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d).
The health care industry is heavily regulated and has several special risk areas that need to be looked out for. An effective compliance program is necessary in order to mitigate these risks. In addition to the challenges that are associated with taking care of patients, health care providers are subject to huge and sometimes intricate sets of rules that govern the coverage and reimbursement of medical services. Because federal and state sponsored health care programs play such a big role in paying for health care, compliance with these rules are necessary in order to avoid penalties that can occur. These penalties can include such things as recoupment of improper payments, along with sanctions imposed by Medicare and Medicaid against health care businesses that engage in abuse or fraudulent practices (Corporate Responsibility and Corporate Compliance: A Resource for Health Care Boards of Directors, (n.d.).
A good health care administrator will define and implement a good risk management plan in order to avoid as many problems as possible. The health care administrator is responsible for making sure that the health care facility runs a smoothly as possible. This includes making sure that the facility has an effective compliance program along with managing any accreditation and licensing actions that they facility may be undergoing.
Other risks that must be taken into account are those that deal with abuse and fraud. This is also an area that the health care...
They must make sure that the rules are known by everyone and then followed as closely as possible. So many facilities depend on state and government funding to survive that they cannot afford to take any chances at losing any of it. Knowing the rules and abiding by them is the best way for a health care facility to be successful. Seeing that this is what happens is ultimately the responsibility of the health care administrator in charge of the facility.
The main function of any health care facility is to provide the best health care possible. This can only be done if the facility as a whole is run as efficiently and effectively as possible. The position of the health care administrator may not be a glorious one, but it is definitely a very important one, in order for the facility to be a success.
References
Corporate Responsibility and Corporate Compliance: A Resource for Health Care Boards of Directors. (n.d.) Retrieved April 3, 2009, from Office of the Inspector General Web site:
http://oig.hhs.gov/fraud/docs/complianceguidance/040203CorpRespRsceGuide.pdf
Health Administration. (n.d.). Retrieved April 3, 2009, from Web site:
http://www.nmsu.edu/~soahec/manual/hadmin.html
Health Care Administration and Management Careers. (2007). Retrieved April 3, 2009, from Healthcare Careers Web site: http://www.health-care-careers.org/healthcare-administration-career-overview.html
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