What should a compliance program's goal focus primarily on from a monitoring perspective?

A compliance program's goal, particularly from a monitoring perspective, should focus primarily on detecting and preventing criminal conduct. This emphasis is essential because a robust compliance program aims to uphold the integrity of healthcare organizations by ensuring adherence to laws, regulations, and ethical standards.

Detecting and preventing criminal conduct is critical to protecting the organization from legal penalties, financial losses, and reputational damage. It involves monitoring activities to identify potential violations, such as fraud or abuse, and implementing mechanisms to prevent such conduct before it occurs. This proactive approach is aligned with the regulations set forth by bodies such as the Office of Inspector General (OIG) and is foundational to a culture of compliance within the organization.

While increasing profits, enhancing patient satisfaction, and streamlining billing processes are important components of a healthcare organization's overall strategy, they do not directly address the legal and ethical compliance framework necessary to safeguard against misconduct. A compliance program primarily serves to create a safe and lawful operational environment, which ultimately supports the organization's broader objectives, including financial performance and patient care, without compromising compliance.