Enterprise Risk Management for Health Care, Co-published with the American Society of Healthcare Risk Management (AHLA Members)
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Health care organizations, from physician groups to large complex health systems, are operating in an environment of conflicting regulatory imperatives, shortages of critical staff, changing technology, and evolving business conditions. With limited resources, leaders and staff struggle to establish priorities among competing needs and to improve strategic planning, budgeting, and resource allocation. Enterprise Risk Management (ERM), a discipline adapted from the financial services industry, provides an analytical and philosophical framework for identifying, assessing, and strategically addressing risks and opportunities.
This Fourth Edition of Enterprise Risk Management for Health Care was entirely redesigned by members of the American Health Law Association and the American Society for Healthcare Risk Management to provide guidance for leaders and advisors of health care organizations at any point along the ERM journey. With the benefit of lessons from sound ERM programs in other industries, the authors closely focus on issues unique to health care organizations, examining applications of ERM in this challenging context, with consideration of legal implications present across the full range of health care risk domains.
This new edition is of value to health care risk professionals, attorneys, strategic planners, internal auditors, human resources and finance managers, and others, whether they drive change from within an organization or as outside advisors. This Fourth Edition of Enterprise Risk Management for Health Care serves as both primer and a comprehensive guide for a variety of audiences.
EDITORS: David N. Crapo, Faisal Khan, Sheila Hagg-Rickert, Faye Dance Sheppard
AUTHORS: Carolyn Bailey, Carolyn Bergkvist, Susan Boisvert, Cynthia Borelli, Liza R. Brooks, Justin K. Brown, Rebecca F. Cady, Bethany Corbin, Jeffrey F. Driver, Doris Fischer-Sanchez, Christopher J. "CJ" Frisina, Keevana Glossin, Michelle Hackley, Sheila Hagg-Rickert, Diana Hamer, Anne Huben-Kearney, Susan R. Huntington, Gabriel L. Imperato, Mark A. Kadzielski, Teresa M. Kielhorn, Jason J. Krisza, Deborah Lessard, Melissa L. Markey, William J. McDonough, Caulin McGraw, Ryan D. Meade, Michael J. Morris, John P. Murdoch II, Roseanna Murray, Melinda Oliver, Stephen Pavkovic, Richard S. “Rick” Porter, Montrece Ransom, Alyssa Riggins, Phoebe Roth, Michael F. Schaff, Jenna N. Scott, Faye Dance Sheppard, Brian A. Smith, Nicole A. Strombom, David Vogt, Moira Wertheimer, Brendan E. Williams
The 3rd Edition ISBN was 9781522126355.
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Published March, 2024.
Table of contents
Overview: Introduction to Enterprise Risk Management
DOMAIN I OPERATIONAL RISK
Chapter 1 The Role of Governance in Managing Organizational Risk
Chapter 2 An Enterprise Risk Management Approach to Contracting
Chapter 3 Managing Supply Chain Risks: An Enterprise Risk Approach
Chapter 4 Peer Review and Credentialing in an Era of Enterprise Risk Management
Chapter 5 Reducing Enterprise Risk Through Diversity, Equity, and Inclusion
DOMAIN II CLINICAL AND PATIENT SAFETY RISK
Chapter 6 Enterprise Risk Management Considerations Regarding Individual Rights
Chapter 7 Patient Rights: Informed Consent and Clinical Research
Chapter 8 Public Health, Infection Prevention and Control, and the Law: Exploring Enterprise Risk Management
Chapter 9 The Risk Management Benefits of Incorporating ERM Approaches into Health Care Investigations
DOMAIN III STRATEGIC RISK
Chapter 10 Risks Related to Emerging Health Care Delivery Models
Chapter 11 Using Enterprise Risk Management-Based Frameworks to Advance Population Health
DOMAIN IV FINANCIAL RISK
Chapter 12 Managing Risks Related to Federal Reimbursement
Chapter 13 Health Insurers' Enterprise Risk Management Techniques
Chapter 14 Private Equity Investment in Health Care Enterprises
Chapter 15 Captive Insurance Company as an ERM Driver
DOMAIN V HUMAN CAPITAL RISK
Chapter 16 The Employment Relationship: Identifying and Managing Risks
DOMAIN VI LEGAL AND REGULATORY RISK
Chapter 17 Managing Fraud and Abuse Risks Through an Effective Compliance Program
DOMAIN VII TECHNOLOGY RISK
Chapter 18 Enterprise Risk Management Considerations for Electronic Health Records, Personal Health Records, and Health Information Exchanges
Chapter 19 Cybersecurity Risks for Health Care Enterprises
Chapter 20 Managing the Risks of Telehealth Practice
DOMAIN VIII HAZARD RISK
Chapter 21 Environmental Risk Management
Conclusion: Enterprise Risk Management Across the Health Care Domains
Index