Alternative Compensation Arrangements and Productive Efficiency in Partnerships: Evidence from Medical Group Practice

Although the role of the services sector in the economy has grown increasingly large, and partnerships are a prevalent form of organization in this sector, relatively little is known about the behavior and performance of these firms. In this paper an attempt is made to fill that gap by developing and testing a model of the effect of alternative compensation arrangements on productive efficiency in medical group practices. The technique employed is two-stage production frontier estimation. This technique provides direct estimates of productive efficiency and allows for differences across agents in ability or responsiveness to financial incentives. In the frontier literature productive efficiency is assumed to be exogenously given. In this paper it is determined endogenously, thus a simple econometric technique correcting for this endogeneity in estimating the production frontier is employed. In addition, the measures of efficiency themselves can be made dependent variables for explicit econometric analysis of the determinants of efficiency. Overall, the empirical results are consistent with theoretical work on internal theory of the firm, which predicts that productivity compensation schemes will work well for firms with non-joint production and observable output. These two criteria are met by medical group practices. The treatment of measured efficiency as an endogenous variable is unique and allows some interesting insights into the determinants of productive efficiency. We find that relating compensation to productivity does increase the quantity and efficiency of production, as theory has hypothesized. The number of members in a group decreases both the quantity produced and the efficiency with which that output is produced. Experience does lead to greater productivity and efficiency. Medical groups in general are measured as being no less efficient than an average manufacturing firm, but Health Maintenance Organizations are less efficient than average.

Understanding Conflict Escalations in Virtual Teams: A Social Network Approach

One crucial aspect of conflict management in teams is to avoid conflict escalation. When escalation occurs the entire team will be consumed by arguments among disputants and cannot accomplish its task. While many studies have provided theoretic framework for the academic understanding of team conflicts, they did not suggest convenient measurement for the monitoring of the status of team conflicts. This project seeks to bridge this gap by studying four hundred virtual teams that were formed over past ten for complex tasks. We will apply social network analysis to identify the social network patterns associated with conflict escalations. We believe that the results from this research could contribute to the theoretic understanding of the conflicts in virtual teams. In addition, this study could provide mangers and team leaders measurements to monitor the status of conflict. Finally, the research described may provide insight for the design of CMC systems

Top Management Lead Entrepreneurship in Handling Competing Institutional logics for DHIS-2 Adoption in Ethiopian Public Health Care Context

IT governance matters in information system implementation. However, managers are left with generative strategies to address contradictory issues in health information system(HIS) implementation. The prescriptive and unilateral IT governance framework is inadequate to design appropriate IT governance mechanisms in complex HIS where diversified actors with different IT perspectives are in play. IS research advocate to employ collaborative and loose coupling strategies to address contradictory issues in complex health setting, yet it is rarely depicting how managers employ collaborative and loose coupling strategies to incorporate all stakeholders. This study aimed to explore how managers design IT governance mechanism in the case of District Health Information System 2(DHIS-2) adoption in public health care setting where multiple stakeholders are in play. Institutional logic concept is used to understand how stakeholders’ principles, assumptions and goal influenced IT governance mechanism design. The finding depicts first how lack of resource and technical capacity generate dominant actors and later how these dominant actors’ institutional logic shaped IT governance mechanism design. The study highlighted how high level official new to the context with decision right guided senior managers to devise various proactive IT governance mechanisms (stakeholders’ participation, experience sharing, demonstration, training, piloting, internal and external system evaluation, delaying) to consider new alternatives. These IT governance mechanisms enabled managers and actors to distance from the prevailing institutional logics, garnered more actors with resource and technical capacity to the new system, weakening the dominant institutional logics and used as a foundation to make prompt decision. On the other hand the study highlighted how dominant institutional logics challenged this entrepreneurship with country wide established network for decade. The study highlighted the importance of high level official distance from the prevailing institutional logics and guidance to enable senior managers designing better IT governance mechanism which incorporates all stakeholders for system adoption

Web Services: Enabling Dynamic Business Networks

A Dynamic Business Network is a distinct system of participants (customers, suppliers, complimentors, competitors, service providers) that use the network to achieve customer satisfaction and profitability and where participants and relationships evolve over time. However, unpredictability and rapid change in a Dynamic Business Network creates a significant challenge in implementing and supporting business application software. Traditional information systems implementation methods require an a priori design and are built for a particular purpose for use over an extended period of time. Loosely coupled business networks change interrelationships between nodes both quickly and frequently, thus providing little or no notice for planning, implementing, or changing the supporting applications. The dynamic sourcing capabilities of the emerging Web Services framework provide a key to enabling these complex eco-systems. We explore the strategic and technological dimensions of Web Services and describe how they can be used to support dynamic business networks