Case Study: Humana Tackles Compliance Early and Often - ' Good Corporate Hygiene ' (
Page 5 of 8 )
Good Corporate Hygiene
Like many pieces of government regulation, HIPAA has a few areas open to interpretation, and Humana hasn't gotten everything right. It has erred in several cases by being too conservative with patient data. Initially, for instance, the company disclosed almost no patient health information to agents and brokers, which made it difficult for them to act on behalf of members they represented. Humana also started out with a very difficult process of authenticating the identity of people trying to access accounts on the Web, which made it too laborious to do something as simple as check the status of a claim.
On the plus side, the security and privacy policies developed to help Humana comply with HIPAA work well for other aspects of the business—and Goodman believes that compliance enhances Humana's overall operations. That's because HIPAA sets standards for data exchange, and as more doctors and hospitals adopt the standards, it will smooth the back-end process needed to handle transactions.
"When you're fully HIPAA compliant, it should make it easier for payers and providers to communicate," says Goodman. "We all have these codes—transaction type 73 or whatever. If we know that a hospital is going to comply with that transaction code, then exchanging information is easier."
The return on HIPAA investments will increase over time, Goodman says. For instance, at some point each of the nation's 600,000-plus doctors will receive a unique provider ID that they will then use for their entire career. "Right now we have all sorts of issues trying to keep track of doctors, like all payers do," Goodman says. "So that will absolutely have bottom-line benefits."
That's as it should be, says Eric Brown, an analyst at Forrester Research Inc. "Look, HIPAA is a big piece of work. But if you're an IT guy you would look at it and say, 'This is good hygiene.' It's stuff you're going to do anyway."
Story Guide:
Humana Tackles Compliance Early and Often
Compliance Inc.
New Security Director
IT's Role in Compliance
Good Corporate Hygiene
The Culture of Compliance
From Regulated To Heavily Regulated
Sidebar: The Cost of Compliance
Next page: The Culture of Compliance
Case Studies 
