The third sector is becoming a growing provider of public, social, and health services. However, there is little evidence on the effectiveness of third sector organisations (TSOs), and their capacity ...to implement evidence-based interventions (EBIs). Understanding implementation aspects of service delivery remains an important issue in clinical practice, but is poorly understood in the context of TSOs. This is problematic, since implementation issues are known to be critical for effective intervention outcomes.
To identify and synthesise existing research on what barriers and facilitators influence the implementation process of TSOs delivering EBIs.
This review is reported according to PRISMA guidelines and was pre-registered in PROSPERO. Key databases were searched using relevant terms, experts in the field were contacted, and websites were reviewed. All identified studies were double-screened, and data were extracted independently by two authors. Included studies were synthesised using thematic analysis and were quality appraised.
Thirty-one studies were included, most of which were conducted in North America. The thematic synthesis identified resource limitations, in particular staff and finance, to be the most reported barrier to TSOs implementing EBIs. Organisational culture, including factors such as alignment between the mission of the TSO and EBI, and support/prioritisation of the implementation process were the most reported facilitators. These findings generalise across the included studies and are robust to study quality assessment.
While it is often assumed that good outcomes follow when implementing interventions that have been developed and tested according to best practice, little attention has been paid to how EBIs are best transported, contextualised, and implemented by third sector providers. This systematic review found that TSOs faced considerable challenges in implementing EBIs, which were primarily a lack of support and expertise, and unclear/insufficient guidelines on how to adapt EBIs to different populations. To address these challenges, it is important to engage with central stakeholders, such as funders, researchers, policymakers, and practitioners, to discuss how these needs can be met.
PROSPERO: CRD42017073090 .
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Accountable care organizations (ACOs) and the more general movement toward accountable care, in which payments are aligned directly with improvements in quality and cost, are intended to increase the ...incentives and support for higher value in health care. As of mid-2013, there are over 4 million beneficiaries covered by Medicare ACOs, and large private payers continue to enter new ACO arrangements with providers in all parts of the country. An increasing number of states have approved and are implementing accountable care models for their Medicaid programs. A review of some of these early state adopters demonstrates how the features of Medicaid populations, Medicaid providers, and Medicaid financing create some distinct issues for implementing ACOs in Medicaid. Many states that have relied on Medicaid managed care plans are moving to accountable care through these private plans. Some states also are implementing accountable care reforms through direct reforms in their payments to Medicaid providers, both through specific providers and regionally-based contracts. Others are implementing a mixture of private plan and public management approaches. States are moving toward more comprehensive accountable care payments through patient-centered medical homes, episode-based payments, and patient-level accountable care payment reforms; these payment reforms can be sequential and synergistic. Accountable care in Medicaid involves some distinct considerations such as performance measures, additional complications in shared savings related to the federal-state Medicaid funding structure, and potential antitrust issues in cases where states are pursuing reforms with implications for most or all providers in a geographic area. The evidence on the impact of the various early approaches to accountable care in Medicaid is just beginning to emerge, and it is likely that the best course for states will continue to depend on the distinctive institutional features of their Medicaid programs and health care delivery systems. As in other parts of the health care system, accountable care in Medicaid is likely to continue to expand and to evolve. (
Population Health Management
2013;16:S-4–S-11)
Current State of Value-Based Purchasing Programs Chee, Tingyin T; Ryan, Andrew M; Wasfy, Jason H ...
Circulation (New York, N.Y.),
2016-May-31, 2016-05-31, 20160531, Volume:
133, Issue:
22
Journal Article
Peer reviewed
Open access
The US healthcare system is rapidly moving toward rewarding value. Recent legislation, such as the Affordable Care Act and the Medicare Access and CHIP Reauthorization Act, solidified the role of ...value-based payment in Medicare. Many private insurers are following Medicare’s lead. Much of the policy attention has been on programs such as accountable care organizations and bundled payments; yet, value-based purchasing (VBP) or pay-for-performance, defined as providers being paid fee-for-service with payment adjustments up or down based on value metrics, remains a core element of value payment in Medicare Access and CHIP Reauthorization Act and will likely remain so for the foreseeable future. This review article summarizes the current state of VBP programs and provides analysis of the strengths, weaknesses, and opportunities for the future. Multiple inpatient and outpatient VBP programs have been implemented and evaluated; the impact of those programs has been marginal. Opportunities to enhance the performance of VBP programs include improving the quality measurement science, strengthening both the size and design of incentives, reducing health disparities, establishing broad outcome measurement, choosing appropriate comparison targets, and determining the optimal role of VBP relative to alternative payment models. VBP programs will play a significant role in healthcare delivery for years to come, and they serve as an opportunity for providers to build the infrastructure needed for value-oriented care.
A unifying theme in the literature on organizations such as public bureaucracies and private nonprofits is the importance of mission, as opposed to profit, as an organizational goal. Such ...mission-oriented organizations are frequently staffed by motivated agents who subscribe to the mission. This paper studies incentives in such contexts and emphasizes the role of matching the mission preferences of principals and agents in increasing organizational efficiency. Matching economizes on the need for high-powered incentives. It can also, however, entrench bureaucratic conservatism and resistance to innovations. The framework developed in this paper is applied to school competition, incentives in the public sector and in private nonprofits, and the interdependence of incentives and productivity between the private for-profit sector and the mission-oriented sector through occupational choice.
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BFBNIB, CEKLJ, INZLJ, IZUM, KILJ, NMLJ, NUK, ODKLJ, PILJ, PNG, SAZU, UL, UM, UPUK, ZRSKP
A partir de una muestra aleatoria de doscientas Organizaciones de la Sociedad Civil (OSC) en México, se analiza la transparencia con que dichas organizaciones reportan sus fuentes de financiamiento y ...sus reglas básicas de funcionamiento, como la membresía. Los resultados apuntan a que la transparencia con que las OSC en México hacen explícitos los intereses de personas u organizaciones que representan o las financian es muy baja. El artículo argumenta, con base en estos resultados y en la experiencia de este sector de organizaciones en otros países (se utiliza el caso de eua), que cuando el grado en que los intereses de los miembros y los financiadores se hacen explícitos y públicos, redunda en una mayor solidez social y política, a largo plazo, para las propias OSC.
Care coordination has become a central theme of new payment and delivery systems. There is, however, at least one downside to care coordination arrangements: they clash with existing regulations on ...financial conflicts of interest in medicine.
Through an ethnographic study of the 'Barefoot College', an internationally renowned non- governmental development organisation (NGO) situated in Rajasthan, India, this book investigates the methods ...and practices by which a development organisation materialises and manages a construction of success -- .
"Think globally, act locally" is a phrase many of us grew up hearing. What we weren't told, however, is how hard it is to accomplish. This work mines the well-researched field of global mindset by ...exploring the ways global knowledge allows organizations of any size or tenure to become more effective on the global scene. It draws on a case study of an international religious community to show how global partnerships can be improved and how organizational members can grow professionally and personally from a global mindset--even if they never step foot on a plane.
In this article we show the potential of using documents to answer research questions pertinent to nonprofit and voluntary sector studies. We start by introducing what the methodological literature ...has to say about how documents are employed as a data source, along with their strengths and weaknesses. Then, we review 178 articles in three main nonprofit journals to analyze how researchers have used documents to understand nonprofit and voluntary sector organizations. We also provide a case example of document analysis to reveal the processes involved in using documents as a source of evidence. We emphasize that situating documents in a field of action invites researchers to pay attention not only to the information they contain but also what their production and consumption reveal about organizational life. Finally, we conclude with the implications and considerations for using documents in nonprofit and voluntary sector research.
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CEKLJ, DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, ODKLJ, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UILJ, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
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