Organizing the U.S. Health Care Delivery System for High Performance

Analyzes the fragmentation of the healthcare delivery system and makes policy recommendations -- including payment reform, regulatory changes, and infrastructure -- for creating mechanisms to coordinate care across providers and settings

Partnering for Impact: Government-Nonprofit Contracting Reform Task Forces Produce Results for Taxpayers

This report reviews the creation, recommendations, and implementation activities of joint government nonprofit contracting reform task forces in nine states to identify trends and insights that can be applied elsewhere. It is the latest publication in an ongoing series from the National Council of Nonprofits that identifies solutions to a national crisis: broken and antiquated contracting processes that waste limited resources and frustrate the ability of governments and charitable nonprofits to achieve their missions. This report provides proven ways for governments and nonprofits to collaborate to save money for taxpayers and donors while maintaining or even improving client-based outcomes and enhancing accountability

Strengthening governance of social safety nets in East Asia

Several East Asian countries, in the aftermath of the global financial crisis, are considering an expansion of their social safety net programs. In many cases, existing delivery mechanisms for social assistance in the region tend to be basic, in line with the small size of programs. In a context of coverage expansion and proliferation of new programs, the risk of creating increasingly complex systems characterized by cross-incentives is high. Lack of coordination, ambiguous criteria for identifying and selecting beneficiaries, low administrative capacity, lack of transparency and limited beneficiary participation pose risks for program effectiveness and can decrease accountability. Good governance can improve program outcomes through effective program coordination, stronger accountability arrangements, provider incentives and greater transparency and participation. This paper proposes an analytical framework to systematically identify governance risks and constraints which, if removed, could improve the outcomes of modern social assistance programs.Health Monitoring&Evaluation,Safety Nets and Transfers,National Governance,Governance Indicators,Poverty Monitoring&Analysis

Challenges to democratic legitimacy, scrutiny, accountability in the UK national and local state

This article suggests that at national and local levels, the British state is seemingly incapable of solving multi-faceted and intractable social, economic and environmental problems alone. It is argued that new national and local governance arrangements, based on new ideas, different ways of working, and approaches to problem solving have brought into a sharper focus on the issues of democratic legitimacy, scrutiny and accountability. All three complex and ambiguous concepts have long been a concern in public administration. This article draws from existing conceptual frameworks to show that traditional forms of legitimacy, scrutiny and accountability are now under threat. It examines the merits of the new forms, with some recommendations for the future

Costs, Complexification and Crisis: Government's Human Services Contracting System Hurts Everyone

Multiple government reports, news accounts from across the country, and now hard data from the first comprehensive nationwide survey of problems nonprofits experience through government contracts all point to one inescapable conclusion: while governments rely extensively on nonprofits to deliver human services to their most vulnerable residents, governments do so using a contracting "system" that is so woefully broken that it now jeopardizes public health and safety.The decisions to rely on nonprofits to provide services have sound policy, economic, and administrative justifications. Yet the convoluted, disjointed, and patch-worked laws and practices by which governments contract with nonprofits have led to nonpayment, underpayments, and late payments to nonprofits, in part because contracting and reporting processes have become excessively complex and irrational (through continual "complexification" as opposed to simplification).The Urban Institute's new in-depth study, Human Service Nonprofits and Government Collaboration: Findings from the 2010 National Survey of Nonprofit Government Contracting and Grants ("Urban Institute Study"), provides the results of the first national survey documenting the serious and widespread problems experienced by nonprofit human service providers under contract with governments at the local, state, and federal levels.1 Human service nonprofits include groups that provide essential needs such as food assistance, public safety, housing, child care, community and economic development, youth development, and more (but do not include other charitable nonprofits, such as arts and culture, education, or health care).This related Special Report by the National Council of Nonprofits provides additional context to the Urban Institute's findings. This Report explains how the contracting problems affect everyone in America, not just nonprofits. It also identifies specific practices that contribute to the problems being experienced, and proposes solutions that nonprofits, government officials, funders, and citizens can adopt to improve services, restore value for taxpayers, and benefit communities

Public-Private Partnerships for E-Government Services: Lessons from Malaysia

Implementation of e-government is seen as a tool to improve government service delivery to citizens, businesses and within government agencies. The benefits could be more transparency, greater convenience, less corruption, revenue growth and cost reduction. However, lack of financial resources, and low levels of skills and limited capacity of governments are some of the main obstacles faced in pursuance of e-government nationwide. The introduction of Public-Private Partnerships (PPP) is seen as a solution to overcome many of the obstacles and challenges faced by governments in realizing the objectives of e-government projects. PPP model is expected to increase opportunities for both the public and private sectors to serve their customers more effectively and efficiently. The main aim of this paper is to explore the need for PPP in e-government service delivery. This is done by discussing some success stories and looking at lessons learned by the Malaysian government to serve the stakeholders better in line with its vision and mission.- public-private partnership, information, communication, technology, e-government

Towards a network government? A critical analysis of current assessment methods for e-government

Contemporary public administrations have become increasingly more complex, having to cordinate actions with emerging actors in the public and the private spheres. In this scenario the modern ICTs have begun to be seen as an ideal vehicle to resolve some of the problems of public administration. We argue that there is a clear need to explore the extent to which public administrations are undergoing a process of transformation towards a netowork government linked to the systematic incorporation of ICTs in their basic activities. Through critically analysing a selection of e-government evaluation reports, we conclude that research should be carried out if we are to build a solid government assessment framework based on network-like organisation characteristics

Improving the Delivery of Key Work Supports: Policy & Practice Opportunities at a Critical Moment

Examines the consequences of a lack of coordination and seamless service delivery across support programs. Outlines policy, procedural, and data utilization options and best practices to expedite receipt of benefits across programs, as well as challenges