HMOs don't have to fail

One of the bright spots in the sometimes black picture that is painted of our national health care system is HMOs. Health maintenance organizations provide health services to an enrolled group of patients for a fixed, prepaid fee. This arrangement induces HMOs to try to keep patients healthy for a competitive rate. Because of its special nature, however, an HMO cannot be managed like a fee-for-service hospital or group practice. And because few managers fully understand them, more and more HMOs are failing. The authors of this article say, however, that some failures can be avoided. Good management techniques can help HMO managers-whether they are community-spirited citizens or seasoned executives-overcome many of the problems that plague HMO plans: out-of-control utilization rates, growth that can occur overnight, conflict between the values of HMOs and of the physicians that staff them, and competitors in the health field.     

ENVIRONMENT, ORGANIZATION AND EFFECTIVENESS: A BIOGRAPHICAL APPROACH[1]

Answers to the question of what makes an organization effective have proved elusive despite more than 20 years of intensive theorizing and research. Yet the search for answers, which gained momentum with Lawrence and Lorsch's (1969) Organization and Environment, clearly has had salutary effects on students of organizations and their work. This paper offers an approach to analysing organizations explicitly based on two of those benefits. The first is the shift toward a more dynamic orientation for explaining organizational configurations and outcomes. The second is the identification of strategic decisionmaking as the key link between organizational environment, structures, and effectiveness. By merging these two, we construct a biographical approach to the study of organizations. This approach sees organizations as evolving through time in response to, or in anticipation of, both external and internal forces. We view effectiveness as the outcome of a variety of decisions taken by one or more groups of organizational actors - elites or coalitions - in the context of bounded rationalities and environmental and structural constraints. So decision processes underpin observed configurations of environmental and structural features and link these configurations to effectiveness. An organization's biography - the pattern of its evolution - can be conceptualized as a succession of decisions and their consequences, with some decisions having a major long-term influence on the direction taken by the organization and its effectiveness, while others have but an incremental influence. This article is an initial effort to make concrete our ideas. The opening section discusses organizational decision-making and organizational effectiveness. This is the core of our approach: a basis for categorizing organizational decisions and in particular for singling out those which can be regarded as strategic. It is our contention that significant decisions vary across organizations and that it will embrace rather than ignore history and context. And ultimately, it will enhance our understanding of organizational effectiveness.     

A resource‐based view of manufacturing strategy and the relationship to manufacturing performance

This paper examines manufacturing strategy from the perspective of the resource‐based view of the firm. It explores the role of resources and capabilities in manufacturing plants that cannot be easily duplicated, and for which ready substitutes are not available. Such resources and capabilities are formed by employees' internal learning based on cross‐training and suggestion systems, external learning from customers and suppliers, and proprietary processes and equipment developed by the firm. Based on data from 164 manufacturing plants, the paper empirically demonstrates that competitive advantage in manufacturing (as measured by superior plant performance) results from proprietary processes and equipment which, in turn, is driven by external and internal learning. The implication is that resources such as standard equipment and employees with generic skills obtainable in factor markets are not as effective in achieving high levels of plant performance, since they are freely available to competitors. The paper also demonstrates the important role of internal and external learning in developing resources that are imperfectly imitable and difficult to duplicate. Copyright © 2002 John Wiley & Sons, Ltd.     

Determining output shadow prices for a cost-constrained technology

We develop a method for computing output shadow prices when total cost and input prices are exogenous, using the indirect output distance function of Shephard (1974). We show that indirect distance function shadow price imputations for output prices are the same to a proportional constant as marginal cost imputations. We motivate our results by relating them to the problem of valuing the output of nonprofit institutions, to some measurement issues for noncompetitive industries, and to a problem of imputing sales of the commercial banking industry to consuming sectors of the economy in the national income accounts.Thanks are due to a very informed and helpful referee.Rolf Färe supported by IHE, Lund, Sweden.     

Measuring Effective Tax Rates in the Presence of Multiple Inputs: A Production Based Approach

We suggest a new method for comparing tax regimes acrossjurisdictions. The approach aggregates taxes on inputs by focussingon production, rather than investment, decisions. Taxes on variousinputs affect production decisions by increasing marginal costs.By calculating the difference between the tax-inclusive and tax-exclusivemarginal cost of production, we determine the effective excisetax rate on marginal costs implied by all of the various taxesimposed upon the firms inputs. The effective tax rate on marginalcosts provides a convenient summary measure of the potentialimpact of taxes on all inputs on production location decisions.     

The Influence of Affect on Managers' Capital‐Budgeting Decisions*

In this paper, we propose that affective reactions are integral to accounting decision contexts like capital budgeting, and that researchers must jointly consider affect and cognition to better understand accounting decision makers' behavior. We argue that interpersonal relationships are characteristic of many capital‐budgeting contexts, and that these relationships can lead to emotional affective reactions. For example, reactions such as frustration and anger may result if a manager is treated unfairly by another individual involved in a capital project. Drawing on relevant work in neurobiology and psychology, we then predict that these affective reactions can influence managers' capital‐budgeting decisions. We report on four experimental scenarios that demonstrate the impact of affective reactions on capital‐budgeting decisions. Consistent with our predictions, the results indicate that managers consider both financial data and affective reactions when evaluating the utility of an investment alternative. Our results suggest that researchers should consider both affect and cognition to more fully understand decision making in accounting contexts.     

Promoting youth occupant restraint based on need

Motor vehicle crashes are a leading cause of death for youth. Appropriate occupant protection significantly reduces these preventable injuries. Secondary field observation survey records were studied to identify populations that would most likely benefit from youth occupant protection programs. Multivariate regression analysis showed that drivers of youth between 4 and 14 years were in need of programs promoting youth and driver occupant restraint use. When these drivers were using seat belts, it was 35 times more likely they had youth occupants in safety restraints. A focus on pickup truck drivers may also give these programs greater efficacy in increasing youth restraint use. This study was limited to a single state, but the approach should be transferable to other jurisdictions where youth occupant protection field observation studies are conducted.     

PCAOB Inspections: Public Accounting Firms on “Trial”

The objective of our article is to obtain a better understanding of how auditors anticipate the potential for PCAOB inspection, experience the inspection, cope with the consequences of the inspection, and understand the PCAOB's influence within the context of professionalism. We use a qualitative approach that uses both surveys (55) and interviews (20) of auditors (of varying rank and firm) across a five‐year period (2012–2017). Respondents suggest that PCAOB inspectors are powerful, representing the “prosecution,” “judge,” and “jury” of the auditing profession. We therefore use a structural metaphor of the PCAOB inspection as a judicial “trial.” By controlling the criteria used to evaluate performance, inspectors have the power to repeatedly “subpoena,” “interrogate,” and return a “verdict” on the firm (auditor); those judged as “guilty” require supervised “probation.” This process is perceived as having improved audit quality but at a cost. Passing an inspection is so important that auditors (firms) have resorted to impression management strategies and “functionally stupid” work practices (e.g., excessive documentation, a decrease in critical thinking as a result of a “box ticking” approach to auditing). Furthermore, some respondents believe that being a good auditor has come at the expense of being a good accountant; the emphasis on audit process and concurrent de‐emphasis on technical accounting could ultimately lead to audits themselves falling short. In addition, it is evident that inspectors and auditors differ in their perceptions of risk, likely manifesting because inspectors are standards‐focused while auditors (firms) are methodology‐focused. Finally, the inspection process has created excessive stress and tension, beyond budget and fee pressures, which some auditors perceive as affecting the pool of talented auditors that firms may be able to attract and retain in the future.     

Gangs and Deviant Leisure

The objectives of this study, guided by the principles of the social learning theory, were to explore the participation and motivations of gang members for involvement in deviant leisure activities. In-depth individual interviews were conducted with 30 former gang members residing in Chicago and central Illinois. The findings showed that their leisure behavior included house parties that typically included the use of drugs, alcohol, and sex; “hanging around” on street corners and “gangbanging” violence perpetrated against members of opposing gangs or other members of the same gang; and various types of vandalism. Motivations for involvement in deviant leisure included those outlined in the social learning theory, as well as thrill and pleasure from committing crimes and achieving flow-like states. The research confirmed that both individual factors and social processes contributed to explaining gang members' involvement in deviant pastimes.