Healthcare regulation is intended to ensure that patients receive safe, high-quality care. Federal, state and local regulatory bodies are tasked with protecting healthcare consumers, providing safe work environments for healthcare providers and regulating reimbursement as well as ensuring that public health initiatives are carried out. Regulators also may be responsible for establishing and enforcing penalties for non-compliance with these regulations.
Regulatory Compliance in Healthcare
One of the challenges of regulatory compliance in healthcare is that there are a rather large number of agencies regulating various aspects of healthcare at the federal, state and local levels. In addition, there are other agencies, usually accrediting agencies, with whom participation may be voluntary (and also quite valuable) such as Joint Commission and the National Committee for Quality Assurance (NCQA).
Among others, healthcare organizations are regulated by:
It is impossible to name an aspect of healthcare that is not covered by some sort of regulation, which makes compliance perhaps one of the most significant challenges for healthcare leaders.
Regulatory Compliance – Why it Matters
Regulatory compliance matters because the stakes in virtually every aspect of healthcare are high. They are high for patients, providers, healthcare organizations and consumers. A great deal of healthcare regulation deals with issues relating to patient safety where the stakes are perhaps the highest. Compliance with healthcare regulations ensures that providers follow the kinds of procedures that will result in safe and effective patient care.
Healthcare providers and organizations that are not in compliance face censure that can range from significant fines, the largest of which could be in the millions of dollars, and sanctions that can include the loss of license or accreditation. They may also face lawsuits, the loss of their ability to contract with payors and the financial repercussions of the bad publicity that may accompany a well-publicized case of non-compliance.
Navigating Regulatory Compliance
In order to keep pace with everything on the regulatory spectrum, healthcare organizations need a compliance plan that addresses federal, state and local regulatory and accreditation issues. Creating a plan that addresses all regulatory and accreditation requirements is an enormous task and requires ongoing auditing and monitoring to ensure that risks to patients, providers and organizations are minimized.
HealthStream’s solutions focus on:
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Fulfill compliance requirements with a variety of programs and courseware designed to address critical regulatory requirements as well as educate staff to recognize and mitigate risks.View All Products
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