Implementing Cost Control in Health Care: Strategies Driven by an Organizational Systems Approach

In this paper, we offer a systems approach to assist health care organizations in their cost-containment efforts. A general model of the organization which specifies the various components of this approach is offered. Each system—technology, structure, psychosocial, managerial, and cultural—is linked to illustrative selected actions designed to improve cost performance. In our view, the key to successful interventions to contain costs lies in careful consideration of both the direct and interactive impacts on all systems of the health care organization. A case example of an Academic Medical Center's effort to curtail costs illustrates both the model and the sample actions.