Continuous learning is essential for healthcare compliance professionals navigating constant regulatory updates, operational changes, and emerging risks. In this episode of Compliance Deconstructed, hosts Jessica Zeff, Lorie Davis, and Elvan Baker explore why ongoing professional development is critical to staying effective, confident, and compliant in a rapidly evolving healthcare industry.

This in-depth discussion highlights how professional development goes beyond certifications and formal training to include practical, day-to-day learning opportunities. From mastering new technologies to sharpening problem-solving skills, continuous learning helps compliance professionals remain relevant and prepared for audits, investigations, and organizational change.

You will also hear how networking, peer collaboration, and industry engagement play a vital role in compliance education. Conferences, association meetings, and professional communities create space for shared experiences, innovative solutions, and real-world insights that cannot be found in policy manuals alone.

Finally, this info-packed episode emphasizes the value of mentorship, coaching, and embracing new challenges within compliance roles. By stepping outside comfort zones, seeking guidance from experienced professionals, and reflecting on lessons learned, compliance leaders can strengthen their skill sets and build resilient, future-ready careers.

Key Takeaways

• Continuous learning is critical to staying current in healthcare compliance amid regulatory and industry changes
• Professional development extends beyond certifications to hands-on experiences and skill-building
• Networking with peers offers practical insights and real-world compliance solutions
• Taking on new challenges accelerates growth in leadership, communication, and risk management
• Mentorship and coaching can fast-track professional and compliance expertise
• Viewing learning as an investment—not a burden—leads to long-term career success

Learn more about Healthcare Compliance and discover how Simply Compliance can help your company at simplycomplianceconsulting.com.

Medicaid audits play a critical role in ensuring healthcare organizations meet compliance, quality, and contractual requirements, and this episode of Compliance Deconstructed breaks down what providers and health plans need to know. Hosts Jessica Zeff, Lorie Davis, and Elvan Baker explore how ECRO and ISCA audits function within Medicaid programs and why understanding them is essential for operational success.

Throughout this in-depth conversation, your hosts explain that ECRO audits, conducted by External Quality Review Organizations, focus on evaluating the quality of care, member services, and adherence to state and federal Medicaid standards.

ISCA audits concentrate on internal systems capability, including data integrity, IT security, and the reliability of systems used to manage Medicaid services and member information.

You will learn that Medicaid audit processes vary by state, with some states conducting comprehensive annual reviews and others using staggered or rotating audit schedules. Lorie, Jessica, and Elvan emphasize the importance of knowing state-specific requirements and timelines to ensure audit readiness and avoid compliance gaps.

The conversation also highlights the importance of contracts, protocols, and staff preparation in successful audit outcomes. By understanding contractual obligations, educating staff on their roles, and practicing audit readiness through mock interviews and data reviews, organizations can approach ECRO and ISCA audits with greater confidence and clarity.

Key Takeaways

• ECRO audits evaluate quality of care, member services, and compliance with Medicaid requirements.
• ISCA audits assess the security, accuracy, and capability of internal data and IT systems.
• Medicaid audit structures and timelines vary by state and require careful review.
• State contracts define the standards and protocols used during ECRO and ISCA audits.
• Staff education and role clarity are essential for accurate and effective audit responses.
• Proactive preparation, including mock audits and data reviews, supports stronger compliance outcomes.

Learn more about Healthcare Compliance and discover how Simply Compliance can help your company at simplycomplianceconsulting.com.

In this episode of Compliance Deconstructed, hosts Jessica Zeff, Lorie Davis, and Elvan Baker unpack why whistleblowing remains a critical pillar of effective healthcare compliance programs. They explore how speaking up about concerns - whether ethical, operational, or regulatory - helps healthcare organizations identify risks early and protect patients, staff, and reputation.

This in-depth discussion reframes whistleblowing as a proactive compliance tool rather than an act of disloyalty, especially within highly regulated healthcare environments. The hosts explain how fostering transparency and psychological safety strengthens compliance culture and supports long-term organizational integrity.

Jessica, Lorie, and Elvan also examine the tension between perceived loyalty and truth-telling in healthcare workplaces. They highlight how leadership attitudes and “all-or-nothing” cultures can unintentionally discourage reporting and increase compliance and regulatory risk.

This episode concludes with practical guidance for building safe, trusted reporting systems in healthcare organizations. From non-retaliation policies to multiple reporting channels, you’ll get an outline of actionable steps compliance leaders can take to encourage employees to raise concerns before small issues become systemic failures.

Key Takeaways

• Whistleblowing is about raising concerns in good faith to improve healthcare compliance and patient safety.
• A strong speak-up culture helps healthcare organizations detect risks early and prevent regulatory violations.
• Loyalty to an organization includes being willing to question processes and highlight compliance gaps.
• Fear of retaliation is a major barrier to reporting concerns and must be addressed through policy and practice.
• Multiple, well-communicated reporting channels increase trust and reporting effectiveness.
• Healthcare leaders play a critical role in modeling transparency and encouraging ethical accountability.

Learn more about Healthcare Compliance and discover how Simply Compliance can help your company at simplycomplianceconsulting.com.