Everyone is; should healthcare? Outsourcing: Issues in strategic planning, organizational culture, and organizational ethics

Expenditures for personal health services in the United States have doubled over the last decade. They continue to outpace the growth rate of the gross national product. Costs for medical care have steadily increased at an annual rate well above the rate of inflation and have gradually outstripped payers' ability to meet their premiums. This limitation of resources justifies the ongoing healthcare reform strategies to maximize utilization and minimize costs. The majority of the cost-containment effort has focused on hospitals, as they account for about 40 percent of total health expenditures. Although good patient outcomes have long been identified as healthcare's central concern, continuing cost pressures from both regulatory reforms and the restructuring of healthcare financing have recently made improving fiscal performance an essential goal for healthcare organizations. ^ The search for financial performance, quality improvement, and fiscal accountability has led to outsourcing, which is the hiring of a third party to perform a task previously and traditionally done in-house. The incomparable nature and overwhelming dissimilarities between health and other commodities raise numerous administrative, organizational, policy and ethical issues for administrators who contemplate outsourcing. This evaluation of the outsourcing phenomenon, how it has developed and is currently practiced in healthcare, will explore the reasons that healthcare organizations gravitate toward outsourcing as a strategic management tool to cut costs in an environment of continuing escalating spending. ^ This dissertation has four major findings. First, it suggests that U.S. hospitals in FY2000 spent an estimated $61 billion in outsourcing. Second, it finds that the proportion of healthcare outsourcing highly correlates with several types of hospital controlling authorities and specialties. Third, it argues that healthcare outsourcing has implications in strategic organizational issues, professionalism, and organizational ethics that warrant further public policy discussions before expanding its limited use beyond hospital “hotel functions” and back office business processes. Finally, it devises an outsourcing suitability scale that organizations can utilize to ensure the most strategic option for outsourcing and concludes with some public policy implications and recommendations for its limited use. ^

Asymmetric rivalry within and between strategic groups

Our study examines asymmetric rivalry within and between strategic groups defined according to the size of their members. We hypothesize that, owing to several forms of group-level effects, including switching costs and efficiency, strategic groups comprising large firms expect to experience a large amount of retaliation from firms within their group and accommodation from the group comprising smaller firms. Small firms, on the other hand, expect to experience a small amount of retaliation from the group comprising large firms and no reaction from the other firms in their group. We estimate the effect of group-level strategic interactions on firm performance. Our analysis reveals that the rivalry behavior within and between groups is asymmetric, which supports the dominant-fringe relation between firms, as described in our hypothesis.

Fiscal year 1996 strategic plan, July 1, 1995 /

"July 1, 1995."

Social security : keeping the promise : strategic plan, 1997-2002.

"September 1997".

Centralised or decentralised? Strategic implications of resource allocation models

This paper examines the strategic implications of resource allocation models (RAMs). Four interrelated aspects of resource allocation are discussed: degree of centralisation, locus of strategic direction, cross-subsidy, and locus of control. The paper begins with a theoretical overview of these concepts, locating the study in the contexts of both strategic management literature and the university. The concepts are then examined empirically, drawing upon a longitudinal study of three UK universities, Warwick, London School of Economics and Political Science (LSE), and Oxford Brookes. Findings suggest that RAMs are historically and culturally situated within the context of each university and this is associated with different patterns of strategic direction and forms of strategic control. As such, the RAM in use may be less a matter of best practice than one of internal fit. The paper concludes with some implications for theory and practice by discussing the potential trajectories of each type of RAM.

Strategic groups, competitive groups and performance within the U.K. pharmaceutical industry:Improving our understanding of the competitive process

Strategic group research originated in the 1970s and a number of notable studies centered on the U.S. pharmaceutical industry. Results were, however, conflicting. This paper explores the nature of strategic groups in the U.K. pharmaceutical industry. The study confirms the presence of between six and eight strategic groups across the period studied, 1998-2002. The study also demonstrates a statistically significant relationship between these strategic groups and performance using three performance measures. The paper then compares strategic groups with competitive groups and concludes that the distinction is important and may explain the contradictory findings in earlier strategic group research. Copyright © 2007 John Wiley & Sons, Ltd.

Strategic group theory:review, examination and application in the UK pharmaceutical industry

Purpose – The purpose of this paper is to consider the current status of strategic group theory in the light of developments over the last three decades. and then to discuss the continuing value of the concept, both to strategic management research and practising managers. Design/methodology/approach – Critical review of the idea of strategic groups together with a practical strategic mapping illustration. Findings – Strategic group theory still provides a useful approach for management research, which allows a detailed appraisal and comparison of company strategies within an industry. Research limitations/ implications – Strategic group research would undoubtedly benefit from more directly comparable, industry-specific studies, with a more careful focus on variable selection and the statistical methods used for validation. Future studies should aim to build sets of industry specific variables that describe strategic choice within that industry. The statistical methods used to identify strategic groupings need to be robust to ensure that strategic groups are not solely an artefact of method. Practical implications – The paper looks specifically at an application of strategic group theory in the UK pharmaceutical industry. The practical benefits of strategic groups as a classification system and of strategic mapping as a strategy development and analysis tool are discussed. Originality/value – The review of strategic group theory alongside alternative taxonomies and application of the concept to the UK pharmaceutical industry.

A composite framework for the strategic alignment of information systems development

Information systems are corporate resources, therefore information systems development must be aligned with corporate strategy. This thesis proposes that effective strategic alignment of information systems requires information systems development, information systems planning and strategic management to be united. Literature in these areas is examined, breaching the academic boundaries which separate these areas, to contribute a synthesised approach to the strategic alignment of information systems development. Previous work in information systems planning has extended information systems development techniques, such as data modelling, into strategic planning activities, neglecting techniques of strategic management. Examination of strategic management in this thesis, identifies parallel trends in strategic management and information systems development; the premises of the learning school of strategic management are similar to those of soft systems approaches to information systems development. It is therefore proposed that strategic management can be supported by a soft systems approach. Strategic management tools and techniques frame individual views of a strategic situation; soft systems approaches can integrate these diverse views to explore the internal and external environments of an organisation. The information derived from strategic analysis justifies the need for an information system and provides a starting point for information systems development. This is demonstrated by a composite framework which enables each information system to be justified according to its direct contribution to corporate strategy. The proposed framework was developed through action research conducted in a number of organisations of varying types. This suggests that the framework can be widely used to support the strategic alignment of information systems development, thereby contributing to organisational success.

Strategic innovation networks

This thesis draws on two key areas of the innovation literature, the strategic management of technology (SMOT) and innovation networks. The aim is to integrate these two areas of the management of innovation literature to develop a framework which I describe as the Strategic Innovation Network (SIN). The key proposition that the revised framework (SIN) aims to address is based on the work of Chandler (1962). Chandler's (1962) conclusion that 'structure follows strategy' is examined in relation to the interaction between corporate/technology strategy and network structure. The SIN is intended to address weaknesses in both the SMOT and network literature. The research data is based on five detailed longitudinal case studies. The organisations are defined as mid-corporate firms operating in traditional manufacturing sectors. Each organisation was chosen on the basis that it was aiming to develop its innovative capacity through product or process innovation projects. The research was carried out over an 18 month period with interviews being held regularly to develop the longitudinal aspect of the study analysis. The data for each individual case study is examined using the SIN framework. The longitudinal approach addresses the objective to provide a dynamic model of the innovation processes by mapping the changes in network structure during the course of individual projects. The network structural changes are examined in relation to each organisation's strategy and five key dynamic network stages are identified in relation to the innovation process. These network stages show the influence strategy has on the structures adopted by the five case studies.

Strategic positioning in voluntary and non-profit organizations in the UK : exploring the experiences of British charitable organizations:Exploring the experiences of British Charitable Organizations

This thesis explores the strategic positioning [SP] activities of charitable organizations [COs] within the wider sector of voluntary and non-profit organizations [VNPOs] in the UK. Despite the growing interest in SP for British COs in an increasingly competitive operating environment and changing policy context, there is lack of research in mainstream marketing/strategic management studies on this topic for charities, whilst the specialist literature on VNPOs has neglected the study of SP. The thesis begins with an extended literature review of the concept of positioning in both commercial [for-profit] and charitable organizations. It concludes that the majority of theoretical underpinnings of SP that are prescribed for COs have been derived from the commercial strategy/marketing literature. There is currently a lack of theoretical and conceptual models that can accommodate the particular context of COs and guide strategic positioning practice in them. The research contained in this thesis is intended to fill some of these research gaps. It combines an exploratory postal survey and four cross-sectional case studies to describe the SP activities of a sample of general welfare and social care charities and identifies the key factors that influence their choice of positioning strategies [PSs]. It concludes that charitable organizations have begun to undertake SP to differentiate their organizations from other charities that provide similar services. Their PSs have both generic features, and other characteristics that are unique to them. A combination of external environmental and organizational factors influences their choice of PSs. A theoretical model, which depicts these factors, is developed in this research. It highlights the role of governmental influence, other external environmental forces, the charity’s mission, organizational resources, and influential stakeholders in shaping the charity’s PS. This study concludes by considering the theoretical and managerial implications of the findings on the study of charitable and non-profit organizations.

Business information systems:technology, development and management in the E-business

Information technology is at the centre of today’s business environment. The increasing importance of e-commerce and the integration of information systems in all areas of a business means it is crucial for managers to understand and implement IS (information systems). This major text, now in its second edition, provides the skills and knowledge necessary to choose the right systems, and to develop and manage them effectively. Business Information Systems: Technology, Development and Management assumes no prior knowledge of IS or IT, and emphasises the importance of IS to management decision making. It takes a 3 part structure: Part One covers hardware and software technologies; Part Two looks at information systems analysis and design; and Part Three describes the strategic management of IS. This successful format allows each section to be studied alongside individual modules, and enables students to focus clearly on specific areas and use the book for more than one course. This book is suitable for college students, undergraduate degree and postgraduate students taking courses with modules in the practical IT skills of selection, implementation, management and use of BIS. The practical sections are also of use to managers in industry involved in the development and use of IS.

Organizational learning orientation profile and implications for strategic planning capacity

Theory development on the relationship between strategic planning and organizational performance has focussed on largely discrete examinations of dependent and independent variables. While the literature has examined the impact of organizational learning on strategic planning, no holistic empirical approaches have been employed in order to fully explore the inter-play between these important constructs. This paper addresses the cited limitations in both the strategic planning and organizational performance literatures by creating profiles of organizational learning and strategic planning capacity using a configuration theory-based approach. The organizational learning orientation profiles (OLOPs) created of prospector, disseminator, interpretative and memory, contribute to theory development regarding the relationship of strategic planning and organizational learning. The theory developed provides insights that have not been previously reported.

Strategic groups, cognitive groups and environmental change in the UK pharmaceutical industry

This chapter explores the relationship between changes in strategy and environmental pressures within the UK Pharmaceutical Industry during a ten- year period. Two stable strategic time periods (SSTPs) were identified each of five years duration. Within each time period seven strategic groups were found but 11 out of 29 firms (37.9%) changed strategic groups membership during the period studied. The break between these two SSTPs was found to coincide with a sharp increase in the substitution of branded pharmaceuticals by cheaper parallel imports. A significant relationship was found between firms that changed groups and both their continent of origin and nationality. Firms whose home markets are more vulnerable to substitution were more likely to switch strategic groups. © 2011 Nova Science Publishers, Inc. All rights reserved.