Journal of Health Care Management--May/June 1998
In this article we examine management service organizations (MSOs),
physician-hospital organizations (PHOs), hospital-affiliated independent
practice associations (IPAs), and hospital-sponsored "group practices without
walls" (GPWWs) that allow physicians to retain their practices and link
hospitals and health systems to physicians through contractual arrangements.
Also examined were medical foundations (MFs), integrated salary models (ISMs),
and integrated health organizations (IHOs) that own the physical assets of
physician practices and contract with payors for physician and hospital
services. The research provides several new insights for understanding the
structure and process of physician-hospital integration. It was found that the
extent of processual integration in physician-hospital organizational
arrangements can be measured along six dimensions: administrative and practice
management services; physician financial risk-sharing; joint ventures to create
new services; computer linkages; physician involvement in strategic planning;
and salaried physician arrangements. These dimensions are consistent with the
conceptual and empirical dimensions developed by others. These findings refute
the notion raised by some industry observers that the new physician-hospital
organizational models simply formalize integrative activities already in place.
Earlier studies from the 1980s reported that hospitals integrated physicians
through involvement in governance, capital planning, and the provision of
practice management services. In contrast, we found that current
integration.