As payers and providers mobilize to meet the new interoperability requirements, early engagement by risk and compliance teams is critical to building a successful program and establishing control-enabled processes that create value while minimizing risk.
An effective interoperability implementation will require a cross-functional approach to focus an organization’s efforts and resources in a concerted manner, and internal audit and compliance are critical components.
Collaborate with business operations and IT to develop a program strategy and roadmap to align efforts to be compliant with interoperability requirements. Be a key driver of discussions around developing control-enabled processes in a scalable and sustainable fashion.
Given the large number of new processes and capabilities, help identify risks and key controls necessary to ensure sustained compliance with interoperability requirements within IT and business operations.
Conduct in-flight readiness assessment and/or add an interoperability compliance assessment / audit to your work plan for 2021. Probe into specific requirements during risk assessment discussions.
Partner, Health Services Risk and Regulatory, PwC US
Principal, Health Services Payer, PwC US
Fran Grabowski, Jr.
Director, Risk and Regulatory, PwC US
Director, Health Industries, PwC US