Navigating The Compliance And Regulatory Environment Across Rural Health – Medcity News

Navigating the compliance and regulatory environment across rural health – MedCity News

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Health IT, MedCity Influencers
By Baha Zeidan
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Rural areas are particularly vulnerable, and delivering healthcare services while ensuring a positive patient experience presents a unique set of challenges.
Couple those challenges with the increasingly complex compliance and regulatory environment, whether it’s the Omnibus Burden Reduction rule or complying with HIPAA changes amid increasing cyber threats, navigating the rural healthcare landscape can be tricky.
Increasingly, rural hospitals are closing their doors, and rural medical centers are having trouble attracting the talent they need to maintain operations.
An analysis from the Federal Reserve Bank of Richmond revealed that hospitals nationwide have 105,000 fewer workers than in February 2020, a roughly 2% decline. Rural providers acutely feel the pinch.
Maintaining, let alone enhancing the patient experience, is near impossible for resource-constrained rural healthcare providers. Often, providers struggle with streamlining their operations and don’t act quickly or decisively.
If there is a silver lining to the Covid-19 pandemic, it has been a catalyst for change that many rural and community practices and hospitals wanted to make but did not for various reasons.
Insurance regulations
As insurance becomes increasingly complex, many health organizations have needed additional staff to keep up with the requisite paperwork. The costly proposition is not one most hospitals can afford amid the shifting landscape.
Finding the talent and expertise needed to navigate complex regulations is a multi-pronged dilemma, especially in many rural areas suffering from population declines. But not doing so can prove more costly in the long run.
Organizations must simplify their process to meet the regulatory requirements and evolve as regulations change. That is especially true for patients with two insurance plans — a commercial plan and Medicaid as the secondary.
A system that can handle the complexities of rural health settings and alert the billing department when payments are made and when to act serves as a pressure valve to an overburdened department.
The right technology partner can help streamline the management of insurance regulations, including Medicare and Medicaid. While not without cost implications, technology partners can securely house necessary documentation, maintain records and process payments to help alleviate the regulatory burden on already stretched teams.
The cybersecurity threat
Every year seems to be worse than the year before regarding cybersecurity. Hackers and bad actors have increasingly set their sights on healthcare recently.
The reasons are varied, but providers are likely to pay ransoms to restore IT services, considering that it is a matter of life and death and that private health data is a profitable commodity on the dark web. The median ransom is $75,000, making cybersecurity one of the most critical investments hospitals can make.
Rural providers’ lean IT teams and limited budgets hinder the investments they can make. Every investment is critical, and health IT platforms must include built-in security solutions.
Amid the Covid-19 pandemic, the Office for Civil Rights released multiple waivers to help ease the burdens of complying with HIPAA. However, as the world emerges and moves on from the pandemic, HIPAA will again be a top compliance priority.
Technology is a partner
Whether minimizing the time staff members need to review electronic health records (EHR) to help offset staff shortages, streamlining the billing process and giving unprecedented insights into patient records, the right technology can provide critical support to healthcare teams.
Ultimately, navigating the complex compliance and regulatory environment requires new solutions to long-standing issues. Against new and long-standing challenges, rural providers must adapt to position their organizations for future success and stability.
Solutions that empower health care providers to transform their operations digitally will play a key role here. Providers must make strategic investments that reap long-term returns, particularly in cybersecurity, analytics and cloud-based platforms.
For example, data-driven analytics will empower rural providers to understand better how different social determinants of health (SDOH) impact their population. This insight will help organizations apply for grants that benefit and elevate community-centric programs.
Additional investments in broadband access at the federal level will help close the digital divide. Doing so will allow more patients to access health services via telehealth and patient portals.
The pandemic brought a new focus on health inequities, as long-disadvantaged communities encountered worse outcomes from Covid-19.
We’re faced with unprecedented headwinds. Many rural and community practices and hospitals have scaled back their services to maintain some level of operations.
Technology can help organizations navigate these headwinds and position themselves for future success. The time to act is now — before a new regulation mandates it.
Photo: marekuliasz, Getty Images
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Baha is the Co-founder and CEO of Azalea Health, a leading healthcare IT company whose mission it is to help underserved healthcare providers improve patient care and profitability. Under Baha’s leadership, Azalea has established itself as a high-growth innovator and leader, developing a comprehensive, cloud-based health IT platform for ambulatory practices and hospitals — including introducing the industry’s first fully-integrated proprietary telehealth solution with its EHR.
Azalea Health has achieved Inc. 5000 rank of fastest-growing companies in the U.S for three consecutive years and has been named a Top 40 Innovative Technology Company by The Technology Association of Georgia (TAG).
Baha has been recognized in the industry with a number of awards including the Phoenix Award by the Metro Atlanta Chamber Bioscience-Health IT Leadership Council in conjunction with the Health IT Leadership Summit for his outstanding contribution to the growth of the health IT industry in Georgia. He is also a 2018 recipient of the Atlanta Business Chronicle’s 40 Under Forty Award and a 2019 recipient of their Most Admired CEOs Award.
This article is featured in the Healthcare Docket newsletter, a partnership between Breaking Media publications MedCity News and Above the Law.
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