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Related Experiment Video

Updated: Jul 27, 2026

An R-Based Landscape Validation of a Competing Risk Model

An R-Based Landscape Validation of a Competing Risk Model

Published on: September 16, 2022

Risk assumption and physician alignment with health care organizations.

J A Alexander¹, T M Waters, S Boykin

¹Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor 48109, USA.

|August 8, 2001

Summary

Physician groups that adopt managed care revenue and group-based incentives show higher alignment with health care systems. Balancing individual and group risk is key for physician loyalty and commitment.

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Last Updated: Jul 27, 2026

An R-Based Landscape Validation of a Competing Risk Model

An R-Based Landscape Validation of a Competing Risk Model

Published on: September 16, 2022

Area of Science:

Health Services Research
Physician Behavior
Healthcare Management

Background:

Physician alignment with healthcare systems is crucial for integrated care delivery.
Understanding factors influencing physician commitment and loyalty is essential for system success.
Risk assumption models can impact physician engagement and organizational alignment.

Purpose of the Study:

To investigate the relationship between physician risk assumption and their alignment with healthcare systems.
To analyze how different risk-sharing models affect physician loyalty and commitment.
To identify key drivers of physician-system alignment in integrated healthcare settings.

Main Methods:

Cross-sectional comparative analysis of 1,279 loosely affiliated and 1,781 closely affiliated physicians.
Utilized validated multi-item scales for physician alignment measures.
Employed two-stage Heckman models to correct for sample selection and clustering.

Main Results:

Higher managed care revenue within physician groups correlated with increased normative commitment and system loyalty.
Individual managed care risk positively influenced normative and behavioral commitment.
Physician equity positions and individually-based incentives were negatively associated with alignment.

Conclusions:

Organizations should balance individual risk schemes with group and system performance incentives.
Achieving long-term physician loyalty and commitment requires a strategic approach to risk-sharing.
Integrated healthcare systems must carefully design incentive structures to foster alignment.