MANAGING RISING RISK IN PHYSICIAN PRACTICES
A mix of new regulations and initiatives—with audits and attestations in their wake—have put a new
focus on compliance in physician practices and clinics.
By Lori Brocato, Steven Emery, and Jan McDavid, Esq.
RECOVERY AUDITS, BREACH notification regulations, and
modifications to the HIPAA privacy rule are forcing rapid workflow changes within healthcare organizations and mandating a
new level of awareness and planning to maintain both compliance and productivity. Much of the discussion on these topics
has related to the acute care hospital setting. Less attention has
been paid to physician or group practices and clinics.
While the requirements are largely similar in both settings,
practices and clinics face unique challenges in meeting them,
particularly a lack of staffing and resources dedicated to compliance. They must bring a new focus to compliance, identifying
cost-effective ways to successfully manage the changes, including staffing, processes, and technology.
Few Staff to Manage Many Changes
Perhaps the biggest difference between the hospital and practice settings is the scale of operation. Many practices have limited financial and human resources to deal with increased volumes, technological advances, or workflow changes.
The shortage of skilled workers, specifically in the areas of
claims audits and security, is even more problematic in prac-
tices and clinics than in acute care hospitals. HIM skills are at
a premium in small and mid-sized practices and clinics, and a
limited number of staff must manage many responsibilities that
often are managed by specialists in larger facilities.