The MBTA shuttles over a million passengers a day around Greater…

The combined use of limited, or selective, provider networks and a defined contribution strategy presents an immediate opportunity for government entities and employer groups to achieve significant and sustainable health insurance savings and reduce medical cost trends, while maintaining coverage levels and quality of care. This solution illustrates the impact of changes in consumer behavior that occur as a result of economic conditions and opportunities.

Like many other states, Massachusetts has struggled with out-of-control spending on school construction, often putting money into many unnecessary projects at the expense of more deserving ones. State Treasurer Tim Cahill, a long-time entrepreneur who took office in 2003, traced the wasteful spending to poor administrative organization, a lack of oversight, and an antiquated system of reimbursements whose legacy had become exorbitant debt and a backlog of projects. Applying his business acumen and experience, Cahill in 2004 created the Massachusetts School Building Authority, an entity that would bring the rigors of the private sector to eliminate wasteful spending while raising the quality of education offered by the state.

The City of Gallup, NM, like many governmental bodies that employ field crews, suffered from an ever-increasing number of worker's compensation claims and associated annual increases in worker's compensation insurance premiums. The implementation of the Cash Incentive Safety Initiative has both improved the health of employees and reduced costs associated with absent and injured workers. As explained below, there is real potential for similar programs to benefit municipal and state governments nationwide.

After nearly a decade of evolution, municipal Stat programs, such as NYPD'sCompStat and Baltimore's CitiStat, have proved very successful in improving city service delivery and cutting unnecessary spending. Though slightly different in each implementation, all Stat programs involve frequent meetings at which key decision-makers and department heads review data on operational performance, identify problems and solutions, and track follow-up. The City of Baltimore reported $70 million in savings attributable to CitiStat in its first three years of operations. In Massachusetts, Somerville has run its successful SomerStat initiative for close to three years, and reports $10 million in realized or anticipated savings. Expansion of the Stat program holds tremendous potential for the Commonwealth's cities and towns, as well as state government.

Iowa's Charter Agencies Initiative, originally developed by the Public Strategies Group, a Minnesota-based government-consulting firm, is one in a series of programs implemented by Iowa Governor Tom Vilsack to ad-dress the ballooning state budget. The program stresses increased efficiency, reduced costs, and greater freedom for state agencies (and the Governor's office) to offer better value to Iowa's citizens.

Bid-to-Goal is a program originally developed by the City of San Diego's Metropolitan Wastewater Department (MWWD), in conjunction with consulting firm Henningson, Durham and Richardson (HDR), in 1997 as an "optimization strategy" to more cost-effectively implement large public works initiatives. By means of a binding pact between the city and public sector employees, the MWWD had hoped to create a hybrid dynamic that incorporates the most desirable features of both public and private sector contracting.

The Massachusetts Department of Industrial Accidents has implemented numerous reforms that have improved the safety of workplaces throughout the state since Governor Mitt Romney’s election in 2002. In the process, the DIA has reduced the number companies that do not adhere to the state’s worker compensation laws.

While organized, searchable Internet listings have become an integral part of the market-rate home buying process, such tools are typically not used to help homeless or low-income families find suitable housing in Massachusetts. HousingWorks, a Massachusetts corporation, uses these technologies to match those in need with affordable housing units. It provides a central database for those who provide affordable housing, and for those who need it.