Today's public managers not only have to function as leaders within their agencies, they must also establish and coordinate multi-organizational networks of other public agencies, private ...contractors, and the public. This important transformation has been the subject of an explosion of research in recent years.The Collaborative Public Managerbrings together original contributions by some of today's top public management and public policy scholars who address cutting-edge issues that affect government managers worldwide. State-of-the-art empirical research reveals why and how public managers collaborate and how they motivate others to do the same. Examining tough issues such as organizational design and performance, resource sharing, and contracting, the contributors draw lessons from real-life situations as they provide tools to meet the challenges of managing conflict within interorganizational, interpersonal networks. This book pushes scholars, students, and professionals to rethink what they know about collaborative public management-and to strive harder to achieve its full potential.
Local governments do not stand alone—they find themselves in new relationships not only with state and federal government, but often with a widening spectrum of other public and private organizations ...as well. The result of this re-forming of local governments calls for new collaborations and managerial responses that occur in addition to governmental and bureaucratic processes-as-usual, bringing locally generated strategies or what the authors call "jurisdiction-based management" into play. Based on an extensive study of 237 cities within five states, Collaborative Public Management provides an in-depth look at how city officials work with other governments and organizations to develop their city economies and what makes these collaborations work. Exploring the more complex nature of collaboration across jurisdictions, governments, and sectors, Agranoff and McGuire illustrate how public managers address complex problems through strategic partnerships, networks, contractual relationships, alliances, committees, coalitions, consortia, and councils as they function together to meet public demands through other government agencies, nonprofit associations, for-profit entities, and many other types of nongovernmental organizations. Beyond the "how" and "why," Collaborative Public Management identifies the importance of different managerial approaches by breaking them down into parts and sequences, and describing the many kinds of collaborative activities and processes that allow local governments to function in new ways to address the most nettlesome public challenges.
Summary The private for-profit sector's prominence in health-care delivery, and concern about its failures to deliver social benefit, has driven a search for interventions to improve the sector's ...functioning. We review evidence for the effectiveness and limitations of such private sector interventions in low-income and middle-income countries. Few robust assessments are available, but some conclusions are possible. Prohibiting the private sector is very unlikely to succeed, and regulatory approaches face persistent challenges in many low-income and middle-income countries. Attention is therefore turning to interventions that encourage private providers to improve quality and coverage (while advancing their financial interests) such as social marketing, social franchising, vouchers, and contracting. However, evidence about the effect on clinical quality, coverage, equity, and cost-effectiveness is inadequate. Other challenges concern scalability and scope, indicating the limitations of such interventions as a basis for universal health coverage, though interventions can address focused problems on a restricted scale.
The World Health Organization advocates the goal of universal coverage of health systems to ensure that everyone can avail the services they need and are protected from the associated financial ...risks. Governments are increasingly engaging and interacting with the private sector in initiatives collectively referred to as public-private partnerships (PPPs) to enhance the capacity of health systems to meet this objective. Understanding the values that motivate partners and demonstrating commitment for building relationships were found to be key lessons in building effective PPPs; however there, remain many research gaps. This study focusses on the practice of PPPs at the inter-organisational (meso) level and interpersonal (micro) level in Hong Kong Special Administrative Region (HKSAR). The influence of the structural components of different PPPs on stakeholder interpretation and actions, as well as the eventual outcomes of the PPPs, is examined, in terms of a realist evaluation, which applies a context–mechanism–outcome configuration as the research methodology. Seven key factors initiating commitment in a partnership, critical for sustainable PPPs, were identified as follows: (1) building of trust; (2) clearly defined objectives and roles; (3) time commitment; (4) transparency and candid information, particularly in relation to risk and benefit; (5) contract flexibility; (6) technical assistance or financial incentive behind procedural arrangements; and (7) the awareness and acceptability of structural changes related to responsibility and decisions (power and authority).
•Definition and conceptualization of PPPs are inconsistent in different countries.•Heterogeneity of PPPs in different contexts is important during evaluation.•Realist evaluation was recommended methodology to better understand the impact of PPPs.•7 key factors were identified for the role of PPP in strengthening health system.
Governments around the world, but especially in Europe, have increasingly used private sector involvement in developing, financing and providing public health infrastructure and service delivery ...through public–private partnerships (PPPs). Reasons for this uptake are manifold ranging from rising expenditures for refurbishing, maintaining and operating public assets, and increasing constraints on government budgets stifle, seeking innovation through private sector acumen and aiming for better risk management. Although PPPs have attracted practitioner and academic interest over the last two decades, there has been no attempt to integrate the general and health management literature to provide a holistic view of PPPs in healthcare delivery. This study analyzes over 1400 publications from a wide range of disciplines over a 20-year time period. We find that despite the scale and significance of the phenomenon, there is relatively limited conceptualization and in-depth empirical investigation. Based on bibliographic and content analyses, we synthesize formerly dispersed research perspectives into a comprehensive multi-dimensional framework of public-private partnerships. In so doing, we provide new directions for further research and practice.
•Governments turn to private sector involvement in developing, financing and providing health infrastructure and services.•These public–private partnerships (PPPs) carry important organizational strategy, management and policy implications.•We combine comprehensive bibliographic and content analyses of over 1400 PPP papers published over the last two decades.•Despite the significance of PPPs, there is limited prior conceptualization and in-depth empirical investigation.•We synthesize formerly dispersed research perspectives into a comprehensive multi-dimensional framework of PPPs.
Managing PPP projects is not a routine job, as every PPP project is different and should be managed accordingly. These projects require considerable capability and skills from both public sector and ...private sector managers involved, Strategic Issues in Public Private Partnerships, Second Edition, delivers the insight and tools necessary to assist those managers. As Public private partnership (PPP) arrangements become an increasingly popular way for national governments to fund and develop public infrastructure and urban areas with private sector contributions, a better understanding of the risks involved is crucial. The second edition of Strategic Issues in Public Private Partnerships : Provides an international overview of the application of concessions - the most common form of PPP eg PFI (Private Finance Initiative); BO(O)T (Build/Own/Operate/Transfer) or DBFMO (Design/Build/Finance/ Maintain/Operate). Focusses on the introduction of concessions and the problems encountered, the solutions found for these problems, and the different approaches to concessions chosen across different countries. Provides a strategic overview for those involved in setting up and managing PPP projects. Illustrates lessons from different national backgrounds and gives managers the insight and tools to manage PPP projects effectively. Essential reading for Contractors & funding organizations involved in PPP projects as well as Researchers in construction management and public administration.
A single hospital admission can deplete household resources so considerably as to induce impoverishment, especially in the Indian context of low government healthcare expenditure. Rashtriya Swasthya ...Bima Yojana (RSBY) was a national health insurance scheme for below-poverty-line Indian families, to provide improved access to hospitalization and greater financial protection via a public-private-partnership employing private sector implementation capacity. Study objectives were to understand governance (including regulatory) environment and contract arrangements; evaluate expansion of services to beneficiaries; and assess compliance of providers and user satisfaction. A case study approach in two districts met the need for in-depth information on scheme functioning, and RSBY implementation was examined between 2011 and 13 in Patiala (Punjab) and Yamunanagar (Haryana). Methods included 20 key stakeholder interviews, analysis of secondary datasets on beneficiaries and claims, primary data collection in 31 public and private hospitals and in greater depth in 12 hospitals, and an exit survey of 751 patients. Enrolled and non-enrolled hospitals were mapped in each district and service availability of enrolled hospitals assessed; enrollee characteristics were analysed; for the 12 hospitals, information was obtained on structural quality and process of care, and patient satisfaction and out-of-pocket payments.
The Indian states and the government of India did not specify formal regulatory and implementation procedures in detail and states largely contracted out their functions to private insurance firms. Findings show regulatory weaknesses, and contractual breaches. Enrolment rates were low in both districts and more so for Patiala and there was limited access to services. There was little difference in process of care between public and private hospitals, though the structural capacity of private hospitals was better than public hospitals. RSBY helped improve accessibility and gave some degree of financial protection to patients. It also actively engaged with existing resources in the Indian health care and insurance markets.
•Contract specification and compliance were major challenges in RSBY.•Out-of-pocket payment for care was significant, especially in private hospitals.•There were few differences in care quality between public and private hospitals.•RSBY patients were slightly more satisfied than non-RSBY patients.•PPP schemes demand effective regulatory and monitoring systems.
Summary The private sector has a large and growing role in health systems in low-income and middle-income countries. The goal of universal health coverage provides a renewed focus on taking a system ...perspective in designing policies to manage the private sector. This perspective requires choosing policies that will contribute to the performance of the system as a whole, rather than of any sector individually. Here we draw and extrapolate main messages from the papers in this Series and additional sources to inform policy and research agendas in the context of global and country level efforts to secure universal health coverage in low-income and middle-income countries. Recognising that private providers are highly heterogeneous in terms of their size, objectives, and quality, we explore the types of policy that might respond appropriately to the challenges and opportunities created by four stylised private provider types: the low-quality, underqualified sector that serves poor people in many countries; not-for-profit providers that operate on a range of scales; formally registered small-to-medium private practices; and the corporate commercial hospital sector, which is growing rapidly and about which little is known.
Objective
To compare staffing levels and deficiencies of the 10 largest U.S. for‐profit nursing home chains with five other ownership groups and chain staffing and deficiencies before and after ...purchase by four private equity (PE) companies.
Data Sources
Facilities for the largest for‐profit chains were identified through Internet searches and company reports and matched with federal secondary data for 2003–2008 for each ownership group.
Study Design
Descriptive statistics and generalized estimation equation panel regression models examined staffing and deficiencies by ownership groups in the 2003–2008 period, controlling for facility characteristics, resident acuity, and market factors with state fixed effects.
Principal Findings
The top 10 for‐profit chains had lower registered nurse and total nurse staffing hours than government facilities, controlling for other factors. The top 10 chains received 36 percent higher deficiencies and 41 percent higher serious deficiencies than government facilities. Other for‐profit facilities also had lower staffing and higher deficiencies than government facilities. The chains purchased by PE companies showed little change in staffing levels, but the number of deficiencies and serious deficiencies increased in some postpurchase years compared with the prepurchase period.
Conclusions
There is a need for greater study of large for‐profit chains as well as those chains purchased by PE companies.
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