Assessing the Impact of Interorganizational Linkages on Medical Home Model Adoption by U.S. Acute Care Hospitals

Abstract

The medical home model aims to increase care coordination and health care quality. While the adoption of the model has been increasing, the role of U.S. acute care hospitals’ interorganizational linkages on adoption is yet to be explored. Using a national sample of hospitals throughout the United States, we examined what interorganizational linkage features are associated with medical home adoption of hospital-owned physician practices and assess the pattern of adoption by acute care hospitals between 2011 and 2019. A generalized estimating equation with binomial distribution was utilized to assess the association between interorganizational linkages and medical home adoption. Hospitals with structural linkages and institutional linkages were more likely to have adopted the medical home. Moreover, the likelihood of medical home adoption increased relative to an increasing number of interorganizational linkages. Medical home adoption and dissemination efforts may be more effective when focused on hospitals possessing interorganizational linkages, specifically those with structural linkages.

Keywords

medical home adoption interorganizational linkages acute care hospitals

Get full access to this article

View all access options for this article.

References

Agency for Healthcare Research and Quality. (n.d.). Defining the PCMH. https://pcmh.ahrq.gov/page/defining-pcmh

Alexander

J. A.

Morrisey

M. A.

(1989). A resource-dependence model of hospital contract management. Health Services Research, 24(2), 259–284.

American Hospital Association. (2019). American Hospital Association annual survey.

Baker

L. C.

Bundorf

M. K.

Devlin

A. M.

Kessler

D. P.

(2018). Hospital ownership of physicians: Hospital versus physician perspectives. Medical Care Research and Review, 75(1), 88–99.

Barringer

B. R.

Harrison

J. S.

(2000). Walking a tightrope: Creating value through interorganizational relationships. Journal of Management, 26(3), 367–403.

Beauvais

Richter

Fulton

(2016). Moving the needle: Evaluating the impact of new care delivery models on hospital profitability. Journal of Health Care Finance, 43(2), 91.

Bentley

(2016). Rates of hospital acquisition of physician practices have accelerated dramatically in rural areas. https://avalere.com/insights/rates-of-hospital-acquisition-of-physician-practices-have-accelerated-dramatically-in-rural-areas

Birk

(2020). Rural hospital finances hit hard by looming threat of COVID-19 as leaders scramble to preserve cash. Healthcare Financial Management, 74(5), 14–15. https://login.ezproxy3.lhl.uab.edu/login?url=https://www.proquest.com/trade-journals/rural-hospital-finances-hit-hard-looming-threat/docview/2397837411/se-2?accountid=8240; https://uab.primo.exlibrisgroup.com/openurl/01UALB/UAB_Libraries?genre=article&atitle=Rural+hospital+finances+hit+hard+by+looming+threat+of+COVID-19+as+leaders+scramble+to+preserve+cash&author=Birk%2C+Susan&volume=74&issue=5&spage=14&date=2020&rft.btitle=&rft.jtitle=Healthcare+Financial+Management&issn=0735-0732&isbn=&sid=ProQ%3Aabiglobal_

Boschma

(2005). Role of proximity in interaction and performance: Conceptual and empirical challenges. Regional Studies, 39(1), 41–45.

10.

Burke

Wang

Wan

T. T.

Diana

(2002). Exploring hospitals’ adoption of information technology. Journal of Medical Systems, 26(4), 349–355.

11.

Burns

L. R.

McCullough

J. S.

Wholey

D. R.

Kruse

Kralovec

Muller

(2015). Is the system really the solution? Operating costs in hospital systems. Medical Care Research and Review, 72(3), 247–272.

12.

Capps

Dranove

Ody

(2018). The effect of hospital acquisitions of physician practices on prices and spending. Journal of Health Economics, 59, 139–152.

13.

Carroll

N. W.

Smith

D. G.

Wheeler

J. R.

(2020). The cost of capital, leverage, and system membership: Does system membership help hospitals achieve optimal leverage? In Hefner

J. L.

Al-Amin

Huerta

T. R.

Aldrich

A. M.

Griesenbrock

T. E.

(Eds.), Transforming health care (pp. 61–74). Emerald.

14.

Centers for Medicare & Medicaid Services. (2016). Medicare Program; Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) incentive under the physician fee schedule, and criteria for physician-focused payment models. Final rule with comment period. Federal Register, 81(214), 77008–77831.

15.

Centers for Medicare & Medicaid Services. (2021). Comprehensive primary care initiative. https://innovation.cms.gov/innovation-models/comprehensive-primary-care-initiative

16.

Cramer

G. R.

Singh

S. R.

Flaherty

Young

G. J.

(2017). The progress of US hospitals in addressing community health needs. American Journal of Public Health, 107(2), 255–261.

17.

Deeds

D. L.

Hill

C. W.

(1996). Strategic alliances and the rate of new product development: An empirical study of entrepreneurial biotechnology firms. Journal of Business Venturing, 11(1), 41–55.

18.

DiMaggio

P. J.

Powell

W. W.

(1983). The iron cage revisited: Institutional isomorphism and collective rationality in organizational fields. American Sociological Review, 48(2), 147–160.

19.

Dyer

J. H.

Singh

(1998). The relational view: Cooperative strategy and sources of interorganizational competitive advantage. Academy of Management Review, 23(4), 660–679.

20.

Edwards

S. T.

Bitton

Hong

Landon

B. E.

(2014). Patient-centered medical home initiatives expanded in 2009–13: Providers, patients, and payment incentives increased. Health Affairs, 33(10), 1823–1831.

21.

Fottler

M. D.

Schermerhorn

J. R.

Jr Wong

Money

W. H.

(1982). Multi-institutional arrangements in health care: Review, analysis, and a proposal for future research. Academy of Management Review, 7(1), 67–79.

22.

Fennell

M. L.

(1980). The effects of environmental characteristics on the structure of hospital clusters. Administrative Science Quarterly, 25(3), 485–510.

23.

Funk

R. J.

(2014). Making the most of where you are: Geography, networks, and innovation in organizations. Academy of Management Journal, 57(1), 193–222.

24.

Galaskiewicz

(1985). Interorganizational relations. Annual Review of Sociology, 281–304.

25.

Galaskiewicz

Wasserman

(1989). Mimetic processes within an interorganizational field: An empirical test. Administrative Science Quarterly, 34(3), 454–479.

26.

Gill

J. M.

(2018). Will consolidation of primary care into hospital systems spell doom for the patient-centered medical home and the US health care system? Family Medicine, 50(3), 176–178. https://doi.org/10.22454/FamMed.2018.989867

27.

Goes

J. B.

Park

S. H.

(1997). Interorganizational links and innovation: The case of hospital services. Academy of Management Journal, 40(3), 673–696.

28.

Gounaris

Koritos

C. D.

(2012). Adoption of technologically based innovations: The neglected role of bounded rationality. Journal of Product Innovation Management, 29(5), 821–838.

29.

Hamel

(1991). Competition for competence and interpartner learning within international strategic alliances. Strategic Management Journal, 12(S1), 83–103.

30.

Health Resources & Services Administration. (2018). HRSA accreditation and patient-centered medical home recognition initiative. https://bphc.hrsa.gov/qualityimprovement/clinicalquality/accreditation-pcmh/index.html

31.

Health Resources & Services Administration. (2021). Patient-centered medical home resources: Comparison chart. https://bphc.hrsa.gov/qualityimprovement/clinicalquality/accreditation-pcmh/selection/patient-centered-medical-home-resources-comparison-chart

32.

Hearld

Alexander

J. A.

Wolf

L. J.

Shi

(2019). Dissemination of quality improvement innovations by multisector health care alliances. Journal of Health Organization and Management, 33(4), 511–528.

33.

Henry

T. A.

(2019). Employed physicians now exceed those who own their practices. JAMA. https://www.ama-assn.org/about/research/employed-physicians-now-exceed-those-who-own-their-practices#:~:text=Chances%20are%20now%20slightly%20more,Research%20Perspectives%20(PRP)%20series.

34.

Metcalfe

Short

Morrow

(2020). Annual spending per patient and quality in hospital-owned versus physician-owned organizations: An observational study. Journal of General Internal Medicine, 35(3), 649–655.

35.

Jackson

G. L.

Powers

B. J.

Chatterjee

Bettger

J. P.

Kemper

A. R.

Hasselblad

Dolor

R. J.

Irvine

R. J.

Heidenfelder

B. L.

Kendrick

A. S.

Gray

Williams

J. W.

(2013). The patient-centered medical home: A systematic review. Annals of Internal Medicine, 158(3), 169–178.

36.

Jensen

Roy

(2008). Staging exchange partner choices: When do status and reputation matter? Academy of Management Journal, 51(3), 495–516.

37.

The Joint Commission. (n.d.-a). Joint Commission accredited organizations with primary care medical home (PCMH) certification.

38.

The Joint Commission. (n.d.-b). Primary care medical home certification program. https://www.jointcommission.org/accreditation-and-certification/certification/certifications-by-setting/hospital-certifications/primary-care-medical-home-certification/

39.

Kimberly

J. R.

Evanisko

M. J.

(1981). Organizational innovation: The influence of individual, organizational, and contextual factors on hospital adoption of technological and administrative innovations. Academy of Management Journal, 24(4), 689–713.

40.

Kogut

(1988). Joint ventures: Theoretical and empirical perspectives. Strategic Management Journal, 9(4), 319–332.

41.

Kruse

C. S.

Kothman

Anerobi

Abanaka

(2016). Adoption factors of the electronic health record: A systematic review. JMIR Medical Informatics, 4(2), e19. https://doi.org/10.2196/medinform.5525

42.

Marsteller

J. A.

Hsu

Y.-J.

Gill

Kiptanui

Fakeye

O. A.

Engineer

L. D.

Perlmutter

Khanna

Rattinger

G. B.

Nichols

Harris

(2018). Maryland multipayor patient-centered medical home program: A 4-year quasiexperimental evaluation of quality, utilization, patient satisfaction, and provider perceptions. Medical Care, 56(4), 308.

43.

Mathematica Policy Research. (2018). Evaluation of the comprehensive primary care initiative. https://downloads.cms.gov/files/cmmi/CPC-initiative-fourth-annual-report.pdf

44.

McCullough

J. S.

(2008). The adoption of hospital information systems. Health Economics, 17(5), 649–664.

45.

Mohr

R. A.

(1992). An institutional perspective on rational myths and organizational change in health care. Medical Care Review, 49(2), 233–255.

46.

National Committee for Quality Assurance. (n.d.). Patient-centered medical home (PCMH). https://www.ncqa.org/programs/health-care-providers-practices/patient-centered-medical-home-pcmh/

47.

Nelson

K. L.

(2012). Municipal choices during a recession: Bounded rationality and innovation. State and Local Government Review, 44(1 Suppl.), 44S–63S.

48.

Palumbo

Manna

(2018). Innovation at the crossroads: An investigation of the link between inter-organizational relationships and innovation. International Journal of Organizational Analysis, 26, 432–449.

49.

Pennel

C. L.

McLeroy

K. R.

Burdine

J. N.

Matarrita-Cascante

Wang

(2016). Community health needs assessment: Potential for population health improvement. Population Health Management, 19(3), 178–186.

50.

Pesko

M. F.

Ryan

A. M.

Shortell

S. M.

Copeland

K. R.

Ramsay

P. P.

Sun

Mendelsohn

J. L.

Rittenhouse

D. R.

Casalino

L. P.

(2018). Spending per Medicare beneficiary is higher in hospital-owned small- and medium-sized physician practices. Health Services Research, 53(4), 2133–146.

51.

Ponds

Van Oort

Frenken

(2007). The geographical and institutional proximity of research collaboration. Papers in Regional Science, 86(3), 423–443.

52.

Robert Wood Johnson Foundation. (n.d.). About the county health rankings & roadmaps. http://www.countyhealthrankings.org/about-project

53.

Scott

K. W.

Orav

E. J.

Cutler

D. M.

Jha

A. K.

(2017). Changes in hospital–physician affiliations in US hospitals and their effect on quality of care. Annals of Internal Medicine, 166(1), 1–8.

54.

Shay

P. D.

Mick

S. S. F.

(2017). Clustered and distinct: A taxonomy of local multihospital systems. Health Care Management Science, 20(3), 303–315.

55.

Sinaiko

A. D.

Landrum

M. B.

Meyers

D. J.

Alidina

Maeng

D. D.

Friedberg

M. W.

Kern

L. M.

Edwards

A. M.

Flieger

S. P.

Houck

P. R.

Peele

Reid

R. J.

McGraves-Lloyd

Finison

Rosenthal

M. B.

(2017). Synthesis of research on patient-centered medical homes brings systematic differences into relief. Health Affairs, 36(3), 500–508.

56.

Syrop

(2016). Physician practices in rural areas being acquired by hospitals at dramatic rate. https://www.ajmc.com/view/physician-practices-in-rural-areas-being-acquired-by-hospitals-at-dramatic-rate

57.

Townley

Mooney

(2014). The role of hospitals in medical home initiatives and strategies to secure their support and participation. https://www.nashp.org/wp-content/uploads/sites/default/files/Hosp_PCMH_Brf.pdf

58.

Trinh

H. Q.

Begun

J. W.

Luke

R. D.

(2014). Service duplication within urban hospital clusters. Health Care Management Review, 39(1), 41–49.

59.

van den Berk-Clark

Doucette

Rottnek

Manard

Prada

M. A.

Hughes

Lawrence

Schneider

F. D

. (2018). Do patient-centered medical homes improve health behaviors, outcomes, and experiences of low-income patients? A systematic review and meta-analysis. Health Services Research, 53(3), 1777–1798.

60.

Walker

D. M.

Mora

A. M.

Hogan

T. H.

Diana

M. L.

McAlearney

A. S.

(2018). Assessing trends in hospital system structures from 2008 to 2015. Medical Care, 56(10), 831–839.

61.

Wejnert

(2002). Integrating models of diffusion of innovations: A conceptual framework. Annual Review of Sociology, 28(1), 297–326.

62.

Westfall

J. M.

Zittleman

Ringel

Sutter

McCaffrey

Gale

Gerk

Sanchez

LeBlanc

Dickinson

L. M.

Dickinson

(2014). How do rural patients benefit from the patient-centred medical home? A card study in the High Plains Research Network. London Journal of Primary Care, 6(6), 136–148.

63.

Williamson

O. E.

(1991). Comparative economic organization: The analysis of discrete structural alternatives. Administrative Science Quarterly, 36(2), 219–44.

64.

Zuckerman

H. S.

D’Aunno

T. A.

(1990). Hospital alliances: Ccooperative strategy in a competitive environment. Health Care Management Review, 15(2), 21–30.