The History of Healthcare Compliance

Dave Clifton

At its core, healthcare compliance ensures the quality of care, patient safety, and integrity of healthcare systems. Over the years, healthcare compliance has evolved significantly, driven by changing regulations, advances in technology, and a growing emphasis on patient-centric care. So, how has the history of healthcare compliance changed since its inception?

What is Healthcare Compliance?

Healthcare compliance is the process of following the laws, regulations, and ethical standards that govern the healthcare industry. It ensures that healthcare organizations and professionals adhere to guidelines that protect patient safety, maintain data privacy, and uphold the integrity of medical practices. Compliance is essential for operating within the legal framework, providing high-quality care, and maintaining the trust of patients and the community​.

Healthcare Compliance is Ever-Evolving

Healthcare compliance has undergone significant transformations over the years due to various factors and evolving societal needs. One key driver is the increasingly complex and dynamic healthcare landscape. With advances in medical technology, new treatment modalities, and an expanding array of healthcare services, the regulatory framework has had to adapt to ensure patient safety, quality of care, and ethical standards. Additionally, the globalization of healthcare and the interconnectedness of healthcare providers across borders have necessitated the development of international standards and guidelines to harmonize compliance efforts worldwide.

Moreover, digitization has revolutionized healthcare compliance. The adoption of electronic health records (EHRs), telemedicine, and data analytics has brought about new challenges and opportunities. The protection of patient data, adherence to privacy regulations like the Health Insurance Portability and Accountability Act (HIPAA) in the United States, and the prevention of cyber threats have become paramount concerns. Healthcare organizations are now required to invest in robust cybersecurity measures and stay updated on rapidly changing technology regulations.

Key Changes in the History of Healthcare Compliance

The face of healthcare compliance has changed dramatically in the last 100-plus years:

  • Inception (Early 20th Century): Healthcare compliance began as a response to concerns about the quality of healthcare provided by medical practitioners. Licensing and credentialing were introduced to regulate healthcare professionals and ensure minimum standards of care.
  • Medicare and Medicaid (1960s): The introduction of government-funded healthcare programs brought about increased scrutiny and regulation. Compliance in healthcare began to encompass billing, fraud, and abuse prevention.
  • HIPAA (1996): The Health Insurance Portability and Accountability Act (HIPAA) established strict standards for patient data privacy and security. Compliance efforts shifted toward protecting patient information.
  • HITECH Act (2009): The Health Information Technology for Economic and Clinical Health (HITECH) Act incentivized the adoption of electronic health records (EHRs) and increased penalties for data breaches. Compliance efforts expanded to encompass EHR security.
  • Affordable Care Act (2010): The ACA introduced the concept of value-based care, emphasizing quality and patient outcomes over quantity of services. Compliance evolved to include performance reporting and quality metrics.
  • MACRA (2015): The Medicare Access and CHIP Reauthorization Act (MACRA) introduced the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs). Compliance now involves reporting quality data and participating in payment models that incentivize better care.
  • Digital Health (2020s): The proliferation of telemedicine, wearable devices, and health apps has raised new compliance challenges related to data security, patient consent, and remote care delivery.

Ensure Your Compliance Program Evolves With the Industry

Gone are the days of packed filing cabinets, spreadsheet tracking, and manual exclusions monitoring. Today’s compliance professionals are relying on software and its automation to complete tasks more efficiently. From requesting PSV documents to tracking compliance training and monitoring for exclusions, everything can now be done in one cloud-based compliance platform. If you’re ready to take your healthcare organization’s compliance to the next level, consider MedTrainer.


See how MedTrainer can streamline your compliance.