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Healthcare Policies You Need to Know

We might be a decade past the biggest healthcare regulatory changes in the United States — the enactment of Obamacare — but that doesn’t mean you can take your hands off the wheel and coast. 

Healthcare policy is ever-changing, with new rules and regulations coming into and out of play every year. There are state and federal mandates to keep in mind, and compliance is not an option: If your practice is found to be lacking in policy requirements, you could face fines, investigations, and other actions against you. 

Broadly speaking, healthcare policy is the general regulatory framework of decisions, goals, and actions that govern how healthcare is provided and accessed, and it includes safety practices, medication restrictions, vaccination programs, payment programs, the price of various treatments and procedures, and coverage implications. There are six subcategories under which policies can be divided: public health, global health, healthcare services, health insurance, mental health, and pharmaceuticals. These all overlap and feed into each other and must be viewed comprehensively. 

Many of these policies are set at either a federal or state level and are required for safe operation, as checked by audits, filing reports, licensing updates, etc., routine checks that ensure everyone and everything is up to code and in compliance with the laws. While it may be frustrating and time-consuming to establish regular checks to ensure adherence to the letter of the law, these programs and policies also ensure your patients receive the highest standard of care. 

Among the policies to closely monitor: 

Patient Care Policies

Patient care policies establish safe staffing levels, workflows for treatments, and a guidance system for responding to various emergency situations, all of which are tailored to your practice’s patient population and their needs. Different facilities require different practices — an OBGYN office wouldn’t have a protocol for conducting a biopsy to determine if a mole is malignant, for example — but all must comply with the policies pertaining to their work and patient population.

Employee Health Policies

Employee Health Policies are critically important, and make sure your nurses, volunteers, doctors, administrators, and everyone else is kept safe by adhering to sanitation and other protocols to keep floors clean and dry, machines properly sanitized, sharps properly disposed of, and files properly protected. This includes establishing a smoke-free work environment for your team, having a protocol in place should someone come to work intoxicated or otherwise not sober, and an easy and readily available supply of latex or nitrile gloves and surgical-grade masks for protection against viruses and other transmissible bacteria. It also means taking time off when they’re sick so they can heal themselves (and avoid spreading illnesses to patients). 

Drug Policies

Drug policies are an important part of a healthcare organization’s protocols and policies that must be carefully watched. These govern how drugs are safely handled and property distributed to ensure people aren’t getting access to drugs they do not need, or in an excessive amount for their ailment. Drug policies cover not just how drugs are administered but how they are stored and how to properly label the different classes of medication, in addition to reporting missing medicine and investigating that kind of incident.

Security and Privacy Policies

Security and privacy policies protect your patients’ sensitive data as outlined under various federal protocols. It keeps their personal information, from name and date of birth to their medical condition, under tight wraps, as mandated by the HIPAA Privacy Rule, but this also requires steps to take should that data be breached. Failure to comply fully with HIPAA regulations can result in fines of up to $50,000 or more per violation. But it’s more than that: Security policies also address how to handle reports or accusations of abuse or mistreatment, in addition to some of the threats faced in all aspects of society, like how to respond to an active shooter situation. 

It’s no wonder many healthcare organizations hire people specifically to monitor policy and conduct internal audits and reviews to make sure their office is fully compliant and up-to-date on all the rules and regulations. Failures can result in fines, additional audits, and other repercussions, the most worrying of which is failing to provide the best and most up-to-date patient care. 

If you’d like to look into hiring a medical and healthcare policy expert, call AMEA Healthcare. We specialize in healthcare staffing and can help you find the right person, who is deeply knowledgeable in this field and ready to help your organization stay on top of all these policies and rules. Call AMEA today, and let’s get started!

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