Applied game theory for the hospital manager. Three case studies

This article reviews the more complex aspects of game theory than those presented in a recent HCM article. Following a basic overview of terminology and simplified examples, case studies are presented to show the hospital manager how game theory is a useful modeling strategy for predicting human interactions and the potential outcomes of certain decisions, especially economic ones. Understanding game theory provides the manager with an understanding of basic and advanced strategies that can be utilized to competitive advantage in the health care market (thus giving it applicability at the manager's clinical level of decision making), as well as grasping the "larger picture" of health care decision making at high levels, such as in professional societies and government.     

Case management: managing the nurse case manager

Nurse executives and nurse managers have become proactive in response to the health care crisis by creating and implementing innovative health care delivery models such as nursing case management. Nursing case management utilizes a nurse as case manager and the unit-based system of managed care to achieve financial and clinical outcomes for target patient groups. Nurse managers can support the nursing case management model best by practicing good managerial skills, developing a participative style of leadership, and empowering the nurse case manager.     

Toward a behavioral model of the physician as case manager

The search for means to contain rising health care costs has increasingly focused on the physician's key role in resource consumption decisions. A particularly explicit example of this is the new wave of interest in public and non-public programs which designate a primary care physician to be a 'physician case manager'. This title seems to reflect an attempt to assign and impute to the physician functions and responsibilities significantly beyond traditional clinical duties. This paper explores the multiple functions of the physician to develop a behavioral model of the physician case manager. This model is employed to identify a series of practice style orientations (PSOs) which represent differing emphases given to the core functions physicians are required to perform. Strong physician case management is characterized as those PSOs in which the rationer/resource allocator function is emphasized. The paper concludes by suggesting what types of external pressures and incentives may be useful in fostering strong case management.