Deeper Than the Headlines: Inspector General Keynote Address at HCCA

Daniel Levinson, Inspector General of HHS, was a keynote speaker on Monday, March 27th at the HCCA’s Compliance Institute. Every year most attendees eagerly listen to what he has to say. Among other things, he spoke of what he termed “Compliance 2.0.”

Compliance as a profession has been developing over the last 20+ years. We’ve reached a point where compliance programs are maturing and the profession as a whole has really moved into a 2.0 version and paramount to that version of compliance is what Levinson described as bringing together both technology and the right expertise. His remarks were broken down into the ‘human component’ as well as the ‘technology component.’

Human Component

Included in the human factors are a demonstration of our connection to quality healthcare delivery, targeting limited resources and having a positive impact on the organization.

He spoke at length of a study on corporate culture which first appeared in 2015 in CFO Magazine. The working paper can be obtained from the National Bureau of Economic Research ( and is titled “Corporate Culture: Evidence from the Field.” Levinson summarized some of the key findings resulting from the research which included hundreds of corporate executives in 1348 U.S. corporations.

Importantly, 91% of executives said that corporate culture is one of the top drivers of value and success of their organization, but only 15% said the culture at their particular organization was where it should be. 55% stated that the single most important aspect that drives culture is the CEO. This probably doesn’t come as much of a surprise but Levinson pointed out this is what is often referred to as “tone at the top” and its importance is not only essential in the overall corporate culture but also the compliance program.

He discussed how both the DOJ and the OIG feel the tone at the top is essential for effective compliance programs and it is something both agencies seriously consider when evaluating the effectiveness of compliance programs. He referenced the recently published DOJ document “Evaluation of Corporate Compliance Programs,” which I blogged about at the end of February, and how tone at the top is an important aspect of this document.

Technology Component

Compliance 2.0 really wouldn’t be a 2.0 if it weren’t for the advancements we are seeing in technology. To set the stage, Levinson used the example of the ubiquitous fitness tracker that most of us are now wearing on a daily basis. We carry this technology with us everywhere. Is it a fashion statement only or does its usefulness stem from how we focus and use the information? The technology helps translate important data into something that might change behavior.

Likewise, technology in Compliance 2.0 is really only useful if it helps translate data into a change in behavior.

Levinson said that compliance programs today should observe, measure and assess. He encouraged compliance professionals to look for incremental gains and not to always be “swinging for home runs.” To this point, he referenced a Harvard study that looked at death rates in hospitals and the week of admission, as in in the weeks before, during and after, an on-site visit from the Joint Commission. Most of us know of the increased emphasis to put our best foot forward during visits from the Joint Commission. Not surprisingly, the results showed a modest decrease in death rates when patients were admitted to the hospital during a week when Joint Commission was on-site as opposed to a patient being admitted the weeks before or after the Joint Commission visit.

He did point out this was not meant to slam hospitals and the result showed only a very modest improvement, but given the number of patient admissions that occur across the country, this would have equated to the saving of 3,500 lives. His point was to emphasize the principle of incremental gains as opposed to trying to solve everything all at once. This principle, he said, should be applied to our efforts in compliance.

By way of concluding his remarks, he shared a few of the areas he feels the OIG needs to focus their efforts and limited resources on. They included prescription drug abuse (think of the opioid abuse problems in the U.S.), home health services and Medicaid program integrity.
He also shared news of an upcoming resource from the OIG titled, “Measuring Compliance Program Effectiveness—A Resource Guide.”

This new resource is the result of a roundtable hosted by the OIG in January of 2017. The roundtable brought together outside legal counsel and healthcare consultants who work with many varied clients. The goal was to highlight effect compliance practices they have observed in their work across the country.

Lastly, he highlighted the 10 different sessions scheduled at the conference where OIG employees would be speaking. If you miss these sessions don’t forget the HCCA posts the slides on their website and also makes audio recordings available.

Questions or Comments?