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PAM Articles 
The Dynamics of Strategic Change in Hospitals: Managed Care Strategies, Organization Design, and Performance
Author: CHRISTOPHER G. WORLEY, PH.D., THOMAS G. CUMMINGS, PH.D. AND FOSTER W. MOBLEY, M.B.A.
Published in PAM, Vol. 5 No. 1
The organizational changes and performance consequences of
California hospitals pursuing managed care strategies between 1986-87
and 1991-92 are examined. The results suggest that hospitals made
substantive changes in their strategic orientations. The primary source of
change, however, was prior levels of commitment. High commitment to
managed care strategies in time 1 produced further commitments in time 2,
and support a momentum model of strategic adaptation. The performance
consequences of strategic change are a complex function of time, direct,
and indirect influences.
