title: Marketing implications of the shift in power of the hospital.
abstract: With the introduction of the Prospective Payment System, hospital accountants' role changed from reimbursement maximizers to an important role in decision making. Faced with increased competition, hospitals are installing financial controls. Hospital marketers are also engaging in external promotional and health awareness campaigns and expanding their services to stabilize income and reduce the effects of a changing environment. Thus, hospitals operate in a more competitive environment with increasing uncertainty. When faced with uncertainty, organizations often believe that they must convince society that their existence is legitimate. Increasing specialization and organizational complexity in health care professions have made the expert important. Experts, such as the role assumed by hospital accountants and physicians, maintain power because the organization depends on them for their special skills and information. Marketing should also develop an internal marketing program to reach these power influencers. Scarce resource coupled with uncertainty move hospital accountants as experts into the power equation in the changing control of the U.S. healthcare system. Previously, the physician was the major source of hospital power. Since accountants often serve as monitors of scarce resources, information about the resource allocation directly affects the distribution of power. Marketers should acknowledge that this places hospital accountants in a critical role of assisting their institutions in adapting to a new environment.
authors.affiliation: College of Business Administration, University of Tennessee, Martin 38238, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Rayburn
authors.forename: L G
authors.initials: LG
authors.lastname: Rayburn
mesh_terms: D000066:Accounting / Q000639:trends; D003659:Decision Making, Organizational; D003953:Diagnosis-Related Groups / Q000191:economics; D004465:Economic Competition / Q000458:organization & administration*; D017598:Efficiency, Organizational; D005377:Financial Management, Hospital / Q000592:standards / Q000639:trends*; D005380:Financing, Government / Q000639:trends; D015276:Health Care Rationing; D007400:Interprofessional Relations; D008389:Marketing of Health Services / Q000191:economics / Q000639:trends*; D008505:Medical Staff, Hospital / Q000191:economics; D010819:Physician's Role; D011209:Power, Psychological; D011445:Prospective Payment System / Q000639:trends*; D014481:United States