Why Your Company Needs a Healthcare Compliance Consultant

A healthcare compliance consultant is a partner organization that can help you through the ongoing process of staying current with regulations with your enterprise healthcare plan. While this might sound like a somewhat niche concept, it’s actually integral to operate an enterprise today. Stakeholders and executives need to ensure they’re doing what’s necessary to stay current on this front. Let’s look at why your company needs a healthcare compliance consultant. 

Why Is Healthcare Compliance Consulting Important Today?

Estimates from the Congressional Budget Office point to a massive influx in penalties and payments related to health insurance coverage. It’s been posted that from 2018-to 2027; the cumulative amount of employer penalties will reach a massive $207 billion. While that’s the total from an entire decade, it still works out to an average of over $20 billion per year.

This should immediately get the attention of any executive or individual who cares about the long-term financial health of their organization (not to mention their employees). There are going to be massive financial penalties for those enterprises that fail to meet healthcare compliance guidelines.

When thinking about how to prepare for healthcare compliance—both now and in the future—business leaders need to be open and adaptable. Furthermore, there needs to be a multi-dimensional focus: on what’s happening right now and also what’s coming down the pipeline. These are a few of the top compliance factors that should be on every organization’s radar:

  • Cybersecurity and ransomware – It’s no secret that cyber crimes have been a major issue for enterprises over the past few years. This isn’t going to change, as increasing numbers of nefarious parties gain access to the technology and resources required to breach networks. Staying compliant with cybersecurity is important now, but will only grow in significance going forward.
  • Record access – Giving employees and patients access to their medical records in a timely manner is increasingly becoming a critical regulatory focus. Staying in-line with evolving regulatory trends will be essential to stay on top of this.
  • An everchanging landscape – As already mentioned, the way healthcare regulation presents itself today won’t be the same in a few years. It’s essential to be on top of changes so they do not surprise you.

These are only a few of the top reasons why healthcare compliance is so important today. Next, we’ll see why healthcare compliance consulting is an important piece of this picture.

What Can a Healthcare Compliance Consultant Do for Your Organization?

Most leaders know that hiring consultants can be helpful; but many will resist doing so in order to hopefully save money. While this can be the right decision in some circumstances—especially when the work can be done effectively in-house, there are some realms where it’s best to work with a consulting firm. Healthcare compliance is one of these areas.

Healthcare compliance consultants will fill several key roles in your overall regulatory approach. These are few of their top functions:

  • Let you know when the laws change – You might have a legal department, but chances are they’re not super well versed in the ongoing changes to compliance law and healthcare regulation. A consulting firm will have specialized knowledge here and know exactly how it applies to your business.
  • Ensure proper documentation – Even missing something minor can lead to massive losses when there’s a compliance violation. All documents need to be drafted meticulously in order to safeguard against violations.
  • Benefits package expertise – While it might not be too complicated to get the most basic benefits packages right, not all situations are straightforward. A healthcare compliance consulting firm can ensure you’re doing everything right even with less-standard plans.
  • Continual auditing – A continuing relationship with a healthcare compliance firm can stop any potential missteps in your internal healthcare compliance review. Your consulting partner should know your situation and local regulations inside and out to guarantee you’re staying compliant. 

Hiring a healthcare-consulting firm can be a great way to stay ahead of the risks associated with this tricky regulatory field. Finding an agency with deep experience in compliance and healthcare risk management will help alleviate concerns.

Leave a Reply

Your email address will not be published. Required fields are marked *