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Learn MoreHealthcare compliance is an ongoing process for meeting the legal, ethical and professional standards that are applicable to healthcare organizations and providers. The scope of compliance for healthcare organizations is extremely broad and includes an array of areas covering patient care, patient confidentiality, reimbursement, Joint Commission standards, Health Insurance Portability and Accountability Act (HIPAA), research standards and managed care contracting. The requirements of federal, state and local regulatory agencies as well as business and ethical standards are also covered by compliance.
Providing healthcare comes with enormous risks – to both providers and patients. Healthcare organizations that have established robust compliance programs can reduce their exposure to these risks. However, it is not an easy job. The rules tend to be very complex; there are a huge number of them; and they change frequently. Compliance can be difficult to achieve, but is essential to the creation of a high-performing, safe, reliable and low-risk environment.
The cost of non-compliance can be enormous – literally. Protected Health Information (PHI) and the requirements of HIPAA are areas of significant vulnerability for healthcare organizations and insurers. In 2015, the Office of Civil Rights (OCR) fined a health insurance provider $16 million for a data breach that exposed the PHI and other personal information of nearly 79 million subscribers. In 2018, the Centers for Medicare and Medicaid Services (CMS) fined a healthcare organization $2.5 million when a provider’s laptop was stolen which resulted in the PHI of approximately 1,400 patients being exposed. Post-incident investigations revealed that these organizations had not properly assessed their risk, lacked procedures to notify patients who had their PHI compromised and obviously both had failed to keep PHI secure.
The Office of the Inspector General (OIG) has helped to define compliance for healthcare organizations. Their guidance includes a recommendation that organizations strive to build a culture of compliance. The OIG provides resources that help hospitals, physicians and other healthcare providers remain in compliance with current federal regulations. While the OIG recognizes that there is not a one-size-fits-all compliance program that will work for every organization, there are some essential elements.
Quality and compliance in healthcare is possible. Be sure that your organization is working to establish a culture of compliance.
HealthStream’s learning management system and comprehensive suite of competency management tools empower your healthcare workforce to deliver the best patient care.
View All Learning & PerformanceHealthStream offers performance learning management solutions to help develop your healthcare staff into leaders and reduce turnover.
View All ProductsHealthStream works with healthcare organizations to create engaging and high-quality training videos for your staff and management.
View All ProductsImprove care quality and save money by making informed decisions about your healthcare facility and staff with HealthStream's reporting analytics solution.
View All ProductsHealthStream's proven methods for the improvement and overall engagement of your healthcare staff foster a positive workplace and increase retention rates.
View All ProductsWhen you enact HealthStream's quality compliance solutions, you can do so with the confidence your healthcare organization will meet all standards of care.
View All Quality & ComplianceBe confident in your staff’s ability to reduce risk by providing compliance training that changes behavior.
View All ProductsDevelop next-level people for next-level care by prioritizing quality and safety improvements.
View All ProductsStandardize policy and procedure management with an automated, customized, and centralized system.
View All ProductsEstablish a culture of belonging with education supporting DEI, wellness, engagement, and leadership development.
View All ProductsHealthStream offers professional training and education on how to best optimize your reimbursement process within your healthcare organization.
View All ReimbursementStreamline the revenue cycle management process and protect your bottom line with expert-backed education.
View All ProductsExpand the decision-making skills and effectiveness of your healthcare workforce with HealthStream's clinical development programs and services.
View All Clinical DevelopmentLearn about our advanced resuscitation training solutions. Our solutions are designed to help improve patient outcomes.
View All ProductsUnlocking the full potential of clinicians goes beyond aspiration – it’s a commitment we embody. Our competency development solutions help personalize learning for every clinician so you can confidently bridge the gap between theory and practice for your nurse residents while meeting the unique development needs of your seasoned clinician.
View All ProductsEnhance maternal & child nursing care with solutions focused on improving the quality of care for mothers, infants, and children.
View All ProductsAddress staffing challenges, standardize orientation and onboarding, and deliver an effective training program for your team to easily achieve and maintain certification with our critical, emergency, and acute care solutions.
View All ProductsWe understand the critical importance of earning and maintaining your patients' trust in the delivery of exceptional sedation and surgical outcomes. As a premier provider of healthcare education, we are committed to empowering you in promoting safer, more successful outcomes for each and every patient, without exception.
View All ProductsOur solutions are meticulously designed to cater to the diverse needs of patients, healthcare professionals, and organizations. Within this innovative framework, we have curated specialized subsets of solutions aimed at addressing the ever-evolving challenges faced by individuals dealing with illnesses or chronic conditions.
View All ProductsMake sure your healthcare staff can schedule out appointments and work schedules with ease using HealthStream's line of software solutions.
View All SchedulingHealthcare workforce management is essential. We provide advanced scheduling solutions for organizations to solve issues such as nurse retention
View All ProductsComprehensive, industry-leading provider onboarding and credentialing software that validate health outcomes and support provider assessment.
View All CredentialingOur affordable CVO credentialing services establish patient safety by enabling primary source verification for your healthcare organization.
View All ProductsIntegrate with Epic to validate and add new providers directly to your provider master file.
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