Compliance 360 Study Finds “Demonstrating Compliance Effectiveness” a Top Priority for Healthcare Organizations in 2011

Increased, Proactive Focus from CMS Cited as the Key Motivator

ATLANTA--(BUSINESS WIRE)-- Compliance 360, a leading provider of Software-as-a-Service (SaaS) solutions for enterprise governance, risk management and compliance (eGRC), today announced the results of its 2011 Healthcare Compliance Effectiveness Study, which takes a critical look at how healthcare organizations are handling the growing regulatory demands to measure and demonstrate the effectiveness of compliance programs. With input from hundreds of healthcare compliance professionals from across the country, Compliance 360 found that CMS’ increased focus on compliance program effectiveness was the main reason for healthcare organizations ranking “demonstrating and measuring the effectiveness of their compliance programs” as a top priority for 2011 and beyond.

The passage of the Patient Protection and Affordable Care Act has made it mandatory for healthcare organizations to implement compliance plans. CMS is also raising the stakes by shifting its focus from policies, procedures and retrospective audits to proactive compliance program effectiveness and measuring the quality of outcomes. Healthcare organizations are now pressured to not only have compliance programs in place, but also to demonstrate that those programs are actually working.

To better understand the impact of these new requirements, Compliance 360 surveyed 846 compliance professionals from health insurance plans and healthcare providers to better understand their priorities for measuring and demonstrating compliance effectiveness and the methods they are using to do so. Major findings include:

  • Demonstrating and Measuring Compliance Effectiveness a Top Priority Due to Increasing CMS Focus: For an overwhelming majority of respondents – 84 percent from health insurance plans and 79 percent from healthcare providers – demonstrating compliance effectiveness is either “Our #1 Priority” or “One of Our Top Priorities” in 2011. When asked about the underlying motivation for this prioritization, 83 percent of health insurance plans and 77 percent of healthcare providers said “Increasing Focus from CMS.” Additional motivators included other regulatory pressures or external auditors and pressure from CEOs and board of directors.
  • Most Healthcare Organizations Using Internal Audits for Compliance Effectiveness; Few Using Automated Dashboards and Scorecards: 65 percent of respondents indicated that they are currently using “Internal Audit/Assessment Results” to demonstrate and measure compliance effectiveness. Other methods included “External Audit Results” (34 percent), “Ad Hoc or Qualitative Measures” (34 percent) and “Manual Scorecards” (31 percent). Surprisingly, only 12 percent said they were using “Automated Scorecards” (either purchased by a vendor or built internally). Compliance 360 expects to see that percentage increase during 2011 and beyond due to elevated regulatory pressures and healthcare organizations’ need to streamline manual processes.
  • Many Organizations Lack Confidence in Their Ability to Demonstrate Compliance Effectiveness: Despite ranking it as a top priority, 39 percent of respondents said they were “Not Confident” or “Moderately Confident” in their actual ability to demonstrate and measure compliance effectiveness. Compliance 360 attributes this, in part, to the lack of standardized assessment guidelines for healthcare organizations to reference when measuring compliance effectiveness. With CMS expected to provide a self-assessment framework later this year, overall confidence levels are expected to rise in the future.

“With mounting proactive regulatory scrutiny, healthcare compliance professionals realize that they need to have the ability to provide hard-lined results that show the effectiveness of their compliance programs. The risk of sanctions and fines are far too great, and far too real, not to take this seriously,” said John Brooke, general manager of healthcare, Compliance 360. “A growing number of healthcare organizations are utilizing software applications to give them the visibility into their programs they need to demonstrate proof of compliance, and we expect this trend to continue as regulatory pressures continue to mount.”

To download a copy of the free 2011 Compliance Effectiveness Study, visit:

To learn more about the seven elements of effective compliance programs, visit:

About Compliance 360

Ranked as the fastest growing GRC software vendor in Inc. Magazine’s 2010 list of America’s fastest growing private companies , Compliance 360 is the leading provider of enterprise governance, risk management , compliance and audit management solutions for companies that operate in regulated industries. With these solutions, organizations reduce risks, improve efficiencies and protect their brands using a single platform to address their comprehensive GRC requirements. The Compliance 360 Software-as-a-Service (SaaS) solution suite helps organizations address policies and procedures management, regulatory compliance management , internal and external audits , third party risk and vendor management , contract management, incident management, fraud, waste & abuse , surveys, accreditation, enterprise risk management and IT governance. Compliance 360 is headquartered in Atlanta and assists more than 225,000 users every day in a variety of complex, regulated business environments, including healthcare, insurance, financial services and others. For more information, visit .


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