How to Prove Healthcare Compliance Program Effectiveness
Can you walk the healthcare compliance walk? Regulators no longer accept activity reports as proof of success. They want hard evidence that your compliance program changes behavior and operates independently.
What’s next? Here are three actionable steps to improve your healthcare compliance program, as suggested by our annual survey, in partnership with Strategic Management Services, on the current state of healthcare compliance programs.
Since Outcomes Beat Outputs, Validate Proof Externally
Hotline calls logged and employees trained show effort, but not really effect. Effectiveness hinges on outcomes verified by parties outside the compliance function. Independent audits and peer benchmarks deliver the credibility oversight agencies expect and expose blind spots internal dashboards miss.
Ensure Compliance Reports Outside Legal
Roughly one in five or six organizations still route compliance through Legal—even though the Department of Justice and the HHS Office of Inspector General label that structure a conflict of interest. Recent OIG guidance reinforces that compliance should stand on its own. If your organization keeps the two together, be ready to justify why and demonstrate safeguards that preserve independence.
Pay Attention to the Extent Consultants Can Close Skill and Staffing Gaps
Responsibilities keep expanding—think privacy oversight, cybersecurity, enterprise risk management, and the list goes on—while hiring lags. Many compliance leaders bring in specialized consultants for short-term lifts or niche expertise. This can be especially true when turnover creates staffing gaps. If you plan to engage a consultant, here are some potential tasks they can help tackle:
- Conduct a thorough compliance risk assessment
- Identify high-likelihood, high-impact areas, and prioritize them
- Verify that corrective actions actually work
Final Thoughts
Independent evidence, clear reporting lines, and targeted outside expertise define a credible compliance program. Audit your metrics, rethink your org chart, and bring in help where the stakes are highest.
