Date of Conferral



Doctor of Business Administration (D.B.A.)


Business Administration


Edward Paluch


A lack of effective operational internal controls among health management organization (HMO) leaders could lead to poor operational practices, mismanagement of the government's health care funds, increased health care spending, and a negative impact on patient health outcomes. Grounded in transformational leadership theory, the purpose of this qualitative, single case study was to explore successful internal control strategies used by leaders at a southeastern Pennsylvania HMO. Data were collected from semistructured interviews with 5 participants who held positions of director or above within the organization for at least 3 years, had institutional knowledge, and had responsibility for overseeing the organization's operations. Copious notes and transcribed interviews were analyzed using coding and word frequency to discern patterns and identify themes regarding HMO leaders' strategies. Four essential themes emerged from the analysis: (a) appropriate resources, (b) continuous audit and assessment, (c) communication, and (d) holistic approach to patient care. The findings support that HMO leaders who attain appropriate human and technical resources may efficiently and effectively maximize performance outcomes and cost savings. A key recommendation is that HMO leaders adopt a holistic management strategy that fosters collaborative relationships between leaders, managers, employees, and patients. The implications for positive social change include the potential to increase HMO leaders' understanding of corporate governance strategies that improve operational efficiencies and patient health care outcomes.