Compliance and Risk Management: Two Roles, One Responsibility

A Strategic Alliance with Operational Impact

In many healthcare organizations, compliance and risk management are treated as adjacent departments—friendly colleagues, maybe, but not quite partners. They may share information, attend similar meetings, and occasionally collaborate on investigations. But their day-to-day work often runs on parallel tracks.

That separation might have made sense a decade ago. It doesn’t anymore.

Today’s regulatory landscape is too complex, and the consequences of noncompliance too serious, for these two disciplines to operate in silos. Compliance and risk management must function as strategic allies—each reinforcing the other in pursuit of a shared goal: protecting the organization from harm.

Compliance as a Risk Control

At its core, compliance is a risk mitigation tool.

An effective compliance program identifies, monitors, and addresses activities that expose the organization to legal, financial, or reputational harm. Whether it's billing errors, HIPAA breaches, Stark violations, or exclusion checks, compliance work is preventive by design.

A missed compliance obligation isn’t just a failed task—it’s a risk that moved from theoretical to real. And in many cases, it becomes a cost: civil monetary penalties, repayment demands, corrective action plans, even exclusion or litigation.

When risk management is looking for high-priority areas to watch, the compliance team has the data: audit results, investigation trends, training gaps, hotline reports. In many organizations, this is the most accurate early-warning system available.

Risk Management as Strategic Context

On the flip side, risk management provides essential context for compliance work.

While compliance often focuses on what went wrong and how to fix it, risk teams look at broader exposure—what the liability is, whether it’s insurable, and what the downstream impact may be. This perspective helps compliance professionals prioritize effectively.

If a HIPAA incident affects two patients and is caught early, compliance may close it quickly. But if risk identifies that the same vulnerability exists across a software platform used in multiple service lines, the issue takes on enterprise significance.

Shared visibility ensures that problems are not only resolved, but escalated appropriately.

From Events to Systems

Here’s where integration matters most: when organizations move beyond incident management and into risk governance.

Every time compliance investigates a documentation lapse or a policy breach, there’s an opportunity to identify a system-wide vulnerability. But if that information stays within the compliance team—or if risk teams are unaware of recurring issues—leaders lose the chance to act strategically.

In a mature program, compliance trends inform the risk register. Risk dashboards include compliance metrics. And quarterly risk reports don’t just mention audits—they incorporate them.

That kind of alignment is what boards, regulators, and investors increasingly expect to see.

Building a Joint Approach

Healthcare organizations don’t need to merge compliance and risk programs. But they do need to integrate them. Here are a few ways to start:

1. Include Compliance in Risk Committees

   If your organization has an enterprise risk management (ERM) framework, the compliance officer should have a seat at the table. This ensures that regulatory risks are considered alongside financial and operational ones.

   
   

2. Establish Shared Reporting Channels

   Create a process for elevating issues that have both compliance and risk implications. For example, documentation audits revealing repeated EMR access violations may warrant both a compliance investigation and a cybersecurity risk assessment.

   
   

3. Align Risk Assessments

   If both compliance and risk conduct assessments, align them. A coordinated annual risk assessment can reduce duplication, improve accuracy, and help leadership understand where priorities overlap.

   
   

4. Use Common Metrics

   Consider developing shared KPIs—like time-to-resolution for high-risk issues, rate of policy exceptions, or training completion rates for high-risk roles. These indicators can reflect both compliance program health and risk readiness.

The Cost of Separation

When compliance and risk teams don’t coordinate, consequences include:

• Missed escalation opportunities

• Redundant investigations

• Delayed corrective actions

• Inefficient reporting

• Gaps in governance visibility

More importantly, it becomes harder to answer the question every healthcare board should be asking: What are our biggest risks—and how are we addressing them?

One Mission, Two Lenses

Compliance and risk are not competing disciplines. They are complementary functions serving the same mission: protecting the organization, supporting ethical care, and sustaining public trust.

Want help aligning your compliance and risk management functions?Simply Compliance partners with healthcare organizations to build integrated oversight models that work—from board reporting to s

hared KPIs to joint risk assessments. Whether you’re starting from scratch or evolving a mature program, we can help.

Get in touch with Jessica Zeff @ Simply Compliance.