Providers Must Navigate the Complexities of Compliance

Providers Must Navigate the Complexities of Compliance

The demands on addiction treatment facilities to provide evidence-based, compassionate and ethical care have never been greater. An array of regulatory compliance standards at the federal, state and local level reflects an industry-wide emphasis on delivering the highest-quality treatment.

“Comprehending and adhering to the numerous and complex compliance requirements can be challenging, but it’s an integral part of providing quality care and maintaining a center’s integrity and legality,” reads a blog post from Behavioral Healthcare Advisors, a consulting organization specializing in compliance activity.

Accreditation has become an increasingly important area for facilities as they seek to demonstrate value to patients and families. The demands on accredited organizations have been growing. As of the start of 2023, all substance use treatment facilities with Joint Commission accreditation have been required to engage in activities designed to reduce health care disparities in their patient population. This includes designating a point person in the organization to oversee these initiatives, as well as standardizing the collection of patient data on race/ethnicity. These steps are helping treatment providers to demonstrate a commitment to equity in their programs.

Behavioral health organizations now have sound data to support their investment of resources into accreditation activity. According to a 2022 report from the ROI Institute Inc., “The Impact and ROI of Joint Commission Accreditation for Behavioral Health,” every dollar a behavioral health provider invests in accreditation results in a return of $7.23. Improved staff competency and a competitive advantage in the local market are some of the benefits providers cited in their assessment of accreditation-related efforts, a self-analysis that formed the basis for the report.

Substance use treatment providers have the additional responsibility to ensure that their patients’ personal health information is protected from unauthorized use. Even though some protections of the federal 42 CFR Part 2 confidentality regulations have been relaxed in recent years to encourage information sharing and care coordination among providers, addiction treatment facilities still must be conscious of disclosures that could jeopardize patients’ employment or legal status.

Treatment industry leaders also have taken a lead role in promoting compliance activity. It has been heartening to see some of the most prominent names in treatment unite around quality improvement and ethical operations. In its effort to combat patient brokering and other practices that had tarnished the field’s reputation, the National Association of Addiction Treatment Providers (NAATP) took steps to ensure that its membership stands for a commitment to advance the field. NAATP continues to review and refine its ethics code for members on a regular basis, moving in some cases not to admit organizations that won’t commit to its principles.

The blog post from Behavioral Healthcare Advisors suggests that substance use treatment organizations develop a comprehensive compliance program to guarantee that they continue to meet the requirements of the laws and standards that apply to them. The program should include regular performance audits and ongoing staff training on topics such as ethical practice, confidentiality and patient rights.

Technology serves as an important conduit for meeting these goals. Artificial intelligence systems, with their capacity to observe patterns in millions of records, will make possible dramatic improvements in efficiencies. This could come to life for treatment providers in several applications, from using predictive analytics to standardize treatment planning to analyzing payment data to improve claims processing. Achieving these kinds of gains will of course depend on treatment organizations making a commitment to data quality in their operations.

We at Sigmund Software are honored to partner with like-minded organizations and to offer tools for compliance and standardization. Our software solution facilitates collaborative care among providers and eases workflow for program staff. This will enhance compliance on many levels, placing your organization in a positive light among customers and regulators alike. That is an enviable place to be in our ever-changing industry.