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The Challenge of Translating Healthcare Regulations into Training Curricula

Planning meeting

Healthcare organizations across the healthcare continuum, from hospitals and health systems to the broad array of post-acute care providers, need to be certain they are compliant with all the regulations that apply to them as well as to their individual clinicians. The current regulatory environment presents some significant barriers to a full compilation of regulations.

Healthcare Compliance Statistics

Here are some staggering statistics about the current expanse of healthcare regulation according to the American Hospital Association and Manatt Health’s “Regulatory Overload: Assessing the Regulatory Burden of Health Systems, Hospitals and Post-Acute Care Providers” (2017) and the American Hospital Association’s “2019 Environmental Scan” documents:

  • $39 billion – the estimated annual total regulatory compliance cost to healthcare providers [2017]
  • 629 total discreet regulatory requirements that apply specifically to healthcare entities – (341 hospital-related requirements and 288 post-acute care-related requirements) [2017]
  • 59 full time equivalents (FTEs) – the number of staff in a typical hospital who are dedicated to meeting the requirements of regulatory compliance [2019]
  • Different areas and functions within a healthcare organization with compliance responsibilities—quality reporting, meaningful use, hospital conditions of participation, fraud/abuse, privacy, security, billing, coverage verification requirements, etc.
  • Various government agencies with overlapping compliance oversight—CMS, the Office of Inspector General (OIG), the OCR, and the Office of National Coordination for Health Information Technology (ONC), and Joint Commission, to name a few, and not to mention multiple departments and agencies within each of the 50 states
  • Multiple care environments with compliance responsibilities—health systems, hospitals, and organizations across the care continuum, which include long-term care, inpatient rehab, skilled nursing, home health agencies, ambulatory surgery, etc.

The Impact of Regulatory Compliance on Healthcare Operations

The healthcare workforce already faces challenges in terms of burnout, engagement, hiring, retention, retirements, and training. The demands of compliance exacerbate some of these issues. Of the 59 FTEs dedicated to regulatory compliance in an average-sized hospital, approximately 25% are doctors and nurses. If you are thinking about the impact in terms of staffing and provider shortages, that means as many as one quarter of the workforce in clinical areas is not spending time at the bedside caring for patients. Instead, this time is devoted to working on administrative and regulatory requirements. That adds significant strain and diminishes much-needed capacity in a patient care area. The situation is similar to a lesser degree in other areas of the care continuum. For healthcare organizations operating in a post-acute area, compliance obligations will typically require 8.1 FTEs who are exclusively assigned to dealing with regulatory and administrative requirements.

This blog post excerpts the article of the same name by Ben Diamond, Vice President of Compliance Solutions, and Debbie Newsholme, Senior Director of Content DevelopĀ­ment and Compliance Solutions, at HCCS, A HealthStream Company. The article also includes:

  • Compliance Concerns for Specific Continuum Environments
  • The Planning Process for Annual Healthcare Training
  • A Training Planning Case Study: Respiratory Therapist in Tennessee

Read the full article: The Challenge of Translating Healthcare Regulations into Training Curricula.