Politics at the Cutting Edge: Intergovernmental Policy Innovation in the Affordable Care Act

In the eight years since the passage of the Patient Protection and Affordable Care Act (ACA), state governments have remained critical sites of contention over the law. Intense partisan conflict over ACA implementation has raised questions about traditional theories of intergovernmental relations, which posit that federal–state cooperation depends largely on policy design. Yet, few studies have examined how partisanship, as well as other important factors, shape state policy innovations under the ACA. This article examines the ACA’s State Innovation Models (SIM) initiative. SIM is specifically geared towards incentivizing states to experiment with new models of payment and delivery that can improve health outcomes and/or reduce health-care costs. Drawing on a combination of quantitative and qualitative evidence, we find that states’ participation in SIM is shaped by partisanship, administrative capacity, and state policy legacies. Our findings have implications for future efforts at intergovernmental health reforms

Appraisal Requirements for CMMI, Version 1.1 (ARC, V1.1)

The Appraisal Requirements for CMMI (ARC) V1.1 defines the requirements considered essential to appraisal methods intended for use with Capability Maturity Model Integration (CMMI) models. In addition, a set of appraisal classes is defined, based on typical applications of appraisal methods. These classes are intended primarily for developers of appraisal methods to use with CMMI capability models in the context of the CMMI Product Suite. Appraisal methods, as used in this document, may be applied for different purposes, including assessments for internal process improvement and capability evaluations for supplier selection and process monitoring. This document defines the requirements for such methods, but not necessarily the conditions or constraints under which they might be applied. The approach employed to provide guidance to appraisal method developers is to define a set of typical applications of appraisal methods (which are based on years of experience in the process improvement community) called appraisal method classes. Requirements are then allocated to each class as appropriate based on the attributes associated with that class. Thus, a particular appraisal method may be declared to be an ARC Class A, B, or C appraisal method. This designation implies the sets of ARC requirements that the method developer has addressed when designing the method

Capability Maturity Model® Integration (CMMI), Version 1.1--Continuous Representation

Capability Maturity Model Integration (CMMI) models have evolved the Capability Maturity Model (CMM) concept, established by the Capability Maturity Model for Software (SW-CMM), to a new level that enables the continued growth and expansion of the CMM concept to multiple disciplines. Like the SW-CMM, EIA/IS 731, IPD-CMM, SA-CMM, and other process improvement models, CMMI models are tools that help organizations improve their processes. This CMMI model is designed to help organizations improve their product and service development, acquisition, and maintenance processes. Concepts covered by this model include systems engineering, software engineering, integrated product and process development, and supplier sourcing as well as traditional CMM concepts such as process management and project management. Each CMMI model is designed to be used in concert with other CMMI models, making it easier for organizations to pursue enterprise-wide process improvement at their own pace. This CMMI model has a continuous representation, which focuses on measuring process improvement using capability levels. Capability levels apply to process-improvement achievement within individual process areas such as configuration management or verification