual conference. And there are hundreds of sessions, many of which could apply to compliance in any industry.

Because healthcare is so heavily regulated and because its compliance program started nearly two decades ago, healthcare professionals run some of the most complex compliance programs of any industry.

In the framework of the U.S. federal sentencing guidelines, HCCA compliance officers created extensive compliance programs designed for specific  environments -- including large hospital systems, home and hospice care, physicians in clinical practice, medical schools, tele-Heath services, physician non-monetary compensation, AMC (Academic medical centers).

It's striking how much sophistication HCCA compliance officers have introduced into the field. The extreme demands of healthcare policy and huge budgets, plus the pressures of prosecutions and civil litigation have pushed healthcare compliance officers to find real solutions.

HCCA compliance officers use the biggest share of their budgets for education. But aside from providing information, does training actually drive changes in behavior? One presenter argued that since there is no data to prove the value of education to change behavior, compliance officers should shift budgets and their time to other programs.

One example was company-wide posting of low compliance-performance scores. Executives are especially competitive and they will change their behavior in order to get a higher, publicly posted score.

Another example: If you want nurses to perform timely blood tests, add a negative evaluation to the chief nurse's performance evaluation and he or she will innovate and implement all of the necessary changes.

A common argument against compliance is that its effectiveness can't really be measured. Demonstrating the value of reduced risk is easy for the risk management division. It can show that insurance premiums have gone down because of risk avoidance. For compliance, it's not that simple. But the HCCA compliance officers believe their programs have recognized many past deficiencies and cured them with measurable metrics.

One final observation for today: While there's a debate around Compliance 2.0 whether the chief compliance officer should be separate from the legal department, that debate was settled years ago for HCCA compliance officers. All the sessions at the annual event assume this change in business infrastructure has already happened and is working fine.

For smaller companies without the resources to have compliance officers apart from the lawyers, HCCA compliance officers are discussing work-arounds sympathetically, with suggestions how to eventually obtain independence and autonomy for the compliance officers.

Looking forward, the compliance officers here this week are focused on how legal, audit, HR, quality assurance, and compliance can work together, with board supervision, to achieve strategic objectives. And there's a general recognition that each discipline has crucial expertise and specific jurisdiction that all complement each other.

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Disclosure: For the FCPA Blog, I'm reporting from the HCCA Annual Compliance Institute in Florida. The HCCA is waiving the attendance charge for me and providing a press pass. I am paying other expenses that won't be reimbursed, like travel and lodging and I am not accruing any continuing education credits.

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Michael Scher is a senior editor of the FCPA Blog. He has over three decades of experience as a senior compliance officer and attorney for international transactions. He can be contacted here.