Working from an institutional perspective, this study tested hypothese
s about the relationships between workplace characteristics and health
care cost containment practices. The analyses show that urban locatio
n of the workplace, number of employees, and education level of the wo
rkforce are related to three different cost containment strategies: th
e management of utilization with traditional indemnity insurance plans
; offering of alternative health insurance plans (HMOs); and employee
development relative to health care consumption. Workplaces with great
er proportions of black or female employees were less likely and those
with older workers were more likely to engage in employee development
practices. The race, gender, and age variables were not significantly
related to the other strategies. Unionization was not significantly r
elated to any of the three strategies in the multivariate model. These
findings are proposed to have implications for human resource managem
ent, as well as for health care policy and reform efforts.