Adoption of regulatory compliance programmes across United States healthcare organizations: a view of institutional disobedience

The growing acceptance of evidence-based decision-support systems in healthcare organizations has resulted in recognition of information accuracy as a key area of organizational management. In the United States, rigid data mandates related to information management have met with some resistance from healthcare provider groups, who have traditionally found little relevance between personalized healthcare practice and accurate information. Variation in management practice poses quality problems in such an environment, since it precludes comparisons across larger markets or areas, a critical component of evidence-based quality assessments. In this study, a national census of health information managers was employed to provide a benchmark of the degree of such variation, examining how proper billing compliance practices vary across organization types as well as market area indicators. Findings here suggest that managers continue to ignore, to some extent, regulatory compliance standards, despite nationwide laws that mandate adoption of uniform compliance practices and programmes. The level of adoption of compliance management in this study varied significantly across practice characteristics and areas, suggesting the existence of barriers to cross-market comparative performance assessment.