Housing & Community Development

The Impact of Medicaid Managed Care on Primary Care Physician Participation in Medicaid

The Impact of Medicaid Managed Care on Primary Care Physician Participation in Medicaid
Medical Care, Vol. 43, No. 9, pp 911-920, September

Greene, J., Blustein, J. & Remler, D.
09/01/2005

Objectives: Medicaid managed care has been touted as an important vehicle for increasing physician participation in Medicaid. Although there is anecdotal evidence that the opportunity to participate in Medicaid via managed care increases physician participation, no empirical study has validated the claim. This study explores the relationship between Medicaid managed care penetration at the county-level and the likelihood that a physician practicing in that county will participate in Medicaid.

Research Design: We used 3 waves of a large, nationally representative sample of primary care physicians from the Community Tracking Study followed across time (1996-2001) to estimate the impact of changing Medicaid managed care penetration levels on physician participation in the program. County-level Medicaid managed care penetration rates were collected directly from state Medicaid agencies for the study.

Findings: In cross-sectional bivariate and multivariate analyses, Medicaid managed care penetration is significantly associated with physician participation in Medicaid; however, the relationship is nonmonotonic, of small magnitude and generally not in the anticipated direction. Our analyses indicate that a 10 percentage point increase in managed care penetration would reduce the likelihood that physicians participate in Medicaid on average by 2.9 percentage points. Although commercial MCO penetration exhibited a small positive, linear relationship with physician participation, this was not sufficient to offset the effects of Medicaid-dominant MCO penetration. Panel data analysis supported these findings.

Conclusions: This study failed to find that increases in Medicaid managed care lead to increased primary care physician participation in Medicaid during the period 1996-2001.

Following the Money: Using Expenditure Analysis as an Evaluation Tool

Following the Money: Using Expenditure Analysis as an Evaluation Tool
American Journal of Evaluation, Volume 26, Number 2, 150-165.

Brecher, C., Silver, D. & Weitzman, B.C.
06/01/2005

This article describes the nature and utility of fiscal analysis in evaluating complex community interventions. Using New York University's evaluation of the Robert Wood Johnson Foundation's Urban Health Initiative as an example, the authors describe issues arising in defining and operationalizing constructs for fiscal analysis. The approach's utility is demonstrated in the use of interim findings to help redefine the program's goals for resource allocation, to modify its theory of change to include greater emphasis on state-level action, and to emphasize the importance of local public schools as resource centers and intervention targets. The fiscal analysis also provides new insights into the limitations of "preventive" versus "corrective" spending categories and helps make goals for such functional reallocation more realistic. The authors discuss limitations of fiscal analysis due to available data quality, the extent of cooperation needed from public officials to collect relevant data, and the level of expertise needed to interpret the data.

Measuring School Performance and Efficiency: Implications for Practice and Research

Measuring School Performance and Efficiency: Implications for Practice and Research
Eye on Education: Larchmont, NY,

Stiefel, L., Rubenstein, R., Schwartz, A.E. & Zabel, J., eds.
05/30/2005

School performance and efficiency measurement have taken center stage in much of the debate and research in education policy since at least the mid-1990s. Despite the clear theoretical and practical importance of understanding the ways in which school performance can be measured, only limited research exists on alternative ways to measure how well schools are educating their students, delivering what parents want, and using resources efficiently. In this volume, the authors of eight chapters address the measurement of school performance, an issue that lies in between the study of technical characteristics of student assessments, on the one hand, and the effectiveness of accountability systems that use those assessments, on the other. Although psychometricians focus on the reliability, validity, and fairness of individual student assessments, and social scientists address whether state and local accountability systems that use those student assessments are effective ways to influence school performance, the authors of this volume consider the pros and cons of alternative measurements of school performance and efficiency, per se.

Integrating Rigor and Relevance in Public Administration Scholarship: The Contribution of Narrative Inquiry

Integrating Rigor and Relevance in Public Administration Scholarship: The Contribution of Narrative Inquiry
Public Administration Review, Vol. 65, May/June, No.3, pp. 286.

Dodge, J., Ospina, S. & Foldy, E.G.
05/01/2005

A traditional view of scholarly quality defines rigor as the application of method and assumes an implicit connection with relevance. But as an applied field, public administration requires explicit attention to both rigor and relevance. Interpretive scholars' notions of rigor demand an explicit inclusion of relevance as an integral aspect of quality. As one form of interpretive research, narrative inquiry illuminates how this can be done. Appreciating this contribution requires a deeper knowledge of the logic of narrative inquiry, an acknowledgement of the diversity of narrative approaches, and attention to the implications for judging its quality. We use our story about community-based leadership research to develop and illustrate this argument.

The Use of Logic Models by Community-Based Initiatives

The Use of Logic Models by Community-Based Initiatives
Evaluation and Program Planning 2005; 28:167-172

Kaplan, S.A. & Garrett, K.E.
03/11/2005

Many grant programs now require community-based initiatives to develop logic models as part of the application process or to facilitate program monitoring and evaluation. This paper examines three such programs to understand the benefits and challenges of using logic models to help build consensus and foster collaboration within a community coalition, strengthen program design, and facilitate internal and external communication. The paper concludes with recommendations for how to make the logic model development process more useful for community-based initiatives.

It's About Time: Catching Method Up to Meaning-The Usefulness of Narrative Inquiry in Public Administration Research

It's About Time: Catching Method Up to Meaning-The Usefulness of Narrative Inquiry in Public Administration Research
Public Administration Review, Vol. 65, No. 2, pp. 143.

Ospina, S. & Dodge, J.
03/01/2005

A traditional view of scholarly quality defines rigor as the application of method and assumes an implicit connection with relevance. But as an applied field, public administration requires explicit attention to both rigor and relevance. Interpretive scholars' notions of rigor demand an explicit inclusion of relevance as an integral aspect of quality. As one form of interpretive research, narrative inquiry illuminates how this can be done. Appreciating this contribution requires a deeper knowledge of the logic of narrative inquiry, an acknowledgement of the diversity of narrative approaches, and attention to the implications for judging its quality. We use our story about community-based leadership research to develop and illustrate this argument.

Financial Management for Public, Health, and Not-for-Profit Organizations

Financial Management for Public, Health, and Not-for-Profit Organizations
2nd Edition, Prentice Hall, Upper Saddle River, NJ, 672 pages.

Finkler, S.A.
01/01/2005

This is one of the only books available that addresses financial and managerial accounting within the framework of the three major areas of the public sector. Clear and comprehensive, Finkler's unique and accessible text provides the fundamentals of financial management for those who lack a financial background so that readers can access and apply financial information more effectively. Details the many aspects of strategic and budgetary planning. Outlines the processes involved in implementing and controlling results. Features aspects of accounting unique for Health Care, not-for-profit organizations and state and local governments. Explains balance sheets, operating and cash flow statements. Provides basic foundation for financial analysis. For managers and policy-makers in public service organizations who want to make more efficient use of their organization's financial information.

Rethinking Periodization? APD & the Macro-History of the United States

Rethinking Periodization? APD & the Macro-History of the United States
Polity 2005, Volume 37, Number 4.

Kersh, R.
01/01/2005

Dividing American history into discrete periods dates to the first European colonists in North America, several of whom variously declared their region or colony to represent a "new beginning" a "new land of Canaan," a New England, and so forth: "in the New World is born a new history," as one early sermonizer had it. (1) Soon thereafter clerics and political leaders (often the same people) lamented their fellows' fall from grace; the dichotomy of golden age and descent into depravity, of Awakening and backsliding, has been an American motif ever since. Eventually, the sweep of U.S. history was sorted on a chronological, rather than theological or eschatological, basis. For well over a century political historians have in the main hewn to a familiar temporal script.

The Redevelopment of Lower Manhattan: The Role of the City

The Redevelopment of Lower Manhattan: The Role of the City
The Contentious City: The Politics of Recovery in New York City edited by John Mollenkopf. Sage Foundation,

Moss, M.
01/01/2005

The attack on the World Trade Center reinforced a process of change in lower Manhattan that had been under way for at least the past fifty years. The public and private responses to the destruction wrought on September 11 have provided the funds, organizational capacity, and public commitment to do what a previous generation of municipal planners tried to accomplish, with only partial success: creating a mixed residential and office community in what was once New York City's dominant financial and business district. Federal aid to rebuild lower Manhattan has been the catalyst for modernizing and expanding its mass transit systems and facilities, providing low-cost financing for converting obsolete office buildings into housing, improving pedestrian movement, investing public funds in parks and cultural institutions, and subsidizing the creation of new public schools. This chapter examines the key public and private organizations that have shaped this redevelopment and the implications for the future of lower Manhattan and for office development in the rest of New York City.

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