ORGANIZATIONAL APPROACHES TO INTEGRATED HEALTH-CARE-DELIVERY - A TAXONOMIC ANALYSIS OF PHYSICIAN ORGANIZATION ARRANGEMENTS

Integrated health care organizations depend fundamentally on bringing organizations and physicians into closer alignment. Little empirical r esearch has been conducted on the organizational mechanisms by which s uch alignment is attempted. This study employed primary data from 79 h ospitals and health care systems to identify current approaches to ali gning the strategic and economic interests of organizations and physic ians. An empirical classification of both unbundled and structured phy sician-organization arrangements (POAs) resulted in 5 distinct strateg ic configurations. These configurations were differentiated by key con textual factors that shape patterns of development and operation of PO As. Particularly salient among these were managed care penetration, or ganization size, locus of control, and organization strategy Results o f the taxonomic analysis underscore the facts that most delivery organ izations employ multifaceted rather than single approaches to physicia n integration and that these approaches are endemic to particular envi ronmental and organizations conditions.