State Compliance Decision Management

Gain Agility and Growth Amid Changing Policies

Tracking and complying with the rapid and multifarious changes in health care regulations often feels like chasing a moving target. Not only is health care one of the most highly regulated industries in the US, its also the most complex. Multiple state level obligations exist, and these often vary from state to state. The time and resources required by your organization to follow regulations and track state spend can considerably add to your bottom line, and non-compliance with state regulations also holds the risk of significant fines and negative PR for your company.

As state level rules continue to be passed, health care companies need a data, business rules and reporting and analytics strategy in place to handle the changes on a state-by-state basis. The advanced predictive analytic tools and other technology of FICO’s Compliance Decision Management solutions puts your company ahead of reporting requirements and changes your position from a retrospective approach of tracking spending to one where you can plan how and where to spend. Implementing a rules driven compliance process also helps to reduce costly reporting errors and streamlines the support necessary to follow OIG and PhRMA guidelines, internal rules and legislative requirements.

FICO also helps to streamline the compliance process, removing the need for deep IT involvement to address every new change or addition in compliance requirements. Changes can be implemented in real time and allows business managers to have greater control. And with the ability to carefully track and predict spending, companies can better manage marketing budgets and priorities, allocating spending where it is most effective to drive profits and better return on investment.

With FICO’s state compliance decision management solution you can:

• Ensure that systems are up-to-date on all regulatory rules by allowing business managers to easily update and manage compliance updates and additions, freeing up IT to focus on critical initiatives.
• Streamline and improve processes and systems to track and manage all current reporting obligations and quickly and easily apply modifications to existing rules and quickly add any future requirements.
• Optimize overall performance by building logical bridges to CRM/SFA applications.
• Gain significant Return on Investment by making the business process more agile, improving reporting and leveraging the re-use of business rules across multiple applications.
• Ensure comprehensive and accurate state level reporting, lowering business cost and risk of fines.