Compliance Program Maturity Models

Richard P. Kusserow | September 2020

Care Is Needed when Applying Maturity Models to Health Care Compliance.

Maturity refers to the degree to which an organization’s processes have been formalized, implemented, and integrated into the business operations and culture of the organization. Maturity models were originally developed as organizational assessment tools, especially by the U.S.  Department of Defense in the early 1990s. They have been used in assessing the capacity of software contractors to deliver on projects. Since then, there has been a proliferation of maturity models in the energy and financial sectors, each describing different aspects of organizational capability.

They have now been introduced to the health care sector. These models normally follow a pattern describing a continuous progression where the first level has little or no capabilities while the highest level or stage of development represents a complete state of maturity. Each level is a measure of process maturity that the business must solve to have more predictable outcomes. The higher the maturity, the better the chances that incidents or errors will lead to improvements, either in the quality or in the use of the resources, of the discipline as implemented by the organization. They can provide benchmarks to use when assessing how a set of characteristics has evolved.

Reprinted from Journal of Health Care Compliance, Volume 22, Number 5, September–October 2020, pages 23–24, 61–62, with permission from CCH and Wolters Kluwer.

About the Author

Richard P. Kusserow established Strategic Management Services, LLC, after retiring from being the DHHS Inspector General, and has assisted over 3,000 health care organizations and entities in developing, implementing and assessing compliance programs.