The U.S. health care system is in the midst of revolutionary change. Health care costs continue to rise, significant portions of the population remain uninsured, and government regulation is increasing. The culture of organizations influences their ability to change, and research demonstrates that those with the characteristics of learning organizations are most adaptable. This study sought to establish the characteristics of health care payment organizations and to determine how well these align with the characteristics of learning organizations. A survey was sent to 138 individuals employed by 79 organizations in multiple segments of the industry to obtain their perception of their organizations' cultures. A total of 106 responses were received representing all segments. This research found that the industry overall does not demonstrate a culture profile that is closely aligned with the characteristics of learning organizations; instead, it showed a distributed culture profile with a marginal emphasis toward the Market and Clan cultures. The study provides important insight into the characteristics of the industry. Additionally, it indicates that the culture profiles and attributes vary by industry segments within the health care payment industry. The 1st conclusion is that the industry culture is not well positioned to adapt to revolutionary change. Organizations need to explore their individual culture to understand how they are uniquely positioned to become learning organizations. Second, since certain segments of the industry are better positioned; they provide a model for the rest of the industry to adopt. Third, the industry's culture profile overall shows a competitive, goal-oriented environment, driven by financial results. That focus may not be the best model for successfully adapting to revolutionary change. Finally, the study confirms that organizational culture is complex and requires in-depth analysis to plan for and adapt to the continuously changing environment.

Library of Congress Subject Headings

Dissertations (EdD) -- Organization change; Health insurance -- United States; Health care reform; Organizational behavior

Date of Award


School Affiliation

Graduate School of Education and Psychology



Degree Type


Degree Name


Faculty Advisor

Davis, Kay D.;