Compliance KPIs Healthcare Organizations Should Be Tracking Right Now

You can’t improve what you don’t measure — and according to attendees of our recent webinar on KPIs for compliance programs, measuring compliance effectiveness remains a major challenge for many organizations. In a live audience poll, more than 50% identified policies and procedures as the most difficult area to measure and improve, followed by auditing and monitoring at nearly 29%.

This checklist is designed to help compliance leaders move beyond simply having a compliance program and begin evaluating whether core activities are actually effective, measurable, and improving over time.

1. Hotline & Incident Management

A strong reporting culture is one of the clearest indicators of compliance program maturity. Organizations should evaluate not only whether employees know how to report concerns, but whether they trust the process enough to use it.

Evaluate Your Reporting Environment

☐ Employees know where and how to report concerns

☐ Anonymous reporting options are available and functioning

☐ Employees understand non-retaliation protections

☐ Reporting mechanisms are visible and accessible across the organization

☐ Leadership actively encourages good-faith reporting

Measure Hotline Effectiveness

Track trends that help evaluate whether your reporting process is timely, responsive, and trusted:

☐ Average time from report receipt to case closure

☐ Number of reports received by category (HIPAA, billing, HR, Stark/AKS, etc.)

☐ Percentage of cases escalated to formal investigations

☐ Frequency of repeat or recurring issue types

☐ Completion and timeliness of corrective actions

Test the Process

Organizations should periodically test hotline workflows to ensure issues are routed, assigned, investigated, and resolved appropriately.

☐ Conduct mock hotline submissions or test investigations

☐ Verify reports are triaged and assigned timely

☐ Evaluate investigation documentation quality

☐ Confirm leadership visibility into trends and outcomes

Did you know? Healthicity’s SmartLine support these efforts with 24/7 multilingual reporting, anonymous submission options, QR code access, and secure two-way communication tools.

2. Policies & Procedures

Policies and procedures represented the single biggest challenge identified during the webinar poll, with 50.63% of attendees selecting this area as the most difficult to measure and improve.

Many organizations struggle not with creating policies, but with maintaining them, ensuring employees can access them, and measuring whether they are actually being followed.

Assess Policy Governance

☐ Policies are reviewed and approved on schedule

☐ Policy ownership is clearly assigned

☐ Revision histories and version controls are maintained

☐ Policies are updated when regulations or operational risks change

Evaluate Accessibility & Awareness

☐ Employees know where to locate policies

☐ Policies are available electronically and searchable

☐ Code of Conduct attestations are tracked annually

☐ Employee awareness surveys are conducted periodically

Measure Policy Engagement

Instead of simply checking whether policies exist, measure whether they are being used:

☐ Policy access or usage metrics are monitored

☐ High-risk policies are reinforced through training

☐ Audit findings are linked back to policy gaps where appropriate

☐ Policies are incorporated into onboarding and annual education

3. Auditing & Monitoring

Nearly 29% of webinar attendees identified auditing and monitoring as the most difficult area to measure and improve. Effective audit programs should demonstrate more than activity; they should show measurable improvement over time.

Evaluate Audit Program Performance

☐ Annual audit plans are risk-based

☐ Routine audits are completed on time

☐ Emerging risks trigger additional audits throughout the year

☐ Audit completion rates and turnaround times are tracked

Measure Outcomes & Improvement

☐ Audit error rates are trended over time

☐ Reaudit results demonstrate remediation effectiveness

☐ Repeat findings are escalated appropriately

☐ Corrective action plans are monitored through completion

Monitor Regulatory Risk

☐ Overpayments are tracked and documented

☐ 60-day repayment timelines are monitored

☐ Audit findings are reported to leadership and/or the board

☐ Disciplinary action processes are consistently applied

4. Training & Education

Training effectiveness cannot be measured solely by completion rates. Organizations should assess whether education efforts improve knowledge, reinforce expectations, and address high-risk areas.

Assess Participation & Completion

☐ Compliance training completion rates are monitored

☐ Managers receive reports on overdue training

☐ Completion metrics are tracked by role and department

Measure Training Effectiveness

☐ Pre- and post-training assessments are utilized

☐ Knowledge improvement is evaluated

☐ High-risk roles receive specialized education

☐ Training content reflects current organizational risks

Connect Training to Risk

☐ Training priorities align with annual risk assessments

☐ Lessons learned from incidents and audits are incorporated into education

☐ Regulatory updates trigger timely training revisions

5. Financial Arrangements & AKS/Stark Oversight

The webinar highlighted financial arrangements as a major area where organizations should move beyond general compliance KPIs and establish risk-specific oversight measures.

Establish Strong Arrangement Oversight

☐ Centralized tracking exists for all arrangements

☐ Business need and rationale are documented

☐ Fair market value analyses are retained

☐ Legal review occurs for AKS/Stark risk areas

Monitor Arrangement Compliance

☐ Service logs and activity documentation are maintained

☐ Compensation aligns with services actually performed

☐ Lease and equipment arrangements are monitored appropriately

☐ Random arrangement reviews or audits are conducted

Strengthen Governance

☐ Compliance performs periodic oversight reviews

☐ Arrangement risks are included in the compliance risk assessment

☐ Potential violations trigger investigation and remediation processes

6. Risk Assessments & KPI Reporting

KPIs should align directly with organizational risks and help leadership understand whether compliance efforts are reducing exposure over time.

Evaluate Risk Assessment Processes

☐ Formal risk assessments are conducted regularly

☐ Risks are prioritized and categorized

☐ High-risk areas have dedicated monitoring activities

☐ Mitigation strategies are documented and tracked

Improve KPI Reporting

☐ Metrics are trended over time

☐ Dashboards are used to visualize performance

☐ Reports are shared with leadership and/or the board

☐ Compliance data can be filtered by category, timeframe, or risk area

Focus on Continuous Improvement

☐ Corrective actions are monitored to completion

☐ Repeat issues are identified and escalated

☐ Compliance program effectiveness reviews are conducted periodically

☐ Technology and analytics tools support ongoing monitoring

Final Thought

The most effective compliance programs don’t just document activities, they measure outcomes, identify trends, and demonstrate continuous improvement. Regulators increasingly expect organizations to show how they evaluate effectiveness and use KPIs to strengthen compliance operations over time.

That’s why many healthcare organizations are turning to Compliance Manager. From incident management and hotline reporting to policy oversight, auditing, training, risk assessments, corrective action tracking, and KPI dashboards, Compliance Manager helps organizations bring compliance activities into one connected system.

With configurable workflows, real-time reporting, automated tracking, and leadership-ready dashboards, Compliance Manager helps compliance teams move beyond spreadsheets and manual processes to build a more proactive, measurable, and defensible compliance program.

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