You are the compliance officer of a large multispecialty health care organization located in the Southeastern United States. The organization is privately held and is located in a large metropolitan area boasting over a dozen large-company headquarters. Population demographics of the surrounding area include many technical professionals, state and government employees, military personnel, as well as a large number of retirees. The organization credits its success in the marketplace to a strong brand, high quality, ethical practices, and genuine concern for patients served. However, with recent and proposed changes in health care regulations, there are many pressures on the organization to cut costs, practice patient selectivity to minimize risk, and reduce the number of full-time personnel. The chief executive officer (CEO) has approached you to gain your advice on how the organization can respond to these pressures while maintaining a strong brand image through ensuring compliance with all applicable laws and regulations.
Write a report briefing the CEO that identifies areas of concern that would need to be monitored should initiatives be put in place to cut costs by reducing personnel and exercising greater selectivity in accepting patients to maximize revenue potential while minimizing risk or potential losses.
Be sure to include the following:
- A brief assessment of applicable laws or regulations that must be considered
- Recommendations about how to implement the initiatives to remain compliant while positing the organization for success