Why Independence Matters in Compliance Program Assessments
Key Points:
- In compliance, independence is not optional, it is a necessity.
- Independence means having no other engagements with the organization that could affect objectivity.
Healthcare organizations invest a considerable amount of time and resources in building effective compliance programs. Periodic compliance program reviews are essential to ensure that these programs work as intended, identify gaps, and demonstrate a commitment to regulatory integrity. Engaging an independent reviewer sends a powerful message that the organization values compliance, transparency, and continuous improvement. Independence strengthens the integrity of the review process, enhances credibility with regulators, and provides leadership with the unvarnished insights needed to manage risk effectively.
However, a critical factor in any assessment is its level of credibility. The Office of Inspector General (OIG), Department of Justice (DOJ), and accrediting bodies expect compliance reviews to be conducted by individuals or firms free from competing interests. Executive leadership and boards similarly rely on assessments to be objective, candid, rigorous, and unfiltered. When reviewers also provide consulting, operational support, legal services, or other paid work for the same organization, a conflict of interest arises. Financial or professional relationship can create inherent risk where the reviewer may be reluctant to identify weaknesses tied to their own advice, systems, or recommendations. This can result in softened findings, minimized critical issues, or avoidance of sensitive issues altogether.
In short, there is an incentive to not offend or imperil existing engagements. Even if the reviewer strives to be objective, the appearance of compromised independence can be just as damaging as actual bias. Any lack of independence can undermine the reliability of the review, calling into question whether the organization genuinely sought an objective assessment or merely a validation exercise. Choosing an unbiased reviewer protects the organization, reinforces accountability, and ensures the compliance program review achieves its intended purpose. Choosing a reviewer that is not viewed as independent can be a waste of resources.
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