A Mid-Size System in the Southeast Steps-Up Compliance and Saves on Employee Costs with ComplyTrack

Today’s health organization’s face a plethora of issues including audit bodies, HITECH, OIG work plans, breach management, risk assessment and compliance reporting. But the Chief Compliance Officer is confident in her hospital’s ability to adapt to rapidly changing compliance rules, thanks to hard work, good planning, and ComplyTrack, an enterprise risk management solution from Wolters Kluwer Law & Business.

Creating a New Compliance Department from the Ground Up

This hospital system includes a 300-bed acute care hospital in the southeast, along with a nursing home, hospice, dialysis center, home health care service, and retirement village. When starting as a Chief Compliance Officer seven years ago, she was immediately charged with developing the first compliance and auditing departments for the organization. She has been in the health care compliance area for fifteen years having past experience with developing compliance and auditing departments.


Overview


Challenge – The system’s Compliance Officer was charged with creating a new compliance department for its multi­service, multi-location health enter­prise. With departments in numerous locations and varying compliance and risk management needs, the company needed an effective, end-to-end com­pliance and risk management solution to fully assess risk and facilitate appropriate planning.

Solution - ComplyTrack

Results - The system’s compliance team now manages all communications, investigations, audits and agency interactions through ComplyTrack. With one source for all compliance activities, the team is in control of the complete audit life cycle, with the ability to identify and remediate risk across the entire enterprise.


After addressing the organization’s immediate training and education needs, the Compliance Officer turned her attention to getting the people and tools in place to manage the system’s compliance needs. This included the implementation of ComplyTrack. She selected ComplyTrack for its comprehensive ability to help assess and remediate enterprise risk, perform and manage both internal and external audits, and provide effective reports to regulators, executives, departmental leaders, and board members.

The Audit Detail Manager module in ComplyTrack has proved particularly useful to the entire team. When the system’s first Recovery Audit Contractor (RAC) request arose less than six months into ComplyTrack implementation, its simple learning curve enabled the team to successfully leverage Audit Detail Manager to deliver the results needed and ensure appropriate resolution.

In an average year, the system conducts 75 to 100 internal and external audits. The Chief Compliance Officer anticipates that by using ComplyTrack to centralize all of their audit results, they will be able to complete more audits as needed and in less time, based on the results evident in the enterprise risk assessments.

Reporting Capabilities to Effect Change

Reporting is a significant component of successful audit management. From satisfying regulators to turning audit results into actionable remediation plans, Audit Detail Manager delivers both standard and customized reports for any audience. This capability has helped the team determine the correct action plans by having all pertinent details at their fingertips. Moreover, knowing exactly what factors are needed to correct, review, or educate from a particular audit has empowered their implementation capabilities.

“We’ve customized a lot of reports,” states the Chief Compliance Officer, adding that the reports have been customized for various stakeholders and uses, from the number of physicians involved to the dollar amounts involved in an audit. “Those are all critical for me to be able to say ‘How much time is being spent here? How many dollars are involved in these particular initiatives?’ I think going down the road, you’re going to see that that’s going to be a really critical part of most health care organizations.”

Risk Assessment Manager has helped the organization identify and prioritize areas of the business needing compliance and audit help. Her team deployed detailed risk assessments to each department head so they could better understand the risk factors inherent to their respective departments. Audits were then performed using the extensive question sets that form the backbone of the Risk Assessment Manager. The team then presented a comprehensive risk assessment for each department.

She prefers to review the assessment results personally with leaders, but she also uses the ability ComplyTrack has to deploy them electronically when necessary. As each department learned about its areas of risk, the team used Risk Assessment Manager to formulate a proactive plan for audits, education, and other actions to help empower its activities. The thoroughness of these processes will help the facility to mitigate its exposure in the event of an investigation.

The Complete Solution

After successfully implementing the Audit Detail Manager and Risk Assessment Manager, the Chief Compliance Officer made the decision to integrate other ComplyTrack modules into the system’s compliance processes. The scalable nature of the solution has allowed them to add new modules as needed, to the point where the system is now benefitting from the complete end-to-end ComplyTrack Suite solution.

The Chief Compliance Officer has witnessed measurable cost savings and dramatic increases in efficiencies. Looking ahead she feels the system might enjoy even more savings using ComplyTrack. “We did not bring on another Full-Time Employee (FTE) because the tools are so convenient and user-friendly. Once we get our information in, we can quickly generate great reports out of them. At this point, it saves at least one FTE. Down the road, as we get even more accustomed to the modules and working with them, I can see additional hours being saved by this software.”