Factors that are Predictors of Continuance in a Managed Care Organization at a Regional Health Care Facility in Connecticut

Date of Submission


Document Type


Degree Name

Doctor of Science in Management Systems (Sc.D.)




Judith A. Neal

Committee Member

Gordon R. Simerson

Committee Member

Michael Morris

LC Subject Headings

Hospital--physician joint ventures--Connecticut, Managed care plans (Medical care)--Connecticut

Call No. at the Univ. of New Haven Library

AS 36 N290 Mgmt. Syst. 2004 no.2


This was an empirical study of the physician members of a functioning Physician-Hospital Organization (PHO) at a regional health care institution in Connecticut where the writer had participated as a non-physician. The study's purpose was to provide suggestions to the institution's managers on how to reduce the high failure rate of PHOs caused by the loss of physician support. The study identified factors that correlated with physician support expressed as higher levels of PHO commitment.

The experimental method consisted of the creation of a questionnaire package for administration to physician PHO members based on: (1) empirical studies of organizational commitment and organizational culture presented in the literature review, and (2) a qualitative exploration of the opinions of key physician members in an interview process. Twenty-one hypotheses emerged from the methodology, nine were supported statistically.

The major factors important to the physician members that correlated with PHO support were the: (1) importance of influence and control over the physician/patient relationship, (2) importance of having a local physician as Medical Director, (3) satisfaction with the PHO reimbursement (fee) schedule, and (4) satisfaction with the representation of the physician members of the PHO Board.

The application of these findings to management of the institution is that sustained physician commitment to the PHO depended on: (1) addressing the improvements in the managed care process of major concern to the physician members of the PHO, (2) maintaining continuous two-way communication with the physician membership so that the issues can be identified, and (3) continuing to address physician member concerns.

Limitations of the study, implications for researchers, suggestions for future research, and an epilogue were presented.