Advanced Medical Imaging in Privately Insured Patients Recent Trends in Utilization and Payments

Boston University Health Policy Institut

Hospital implementation of health information technology and quality of care: are they related?

Recently, there has been considerable effort to promote the use of health information technology (HIT) in order to improve health care quality. However, relatively little is known about the extent to which HIT implementation is associated with hospital patient care quality. We undertook this study to determine the association of various HITs with: hospital quality improvement (QI) practices and strategies; adherence to process of care measures; risk-adjusted inpatient mortality; patient satisfaction; and assessment of patient care quality by hospital quality managers and front-line clinicians.This work was supported by a grant from the Commonwealth Fund. We are indebted to Anthony Shih and Anne-Marie Audet of the Fund for their advice, support, and constructive suggestions throughout the design and conduct of the study. We thank our colleagues - Raymond Kang, Peter Kralovec, Sally Holmes, Frances Margolin, and Deborah Bohr - for their valuable contributions to the development of the QAS, the CPS, and the database on which the analytic findings reported here were based. We also thank 3 M (TM) Health Information Systems' for use of its All Patient Refined Diagnosis Related Groups (APR-DRGs) software. We especially wish to thank Jennifer Drake for her contributions not only to survey development, but also to earlier analysis of survey findings relevant to this paper. (Commonwealth Fund)Published versio

Improving Care for Individuals With Limited English Proficiency: Facilitators and Barriers to Providing Language Services in California Public Hospitals

Evaluates twelve public hospitals' efforts to improve language services for patients with limited English proficiency: policies and procedures, organizational commitment, strategies for change, training, effectiveness, and facilitators and barriers

Using Strategic Information Systems to Improve Contracted Services and Assess Privatization Options

Government officials are looking to contracting out and privatization as means to create a public sector that works better and costs less. This new approach to public service delivery is evident in the welfare to work reforms of the 1990s, low- and moderate-income housing construction and management, homeless services, economic development and job training, and the charter school movement. Contracted services require a whole new set of skills for government workers, including contract design, negotiation, monitoring, and evaluation. Sophisticated information systems are crucial to performance management and evaluation systems that are essential to effective contract management. This chapter explores the theory and practice of performance measurement and information technology (IT) in the context of outsourcing public service delivery. It discusses the use of government strategic planning and information-based performance management to plan and manage private contractors performing public tasks. While information systems are critical to the management of in-house organizational units, we believe they are even more important in managing the work of contractors

Public Participation and Shaping Urban Development: The Case of the Atlantic Yard and Nets Arena Project in Brooklyn

This paper provides background on New York City's land use development process requirements and then presents a case study of sports facility development processes in New York City

When Government Is Reinvented, Ethics and Entrepreneurship Can Peacefully Coexist

Article on necessity of public entrepreneurship in governmen

Trends in 20th Century United States Government Ethics

This paper provides a broad overview of five perspectives on the public service ethics agenda, incorporating a current debate which may well emerge as the initial reform agenda of the new millennium. Perspectives explored include the politics/administration dichotomy, the New Public Administration's emphasis on individual responsibility in the context of strong organizational values and norms, the ethical risks of public entrepreneurship, and the recent emergence of spiritualism as a guide to public ethical decision-making. The authors conclude that we are entering a new era of public ethics where performance and morality will be accorded equal priority. They argue that public entrepreneurship is increasingly essential to meet the public's demands for government that works better and costs less. Most public officials will need on-the-job training and/or ethics courses in schools of public policy and administration to competently assess the ethical risks and dangers that a particular policy innovation may encompass

The Use of the Internet in Government Service Delivery

Governments have begun to use the World Wide Web to assist in service delivery. This includes, but goes far beyond, the dissemination of information to the general public and involves a variety of other governmental functions. In reviewing some government websites it is clear that the use of the web for service delivery is still in its infancy. The types of services that can be delivered through the web are still in the process of being imagined and organized by both government and the private sector. Over the next decade we can expect to see a great deal of experimentation and organizational learn- ing in this area. The purpose of this report is to accelerate this learning process by studying several noteworthy current government efforts to use the web for interactive functions. The methodology of this study is to select a number of illustrative case studies on the use of e-commerce and the Internet in government service delivery and communications. The study includes a content analysis of selected state, local, and federal government websites and, where available, an analysis of the costs and benefits of switching to web-based service delivery. We selected cases in Alaska, the U.S. Internal Revenue Service, the city of Boston, Florida, Indiana, and Texas. We discuss the lessons learned from these cases and their broader implications for government service delivery. Then we provide a checklist of the steps that governments should take when using the Internet to deliver government service. Finally, we present background on the websites we reviewed, discuss the development and implementation of the site, and analyze its costs and benefits

Trends in 20th Century United States Government Ethics

As the twentieth century comes to a close, ethics is returning to the public sector reform agenda. Just as it was at the turn of this century the current focus is on the administrative branch of government. Then, as now, scandals involving elected officials prompted the reform initiatives. However, today there is far less consensus on the most appropriate elements of the reform agenda, perhaps reflecting a century of less than successful ethically-driven reforms

Independent Contracting Policy and Management Analysis

This study provides an in-depth management and policy analysis of the independent contractor model in the modern U.S. economy. We pay extensive attention to the complex issue of misclassifying employees as contractors, a minor, but salient issue on the nation’s political and regulatory agenda. The report is divided into three sections: • Part I discusses the independent contracting model and relevant issues of organizational management. • Part II analyzes most common types of independent contractors, varied across industries and varied by size and discusses the complex policy and legal environment that independent contractors operate under in the United States. • Part III concludes with a discussion of independent contracting’s place in the current and future U.S. economy amid recently heightened national scrutiny and includes a discussion of best practices for companies who engage with independent contractors