This article describes the extent to which hospitals use different integrative processes to assimilate physicians and assesses the extent to which their use is associated with managed care penetration and hospital characteristics. Results from a national survey of 1,495 community hospitals indicate that these integrative processes are quite prevalent. The use of integrative processes tends to be more prevalent in hospitals that are large, urban, involved in teaching, and members of hospital systems. Use of particular integrative processes also appears to be associated with different thresholds of managed care penetration.
Lawton R. Burns, Ph.D., M.B.A., is Professor, Department of Health Care Systems, The Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania.
Michael A. Morrisey, Ph.D., is Professor and Director, Lister Hill Center for Health Policy, School of Public Health, University of Alabama at Birmingham.
Jeffrey A. Alexander, Ph.D., is Richard C. Jelinek Professor of Health Management and Policy, Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan.
Victoria Johnson, Ph.D., is Senior Project Manager, Lister Hill Center for Health Policy, School of Public Health, University of Alabama at Birmingham.
This project was funded by grant HS09183 from the Agency for Health Care Policy & Research. We wish to thank the Prospective Payment Assessment Commission (ProPAC) for access to the data used here. However, the analysis presented is the authors' and does not necessarily reflect the opinions or position of ProPAC.