Navigating the compliance and regulatory environment in rural health care

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

Couple these challenges with an increasingly complex compliance and regulatory environment, whether it’s the Omnibus Burden Reduction Rule or complying with HIPAA changes amid growing cyber threats, navigating the rural healthcare landscape can be difficult.

Rural hospitals are increasingly closing their doors, and rural medical centers are having trouble attracting the talent they need to stay afloat.

An analysis by the Federal Reserve Bank of Richmond found that hospitals nationwide had 105,000 fewer workers than in February 2020, a roughly 2 percent drop. Rural suppliers are acutely feeling the pinch.

Maintaining, let alone improving, the patient experience is nearly impossible for resource-constrained rural healthcare providers. Often suppliers struggle with streamlining their operations and do not act quickly or decisively.

If the Covid-19 pandemic has a silver lining, it has been a catalyst for change that many rural and community practices and hospitals wanted to make, but didn’t for a variety of reasons.

Insurance provisions

As insurance becomes more complex, many healthcare organizations need additional staff to handle the necessary paperwork. The expensive proposition is not one that most hospitals can afford amid the changing landscape.

Finding the talent and expertise needed to navigate complex regulations is a multifaceted dilemma, especially in many rural areas suffering from population decline. But not doing so could end up costing you more in the long run.

Organizations need to simplify their process to meet regulatory requirements and evolve with changing regulations. This is especially true for patients with two insurance plans – a commercial plan and Medicaid as a secondary.

A system that can handle the complexities of rural healthcare 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 policies, including Medicare and Medicaid. Although not without cost implications, technology partners can securely store the necessary documentation, maintain records and process payments to help ease the regulatory burden on already stretched teams.

The threat to cyber security

Every year seems to be worse than the last in terms of cybersecurity. Recently, hackers and bad actors have increasingly set their sights on healthcare.

The reasons vary, but providers are likely to pay ransoms to restore IT services, given that it is a matter of life and death and that personal health data is a profitable commodity on the dark web. The average ransom is $75,000, making cybersecurity one of the most important investments hospitals can make.

Rural providers’ weak IT teams and limited budgets hinder the investments they can make. Every investment is critical, and healthcare IT platforms must include built-in security solutions.

Amidst the Covid-19 pandemic, the Office for Civil Rights has released numerous exemptions to help ease the burden of HIPAA compliance. However, as the world emerges and emerges from the pandemic, HIPAA will once again be a top compliance priority.

Technology is a partner

Whether it’s minimizing the time it takes staff members to review electronic health records (EHRs), helping to offset staffing shortages, streamlining the billing process, and providing unprecedented information about patient records, the right technology can provide critical support to healthcare teams.

After all, navigating the complex compliance and regulatory environment requires new solutions to long-standing problems. In the face of new and long-standing challenges, rural providers must adapt to position their organizations for future success and stability.

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

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

Additional investments in broadband at the federal level will help bridge the digital divide. This will allow more patients to access healthcare services through telehealth and patient portals.

The pandemic has put a new emphasis 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 reduced their services to maintain some level of operation.

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

Photo: marekuliasz, Getty Images

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