For the healthcare industry to thrive in challenging times, it has to evolve. The same is true for healthcare compliance programs. To remain successful at monitoring and mitigating risks across the organization, compliance programs need to adapt to the changing environment.
At the foundation of any healthy compliance program is a strong risk assessment process. As industry regulations become more complex and organizations are exposed to increasing risks (operational, financial, or reputational), compliance leaders need to have a better understanding of their risk exposure. To achieve this, they need to improve their risk assessment process. Following are the “why, when, who, what, and how” of an effective risk assessment process.
Why should organizations conduct a risk assessment?
The U.S. Department of Health and Human Services Office of Inspector General (OIG) and the U.S. Department of Justice (DOJ) have set expectations for healthcare entities for conducting compliance risk assessments. Beyond meeting those expectations, however, other benefits of completing a risk assessment include enabling an organization to identify priorities so that compliance resources can be allocated effectively and used more efficiently. A robust risk assessment process also provides a compliance department with a methodical, proactive approach to its compliance efforts. Without a thorough risk assessment process in place, a compliance department might find itself in a reactive position, throwing resources at crises as they come up. In a proactive position, a compliance program is nimble and ready to adapt to new risk, having already identified risk areas and targeted resources to best mitigate them.