Healthcare News & Insights

Keys to working with the board to boost compliance

ThinkstockPhotos-177337349A hospital’s board has the potential to play a significant role in how well the facility stays in compliance with federal regulations. New guidelines spell out exactly what board members need to do to improve their hospital’s performance. 

The Office of the Inspector General (OIG) just released a report with practical ways hospital boards can get more involved with fixing compliance issues.

It’s important for hospital boards to play an active role in their hospital’s compliance efforts when it comes to identifying and preventing fraud, billing mistakes and other tricky healthcare legal issues.

If the board helps oversee compliance, hospitals will have an easier time identifying problems before they have a negative effect on compliance efforts.

Plus, if the board actively enforces compliance at your hospital, it’ll help create a culture where compliance is top priority for all staff, from the top brass on down.

Where to start

To get the ball rolling with your board, there needs to be a system in place where hospitals directly report compliance activities to board members, whether it’s through a monthly meeting or a quarterly debriefing via email. If the board regularly receives information about hospital compliance, it can evaluate how the hospital’s doing over time and catch any suspicious or irregular activity right away.

There are several assessment tools your board can use to review your hospital’s performance, including resources for the OIG’s voluntary compliance program. These tools help the board see the standards for compliance and how well each hospital meets those standards in its daily operations.

Board members need to take a hands-on role with hospital executives to make sure that best practices for hospital compliance are followed, particularly at smaller hospitals that may not have the same budget or staff available for compliance programs that larger facilities would.

Department roles

It’s also important to look at the relationships among crucial areas of a hospital that deal with compliance issues.

Boards and executives need to make sure that all related departments and roles within a hospital are working toward the same compliance goals, including legal advisers (e.g. hospital lawyers), human resources professionals, the quality improvement team and your internal auditors.

Managers from each area involved with compliance should regularly report their performance to the board.

Specifically, the board should look at how each area:

  • identifies compliance risk
  • investigates compliance risk while avoiding duplication of efforts
  • identifies and implements actions and decisions to correct problems, and
  • communicates with other departments/areas to boost compliance.

Scoring performance

The OIG suggests that boards and executives use a scorecard to measure how well each department is fulfilling its role when it comes to hospital compliance. The scorecard allows the board to rank each department’s progress and can give executives an idea of where additional effort is needed.

Items that can be mentioned on the scorecard include the frequency of internal audits and whether each department answers promptly when asked for information about a potential external audit or fraud investigation.

Comparing the results on the scorecard to the recommended standards from the OIG can help facilities create their own compliance benchmarks and goals. Hospital executives and their boards can reward departments who meet these objectives – and figure out how to improve the performance for those that don’t.

Working together

Ultimately, the board needs to make sure every department involved with compliance works well together and speaks a common language. Effective teamwork and communication are the top keys to ensuring a hospital is following the rules. The board should evaluate how each department interacts with the others – and whether their relationship helps bolster the facility’s compliance.

As a way to improve teamwork and communication concerning compliance, it’s an excellent idea to have managers or top-ranking executives involved in each area meet with the board as a group. That way, findings can be discussed and questions can be answered right away. This will clear up confusion and allow any changes to be implemented quickly and easily.

Teamwork is crucial when it comes to evaluating and mitigating a hospital’s compliance risk. Representatives from other areas may discover problems in a compliance plan that wouldn’t come up otherwise. Example: The legal team may notice a hospital’s professional relationship with a primary care practice could unintentionally violate referral and anti-kickback statutes.

Encouraging your hospital’s board to be engaged in compliance can make a big difference. Not only can the board be instrumental in holding managers accountable for their role in compliance, board members can provide executives with crucial top-level support in making decisions with compliance in mind.

Subscribe Today

Get the latest and greatest healthcare news and insights delivered to your inbox.