Getting to go in managed care

Wolford, G. Rodney; Brown, Montague; McCool, Barbara P.

doi:10.1097/00004010-199324000-00002

Cited by 4 publications

(1 citation statement)

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“…Urban hospitals have experienced demands from managed care for both high‐quality services at discounted fees and reductions in admissions and length of stay (Chernew 1995; Ginzberg 1995; Kralewski, Wingert, Feldman, et al. 1992; Wolford, Brown, and McCool 1993). Moreover, as managed care organizations (MCOs) have come to increasingly control a key hospital resource—namely patients—they have served to heighten the general level of competitiveness among urban hospitals (Feldman et al.…”

Section: Framework Of the Analysismentioning

confidence: 99%

Helpful or Harmful? The Impact of Strategic Change on the Performance of U.S. Urban Hospitals

2002

Health Services Research

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Objective. To contribute to the debate as to whether strategic change helps or harms organizations by empirically examining how strategic change in¯uences performance change in urban hospitals. . Study Design. This work employed a longitudinal approach using a panel design to study the effect of environmental and organizational characteristics on urban hospital strategic behavior and performance. A path analytic model was used to examine the simultaneous effects of environmental and organizational characteristics (1994) on strategic behavior (change in strategies to enhance HMO business and change in strategies to control costs 1994±96), as well as the effects of all of these variables on change in urban hospital performance (change in market share, change in operational ef®ciency, change in ®nancial performance 1994±96). Principal Findings. (1) Environmental context exerts a greater in¯uence on urban hospitals' HMO business enhancement strategies, whereas organizational characteristics have more in¯uence on cost-control strategies. (2) Between the two strategies, HMO business enhancement and cost control, strategic change to enhance business with HMOs is much more complex. (3) Strategic change observed across the 1994 to 1996 time period can be either helpful or harmful to urban hospitals. A strategic change that contributes positively to one type of performance can negatively impact the other. Conclusions. Although differences of opinion persist in the strategic change debate, results of this study indicate that strategic change can be helpful or harmful to urban hospitals, and its consequences are far more complex than previously thought. Strategic rationality has its own limitations and cannot always be relied on to yield expected results. Hospital strategic changes require coordination to achieve greater performance results.

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Section: Framework Of the Analysismentioning

confidence: 99%

Helpful or Harmful? The Impact of Strategic Change on the Performance of U.S. Urban Hospitals

2002

Health Services Research

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Carotid endarterectomy clinical pathway: a nursing perspective

Christensen

1997

Journal of Vascular Nursing

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Managed Care: Survival Skills for the Future

Braveman

Fisher

1997

Occupational Therapy In Health Care

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The last two decades have been a time of dramatic and consistent change in the way health care is delivered. The use of managed care strategies by health care providers impacts occupational therapy practitioners directly, yet they are often ill-prepared to respond to changes constructively. With adequate preparation, occupational therapy practitioners may not only respond to organizational change, but play a major role in helping to shape their organization's future. This article presents and defines the major managed care strategies being utilized by health care providers and their impacts on occupational therapy practitioners. The skills and strategies occupational therapy practitioners can use to effectively respond are presented and discussed. Suggested methods for gaining these skills are included. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: getinfo@haworth.com].

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Getting to go in managed care

Cited by 4 publications

References 0 publications

Helpful or Harmful? The Impact of Strategic Change on the Performance of U.S. Urban Hospitals

Helpful or Harmful? The Impact of Strategic Change on the Performance of U.S. Urban Hospitals

Carotid endarterectomy clinical pathway: a nursing perspective

Managed Care: Survival Skills for the Future

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