Internal Structures of the Health Maintenance Organization and the Quality of Care

Abstract

This study investigates effects of HMO structural arrangements on performance, especially quality of care. The commonly used HMO types is assumed not effective in explaining performance differences. For the empirical test, I use bootstrap regression analyses with 36 HMOs. The results of the analyse show that decision-making participation and differentiation accompanied by coordination improve quality of care while formalization has a nonessential effect on quality of care. However, formalization and decision-making participation positively contribute to achieving coordination. The theoretical framework derived from the rational-contingency model of the formal organization better explains performance difference of HMOs than HMO types