Managing risk and monitoring your CHC’s compliance efforts is essential given the current healthcare environment. Risk management and compliance are not the same things:
- Risk management is a system of procedures designed to reduce exposure to and possibility of certain types of liability, as well as managing potential and actual risks that occur.
- Corporate compliance is a risk management component that is an internal process used to detect and resolve fraud, waste, and abuse through self-identification and self-correction. The seven elements of an effective compliance program are (adapted from a resource by the Office of the Inspector General (OIG), Department of Health and Human Services (HHS), 2000):
- Conduct internal monitoring and auditing
- Implement compliance and practice standards
- Designate a Compliance Officer or contact
- Conduct appropriate training and education
- Respond appropriately to detected offenses and develop corrective action
- Develop open lines of communication
- Enforce disciplinary standards through well-publicized guidelines
Tools and Resources
The ECRI Institute, which is free for CHCs to access, has a multitude of resource to assist with risk management. Most of the tools are focused on clinical risk but could be adapted depending on the need.
There are a variety of resources available to assist CHCs in developing, implementing and maintaining a compliance program.
- The OIG website contains both compliance findings as well as compliance tools and resources. This includes guidance for compliance programs for different types of health care organizations and a resource guide for measuring the effectiveness of a compliance program.
- NACHC offers a multitude of resources through their learning center. To access these resources click here. Note: membership number required.
- FTLF’s HealthCenterCompliance.com provides a variety of resources related to CHC Corporate Compliance/Risk Management programs. Some of the resources are available free of charge others are accessed through their NACHC toolkit that may be purchased via the site.
General compliance resources that are not specifically targeted to CHCs include the following:
- The Health Care Compliance Association (HCCA)
- The Society of Corporate and Compliance Ethics
- Health Insurance Portability and Accountability Act (HIPAA) resources from the HHS
Further resources are posted in the members-only section of CCHN’s website.