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Comparing the Clinical Quality and Cost of Secondary Care in Academic Health Centers and in Community Hospitals

This study analyzes data from hospitals in six states, including Massachusetts, to compare the cost and quality of secondary care for under-65, privately insured patients in Academic Health Centers (AHCs) and non-AHC or community hospitals. Six measures of clinical quality of care were chosen from “potentially avoidable adverse hospital outcomes” developed by the Healthcare Utilization Project (HCUP) of the Agency for Healthcare Research and Quality. The authors discuss the research finding in the context of changes in the market for health insurance, including the emergence of “consumer-driven” health insurance products. The study population is the most likely group to be enrolled in the emerging insurance products that encourage consumers to make health care choices on the basis of cost and […]

The Power To Take: The Use of Eminent Domain in Massachusetts

Author: Michael Malamut, Esq., New England Legal Foundation This study is the first to analyze concrete data to determine patterns in the use of eminent domain. The analysis includes a survey of law review articles, practitioners’ manuals and reported Massachusetts opinions; structured interviews with legal practitioners; and a review of Massachusetts eminent domain statutes, especially in comparison to the 1974 Model Eminent Domain Code. The Power to Take: The Use of Eminent Domain in Massachusetts

Government Effectiveness Index: A Cross-State Survey

Author: James Stergios, Director of Research, Pioneer Institute The central objective of the Government Effectiveness Index (GEI) is to assess how Massachusetts is doing in comparison to other states. It seeks to provide measures of effectiveness based on the efficient use of resources (inputs as a function of quantity or output) and on performance outcomes (quality of output). It does so in regard to eight “core” functions of state government (functions common to most states): K-12 educa- tion, higher education, highways, transit, state police, the judiciary, corrections, and financial administration. This first edition tests the GEI model on a sample set of six states: Massachusetts, Michigan, New Jersey, Ohio, Rhode Island, and Virginia. We chose the first four com- parison […]


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Toward a High-Performance Workplace: Fixing Civil Service in Massachusetts

Author: Jonathan Walters, Governing Magazine This paper is a call for continued improvement in a system that in its current form is overly bureaucratic, unresponsive, rule-bound, and control oriented.  The changes suggested address three troubling trends that have been gathering momentum in Massachusetts:  First, the use of “provisional” hires as a way to sidestep testing and hiring rules entirely.  Second, the inclination to exempt entire classes of employees from the civil service system altogether.  And third, continued difficulty on the part of specific agencies to compete for the best and brightest job candidates in what is today a fiercely competitive job market. Toward a High-Performance Workplace: Fixing Civil Service in Massachusetts