Write a 175- to 265-word response to the following:
- Why are ethics and compliance in finance so important in the health industry? What are the compliance considerations? Provide an example.
***Think about the current day economic and financial trends in the market. Why are ethics and compliance in health care finance so important?
- Pharmaceutical Cost
- Mergers & Acquisitions (M&A) in health care
- Disruption from established players and newcomers (think CVS, WalMart, Haven, Walgreens)
- Transitions in Payment/Reimbursement Models
- Provider Shortage
- Consumerism of health care
- Virtual or telehealth
- Increased patient responsibility (high insurance cost/deductibles)
- Baby Boomers
- Pricing transparency
- Electronic Health Records (EHR)
- Movement of health care service delivery from traditional settings toward more distributed settings
***Keep in mind that ethics is about moral principles that govern a person’s behavior or the conducting of an activity.
Consider compliance issues are the actions or facts of complying with a policy, regulation, and legislation.
Due Monday (20 pts)
Read and respond to at least two of your classmate’s discussion posts. Be constructive and professional with your thoughts, feedback, or suggestions. Peer posts should be equally as substantive in nature as your original post.
Khaki’s two cents:
At the very latest due Monday – you can post sooner and is preferred for gaining the most from our learning together.
6 Tips for success with each Weekly Discussion question:
· Post your original response as soon as possible each week, before Thursday is ideal
· You won’t see other responses from your peers until you post, so again post as early as possible.
· Reply to more than just two peers – let’s move the body of knowledge and understanding forward!
· I typically reply to all students, if I reply to you please circle back to my response – should you reply, doing so counts as “credit” towards the requirement to reply to a minimum of two peers 🙂
· Have fun – learning something new can be challenging and fun at the same time.
· Please make sure you include your citation/reference with your original post to the weekly discussion and provide your citation/reference to subsequent replies to your peers, using APA formatting.
Expert Solution Preview
Ethics and compliance are crucial in the health industry due to the potentially disastrous consequences of unethical behavior. Medical professionals have a duty to provide the best possible care to their patients while ensuring that they do not cause any harm. Failure to comply with regulations and policies can lead to severe legal consequences, including loss of license and imprisonment.
Compliance in finance requires adherence to regulations and policies that govern how healthcare organizations handle finances. The regulations and policies aim to prevent fraud and abuse, ensure that all financial transactions are transparent, and avoid conflicts of interest. For example, under the Stark Law, healthcare providers are forbidden from referring patients to entities with which they have a financial relationship. Violations of the law can result in penalties, fines, and exclusion from Medicare and Medicaid programs.
In the current financial and economic landscape, compliance and ethics are even more critical in the health industry. With the rise of healthcare consumerism, patients demand transparency in healthcare pricing, treatment options, and quality of care. Moreover, the movement towards virtual healthcare and transitions in payment and reimbursement models requires healthcare organizations to adhere to strict ethical guidelines to prevent fraud and abuse.
Overall, compliance and ethics in finance are vital to the healthcare industry’s success, as they ensure transparency, prevent fraud and abuse, and uphold patient trust. Failure to comply with regulations and policies can lead to severe legal consequences, resulting in significant financial and reputational damage to healthcare organizations.