WILEMS RESOURCE GROUP
HEALTH CARE Compliance & engagement Solutions
We'll develop a Compliance Program to meet the needs of your organization and the requirements of the ACO or Direct Contracting Model. If you already have particular elements in place, we can work to build on what you have started. This service includes the creation and implementation of policies & procedures, a monitoring program, training materials and tracking systems for:
Data Use Agreements
Policy & Procedures Review Processes
Utilization of Fraud, Waste & Abuse Waivers
CMS Notifications & Guidance Follow-Up
Compliance Reporting & Investigations
Marketing Material Review Processes
Compliance Training Completion
Access Management for CMS Systems
We'll help you build Engagement Programs for your physicians, practice managers, and beneficiaries. First, we'll conduct a review of your existing Engagement and Marketing Programs to identify areas for improvement. Second, we will refine the program to build awareness of the organization's initiatives and value-based care requirements. The customized program includes recommendations and action plans for:
Print and Electronic Communication Campaigns
Conferences and Live Events
Incentives and Waivers
We'll help your ACO or DCE effortlessly implement two of the five Compliance Program Requirements: a method for anonymous reporting and annual compliance training. The Wilems Resource Group web-based platform allows individuals to complete compliance training or make a compliance report anytime from anywhere. Modules can be purchased separately based on your organization's needs. Upon completion of a training module, the individual submits a brief attestation to confirm their understanding of the material. Completion reports are generated and shared monthly with ACO leadership.
Kimberly and the WRG team have provided a professional, well-rounded and comprehensive compliance program to our ACO. Navigating the complex landscape of compliance in population health is daunting, but we feel in good hands with the WRG team.
Tyler Wilson, Piedmont Community Health Collaborative
Your organization has committed to providing high-quality, coordinated health care through participation in the Direct Contracting Model or a Commercial, Medicare Shared Savings Program, or Next Generation ACO. Our main goal at Wilems Resource Group is to remove burdens and challenges your organization may face related to compliance requirements and engagement programs. We understand that your team needs to focus on the most important aspect of health care...the beneficiary.
At Wilems Resource Group, we measure success on our ability to help you understand program requirements, determine the appropriate level of acceptable compliance risk, and create programming that meets all regulatory requirements. Wilems Resource Group has helped ACOs all across the country remain compliant and be successful within the Medicare Shared Savings Program and the Next Generation ACO Model. We first take the time to understand your company culture and business goals. We listen and learn from you. Working alongside your team, we build customized compliance and engagement programs for your organization, physicians, practice managers, and beneficiaries.
We'll conduct an audit of your existing Compliance Programs to identify any gaps or areas with deficiencies. An internal audit and monitoring program can help ensure you are meeting regulatory requirements and prepare you from an audit request from CMS/CMMI. During the audit, we will identify potential areas for improvement and work with your organization to remediate the issues. This service includes the review of:
Tracking Systems (as listed previously)
Policy & Procedures
Compliance Reporting & Investigations
Monitoring & Oversight Program
We'll review and provide recommendations for your marketing materials based on our experience with CMS/CMMI guidelines and regulations for communication with the public, physicians, and beneficiaries. We can help ensure that your materials:
Meet the regulatory and sub-regulatory requirements released by CMS/CMMI
Are approved by CMS/CMMI as necessary
Accurately portray the elements of the Shared Savings Program and Next Generation Model