The CY2027 Through Line Series: Compliance is now a Competitive Advantage

Welcome back to the Healthcare STARcast! In this episode, we dive deep into the ever-evolving landscape of Medicare Advantage compliance and population health management. Host Subbu Ramalingam sits down with industry expert Regan Pennypacker, Senior Vice President of Compliance at ATTAC Consulting Group, to unpack the heightened regulatory environment, the impact of new and upcoming compliance rules, and the practical strategies that drive organizational performance and member outcomes.Together, Regan and Subbu discuss key friction points between compliance and operational teams, best practices for breaking down organizational silos, and the increasing importance of innovation, even in compliance. You’ll hear firsthand about the unique challenges and opportunities presented by special needs plans, the expansion of AI in healthcare, and how forward-thinking leaders can proactively prepare for future CMS rules without waiting for final confirmations.Whether you’re a compliance leader, a plan operations executive, or simply curious about the interplay between regulation and real-world care delivery, this conversation offers actionable insights and inspiration for navigating today’s complex healthcare landscape.Timestamps:00:00 Improving compliance training strategies06:01 Evolving role of compliance07:55 Starting in Medicare compliance12:50 Industry collaboration and CMS feedback16:34 Monitoring clinical decision making17:23 Updating prior authorization guidelines22:19 Navigating compliance and risk adjustment25:28 Risk adjustment and compliance roles30:08 Effective compliance training tips32:40 Reviewing public comments to CMS35:14 CMS and wellness guidance trends38:10 Adapting to CMS guidelines44:14 Addressing transportation barriers47:35 Helping organizations with compliance challenges50:13 Supporting FDRs and ACO compliance52:48 Leadership style and innovation55:32 AI governance and ethical adoptionShow Website - https://healthcarestarcast.com/Subbu Ramalingam - Show Host - Linkedin - https://www.linkedin.com/in/subburamalingam/FloWise Leadership - https://flowiseleadership.com/ViVega Business Services - https://www.vivega.co/ATTAC Consulting Group - https://www.attacconsulting.com/Media Partner - TopHealth - https://tophealth.care/“Disclaimer: Informational only. Not medical advice. Consult your doctor for guidance.”