Case in Point: Developing a Unique Healthcare Model

[The following post is re-blogged from SAGE Connection. Click here to view the original article.]

Karen Pellegrin, Director of Continuing Education & Strategic Planning and Founding Director of the Center for Rural Health Science at the University of Hawaii at Hilo, Daniel K. Inouye College of Pharmacy

When the Patient Protection and Affordable Care Act (aka “Obamacare”) went into effect, the healthcare industry experienced the largest expansion of US government involvement since Medicare and Medicaid. This shift in government involvement created a ripe environment for government-subsidized clinics to flourish; but they weren’t the only clinics to do so. Mango Medical, a small business in rural Hawaii that does not rely on government subsidies, experienced enormous success in 2015 due to its unique primary care model that pays doctors for value of service over volume.

Karen Pellegrin & Timothy Duerler wrote a case study for SAGE Business Cases called Mango Medical: Growing a Fresh Healthcare Model. The case follows the creation and success of Mango Medical and allows students to gain a deeper understanding of healthcare trends, markets, systems, and strategies used in the US.

Highlighting the case in this latest installment of our Case In Point series, we caught up with Karen to learn more about the rise of the Mango Medical and the current healthcare environment. Karen provided some helpful insight for any instructor teaching about healthcare in business and management or organizational courses. Read the interview below.

  1. Your case describes the growth of a for-profit healthcare corporation in rural Hawaii, where the market seemed more primed for government-subsidized clinics after the passage of the Affordable Care Act. What would you say are the top three takeaways from this case for those learning about different healthcare models?

 Assumptions about subsidies, both the need and the amount, are typically based on current or traditional models of care; if you don’t question those assumptions, you conclude subsidies are required and easy to quantify.  If you question those assumptions, you might be able to create a more efficient model, as Dr. Duerler has.  There are many inefficiencies in our healthcare system, and we need new models to deliver better, more cost-effective care.

The healthcare industry is highly regulated and complex, which makes it tough to navigate; but where most see obstacles, entrepreneurs find opportunities.

In some ways, you could argue that rural Hawaii is such a unique market that the Mango model wouldn’t succeed in other markets.  I would argue that there is more in the model that translates than not.

  1. After the 2016 election, it seems likely we’ll be seeing some changes in government-subsidized health care. How do you see any potential changes affecting a business like Mango Medical?

 Passing the Affordable Care Act was difficult; changing it is proving to be even more difficult despite the known problems.  In general, the Republicans are focused on eliminating federal mandates that reduce choice and eliminating or changing subsidies.  Assuming fewer people would have health insurance or subsidies to cover the cost of care under a Republican replacement, this could affect Mango’s revenue.  However, because of their operating efficiency, Mango might be an attractive option to those without insurance or with high deductibles who are paying out of pocket.  Businesses focused on value and adaptability, like Mango Medical, will likely maintain a competitive advantage in a dynamic market.

  1. What are some of the marketing challenges faced when a new, growing company like Mango Medical has to adapt to a unique, rural setting?

 Communicating with target audiences is always key.  Our research has found that traditional formal marketing approaches are far less effective (and more expensive) than informal methods in reaching target audiences in rural Hawaii – specifically community members and clinicians.  Getting the message across about a new product or service can be done very efficiently and effectively by understanding the local landscape and leveraging existing communication networks.

Learn more by reading the full case study, Mango Medical: Growing a Fresh Healthcare Model, from SAGE Business Cases, open to the public for a limited time. To learn more about SAGE Business Cases and to find out how to submit a case to the collection, please contact Rachel Taliaferro, Associate Editor: rachel.taliaferro@sagepub.com.

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Assessing Leadership Styles in Business Meetings

According to a recent study published in the Journal of Leadership & Organizational Studies,  the typical employee spends an average of 6 hours per week in scheduled meetings (Rogelberg et al., 2006), allowing a considerable amount of time to assess the leadership and presenting skills of the supervisor.

23577007471_72530d5341_z.jpgAuthors Isabelle Odermatt, Cornelius  König, Martin Kleinmann, Romana Nussbaumer, Amanda Rosenbaum, Jessie Olien, and Steven Rogelberg analyze the leadership styles of supervisors and how their employees perceive them in their paper, “On Leading Meetings: Linking Meeting Outcomes to Leadership Styles.”

The article is currently free to read for a limited time, so click here to find out how leadership behavior helps to strengthen motivation in employees to follow through with action items! The abstract for the article is below:

Leading meetings represent a typically and frequently performed leadership task. This study investigated the relationship between the leadership style of supervisors and employees’ perception of meeting outcomes. Results showed that participants reported greater meeting satisfaction when their meeting leader was assessed as a considerate supervisor, with the relationship between considerate leadership style and meeting satisfaction being mediated by both relational- and task-oriented meeting procedures. The results, however, provide no support for initiating structure being associated with meeting effectiveness measures. More generally, the findings imply that leadership behavior is a crucial factor in explaining important meeting outcomes.

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Meeting photo attributed to the Government of Alberta (CC).

Reference
Rogelberg S. G., Leach D. J., Warr P. B., Burnfield J. L. (2006). “Not another meeting!” Are meeting time demands related to employee well-being? Journal of Applied Psychology, 91, 83-96. doi:10.1037/0021-9010.91.1.83 Google Scholar CrossRef, Medline

Benefits of Starting Work Meetings On Time

[We’re pleased to welcome author Nale Lehmann-Willenbrock of the University of Amsterdam, Netherlands. Lehmann-Willenbrock recently published an article in the International Journal of Business Communication entitled, “Well, Now What Do We Do? Wait . . .:A Group Process Analysis of Meeting Lateness,” co-authored by Joseph Allen. From Lehmann-Willenbrock:]

What inspired you to be interested in this topic? One earlier study had shown that meeting lateness is very common in the workplace. Meetings begin late all the time, even though wasting time is typically a red flag for organizations. Lateness can be quite a nuisance for th4330781173_db539e781c_z.jpgose who are punctual. We also know this from our own meetings – it’s just so annoying when you’re on time, but others are late and you are kept waiting, thus wasting precious work time. But in addition to annoying employees individually, there might also be negative effects in terms of the group as a whole. So we were curious what lateness does to the group processes in the actual meeting itself.

Joseph Allen set up a meetings lab, with the purpose of focusing on meetings as a research phenomenon. This gave him the opportunity to manipulate different variables, including different levels of meeting lateness (something that would not be possible when studying actual meetings at work).
During our collaboration on previous projects, we increasingly looked into the fine-grained interaction dynamics that make up a good meeting, or a terrible one.  We have conducted several studies on group dynamics within meetings until now, and find again and again that what happens in the actual meeting matters a great deal to meeting satisfaction and effectiveness.
So the connection between lateness and group dynamics seemed like a logical connection to draw in our research.

Were there findings that were surprising to you? Overall, our findings are really quite aligned with our hypotheses. As expected, groups that begin their meetings late are less effective in terms of discussing problems in depth, generating ideas and solutions, and showing support for one another, in comparison to groups that meet on time. These findings hold when we control for meeting length. This means that the differences in these groups’ interaction patterns and the quality of their problem solving is actually due to the meeting lateness (rather than the shorter time that is available when a meeting starts late).

What is somewhat surprising though is that we found quite substantial effects of lateness in terms of derailing group dynamics and deteriorating problem solving, even though these were ad-hoc laboratory groups. Think about how much stronger the effects might even be in the real workplace, where you have to continue working together beyond the meeting.

How do you see this study influencing future research? In terms of future research, there are a host of potential other negative outcomes of lateness both within and after the meeting. We think that lateness may not just derail group dynamics and visible behaviors, as we have shown in this study, but also individual emotional experiences, for example. Moreover, the negative effects of meeting lateness may linger and carry on into employees’ work days, long after the meeting has passed.

Another factor to consider in future research concerns nonverbal expressions during meetings that start late. We noticed in our video data that group members’ nonverbal expressions became quite pronounced as the lateness period continued and they got more annoyed. Again, such expressions may be even stronger in real meetings, rather than the research lab. In this context, future research can also investigate how lateness affects the emergent group mood in the actual meeting itself.

Moreover, individual lateness to meetings might be an indicator or implicit measure of other negative employee attitudes and behaviors. For example, employees who tend to show up late for meetings might be unsatisfied or frustrated with their jobs more generally. Lateness to team meetings could also mean that the team does not feel committed to their shared task, or that the team experiences interpersonal conflict. Future research can examine these possibilities.

For practice, put simply, our results suggest: Don’t be late to your meetings, people! Leaders especially should not be late, as they are often seen as behavioral models for their employees.
Everyone should be wary of the negative consequences of meeting lateness, and therefore plan ahead so meetings can begin on time.

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Clocks photo attributed to Desmond Williams  (CC).

When, and How, Should Firms Educate Their Customers?

[We’re pleased to welcome author Simon Bell of the University of Melbourne, Australia. Bell recently published an article in the Journal of Service Research entitled “Unraveling the Customer Education Paradox: When, and How, Should Firms Educate Their Customers?,” co-authored by Seigyoung Auh and Andreas B. Eisingerich. From Bell:]

  • What inspired you to be interested in this topic?

We have long been fascinated by service firms’ reluctance to let customers “into the kitchen”. Service firms have traditionally kept customers in the dark. The thinking is that giving cuJSR_16.2_72ppiRGB_powerpoint.jpgstomers too much insight or access to how a firm operates places that firm’s ‘black box’ or proprietary methodologies at risk. Educating customers apparently provides them with the skills to shop around and potentially switch to a competitor. Yet we noticed in our consulting work that some service firms (and even some service employees) were challenging this thinking. They were proactively educating their customers and seeme
d to be the better for it. We were keen to discover what was going on.

  • Were there findings that were surprising to you?

The results of our field study showed that firms were partly right. Increasing customer expertise through proactive efforts to educate their customers actually had an overall negative impact on loyalty. This was because customers build what we call “market-related” expertise – a general knowledge about how markets work – which provides customers with the confidence to shop around. But we also found that educating customers builds “firm-specific” expertise which ties a customer more closely to the firm. It’s just that this positive effect on loyalty did not outweigh the negative. Yet, when we conducted an experimental study we found that the customer loyalty effects of customer education were positive overall. We believe this has a lot to do with the context (i.e., firm and industry) in which customer education programs might be used. Our goal in this paper was to discover whether education did indeed have both positive and negative effects on loyalty, but clearly our next focus should be revealing the different contexts in which the positive effects outweigh the negative (and vice versa).

  • How do you see this study influencing future research and/or practice?

We think our results have some very important implications for managers. We think that, in this “Google age”, customers are already taking responsibility for their own understanding of how services, firms, and markets work. Easily digestible information and knowledge is at everyone’s fingertips so we think it’s risky for firms to keep customers in the dark. Our findings suggest that firms should be proactive in educating customers and pay particular attention to educating them about how their firm operates. Firms need to let customers into the kitchen and provide a greater level of transparency. We showed that it’s impossible to disentangle the market-related education from the firm-specific, but it is perfectly reasonable for firms to craft educational programs around more firm-specific elements. Ultimately, customers that are more competent at consuming your services are better for your business.

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Measuring Organizational Legitimacy in Social Media

[We’re pleased to welcome author Michael Etter of the City University of London, UK. Etter recently published an article in Business & Society entitled “Measuring Organizational Legitimacy in Social Media: Assessing Citizens’ Judgments With Sentiment Analysis,” co-authored by Elanor Colleoni, Laura Illia, Katia Meggiorin, and Antonino D’Eugenio. From Etter:]

8583949219_f55657573e_z.jpgSocial media have given ordinary citizens the opportunity to freely express their opinions and feelings in any tone or style. The heated discussions around various topics from politics, sports, and corporations often evolve in parallel to news media coverage. Accordingly, we have developed the idea that a measurement of citizens’ judgment in social media can give researchers a new way to assess the legitimacy of organizations. Compared to existing measurements that, for example, assess judgments in news media coverage, a measurement based on social media would directly access the voices of ordinary citizens and therefore account for their heterogeneous norms and expectations.

In this article we describe and test how a measurement based on social media data can give indication for organizational legitimacy. We use the method of sentiment analysis that is based on computational linguistics and apply it to a case from the banking industry over a one year period.

Our findings show that, indeed, an analysis of 14’000 tweets reveals a different judgment than the analysis of 730 news articles. Compared to the news media, citizens judge the bank in a much more negative way. Also we find that the bank is discussed by 6000 citizens and for a broad variety of topics (around 400 hashtags). Clearly, social media data gives researchers access to different judgments than found in news media, which are written by a few journalists that adhere to professional norms and standards and are subject to various selection processes. We therefore encourage researchers to take into account social media, such as Twitter, in order to achieve a richer understanding of legitimation processes in a digital world. For practitioners, sentiment analysis of twitter data is a tool to monitor and identify issues and sentiment in a timely manner.

Cell phone photo attributed to Jason Howie (CC).

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How Great Leadership Communication Yields Positive Job Satisfaction Scores

[We’re pleased to welcome authors Julian Erben of the University of Koblenz-Landau and Frank Schneider of the University of Mannheim. Erben and Schneider recently published an article in the International Journal of Business Communication entitled “In the Ear of the Beholder: Self-Other Agreement in Leadership Communication and Its Relationship With Subordinates’ Job Satisfaction,” co-authored by Michaela Maier. From Erben and Schneider:]

There is no doubt that effective leadership communication is one of the key factors for an organization’s success. But how good is leadership communication in the reality of everyday business? To answer this question, it’s not enough to rely solely on leaders’ self-ratings. Armed with a new instrument to assess the perceived quality of a leaders’ communication from the leaders own perspective and the perspective of their respective subordinates, we 17124643767_c7e281926f_z.jpgwere curious to explore how the perception of leadership communication within a leader-subordinate dyad may differ, and how different perceptions are related to concrete organizational outcomes.

The findings in this study underline the importance of taking into consideration both leader and subordinate perceptions of leadership communication. Results show, that they may in fact differ, and whether they differ or not is substantially related to relevant outcomes. It particularly points out the desirability of congruent positive perceptions of leadership communication as it appears to be a clear indicator of high job satisfaction of subordinates.

This has practical implications for the teaching and training of leadership communication, especially the importance of developing supervisory training programs that enhance the communicative behaviors of leaders and at the same time make them more perceptive for how their subordinates see things.

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Image attributed to David Sanabria (CC)

A Space for Place in Business Communication Research

As technology allows more employees to have a “mobile” workplace, what happens to effective business communication overall? Should more businesses adopt an open-concept floor-plan to foster better collaboration?

Author Deborah Andrews of the University of Delaware addresses the emerging millennial habits of group collaboration and workplace design in her recently published article in the International Journal of Business Communication entitled “A Space for Place in Business Communication Research.” From Andrews:

I’m inspired a lot by things, by objects and spaces and what they can make happen. For ye2392869301_65bb870ab9_m.jpgars, too, I have focused my research and teaching on business communication. So when my university started talking about the new “integrated science and engineering” laboratory it was building to fosterinnovation and creativity through collaboration, I wondered: can a building do this? Curious, I looked at some other campuses and, sure enough, many such buildings were being constructed and promoted with similar rhetoric. Because it’s essentially a matter of communication, I was particularly interested in the many occurrences of collaboration in these statements about how the building would deliver on its promise. I saw that term invoked as well in real estate columns, the marketing reports of design consultancies, and popular business articles about new offices being created, for example, by Google, Facebook, and Amazon. I knew then that I had an enticing research project: matching the rhetoric of these new laboratories and offices to results on the ground.

It’s becoming a commonplace of material culture studies that objects create subjects, the things we live with make us the people we are, maybe even more than the other way around. But I’ve been surprised about the extent to which academic administrators, corporate CEOs, and entrepreneurs believe that the right arrangement of plan and furnishings in an office can foster the achievement of organizational goals.

Examining that fit between the rhetoric of the office or lab as a transformative space and results on the ground is an inviting area for communications research. As one anthropologist notes, we often overlook the things in our environment because they are “blindingly obvious.” We take them for granted. My International Journal of Business Communication article aims to encourage researchers to take another look at the physical environment of a 21st Century workplace as it relates to the communication needed to get work done there. We know that the environment shapes us. But can it shape us in desired ways? And how can we tell?

 

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Office image attributed to Jesus Corrius (CC).