It Takes a Village–How the Entire Enterprise Contributes to Compliance Success

By Kate Conklin and Trissi Gray

With increased scrutiny around avoidable readmissions and hospital-acquired conditions, compliance executives within any provider organization are well aware of the penalties associated with failing to reduce readmission rates. In 2016, Medicare withheld $528 million from hospitals who weren’t meeting Readmission Reduction Program (HRRP) requirements and ever-changing regulations around compliance risk areas – such as 2-Midnight Rule – leave providers having to constantly worry about potential financial repercussions. Compliance executives find themselves in a unique situation, as they are tasked to mitigate readmission, identify audit risk and find cost saving opportunities. Without, however, an automated auditing/monitoring process, manual risk management is bound to thwart the success of a provider’s compliance program.

At this year’s 21^st Annual Compliance Institute, Kate Conklin and Trissi Gray will lead a session on “Designing a Successful Analytics-Based Hospital Compliance Program and Securing Cross-Department Endorsement.” Kate and Trissi will highlight how UT Southwestern (UTSW) Medical Center overcame challenges associated with tracking risk manually. The team will elaborate on the value of automation, how to manage claims at risk through sophisticated algorithms and analytics and how to overcome organizational silos to ensure everyone has a vested stake in compliance. Kate and Trissi will also delve into:

• Manual vs. automated compliance monitoring – With several compliance risk areas to monitor, UTSW needed to more time efficient strategy to manage each area of risk. By leveraging sophisticated algorithms and analytics, UTSW found how automation improved their operational efficiency and allowed their team to conduct daily evaluation and proactive identification of compliance-attributed risk, as well as other opportunities that result in organizational cost savings.
• Key stakeholder engagement – Ensuring that all departments, especially those beyond compliance, are onboard and see the role that the entire enterprise plays in compliance is key, but cannot be accomplished without leveraging the rule of engagement. UTSW will highlight how their compliance team moved the needle from the initial, basic stage of engagement towards the advanced mentality of “compliance is everybody’s business” by demonstrating the value of compliance to operation and building trust with key stakeholders through a strategic course of action.

To hear more about how to make the most of automated analytics in a new age of compliance, as well as what it takes for the mission, vision and value of a program to succeed, join Kate and Trissi on Wednesday, March 29 at 8 a.m. at the annual conference.

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