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Navigating Compliance and the Regulatory Environment Across Rural Health – MedCity News

Rural areas are particularly at risk, and providing healthcare services while ensuring a positive patient experience presents a unique set of challenges.

By combining these challenges with an increasingly complex compliance and regulatory environment, whether it is the Omnibus rule to reduce burden or comply with HIPAA changes amid increasing cyber threats, navigating the rural healthcare landscape can be challenging.

Increasingly, rural hospitals are closing their doors, and rural medical centers are having trouble attracting the talent they need to continue operations.

An analysis from the Federal Reserve Bank of Richmond revealed that hospitals across the country had 105,000 fewer workers than they did in February 2020, a drop of nearly 2%. Service providers in the countryside are feeling very tight.

Maintaining, let alone improving, the patient experience is nearly impossible for rural health-care providers who are under-resourced. Too often, service providers struggle to streamline their processes 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 didn’t for various reasons.

Insurance Regulations

As insurance has become increasingly complex, many health organizations have required additional staff to keep up with the required paperwork. An expensive offering is not one most hospitals can afford amid a changing landscape.

Finding the talent and experience needed to overcome complex regulations is a multifaceted dilemma, particularly in many depopulated rural areas. But not doing so can be more costly in the long run.

Organizations must streamline their operations to meet regulatory requirements and evolve as regulations change. This is especially true for patients who have two insurance plans – a commercial plan and Medicaid as a secondary insurance plan.

A system that can handle the complexities of rural health settings and alert the billing department when payments have been made and when to act as a pressure valve for an overburdened department.

The right technology partner can help simplify the administration of insurance regulations, including Medicare and Medicaid. While not without cost implications, technology partners can securely hold necessary documents, keep records and process payments to help ease the regulatory burden on already stressed teams.

Cyber ​​security threat

Each year seems to be worse than the previous year in terms of cybersecurity. Hackers and bad actors are increasingly turning their attention to healthcare lately.

The reasons are varied, but providers are more likely to pay a ransom to restore IT services, considering it is a matter of life and death and private health data is a lucrative commodity on the dark web. The average ransom is $75,000, making cybersecurity one of the most important investments hospitals can make.

Rural service 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 has issued multiple waivers to help ease the burden of HIPAA compliance. However, as the world emerges from the pandemic, the Health Insurance Transfer and Liability Act (HIPAA) will once again be a top compliance priority.

technology partner

Whether it’s reducing the time employees need to review electronic health records (EHR) to help make up for staffing shortfalls, simplifying 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. In the face of new and long-standing challenges, service providers in rural areas must adapt their organizations for future success and stability.

Solutions that enable healthcare providers to digitally transform their operations will play a key role here. Service providers must make strategic investments that reap long-term returns, particularly in cybersecurity, analytics, and cloud-based platforms.

For example, data-driven analyzes will enable service providers in rural areas to better understand how different social determinants of health (SDOH) affect their population. This insight will help organizations apply for grants that benefit and advance community-focused programs.

Additional investments in broadband access at the federal level will help bridge the digital divide. Doing so will allow more patients to access health services via telehealth and patient portals.

The pandemic has brought a new focus on health inequalities, as long-disadvantaged communities have faced worse outcomes from Covid-19.

We are facing unprecedented headwinds. Many rural and community practices and hospitals have scaled back their services to maintain a certain level of operations.

Technology can help organizations weather these headwinds and position themselves for future success. The time to act is now – before a new regulation imposes it.

Photo: Marikoliasz, Getty Images


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