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The Effect of Hospital‐Physician Integration on Operational Performance: Evaluating Physician Employment for Cardiovascular Services
Author(s) -
Zepeda E. David,
Nyaga Gilbert N.,
Young Gary J.
Publication year - 2020
Publication title -
decision sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.238
H-Index - 108
eISSN - 1540-5915
pISSN - 0011-7315
DOI - 10.1111/deci.12401
Subject(s) - quality (philosophy) , business , payment , service (business) , core (optical fiber) , quality management , service quality , operations management , medicine , marketing , finance , computer science , economics , telecommunications , philosophy , epistemology
A dramatic change in the hospital industry is the increasing emphasis on linking provider payment to quality performance metrics. This is one of several considerations leading hospitals to employ physicians. Yet, there is little evidence regarding whether physician employment as a form of hospital‐physician integration leads to better operational performance. Using data from 201 California hospitals that experienced a total of 405,766 eligible opportunities to conform to external performance metrics ( conformance quality ) for treating patients in the cardiovascular service area, we empirically evaluated the relationship between physician employment and conformance quality . We also evaluated whether the presence of core capabilities in the hospital's cardiovascular service area complements or substitutes for physician employment . Findings suggest that physician employment is not only positively associated with conformance quality , but also associated with more consistent conformance quality . Moreover, the presence of core capabilities in the service area substitutes for physician employment . Theoretical, managerial, and policy implications are discussed.