This report surveys 14 Massachusetts cities outside the immediate Boston metropolitan market, which other studies have identified as “weak market” or “gateway” cities. While useful designations, this report employs the term “Middle Cities.”

Robert Melia, author of Pioneer's White Paper entitled Public Profits From Private Contracts and former vice president of Policy Studies, Inc, used child support enforcement as a case study to compare private versus public delivery of human services. Melia argued that competitive contracting is often a more effective way of delivering services not because public employees are inefficient or private companies pay less, but because bureaucratic checks and balances are inherent in government.