The health care industry has been undergoing massive restructuring over the last decade. While much has been written about the forces driving this restructuring, little is known about the operation, performance, and market impact of emerging health care organizations. A major part of the problem is that the key configurational characteristics of these new health organizations have not been identified. As a result, data collection mechanisms that measure and monitor these characteristics have not been developed. Our proposed study begins to fill this void by: (1) developing a framework that identifies key structural and strategic elements of newly emerging health organizations based on organizational behavior and industrial organization theoretical constructs; (2) operationalizing this framework with unique data resources that capture horizontal and vertical organizational alignment obtained through the most recent wave of national data collection of the American Hospital Association; (3) empirically identifying classes of health care organizations that are similar in their configuration and structure; and (4) identifying the key policy issues and research questions relating to each of these classes of organizations. The proposed research will make the best use of existing theory and data to advance understanding of newly evolving organizations and to provide direction for future data collection and research, Specifically, the analysis focuses on 295 health systems and 274 health networks identified through 1994 American Hospital Association data resources. The proposed study will have substantial impact on the field, providing understanding of the strategies of different health organizations, the sphere of activities of these entities so that appropriate accountability can be determined, and the extent to which newly emerging health organizations are integrating health services and health care financing.
