Sustaining compliance: Best practices for your government programs plan

In this episode of Shaping Healthcare, host Laurel Rockall is joined by Pam Thompson, Vice President of Government Programs and Transformation Practice Lead, and Benjamin Strong, Assistant Vice President, both at Citius Healthcare Consulting. Together, they delve into the complexities of health plan compliance, exploring key factors for navigating the evolving regulatory landscape of Medicare, Medicaid, and ACA programs. Tune in for valuable insights on the importance of a culture of compliance, the impact of data privacy and AI, and best practices for sustaining compliant policies in today’s fast-paced healthcare environment!

In this episode of Shaping Healthcare, host Laurel Rockall welcomes Pam Thompson, Vice President of Government Programs and Transformation Practice Lead, and Benjamin Strong, Assistant Vice President, both at Citius Healthcare Consulting. Together, they dive into the intricate world of compliance within government health plans, shedding light on the challenges and best practices that organizations face in this ever-evolving landscape.

Together, they:

Delve into the key factors for navigating the regulatory landscape, emphasizing the importance of keeping documentation, policies, and training materials up to date, as well as having a dedicated compliance team in place.
Explain why data privacy and cybersecurity are critical trends, especially with the increasing reliance on data and the risks associated with breaches.
Discuss the impact of artificial intelligence and integrated care models on compliance, highlighting how these advancements necessitate new regulations and oversight.
Examine the challenges health plans face, such as the rapid pace of regulatory changes and the need for adequate resources to maintain compliance.
Highlight best practices for fostering a culture of compliance, including proactive monitoring, robust auditing processes, and a team-based approach to managing compliance responsibilities.
Consider the role of technology and tools in supporting compliance efforts, from third-party software to root cause analysis methodologies that help organizations address issues effectively.
Explore how consultants can assist health plans in establishing compliance programs, conducting audits, and implementing corrective action plans when necessary.

This engaging conversation provides valuable insights for anyone involved in healthcare compliance, emphasizing that a proactive and collaborative approach is essential for success. Tune in to learn how to strengthen your organization’s compliance efforts and navigate the complexities of government health programs.

Pam Thompson, VP of Government Programs and Transformation Practice Lead at Citius Healthcare Consulting, brings extensive expertise in health plan compliance and government programs. She emphasizes the importance of fostering a culture of compliance and advocating for proactive monitoring to keep up with evolving regulations.

Benjamin Strong, Assistant VP at Citius Healthcare Consulting, specializes in health plan compliance and business process improvement. He focuses on trends like data privacy, cybersecurity, and AI in compliance, stressing the need for clear communication, proactive risk assessment, and best practices for long-term success.

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