CPOE Initiative

/
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.

Health Insurance Cost Control

/
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.

A National Market for Individual Health Insurance

/
Health insurance markets are regulated by the states under the McCarran-Ferguson Act (15 U.S.C. 1011) of 1945. The 'purpose clause' of the Act states that regulation and taxation of the business of insurance by the states is in the public interest. As a result of McCarran-Ferguson, every health insurer must be licensed in the policyholder's state of residence. The states have responded with a complex patchwork of mandates and laws that vary widely across the country.

Wellness Health Incentive Payment Program

/
Sustainable healthcare should always involve an accountable partnership between the payor and the third party insurance administrator. The Wellness Health Incentive Payment (WHIP) Program facilitates better health/wellness outcomes by holding health insurance vendors fiscally responsible for health and wellness activity. The WHIP rewards or penalizes health insurance administrative vendors according to the vendor's wellness activity performance against nationally recognized health and wellness standards.

Massachusetts State Taxpayer Funded School Construction Grants

/
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.

Middle School Aspirations and Pathways to College (MAPS)

/
The Roxbury Preparatory Charter School in Boston's Mission Hill neighborhood prepares its students to enter, succeed in, and graduate from college. A public, grades 6-8 school, Roxbury Prep is founded on the philosophy that all students are entitled to and can benefit from college preparatory programs when: 1) the curriculum is rigorous and well-planned; 2) character, community responsibility, and exposure to life's possibilities are emphasized; and 3) a professional network supports a student's academic, social, and physical well-being.

MITS Summer Institute

/
The mission of the Museum Institute for Teaching Science (MITS) is to raise science literacy by improving the quality of elementary and middle school (K-8) teaching in science, technology, engineering and mathematics (STEM). Science literacy is a critical skill that, if learned at an early age, helps develop critical thinking, reading abilities and computation skills needed to make informed decisions in daily life. America's science literacy, however, has suffered in recent years, posing a serious risk to the nation as the world leader in innovation and its economic future.

The Cash Incentive Safety Initiative

/
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.

MyFloridaMarketPlace

/
In 2000, the Florida state legislature approved funding for an online e-procurement portal called MyFloridaMarketPlace. The project was overseen by Florida's Division of Management Services (DMS), which contracted with Accenture in the fall of 2002 to create and manage the portal.

Reducing Unnecessary Institutionalization of Senior Citizens

/
This proposal involves collecting and integrating existing data on the health of elderly patients. This information would be used to construct patient profiles to help predict and prevent unexpected incidents. A data-driven coordination of programs and services would aid in early interventions, and also help evaluate how different strategies, programs, and agencies could reduce unnecessary nursing home institutionalization.

Extending the Stat Model Across the Commonwealth

/
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.

Repair, Replacement, Renovation and Maintenance Program

/
The Repair, Replacement, Renovation and Maintenance (R3M) Program concept is a strategy for managing Hillsborough County's physical assets. The purpose of the R3M Program is to protect investment in infrastructure, reduce the maintenance backlog, control and reduce costs, minimize waste, and to maintain public buildings and facilities in a safe and efficient condition.

Transforming Urban School Districts through Choice

/
The Foundation for Education Reform & Accountability (FERA), based in Albany, New York, has been implementing a school-choice initiative — the Albany Project — that has created high-quality charter schools to serve more than half of the local public school student population in the state's capital city. FERA believes that a district composed of choice schools can better serve students, parents, and the community than the traditional urban school district system. The Albany Project is demonstrating that the charter school model — freedom from state regulations and education bureaucracy, freedom to innovate, and increased accountability—can better serve all students, not just the small segment of the population fortunate enough to win an enrollment lottery or afford a private school.

The Charter Agencies Initiative

/
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.

The Performance Bonus Pay Program

/
Through its pay-for-performance program, the Dallas County (Texas) Motor Vehicle Division (MVD) has set an example for how similar agencies across the country could be reformed. MVD registers 1.9 million vehicles per year and has 140 employees at 10 sites. In March 1998, the Vehicle Registration and Title Department launched its performance pay program. The program utilizes performance measures to identify and reward quality work.

The Building Permitting Automation Efficiency Program

/
Buildings in Florida's Miami-Dade County typically fill up as quickly as they can be built. Between glimmering high-rise towers for vacationers or retirees, banks and offices that serve as the nerve centers of Miami's south-ward-looking economy, or schools and public buildings to support a growing population, South Florida has the look of a perpetual hard-hat zone. This steady pace of needed construction is maintained by an innovative building department and its Building Permitting Automation Efficiency Program.

The Bid-to-Goal Program

/
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.

Consolidating Off-Road Vehicle Registration

/
We propose to close all five Registration and Titling Bureau offices and al-low the RMV to register all motor vehicles—boats, ATVs and snowmobiles included. This consolidation would bring significant savings while actually improving service for off-road vehicle owners.

The Estuaries Project

/
The Massachusetts Estuaries Project, through the University of Massachusetts-Dartmouth School of Marine Science and Technology (SMAST), supports the Massachusetts Department of Environmental Protection (DEP) in the development and implementation of policies to protect nitrogen-sensitive coastal embayments. The Project collects data and develops models to manage and restore the 89 embayment systems that comprise the coastline of southeastern Massachusetts. The Project encompasses new technologies, regulatory approaches and funding mechanisms to reduce the costs of conducting estuarine restoration.

A Reform of Workers’ Compensation Insurance

/
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.

A Reform of Wetlands Regulations

/
The cost of housing in Massachusetts absorbs too much of the average resident’s income and drives people and businesses out of the state. According to recent research studies, the problem is not a lack of land but an excess of regulation. I propose a concrete and politically palatable policy reform to ensure that septic and wetland regulations are used to protect the environment and public health. This reform would remove the temptation for towns to misuse these rules to discourage development.

The EZ-ID License Plate Program

/
The EZ-ID License Plate Program offers a unique reform to the Massachusetts Registry of Motor Vehicles (RMV) license plate system. The program is designed to make motor vehicle license plates more easily recognizable for law enforcement purposes. It incorporates an easily recognizable symbol such as a circle, square, triangle, heart, diamond or star into the registration number itself.

The HousingWorks Affordable Housing Website

/
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.

GPS for State Contractors

/
The Massachusetts Highway Department, or MassHighway, solved a longstanding management problem by using technology in an innovative way. Contractors who work for MassHighway, such as snowplow operators, are now assigned GPS-enabled cell phones so that managers can track where and when work is being done. This capability ensures that workers, equipment and budget dollars are used efficiently.

The Electronic Grants System for Education

/
The Michigan Electronic Grants System (MEGS) is an initiative that permits online education grant applications to feed directly into the Michigan Department of Education (MDE) system. By removing a time-consuming step from the application process, MEGS has improved performance and slashed administrative costs without any additional state funds. A similar program could benefit both the Massachusetts Department of Education (DOE) and the grant applicants who hope to put state funds to work.