We Provide Hospital CEOs and Compliance Officers with the Data and Insights They Need to Manage Risk Effectively
Hospital Consulting Team Lead – Timothy E. Allen | Former Special Agent (U.S. Secret Service & DOJ-OIG)
Managing risk in the hospital setting presents many unique challenges. In addition to the “normal” risks that other businesses face on a day-to-day basis, hospitals face risks ranging from medical malpractice claims to federal allegations of health care billing fraud as well.
At Corporate Investigation Consulting, we provide risk management consulting services to hospitals nationwide. Our consultants have extensive backgrounds in the health care sector, including prior experience as high-ranking agents with the U.S. Department of Health and Human Services (DHHS), Drug Enforcement Administration (DEA), and other agencies. We focus on delivering data-driven, practical, and effective risk management solutions, and we consult on matters ranging from cybersecurity and billing compliance to external audits and litigation.
Effectively Managing Risk in the Hospital Setting
As a hospital CEO or compliance officer, what does it take to establish and maintain a suitable level of risk? Before you can implement a risk management strategy, you first need to know what risks you need to manage, and you also need to know how much risk you are willing (or should be willing) to take on.
With our consultants’ backgrounds in federal health care fraud enforcement, and with deep experience consulting with hospitals of all sizes in regions across the country, we have a comprehensive understanding of what it takes for a hospital to maintain a suitable level of risk. We are also intimately familiar with the fundamental differences between hospitals of different sizes and in different locations, and we utilize this familiarity to provide custom-tailored risk management consulting services to our clients.
Put our highly experienced team on your side
Roger Bach
Former Special Agent (OIG)
Timothy E. Allen
Former Senior Special Agent U.S. Secret Service
Chris J. Quick
Former Special Agent (FBI & IRS-CI)
Maura Kelley
Former Special Agent (FBI)
Ray Yuen
Former Supervisory Special Agent (FBI)
Michael S. Koslow
Former Supervisory Special Agent (DOD-OIG)
Marquis D. Pickett
Special Agent U.S. Secret Service (ret.)
Our risk management consulting services encompass all aspects of hospital operations, including:
- Patient Risk – Including all aspects of patient care and the patient relationship, from intake procedures to operating room organization, and from inpatient policies to medical record generation and storage.
- Billing Risk – Including managing billing compliance for Medicare, Medicaid, Tricare, U.S. Department of Labor (DOL), health insurance companies, and other private payors.
- Contractual Risk – Including reviewing and consulting with regard to contract terms for agreements with laboratories, pharmacies, durable medical equipment (DME) companies, and other third parties.
- Regulatory Risk – Including all aspects of local, state, and federal hospital regulation, as well as non-health-care-specific regulatory compliance obligations.
- Employment Risk – Including preparation and implementation of appropriate employment policies and procedures, workspace and workflow management, resolving employment-related complaints, and responding to employee claims.
- Business Risk – Including all forms of commercial liability risk, from brand and reputation management to intellectual property-related issues.
- Financial Risk – Including securing debt and equity financing, evaluating renegotiation and restructuring opportunities, and addressing financial shortfalls and other corporate crises.
FAQs: What Does it Take to Effectively Manage a Hospital’s Risk?
Q: How can I determine if my hospital’s risks are being managed effectively?
In order to determine whether your hospital’s risks are being managed effectively, it is first necessary to conduct a comprehensive risk assessment. This involves auditing the hospital’s operations to identify where its risks lie, and then reviewing the hospital’s current risk management practices to assess their sufficiency.
In order to determine whether your hospital’s risks are being managed effectively, it is first necessary to conduct a comprehensive risk assessment. This involves auditing the hospital’s operations to identify where its risks lie, and then reviewing the hospital’s current risk management practices to assess their sufficiency.
Q: What are some examples of risks that tend to get overlooked in the hospital setting?
Some of the risks that most-commonly go overlooked in the hospital setting include those pertaining to cybersecurity and contract management. While hospitals will typically address patient privacy concerns within the context of HIPAA compliance, they will overlook the need for a broader cybersecurity program. However, hospitals must implement stringent cybersecurity protocols on an organization-wide scale, and failing to do so can lead to substantial liability exposure.
Contract management is another area of concern for hospitals. Not only must hospitals ensure that their agreements with third parties include appropriate protections with regard to warranties, indemnification, and insurance coverage, but they must address anti-kickback concerns as well. Violations of the Anti-Kickback Statute and Eliminating Kickbacks in Recovery Act can lead to severe consequences, including the potential for criminal prosecution.
Q: What are some examples of risk management solutions for hospitals?
Risk management solutions for hospitals run the gamut from adopting custom-tailored policies and procedures to implementing cybersecurity protocols, and from standardizing contract terms to overhauling billing compliance programs. When we consult with hospital CEOs and compliance officers with regard to risk management, we provide detailed and actionable recommendations that can be implemented cost-effectively and with minimal (if any) disruptions to the facility’s day-to-day operations.
Q: Do hospitals need to engage outside risk management consultants?
While not strictly necessary, there are a number of reasons why hospitals should engage outside risk management consultants as opposed to trying to independently make decisions in-house. Most significantly, the breadth of issues that needs to be addressed simply exceeds most hospitals’ internal capabilities. By engaging an outside consulting firm such as Corporate Investigation Consulting that offers the services of former senior DHHS and DEA agents, hospital CEOs and compliance officers can confidently make decisions knowing that they are managing their facilities’ risks effectively.
Q: What if my hospital is facing an active litigation or enforcement threat?
If your hospital is facing an active litigation or enforcement threat, then mitigating your hospital’s risk will involve assessing the threat, identifying all potential defenses, and executing a comprehensive and cohesive defense strategy. At Corporate Investigation Consulting, in addition to providing proactive risk management consulting services, we assist hospitals with litigation and enforcement defense as well.
Speak with a Senior Hospital Risk Management Consultant Today
If you have questions or concerns about the sufficiency of your hospital’s risk management efforts, one of our senior consultants will be happy to meet with you to provide a complimentary initial risk assessment. We work with hospitals nationwide. To schedule an appointment at Corporate Investigation Consulting, please call 866-352-9324 or tell us what we can do to help online today.