Medicaid Managed Care for Children with Special Health Care Needs: Examining Legislative and Judicial Constraints on Privatization

Abstract

Over the past decade, much has been written about the results of reinventing government. Most research has examined the effects of executive or managerial perspectives. Using David Rosenbloom's competing perspectives model, we examine Medicaid managed care programs for children with special health care needs to illustrate the influence of legislative and judicial institutional perspectives on the reinvention movement. Legislative and judicial responses to the reinvention of Medicaid managed care reveal the outer limits of what managed care and related executive reforms can accomplish in a Constitutional system that is based on checks and balances among competing institutional perspectives. Furthermore, relative to Medicaid managed care, legislative and judicial responses conserve public responsibility to society's most vulnerable populations. In the long run, the balance of institutional perspectives and values—not managerial innovation per se—will influence public administration.

Trends in the Study of Public Administration: Empirical and Qualitative Observations from Public Administration Review, 2000–2009

“…While emphasizing efficiency and effectiveness, NPM was found to be less efficient and effective in its implementation (Leland and Smirnova 2009; Lenkowsky and Perry 2000; Moynihan 2006; Thompson 2000), and the inconsistency between the theory and practice was highlighted (Van Slyke 2003; Williams 2000). Moreover, observers argued that NPM undermined accountability to citizens and civil society (Eikenberry and Kluver 2004; Kelly 2005; Romzek and Johnston 2005), and that legislative and judicial constraints were overlooked (Reed and Meyer 2004). Also, skeptics recommended alternatives to NPM principles, while underlining the importance of publicness (Bozeman 2002; deLeon and Denhardt 2000; Haque 2001; Walters, Aydelotte, and Miller 2000; Van der Wal 2009), citizenship and civil society (Spicer 2004; Vigoda 2002), “substantive democracy” (Box et al 2001), constitutional democracy (Rosenbloom 2007), public service (Denhardt and Denhardt 2000; Jos and Tompkins 2009), and “the whole‐of‐government approach” (Christensen and Lægreid 2007).…”

The Evolution of Internal IT Applications and e-Government Studies in Public Administration

“…Rosenbloom's three competing approaches to public administration have been adopted as a useful framework by a number of scholars for various studies on the phenomena surrounding the enterprise of government (B. Brown & Stillman, 1985), contemporary public administration approaches (Lan & Anders, 2000), drug testing policy (Knowles & Riccucci, 2001), and the assessment of health care programs in the public sector (Reed & Meyer, 2004).…”

Th e Decision to Contract Out: A Study of Contracting for E‐Government Services in State Governments

“…However, many of these types of services (e.g., health care and human services) are frequently contracted out (Ferris and Graddy 1986; ICMA 1997; Van Slyke 2003). Other scholars have developed criteria for a variety of service characteristics to facilitate the decision to contract out, including stability of demand (Kelman 2002), technology requirements (Brown and Brudney 1998), and legal constraints (Reed and Meyer 2004). Moreover, the use of external producers depends on whether the service is offered by the market.…”