Physician-Hospital Integration Strategies: Impact on Physician Involvement in Hospital Governance

Abstract

This study investigated the impact of three physician-hospital contractual arrangements (PHCAs)--joint ventures, management service organizations, and not-for-profit foundations--on physician involvement in hospital governance and physician-hospital relationships. Analysis of data collected from a national sample of 1,013 hospitals revealed that PHCAs generate greater physician involvement in hospital decision making and result in lower physician-hospital conflict.

Physician Involvement in Setting Priorities for Health Regions

“…Although many authors have emphasized the importance of including physicians in organizational activities, especially in integrated delivery systems, 19 much of the literature has focused on physician involvement in governance 20,21 or as managers. 3,4 In this paper, PBMA is suggested as a mechanism to link physicians into organizational decisionmaking processes.…”

Organization, Society and Politics

“…It is perhaps surprising then that the way corporate governance is understood is so readily comparable across both sectors; where outcomes are governed by the interplay between individual agents' choices, systems of private contracts and a regulatory backdrop of constraints and impositions (Mayers, Shivdasani and Smith, 1997). In US healthcare for instance, 'governance' is often reduced to analyses of the structure of governing boards of hospitals, and particularly the influence and representation of clinical groups (Kocher, Kumar and Subramanian, 1998;Lister and Herzog, 2000;Saleh et al, 2002). This has been paralleled to some extent in the focus for healthcare reform in the United Kingdom, with the creation of new organizational forms in the NHS and systems of incentives.…”

Governance and the Public Good

“…It is perhaps surprising then that the way corporate governance is understood is so readily comparable across both sectors, where outcomes are governed by the interplay between individual agents’ choices, systems of private contracts, and a regulatory backdrop of constraints and impositions (Mayers et al 1997). In the field of US healthcare, for instance, ‘governance’ is often reduced to analyses of the structure of governing boards of hospitals, and particularly the influence and representation of clinical groups (Kocher et al 1998; Lister and Herzog 2000; Saleh et al 2002). This has been paralleled to some extent in the focus for healthcare reform in the UK, with the creation of new organizational forms and systems of incentives.…”