On March 27, 2017, in conjunction with the Health Care Compliance Association annual Compliance Institute, HHS OIG released a Resource Guide for the healthcare industry to facilitate the consideration of potential options for benchmarking and measuring the effectiveness of various key elements of corporate compliance programs.  The Resource Guide was released on the same day that HHS Inspector General Daniel Levinson, the longest tenured HHS inspector general, delivered the keynote address which similarly focused on Compliance 2.0 and the agency’s renewed focus on compliance program maturation and effectiveness.  The Resource Guide, titled Measuring Compliance Program Effectiveness: A Resource Guide, was developed in follow up to an important roundtable on January 17, 2017, which included seasoned compliance representatives from the OIG and industry (including providers, suppliers, and payors). The purpose of the January roundtable was for industry representatives and the OIG to confer about the expectations and strategies being employed to actively assess and gauge whether a compliance program is functioning well and growing.

The purpose of the Resource Guide is to provide examples of potential approaches to measuring the effectiveness of certain elements of a compliance program for organizations of varying size, operational complexity, and resources.  Importantly, “the purpose of this [Resource Guide] is to give health care organizations as many ideas as possible, be broad enough to help any type of organization, and let the organization choose which ones best suit its needs.”  However, the Resource Guide makes clear that this list is not a “checklist” that should be “applied wholesale to assess a compliance program.”  The Resource Guide further acknowledges the impracticality of using all or even a large number of the measurement options outlined.

The Resource Guide is structured to provide tools regarding both “what to measure” and “how to measure” with respect to the following seven elements of a compliance program first established by the U.S. Sentencing Guidelines Manual:  

1. Standards, Policies, and Procedures
2. Compliance Program Administration
3. Screening and Evaluation of Employees, Physicians, Vendors, and other Agents
4. Communication, Education, and Training on Compliance Issues
5. Monitoring, Auditing, and Internal Reporting Systems
6. Discipline for Non-Compliance
7. Investigations and Remedial Measures

The Resource Guide focuses on, among other things:

• Compliance Culture
• Individual Accountability
• Risk Assessments
• Self-Disclosure
• Oversight of Third Parties

The focal points in the Resource Guide are of no surprise given the U.S. Department of Justice’s current priorities. The Resource Guide is available here.