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Many countries across the globe face the challenge of increasing healthcare costs, often increasing faster than GDP or personal income. In an effort to manage these costs, but also to improve the quality and accessibility of healthcare, governments have introduced a purchaser-provider split in the healthcare system. Healthcare financers, such as local governments, employers and health insurers exercise the role of healthcare purchasers. They select and contract providers, and manage buyer-supplier relationships with contracted providers. This is what I call purchasing of care. At the same time, purchasing for care takes place. Healthcare providers, such as hospitals, clinics and family doctors select and contract suppliers of clinical and non-clinical goods and services, and manage relationships with these suppliers. Both types of purchasing and supply management in healthcare need to be executed professionally, in order for a healthcare system to remain financially sustainable. I argue that a high level of purchasing maturity is needed, especially in purchasing of care. High-maturity purchasing starts from the perspective of the end customer, which is the patient in the healthcare sector. Purchasing of care and purchasing for care should both be oriented towards achieving the best value for the patient, which means the best possible health outcomes per euro spent. Purchasing and supply management in healthcare needs to develop from a low trust zero-sum game to an optimal trust positive-sum game with purchasers aiming to realise patient value with supplier-partners under the most favourable conditions.

AbstractThis article utilizes agency theory to explain maverick buying in governmental agencies, that is, noncompliance to centrally negotiated frame agreements. Traditional agency theory assumes the agent to be an opportunistic self-interest seeker. A complementary view of agency problems portrays man as an honest, yet not fully competent, actor; both agents and principals may be burdened by "honest incompetence." We apply both perspectives on principal-agent relationships to study maverick buying in government procurement and link agency problems to three governance mechanisms: monitoring, training, and guidance. We find that guidance and training help to reduce governmental employees' noncompliance, but output monitoring does not. Our findings further indicate that maverick buying is related to goal incongruence and two different types of information asymmetry: Agency problems may arise not only because the agent has information the principal is not aware of but also because the principal may have information the agent is not aware of. Future research in public management using agency theory to study instances of hidden action could benefit from applying a similar dual lens to behaviors previously examined as purely opportunistic.

AbstractThis article discusses the importance of reusing existing data in research. In addition to reuse data for replication of earlier findings and for answering extended or new research questions, we propose a third application of data reuse: studying the phenomenon from an alternative causal perspective. We focus on the reuse of data with a necessity causal perspective ("if not X, then not Y") as employed in necessary condition analysis (NCA). Such reuse of data offers additional insights compared with those obtained from the conventional probabilistic causal perspective ("if X, then probably Y") as employed in regression analysis. NCA is gaining recognition in various fields, including strategic management. Reusing data for conducting NCA is an efficient way to get new causal insights. We provide recommendations on how to use NCA with existing data and emphasize the importance of transparency when reusing data.

In this paper, we investigate how interorganizational networks and interpersonal networks interact over time. We present a retrospective longitudinal case study of the network system that developed a novel aircraft material and analyze change episodes from a structurationist perspective. We identify five types of episodes in which interpersonal and interorganizational networks interact (persistence, prospecting, consolidation, reconfiguration, and dissolution) and analyze conditions for these episodes and sequences among them. Our findings advance a cross-level perspective on embeddedness and show how individuals may draw on relational and structural embeddedness as distributed resources. The multiple levels of embeddedness impact network dynamics by introducing converging and diverging dialectics, thereby limiting path dependence and proactive network orchestration.

PurposeContemporary supply chain relationships inherently rely on delegation of work between organizations and, thus, are subject to agency problems for which a wide range of governance mechanisms exist. This review of agency theory (AT), across four distinct fields, explains the connection between governance mechanisms and supply chain relationship types.Design/methodology/approachThe study uses a systematic literature review (SLR) of articles using AT in a supply chain context from the operations and supply chain management, general management, marketing, and economics fields.FindingsThe authors categorize the governance mechanisms identified to create a typology of agency relationships in supply chains.Research limitations/implicationsThe developed typology provides parsimonious theory on different forms of supply chain agency relationships and takes a step towards a "supply chain-oriented agency theory" explaining and predicting relationship types and governance in supply chains. Furthermore, a future research agenda calls for more accurate measuring of agency costs, to examine residual gains alongside residual losses, to take a dual-sided perspective of agency relations and to adopt AT to examine more complex supply networks.Practical implicationsThe review provides a menu of governance mechanisms and describes situations under which these mechanisms could be deployed to guide managers when developing their supply chain relationships.Originality/valueThe first review to combine and elaborate views from four major disciplines using AT as a lens to supply chain relationships. Expanding the traditional set of governance mechanisms provides academics and practitioners with a bigger "menu" of options to consider.

Purpose Despite the unparalleled importance of value within healthcare, value-based models remain underutilised in the procurement of medical devices. Research is needed to understand what factors incentivise standard, low-priced device purchasing as opposed to value-adding devices with potentially higher overall health outcomes. Framed in agency theory, we examine the conditions under which different actors involved in purchasing decisions select premium-priced, value-adding medical devices over low-priced, standard medical devices.Design/methodology/approach We conducted 2 × 2 × 2 between-subjects scenario-based vignette experiments on three UK-based online samples of managers (n = 599), medical professionals (n = 279) and purchasing managers (n = 449) with subjects randomly assigned to three treatments: (1) cost-saving incentives, (2) risk-sharing contracts and (3) stronger (versus weaker) clinical evidence.Findings Our analysis demonstrates the harmful effects of intra-organisational cost-saving incentives on value-based purchasing (VBP) adoption; the positive impact of inter-organisational risk-sharing contracts, especially when medical professionals are involved in decision-making; and the challenge of leveraging clinical evidence to support value claims.Research limitations/implications Our results demonstrate the need to align incentives in a context with multiple intra- and inter-organisational agency relationships at play, as well as the difficulty of reducing information asymmetry when information is not easily interpretable to all decision-makers. Overall, the intra-organisational agency factors strongly influenced the choices for the inter-organisational agency relationship.Originality/value We contribute to VBP in healthcare by examining the role of intra- and inter-organisational agency relationships and incentives concerning VBP (non-) adoption. We also examine how the impact of such mechanisms differs between medical and purchasing (management) professionals.

PurposeThe paper examines the moderating role of a purchasing function's absorptive capacity (AC) on the relationship between the use of electronic purchasing tools and category level purchasing performance. The authors argue that an e‐purchasing tool may not in itself positively influence performance unless combined with AC as a human interface to maximise its information and transactional improvement potential.Design/methodology/approachSurvey data collected from 297 procurement executives of large companies in ten countries are analysed using confirmatory factor analysis (CFA) and hierarchical moderated regression.FindingsThe results demonstrate few significant direct effects of e‐purchasing tools on category performance. All performance measures studied are enhanced when dimensions of AC and their interactions with the e‐purchasing tools are added. Specifically, buyer competence, manager competence and communications climate have performance‐enhancing effects. In some cases, AC on its own appears to increase performance more than e‐tools.Originality/valueThis paper is the first to study the moderating effects of AC on the relationship between e‐purchasing tool usage and category performance. Its findings support the view that simply implementing technology does not lead to performance improvements, but that a human interface is required to maximise the information and transactional improvement potential of e‐purchasing tools.

BACKGROUND: Despite the high potential of big data, their applications in health care face many organizational, social, financial, and regulatory challenges. The societal dimensions of big data are underrepresented in much medical research. Little is known about integrating big data applications in the corporate routines of hospitals and other care providers. Equally little is understood about embedding big data applications in daily work practices and how they lead to actual improvements for health care actors, such as patients, care professionals, care providers, information technology companies, payers, and the society. OBJECTIVE: This planned study aims to provide an integrated analysis of big data applications, focusing on the interrelations among concrete big data experiments, organizational routines, and relevant systemic and societal dimensions. To understand the similarities and differences between interactions in various contexts, the study covers 12 big data pilot projects in eight European countries, each with its own health care system. Workshops will be held with stakeholders to discuss the findings, our recommendations, and the implementation. Dissemination is supported by visual representations developed to share the knowledge gained. METHODS: This study will utilize a mixed-methods approach that combines performance measurements, interviews, document analysis, and cocreation workshops. Analysis will be structured around the following four key dimensions: performance, embedding, legitimation, and value creation. Data and their interrelations across the dimensions will be synthesized per application and per country. RESULTS: The study was funded in August 2017. Data collection started in April 2018 and will continue until September 2021. The multidisciplinary focus of this study enables us to combine insights from several social sciences (health policy analysis, business administration, innovation studies, organization studies, ethics, and health services research) to advance a holistic understanding of big data value realization. The multinational character enables comparative analysis across the following eight European countries: Austria, France, Germany, Ireland, the Netherlands, Spain, Sweden, and the United Kingdom. Given that national and organizational contexts change over time, it will not be possible to isolate the factors and actors that explain the implementation of big data applications. The visual representations developed for dissemination purposes will help to reduce complexity and clarify the relations between the various dimensions. CONCLUSIONS: This study will develop an integrated approach to big data applications that considers the interrelations among concrete big data experiments, organizational routines, and relevant systemic and societal dimensions. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/16779.