Abstract
This article examines the relationship between the basic structure of a health maintenance organization's delivery system and its organization of mental health services. The conclusion is that the organization of mental health services is strongly influenced by whether the HMO is organized as a group-based delivery system or as a contractually-linked set of independent providers. In addition, larger HMOs of all types are more likely to contract for mental health services, as are HMOs in more competitive markets.
Similar content being viewed by others
References
Anderson, E., & Schmittlein, D.C. (1984). Integration of the sales force: An empirical examination.Rand Journal of Economics, 15, 3–19.
Christianson, J.B., Sanchez, S.M., Wholey, D.R., & Shadle, M. (1991). The HMO industry: Evolution in population demographics and market structure.Medical Care Review, 48 3–46.
D'Aunno, T., Sutton, R.I., & Price, R.H. (1991). Isomorphism and external support in conflicting institutional environments: A study of drug abuse treatment units.Academy of Management Journal, 34, 636–661.
Dorsey, J. (1975). The Health Maintenance Act of 1973 (PL 93-222) and prepaid group practices.Medical Care, 13, 1–9.
Eisenhardt, K.M. (1985). Control: Organizational and economic approaches.Management Science, 31, 134–149.
Ferron, E. (1992). Commentary: Caring for the indigent mentally ill—New strategies and old problems.American Journal of Public Health, 82, 796–798.
Greene, W.H. (1990).LIMDEP. New York, NY: Econometric Software, Inc.
Iglehart, J.K. (1992). The American health care system: Managed care.New England Journal of Medicine, 392, 742–747.
InterStudy. (1989).National HMO census. Excelsior, MN: Author.
Jones, G.R. (1987). Organization-client transactions and organizational governance structures.Academy of Management Journal, 30, 197–218.
Lopez, L. (1991). Who's minding mental health?HMO Magazine, 32, 22–26.
Luft, Harold S. (1981).Health maintenance organizations: Dimensions of performance. New York: John Wiley & Sons.
Masten, S.E. (1984). The organization of production: Evidence from the aerospace industry.Journal of Economic Behavior and Organization, 12, 265–273.
Masten, S.E., Meehan, J.W. Jr., Snyder, M.W. (1991). The costs of organizing.The Journal of Law, Economics, and Organizations, 7:1–25.
McEachem, S. (1990). HMOs, EAPs at odds on mental-health care.Healthweek, p. 14.
Meier, G. (1981). HMO experiences with mental health services to the long-term emotionally disabled.Inquiry, 18, 125–138.
Monteverde, K., & Teece, D.J. (1982). Supplier switching costs and vertical integration in the automobile industry.Bell Journal of Economics, 13:206–213.
Ouchi, W.G. (1979). A conceptual framework for the design of organizational control mechanisms.Management Science, 25, 833–848.
Ouchi, W.G. (1980). Markets, bureaucracies, and clans.Administrative Science Quarterly, 25, 129–141.
Peterson, M.S., Christianson, J.B., & Wholey, D.R. (1992).National survey of mental health, alcohol, and drug abuse treatment in HMOs: 1989 chartbook. Excelsior, MN: InterStudy.
Rader, P.J. (1990). The mental health package.HMO Magazine, 31, 12, 14–16, 28.
Rothschild-Whitt, J. (1979). The collectivist organization: An alternative to rational-bureaucratic models.American Sociological Review, 44, 509–527.
Shadle, M., & Christianson, J.B. (1989). The impact of HMO development on mental health and chemical dependency services.Hospital & Community Psychiatry, 40, 1145–1151.
Thompson, J.D. (1967).Organizations in action. New York: McGraw-Hill.
Trauner, J. (1987). Selective contracting for mental health services.Journal of Ambulatory Care Management, 10, 28–54.
Walker, G., & Poppo, L. (1991). Profit centers, single-source suppliers, and transaction costs.Administrative Science Quarterly, 36, 66–87.
Walker, G., & Weber, D. (1984). A transaction cost approach to make-or-buy decisions.Administrative Science Quarterly, 29, 373–381.
Wenzel, L. (1987). Purchasing systems for chemical dependency and mental health services.Journal of Ambulatory Care Management, 10, 39–54.
Wholey, D.R., & Burns, L.R. (1993). Organizational transitions: From changes by health maintenance organizations.Research in the Sociology of Organizations, 11, 257–293.
Williamson, O. (1975).Markets and hierarchies. New York: Free Press.
Williamson, O. (1979). Transaction cost economics: The governance of contractual relations.Journal of Law and Economics, 22, 3–61.
Williamson, D. (1981). The economics of organization: The transaction cost approach.American Journal of Sociology, 87, 548–577.
Williamson, D. (1985).The economic institutions of capitalism. New York: Free Press.
Author information
Authors and Affiliations
Additional information
The authors are grateful for the financial support of the National Institute of Mental Health, the cooperation of the HMO survey respondents, and the comments of Thomas McGuire and Robert Dorwart.
Rights and permissions
About this article
Cite this article
Wholey, D., Christianson, J. & Peterson, M. Organization of mental health care in HMOs. Adm Policy Ment Health 23, 307–328 (1996). https://doi.org/10.1007/BF02106810
Issue Date:
DOI: https://doi.org/10.1007/BF02106810