Costs of Non-Compliance in Healthcare

Costs of Non-Compliance in Healthcare

Believe it or not, it’ll cost you a lot more time and money to not meet or follow the regulatory compliance standards in healthcare.

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In fact, there are a variety of ways it can negatively impact your healthcare practice, from fines and sanctions to loss of productivity, along with damage to your reputation and business disruption.

Avoid these monetary pitfalls by being proactive and ensuring you adhere to all compliance requirements. We invite you to read further to learn more about different healthcare compliance regulations and the cost of non-compliance.

The Cost of Non-Compliance

According to Ponemon, organizations lose anywhere between $500,000 to over $16 Million in revenue due to a single non-compliance event. However, the financial impact goes even further than your top line. There are also hidden costs when your reputation is tarnished, and there’s a disruption to your business and your services.

Below is a list of some of the possible costs that come along with non-compliance:

Fines, Penalties, and Other Fees

When you think of “cost,” you probably think of a specific monetary value because it is one of the most tangible consequences of non-compliance.

It is also (likely) the scariest to think about, as no one ever wants to get fined. To get a feel for the stiff financial cost of non-compliance in healthcare, an overview of HIPAA Resolution Agreements from the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) shows this alarming statistic. HIPAA fines can be up to $1.5 million per incident per year, with more than $28 million in fines handed out in 2018.

Security Breaches 

With more healthcare providers switching to digital systems, and as information is increasingly being shared between networks, electronic data breaches are on the rise and becoming a major problem.

In a review of just a handful of security breach cases, Becker’s Hospital Review noted one case that levied $792,000 in fines against six hospitals and a nursing home “for failing to prevent unauthorized access to confidential patient information.” In another case, a Boston hospital agreed to pay the U.S. government $1 million to settle allegations (involving the loss of documents) that the hospital violated the HIPAA privacy rule.

Patient Care 

The cascading effect of non-compliance also affects the quality of care you provide patients. When you follow poor practices and procedures, it leads to an increase in patient care issues. 

If your facility as a whole is not complying with regulations and standards, the impact will eventually be felt by the very patients you promise to serve.

It might not be immediate, but if you are fined for non-compliance issues, this will negatively impact your available resources to buy equipment or increase staffing. Furthermore, if you land in the news for a fine or penalty, it will begin to erode trust – both among patients and potential employees.

And if non-compliance forces you to disrupt or discontinue different services or procedures, even temporarily, it can devastate the operation of your facility.

On the contrary, if you are compliant, that means you are doing things “the right way,” which, over time, will lead to better results and better care for patients.  

Here is a good example of how compliance would significantly reduce your risks of violating privacy rules:  If you have in place proper security measures, policies and procedures and staff training to ensure security of patient information, a breach of such “secured” data will not lead to a violation of the HIPAA or HITECH laws.  This is because the privacy and breach notification rules only implicate breach of “unsecured” information.  

How Do You Ensure You’re Staying Compliant? 

Policies and Procedures 

Compliance starts with setting and communicating the expectations to employees, and this usually happens through strong adherence to policies and procedures. At a minimum, this helps mitigate your risk since it shows your organization was putting practices in place to comply with the many laws and regulations.

Having these policies and procedures definitely provides a safeguard. But proving that the policies were distributed, tracked, and included in training will go a long way in reducing penalties and improving compliance.

Compliance Training 

While you are most likely providing some kind of compliance training, is it a cursory approach to simply “check that box”, or is it a robust effort to really train to your policies?

Rather than taking a generic, do-the-right-thing stance to compliance training, dig deep and provide a more meaningful and memorable education experience. How? Your training and policies need to work hand-in-hand to reinforce each other. 

Therefore, your training should cover how the laws and regulations apply to your employees’ jobs and the day-to-day healthcare compliance issues they actually face. 

Providing this type of specific, real-world training helps to show employees what to look for and how to apply the policies and procedures to specific situations they encounter. Learn more about building industry-specific regulatory compliance programs by checking out our article here. 

Plus, robust training helps demonstrate the measures your facility is undertaking to achieve and maintain full compliance with your staff.

Hire an Expert Through Perla 

Your next step is to take control of your practice by ensuring compliance is followed, and protocols are in place. 

Think about involving a consultant who can guide and advise you to reduce these costs. If you don’t know what you should be doing or how to go about this task, then get in touch with Perla

With Perla, you can quickly and efficiently find trusted advisors for your healthcare business.

We screen advisors to verify their professional licenses, search other client reviews, determine the number of years they have practiced, and evaluate their experience and knowledge in their expertise as a healthcare advisor. Perla enables these trusted advisors to stand out from practitioners lacking the requisite background, skills, or recommendations.

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