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Using communities of practice to establish effective compliance and ethics programs

William E. Lucas (william.e.lucas@kp.org) is Senior Compliance Practice Leader at Kaiser Permanente in Portland, OR.

According to the American Hospital Association’s 2017 study, close to 24,000 pages of hospital and post-acute care federal regulations were published in 2016.[1] It also states that there are 629 discrete regulatory requirements that health systems, hospitals, and post-acute care providers must follow. These counts exclude additional state or federal agencies’ regulatory requirements. This is a considerable volume of regulations for compliance professionals and operational and clinical partners, who are responsible for providing the most important obligation of our organization: patient care. This is unlikely a surprise to most compliance professionals. Working in the healthcare industry, we are inundated with both federal and state regulations and standards. Furthermore, industry’s best practices change and evolve, adding another layer of information that needs to be dispersed throughout the organization. A community of practice can help with your organization’s management of its compliance curriculum and demonstrate the effectiveness of your compliance and ethics program.

The Centers for Medicare & Medicaid Services (CMS) recently launched its Patients Over Paperwork Initiative to reduce unnecessary burden, increase efficiencies, and improve the beneficiary experience.[2] Healthcare is a highly regulated industry and will likely remain that way, even considering this new initiative. How do we, as compliance professionals, decipher, support implementation, and monitor sometimes overlapping and conflicting regulatory requirements? Wouldn’t it be helpful to have a forum to discuss and share experiences of regulatory implementation to communicate successes and challenges with those on the front line? One approach to achieving this is establishing a community of practice.

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