Abstract
Independent practice association (IPA) model health maintenance organizations (HMO's) represent one of the fastest growing segments of managed care in the United States. IPA's have unique organizational characteristics which thwart efforts to function as a unified whole, particularly where quality of care programs are concerned. Living systems theory was employed as a method to identify subsystems and critical processes within an IPA model HMO in rural California. The application of living systems theory in this way provided insights into the quality of care program within the IPA, which could eventually lead to a redesign of critical processes within the entire system.
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