Sharon Topping

The hidden financial costs of ERP software

Purpose - The purpose of this paper is to detail how the adoption of enterprise resource planning (ERP) systems creates major distortions in the corporate decision-making process. Design/methodology/approach - The approach is to focus on the distortion in the capital – budgeting process of corporations emanating from the rigidity of ERP software. The rigidity negatively influences decision-making because ERP software often dictates that the firm must change its core business procedures and processes to fit the software. Findings - Lack of flexibility limits the introduction of new products, or targeting a new customer segment by increasing costs and imposing delays in implementation. Research limitations/implications - Firms would benefit from performing detailed analysis of the impact of ERP systems on their ability to make operational decisions. Originality/value - This paper focuses on the problem of decreased flexibility in making changes in the production and accounting components of the firm when purchasing and installing ERP systems that cannot accommodate minor or major changes in the corporation.

Comparing provider perceptions of access and utilization management in full-risk and no-risk medicaid programs for adults with serious mental illness

This article compares provider perceptions of access to services and utilization management (UM) procedures in two Medicaid programs in the same state: a full-risk capitated managed care (MC) program and a no-risk, fee-for-service (FFS) program. Survey data were obtained from 198 mental health clinicians and administrators. The only difference found between respondents in the FFS and MC sites was that outpatient providers in the MC site reported significantly lower levels of access to high-intensity services than did providers in the FFS site (p<.001). Respondents in the two sites reported similar attitudes toward UM procedures, including a strong preference for internal over external UM procedures. These findings support the conclusion that through diffusion of UM procedures, all care in the Medicaid program for persons with a serious mental illness is managed, regardless of risk arrangement. Implications for mental health services and further research are discussed.

Managed Care and Provider Satisfaction in Mental Health Settings

We assess the satisfaction of mental health providers using four dimensions from the medical practice literature—degree of autonomy, relationship with patients, compensation, and administrative burden—and extend current work on professional satisfaction to include frontline service providers rather than only psychiatrists or other physicians. In contrast to results reported for primary care settings, we find that the impact of managed care on satisfaction is minimal for the mental health providers in our study of a Medicaid capitation demonstration in the southeastern US. Instead, variables relevant to everyday working conditions have an important effect on job satisfaction.

Does resource scarcity create interorganizational coordination and formal service linkages? A case study of a rural mental health system

The major objective of this research is to examine and characterize service delivery systems for persons with mental illness in a resource scarce environment, i.e. a rural area characterized by persistent poverty and disadvantaged poulations. Although a number of studies have investigated the integration of mental health, general health, and social services, few have focused on systems of care in rural areas. To characterize service delivery systems, this exploratory study uses a case study approach that includes network analysis, quantitative analysis, and a system assessment. The findings suggest that scarcity of resources in these rural environments is an overriding factor in the development of an integrated service delivery system for persons with a mental illness. With no psychiatrists, long waits for commitment, and few emergency accomodations, these rural environments afford service providers little opportunity for proactive or strategic planning. In fact, we view the development of integrated (e.g. client referral and technical information exchange) service networks in rural communities, especially areas of extreme resource scarcity, as problematic. The resource exchange networks that exist are best characterized as informal, moderately centralized, and of limited density. This translates into a system of care that is provider-driven and crisis-oriented.

Improved Stakeholder Management: The Key Revitalizing the HMO Movement?

In summary, our purpose has been to propose and to demonstrate that the survival of HMOs (in whatever form) depends on the proper identification and management of key stakeholder strategies. It is believed that identification and assessment of key stakeholders holds much promise for improving both HMO management and the future performance of HMOs.

Oral history as a classroom tool: learning management theory from the evolution of an organization

Purpose – The purpose of this paper is to describe the use of oral history to teach students about management history and the implementation of principles of management during the evolution of an organization.Design/methodology/approach – The paper describes the oral history methodology and how the process was adapted to classroom learning.Findings – By studying the historical development of a multispeciality physician practice, students were able to see firsthand the incredible impact of the founders on the future of the organization and understand how the early culture and strategy of the organization set the stage for its successful future. Other findings involved the evolution of the organizational structure and incentive system, staff and recruiting policies, and the impact of the environment overtime. In addition, the use of oral history in the classroom proved to be an effective way of making management history come alive for students.Research limitations/implications – Although designed to benefit...