4. Power is a central construct in channels.

Consider the following scenarios and describe the possible outcomes:

a. In a recent contract negotiation session between a group of physicians and a managed care health plan, the parties disagreed about the level of reimbursement that the physicians would receive for treating subscribers. The physician group is the largest such organization in the community and represents 75% of all primary care providers in the area. What sources of power does this group wield in negotiating a managed care contract?

b. The largest employer in the region has approached the community hospital in the region in which it is located.

The company is the major employer of people, and the hospital is well regarded and is the primary deliverer of care. For many years, the company has been concerned about its growing healthcare costs and has increasingly tried to work with the hospital to discuss ways to better manage or address its concerns. The CEO has been at the head of the hospital for several decades when reimbursement rules focused less on costs and believes the company has few options in the immediate vicinity.

What might be the way in which the employer best approach this from a power perspective?

c. A group of physicians has decided to open its own urgent care center across the street from the hospital emergency room in a strip mall. The hospital administrator learned of the plans at a medical staff meeting and was irate. He left the meeting without speaking and called the chief financial officer (CFO). The CFO’s response was, “We should threaten to remove them from the medical staff, immediately.” Is coercive power the best source of power? Explain your decision.