The relationship between goal congruence and policy adoption among providers of child psychiatric services in Tennessee
This research tests a central assumption of principal-agent theory by exploring the interaction between provider's willingness to implement public sector managed care reforms and their willingness to adopt evidence-based practices (EBPs). Using an explanatory cross-sectional design, and survey method of data collection, the goals of Tennessee's managed-care model, TennCare, were compared with the goals of providers in Tennessee who provide psychiatric services to children. Three factors were identified that interact to support policy adoption: (1) high levels of goal congruence among providers, (2) high levels of commitment to the public interest and (3) a large proportion of providers with a pragmatic cognitive style. The results of this study suggest a lack of “fit” between the “street-level” implementer and TennCare's management strategies which focus exclusively on controls and benefit limits. As public mental health policy moves toward new managed care models that place a greater emphasis on performance and evidence-based practice, policy-makers will need a better understanding of how profession-specific factors affect their ability to implement new policies. While the application of controls may be required in some situations, they must be balanced with appropriate application of inducements and a core appreciation for provider autonomy. The payer/provider divide may be successfully bridged if the system can leverage the strengths of shared goals and values.
Public administration|Clinical psychology|Health care management
"The relationship between goal congruence and policy adoption among providers of child psychiatric services in Tennessee"
ETD Collection for Tennessee State University.