Managing regulatory and compliance risk is a challenge

There is a pressing need for a best-in-class system to consistently support regulatory, reimbursement and compliance professionals in the US healthcare industry. Managing regulatory and compliance risk in the face of constantly evolving rules and guidelines is a significant challenge for both payers and providers.

That is the finding of a whitepaper from Frost & Sullivan, ‘The Increasing Challenge of Managing Regulatory and Compliance Risk’, which explores the characteristics of an ideal information platform to manage compliance needs.

"The healthcare industry must remain functional while enduring a major upheaval, based on as-yet undetermined impacts of policy changes on insurance markets, value-based care reimbursement structures, and other possible policy and regulatory shifts," said Digital Health principal analyst Victor Camlek.

"The potential for massive disruption to the regulatory and compliance process is intense and uncertain. Having access to a best-of-breed source of targeted information and alerts is a critical success factor for all stakeholders."

The healthcare space is seeking an information management solution that is comprehensive, authoritative, and tailored to the needs of coders and healthcare officials. "Up-front coding accuracy is crucial to achieving the regulatory compliance needed to ensure fast and timely reimbursements," noted Camlek. "Such a resource will also provide the basis to develop and update training programs, documentation and policies in the highly-regulated healthcare industry."