Managing Identities in Managed Care: Top -Management -Team Responses to Organizational Complexity and Change

"This thesis examines the phenomena of multiple and competing expectations in complex organizations through the lens of identity theory. I begin with the premise that the challenge of managing multiple interests in organizations is essentially one of managing multiple identities. My main research question is: How does a complex, pluralistic organization ' manage' multiple and competing identities? I explore this issue in the context of healthcare organizations---chosen because of the industry's inherent degree of competing interests and the associated conflicts that have been raised by the managed care movement. In particular, I focus on the identity management strategies and mechanisms employed by the top management team in a large, physician-owned, integrated delivery system, using the Pratt and Foreman (2000) classification scheme as a reference point. Through a 18-month-long ethnographic case study, I gathered extensive qualitative data---including non-participant observations of management committee meetings and formal and informal interviews with upper-level managers and physician leaders. The data were analyzed primarily via a process of thematic coding and pattern-matching, using qualitative data analysis software. The analysis of the data are consistent with the Pratt and Foreman (2000) scheme and provide extensive ""thick description"" of the various strategies and mechanisms used to respond to multiple identities. Furthermore, an additional and highly valuable strategy emerged from the data, wherein managers simultaneously integrated and segregated multiple identities. This semi-integration response spans opposing quadrants and suggests that managers may employ highly complex responses that operate on different levels simultaneously. Lastly, the pattern of mechanisms used to implement the identity management strategies fell along an concrete-abstract continuum which corresponded to the deletion-aggregation diagonal."

Name thesis:degree_name

Ph.D.

Level thesis:degree_level

Dissertation

Discipline thesis:degree_discipline

Business Administration

Grantor

University of Illinois at Urbana-Champaign

Year dc:date

2015

Author dc:creator

• Foreman, Peter Ogden

Contributors dc:contributor

• Michael G. Pratt

• Health Sciences, Health Care Management

Language dc:language

eng

Identifier

(MiAaPQ)AAI3017077

OAI identifier oai:identifier

oai:www.ideals.illinois.edu:2142/84511