Online Program
Session Type: Paper Session
Program Session: 1755 | Submission: 20750 | Sponsor(s): (HCM)
Scheduled: Tuesday, Aug 13 2019 9:45AM - 11:15AM at Sheraton Boston Hotel in Beacon F
 
Integration and Differentiation in Hospital and Healthcare Networks
Integration and Differentiation
Research

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Chair: Lingrui Liu, yale school of public health
HCM: Who Joins The New Franchise Model Of Hospital Networks? Identifying Predictors Of Network Membership
Author: Bonnie Jin, Yale U.
Forming networks and alliances is a common strategy for hospital administrators to consider and pursue during resource scarce or uncertain times following major policy changes. Yet surprisingly little is known about who and what types of hospitals join these non-ownership derived networks, due in part to the challenges of identifying and following networks over time. One novel network form that has emerged in recent years, and has made such identification feasible, are franchise-like “affiliation networks” in which affiliate hospitals pay an annual network membership fee that allows them to access the clinical expertise and resources of a sponsor hospital. Sponsor hospitals are high-status organizations that are nationally-ranked for their quality of care. I hypothesized that improving clinical quality and gaining market advantage would motivate joining these networks. Using longitudinal hospital and market data, I find that hospitals that serve more complex patients and do not have the resources to treat such patients are more likely to seek out external expertise by joining a network. Joining affiliation networks does not appear to be a competitive strategy to pursue because hospitals in less competitive environments are more likely to join.
Paper is No Longer Available Online: Please contact the author(s).
HCM: Strategic Management in Local Hospital Markets: Service Duplication or Service Differentiation
Author: Hanh Q. Trinh, U. of Wisconsin, Milwaukee
The study assesses the influence of market structure on hospitals’ strategic decisions to duplicate or differentiate services in local hospital markets. The study also assesses the effects of duplication and differentiation on hospital performance. We use Linear Structural Equations to simultaneously estimate the relationships among market structure, duplicated and differentiated services, and performance. All hospitals in urban counties in the United States with more than one hospital are included in the sample (n=1,726). Forty-two high-tech services are selected for the study. Power asymmetry between hospitals has effects on both duplication and differentiation, while geographic distance and market competition have effects only on service duplication. Population density, specialist physicians and managed care influence hospitals to differentiate more and duplicate less services, but community munificence induces hospitals to differentiate less and duplicate more. Both strategic activities reduce market share, raise cost, and slash profits. The findings underscore the role of market structure as a check and balance in the provision of high-tech services. Hospital management should consider cutting back some services that are oversupplied and/or unprofitable and analyze the supply and demand in the market to avoid overdoing both service duplication and service differentiation. Keywords: Hospital services, service duplication, service differentiation
Paper is No Longer Available Online: Please contact the author(s).
HCM: An Integrative Perspective on Multilevel Healthcare Networks
Author: Galina Van Der Weert, Radboud U. Nijmegen
Author: Katarzyna Burzynska, Radboud U. Nijmegen
Author: Mark Van Houdenhoven, Radboud U. Nijmegen
Author: Joris Knoben, Radboud U. Nijmegen
Organizations in health care increasingly collaborate in multilevel networks to overcome the increasing complexity in health care delivery. However, these networks do not always obtain the goal or result they primarily intended to. Given their importance for network performance, the structure and governance of these networks might explain why network goals are (not) met. Our point of departure is a systematic literature review in which we investigate how network structure and governance relate to each other and to network performance. Results show that researchers in business/management approach networks with different perspectives than researchers in healthcare. Business/management researchers focus on how to manage networks and network activities, while healthcare researchers focus on how to improve quality of care or a patient’s experience. Moreover, despite the fact that collaboration in healthcare happens at multiple levels, how governance and structure appear in multilevel networks is rarely addressed. Building on this literature review we develop a new perspective that integrates insights from business/management and healthcare literature. Bringing the knowledge within the two fields together, will help health care organizations to design their networks optimally to obtain collective goals: invest in tie strength, install a leading organization that has decision authority, ensure a steady flow of resources and attend to individual organization’s needs.
Paper is No Longer Available Online: Please contact the author(s).
HCM: Effects of Affiliation Network Membership on Financial and Quality Performance
Author: Bonnie Jin, Yale U.
Hospitals are increasingly joining inter-organizational partnerships such as strategic alliances and collaborations to improve quality and financial performance. However, researchers have not examined whether joining these networks positively affects performance due in part to challenges in tracking network membership over time. Affiliation networks, a new franchise-like form which has made identification possible, have the potential to enhance performance by allowing affiliates access to the clinical expertise and resources of a high-status and high-quality sponsor organization in exchange for an annual fee. I used a quasi-experimental design to examine how hospital membership in an affiliation network affects clinical and financial performance for affiliates and their competitors between 2005 and 2016. I find that joining an affiliation network appears to have mixed effects on performance for affiliates and competitors. Financial performance improves for both groups, however, clinical quality improves only among the competitors once an affiliation network enters their market. Joining an affiliation network does not have a significant effect on clinical quality for affiliates despite these networks' heavy emphasis on quality improvement for members.
Paper is No Longer Available Online: Please contact the author(s).
  
KEY TO SYMBOLS Teaching-oriented Teaching-oriented   Practice-oriented Practice-oriented   International-oriented International-oriented   Theme-oriented Theme-oriented   Research-oriented Research-oriented   Teaching-oriented Diversity-oriented
Selected as a Best Paper Selected as a Best Paper