ORGANIZATIONAL VARIATION IN THE MANAGED CARE INDUSTRY IN THE 1990S: IMPLICATIONS FOR INSTITUTIONAL CHANGE

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Abstract
Despite continuing debate about costs and benefits, managed care became an integral part of the health care sector during the 1990s. In this paper, we examine the organizational and practice variation in the managed care industry at two points in the 1990s using a national census of organizations operating in those years. We use a definition of managed care that captures the increased diversity within the industry while still distinguishing it from traditional indemnity, fee-for-service care. We draw on institutional theory to begin to formulate a framework for understanding why certain organizational forms and practices emerged when and where they did.

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