SCALE Leadership Archives Vol. 3

SCALE allows you to invest in compliance, for example HIPAA – these compliance requirements are the same for a 5-provider group as they are for 50 or 150 providers – so the more SCALE, the easier to deploy the resources for a strong compliance program. And beyond compliance programs, supporting compliance with higher quality employees and managers that help you remain compliant every day by making good decisions. 

Another example is chart auditing, which is a critical part of the process. The auditing process is there to help you first and foremost identity outliers; which providers are pushing the productivity envelope. Internally tracking and responding to your outliers quickly comes from a robust program with engaged managers.

 Additionally, larger platforms can afford to bring in expert third parties to help augment what’s missing on a day-to-day basis. We believe that the government will be looking closely at the private equity funded platform investments to assure that these investments create the right vs. wrong provider incentives. Being able to demonstrate a strong audit and response program will be important in demonstrating to the government that management is focused on quality first and foremost. Internal communications should always be balanced and all parties need to demonstrate as much as possible that they are good citizens with quality orientated priorities. We all know that the government views its auditing as a reliable source of revenue.