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Case Study

Hospital system manages regulatory changes through massive disruption

Executive Summary

When the pandemic hit, a California-based hospital system was inundated by COVID-19 caseloads and related pressures. Its Compliance function was overwhelmed too, struggling to manage the volume, speed, and scope of regulatory changes coming in.

Further complicating the situation: Regulators were modifying how they announced changes. With changes posted to new websites that were tough to find, the fear of missing a change was real.

Another challenge was the health system’s decentralized model for managing regulatory compliance. This made it difficult to decide who needed to know about a change and who should take action to comply.

By implementing YouCompli, the Compliance function delivered much greater value to the hospital system.

YouCompli enabled the Compliance function to strengthen its approach to managing regulatory change. YouCompli helped the hospital system improve monitoring, effectively communicate changes to all stakeholders, and track the entire process.

Read how YouCompli empowered the Compliance department to better manage regulatory change and deliver greater value to the hospital system.

The Challenge

Managing healthcare regulatory changes is a balancing act for chief compliance officers (CCO). While monitoring changes from federal, and state and local regulators, they’re also convincing colleagues focused on patient care to prioritize compliance.

For a California-based health system, the COVID pandemic laid bare the need to strike a better balance.

The Compliance department was overwhelmed by the volume, speed, and scope of regulatory changes coming from federal and state regulators during the pandemic. The CARES Act, for example, involved hundreds of changes to existing regulations, added new regulations, and created new loan programs and oversight mechanisms.

Another challenge was the health system’s decentralized model for managing regulatory compliance. The Compliance department was responsible for the program’s oversight, project management, and support. But individual departments handled the day-to-day management of regulatory requirements.

This put ongoing responsibility for monitoring, interpreting, and implementing regulatory changes and new regulations at the department level. This approach made it difficult to decide who needed to know about a change and who should take action to comply.

When COVID hit, the Compliance department faced a third problem: Regulators modified how they announced changes. They sometimes posted updates on new websites that were tough to find, including a separate COVID webpage. CCOs unaware of the new webpage missed out on new and changing regulations.

Overwhelmed by COVID caseloads and associated pressures, the hospital system needed better ways to:

  • Monitor regulatory changes
  • Communicate changes to all stakeholders
  • Manage and track the entire process

In the midst of COVID chaos, it was critical for the hospital system to strengthen its Compliance function. That’s where YouCompli came in.

The Solution

Monitoring regulatory change is time consuming even when a hospital system isn’t in crisis mode. The staggering volume of regulatory changes coming in during the pandemic further complicated the monitoring process.

Deciding who needs to know about changes and who should take action to comply was tougher too. When CCOs’ colleagues are continually overwhelmed with patient care, they are not easily accessible.

Adopting YouCompli strengthened the California- based provider’s system and approach for managing regulatory change. A key was enabling the Compliance function to easily identify and document new regulations, even those posted in unfamiliar places. YouCompli analysts read all new and changed regulations in their entirety and flag relevant changes, regardless of where they’re posted.

By relying on YouCompli to handle monitoring, the Compliance department knew that they weren’t missing anything. YouCompli ensured that the hospital system knew what was changing. YouCompli also helped the Compliance department decide who needed to know about a change and which tasks needed to be performed to comply.

For each requirement associated with a regulation, YouCompli creates a few relevance questions. Users may be asked, “Is your organization is a Medicare contractor?” or other pointed questions that help them decide whether a regulation applies to them.

CCOs can answer a question directly or assign it to the appropriate person to answer. YouCompli maintains a directory of subject matter experts who provide compliance leadership within their departments.

YouCompli tracks the responses, including who answered and when. Then YouCompli prompts users through the decision process and to the next steps in their workflow.

This approach made it easy for the Compliance department to communicate changes to all stakeholders.

Also, YouCompli translates technical legal documents into easy-to-understand business requirements. Whether it’s changing a code, completing a form, or modifying a policy or procedure, YouCompli helped the Compliance department decide what to do.

With YouCompli tracking the entire process, the Compliance department had an audit trail of what needed to be done and who had responsibility.

Adopting YouCompli helped the Compliance team cleanly manage the hospital system’s response to regulatory change and ultimately elevate the Compliance function.

The Impact

Though inundated by COVID caseloads and related pressures, the hospital system couldn’t afford to wait to strengthen its approach to managing regulatory change. Without YouCompli, the hospital system may have missed new or changing regulations or lost track of its response to them.

It was a heightened concern given the extraordinary volume of regulatory changes coming in during the pandemic. It was made more complicated by regulators modifying where they posted changes.

Failing to comply with changing regulations could have sunk the organization in increased risk and liability, as pandemic caseloads were threatening to do the same.

Implementing YouCompli enabled the hospital system to act from a position of strength. The comprehensive system YouCompli provided for monitoring new and changing laws and regula- tions, allowing the Compliance department to no longer worry about missing changes.

Also, YouCompli tools helped the Compliance function easily identify who needed to know about changes and what they should to do comply. Being able to effectively communicate to all stakeholders – during the chaotic early days of the pandemic – was critical for the hospital system.

Finally, YouCompli tracked all the changes the hospital system made. This provided an efficient way to revert when regulators rolled back pandemic-era regulations. If regulators sunset a notice, YouCompli flags it and provides a customized series of questions for the hospital system to answer.

YouCompli also explains what the hospital system needs to do to ensure that it makes the changes to revert to pre-pandemic processes. Using YouCompli to communicate helps everyone in the hospital system see when tasks are completed. Users can attest that they’ve done it, and it’s all tracked in YouCompli.

With YouCompli handling all these steps, the California-based health system strengthened its approach to managing regulatory changes – remarkably – during a pandemic. The comprehensive YouCompli solution helped the Compliance department deliver greater value to the hospital system. With YouCompli, the health
system’s Compliance function evolved from chaos to confidence. YouCompli tools helped the Compliance function easily identify who needed to know about changes and what they should to do comply.

Find out how you can use YouCompli to manage your organization’s response to regulatory changes.

YouCompli customers have access to notifications about changes to regulations, resources to inform policy and procedure updates, and tools to track compliance.