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10.13 Engaging Ideas - 10/13/2017

Friday, October 13th, 2017 | PUBLIC AGENDA




Democracy

Opposing political parties find common ground at civil dialogue event (ASU Now)
Former U.S. Sens. Jon Kyl and Tom Daschle tell crowd at ASU why they think America has become politically polarized

Is the American Idea Doomed? (The Atlantic)
America no longer serves as a model for the world as it once did; its influence is receding. At home, critics on the left reject the notion that the U.S. has a special role to play; on the right, nationalists push to define American identity around culture, not principles. Is the American idea obsolete?


Opportunity/Inequality

In recent decades, the clustering of rich and poor neighborhoods in America has continued, expanding inequality. (LSE USAPP)
Many recent discussions on American cities and neighborhoods have focused on how they are changing, either through gentrification or economic change. In new research, Elizabeth Delmelle finds that gentrification is only one small part of the story of America’s neighborhoods since 1980.

Boston taps into data to find sources of economic inequality (GCN)
Many cities use data to measure the effectiveness of programs and policies, but Boston plans to use its newly created Economic Mobility Lab to study entire systems of programs that are meant to help people move up the economic ladder, find gaps that need to be filled and deploy programs that address those identified gaps.


Engagement

Is It Time to Scale College Towns: Reimagining Public Engagement through Agile Design (Inside Higher Ed)
When living in a college town, you begin your pursuits with a goal of seeking greater understanding, not with the goal of confirming a current set of beliefs. Fundamental to the dynamic university communities that anchor these unique college towns is compassion. Compassion, it turns out, is essential to discovery and discovery is at the center of a vibrant and healthy society. It’s time to invest time and treasure in the compassionate public square for the information age.


K-12

A school choice quandary: parents care more about who attends a school than about its quality, in NYC study (Chalkbeat)
“Among schools with similar student populations, parents do not rank more effective schools more favorably,” write researchers Atila Abdulkadiroglu, Parag Pathak, Jonathan Schellenberg, and Christopher Walters. “Our findings imply that parents’ choices tend to penalize schools that enroll low achievers rather than schools that offer poor instruction.”

Building the Workforce: Apprenticeship Program Offers College Credit, Paychecks, and Diplomas (Education Week)
Colorado student apprentices this year are earning diplomas, paychecks, and college credit while helping the state build its future workforce.


Higher Ed/Workforce

Which public colleges have the top graduation rates for students in financial need? (Washington Post)
Among 100 major public universities across the country — state flagships and other prominent schools — only 11 report a six-year graduation rate of at least 80 percent for students with enough financial need to qualify for federal Pell Grants.

Who Counts as a Black Student? (Inside Higher Education)
Cornell protest revives debate on whether first-generation immigrants from Africa and Caribbean make up disproportionate share of black students at top colleges, and what -- if anything -- should be done as a result.


Health Care

Trump to Scrap Critical Health Care Subsidies, Hitting Obamacare Again (New York Times)
President Trump will scrap subsidies to health insurance companies that help pay out-of-pocket costs of low-income people, the White House said late Thursday.

California governor signs drug pricing transparency bill into law (Healthcare Finance)
California Gov. Jerry Brown signed a sweeping drug price bill that will force drugmakers to publicly justify big price hikes.

Comment

10.06 Engaging Ideas - 10/6/2017

Friday, October 6th, 2017 | PUBLIC AGENDA




Democracy

Most Campaign Outreach Has Zero Effect on Voters (The Atlantic)
A new paper finds that direct mail, door-to-door canvassing, and television ads almost never change people’s minds. What does this mean for American democracy?

The Social Experiment Facebook Should Run (The Atlantic)
What would happen if the platform matched you with people who share your interests but live outside your political bubble?

Recentering American Politics (Slate, The Gist)
For the past 25 years, Bill Kristol of the Weekly Standard and Bill Galston of the Brookings Institution have been debating the meaning of presidential elections. But in 2016, they found themselves agreeing much more frequently on issues such as immigration, the tech industry, and tax reform. These men, on opposite sides of center, decided to develop a plan to recenter American politics. Galston and Kristol’s new project is the New Center.


Opportunity/Inequality

De Blasio Expands Affordable Housing, but Results Aren’t Always Visible (New York Times)
For much of his first term in office, Mr. de Blasio, a Democrat, has made affordable housing a centerpiece of his agenda — highlighting it in his State of the City addresses and calling it the No. 1 issue on the minds of New Yorkers. In July, he heralded a numeric accomplishment: 77,651 units financed so far. Not everyone is impressed by the numbers.

Bad Job: Why corporate America is so much more awful than it used to be. (Slate)
There is no shortage of theories about why modern American life is beset with a stagnant middle class and a lack of good jobs. Indeed, this reality served as one of the backdrops of the last presidential campaign, in which Donald Trump blamed bad trade deals and a hollowed-out manufacturing sector for all the things that ail us economically. In his new book, The End of Loyalty: The Rise and Fall of Good Jobs in America, Rick Wartzman offers a different primary culprit: corporate culture.

Middle class gets richer, but the wealthy do even better, making inequality worse, Fed says (Los Angeles Times)
Most American families grew richer between 2013 and 2016, but the wealthiest households pulled even further ahead, worsening the nation's massive disparities in wealth and income.


Engagement

How Public Engagement Needs to Involve, Part 4 (Public Agenda)
We can give citizen voices more authority by blending two forms of engagement: deliberative democracy, in which people discuss issues and direct democracy, in which they make public decisions at the ballot box, but usually don’t discuss the issues first.

A government office to get you involved (New York Daily News)
From what I see, New Yorkers are ready to get involved. They are tired of the status quo, outraged by injustice and eager to be part of the solution. But often, they are not sure where to go. That’s why I have just introduced legislation to create a New York City Office of Civic Engagement.

Social Media As A Vital Engagement Platform For Government Outreach (Forbes)
Social media has evolved into the preferred method to reach and engage with the masses, culminating in exponential amplification. Individuals, businesses and celebrities have harnessed its power, yet the government has been slow to maximize social media as an outreach tool. Why has the government been slow to adopt?


K-12

Growing Number of States Embrace Career Education (Education Week)
After years of focusing intensely on college readiness, states are turning their attention to students' futures as workers, enacting a flurry of laws and policies designed to bolster career education and preparation.

Millennials, especially of color, are disrupting charter school debate (The Hill)
Polling data suggests a disproportionate opposition to charters among African-American voters of all ages, polling data also shows growing levels of support for charters, as well as other innovations in education policy, among Millennials, who have largely rejected stale fault-lines and an uncritical embrace of legacy practices.

Trump Taps School Choice Champion Jim Blew to Serve in Key Ed. Dept. Policy Post (Education Week)
Jim Blew, the director of Student Success California, an education advocacy group, has gotten the official White House nod to lead the office of planning, evaluation, and policy analysis at the U.S. Department of Education.


Higher-Ed/Workforce

The Hidden Reason Behind College Dropouts (US World & News Reports)
A recent qualitative study by Public Agenda reveals deep frustration among transfer students, who often blame themselves for failing to navigate the movement from one institution to another.

Cuomo's Free College Plan Leaves Many Working Class Students Behind (Gothamist)
At first glance, the Excelsior program described in the press release seems simple and generous: full tuition relief for individuals or families making up to $125,000 per year, by 2019. Yet experts tell Gothamist that Excelsior has an inordinate amount of restrictions that immediately disqualify many students, and leave accepted students at risk of losing the scholarship down the road.

Empty Cabinet: Education Department Has Highest Top Staff Vacancy Rate, at 80% (The 74)
The Education Department’s vacancy rate stands at 80 percent, compared with 50 percent across the executive branch as a whole. The 74 calculated the vacancy rates for the 20 agencies whose members are part of the president’s Cabinet, based on data published by the Partnership for Public Service and The Washington Post as of Sept. 27.


Health Care

Healthcare executives: Improving the patient experience is key to a healthy bottom line (Becker's Hospital Review)
Hospital and health system reimbursement is more closely tied to patient satisfaction than ever before, and the link between patient satisfaction and revenue is expected to strengthen in years to come.

Lapse In Federal Funding Imperils Children's Health Coverage (NPR)
Congress finally seems ready to take action on the Children's Health Insurance Program (
CHIP) after funding lapsed Sept. 30.

Florida hospitals fight transparency rule (Orlando Sentinel)
Florida hospitals are battling a pair of proposed transparency rules requiring hospitals and ambulatory surgical centers to provide information to patients about potential treatment costs.

Comment

10.03 How Public Engagement Needs to Evolve, Part 4

Tuesday, October 3rd, 2017 | MATT LEIGHNINGER



How can public engagement evolve to meet the challenges and conditions of 2017? My previous post explored ways to “scale up” engagement to involve much larger numbers of people in state and federal issues. This time, I’ll address the need to give engagement opportunities more authority, so that people are clear on how their voices will be heard and confident that it will make a difference.

We can give citizen voices more authority by blending two forms of engagement: deliberative democracy, in which people discuss issues, but usually do not make public decisions directly, and direct democracy, in which they make public decisions at the ballot box, but usually don’t discuss the issues first. Deliberative democracy gives people a voice; direct democracy gives them a vote.

Deliberative democracy has produced many instances in which the informed, common-ground recommendations of participants did not seem to affect policy or lead to other kinds of problem solving. These kinds of experiences can leave citizens frustrated and may deepen popular mistrust of government. Similarly, examples of direct democracy have occurred in which voters seemed to make uninformed, ill-considered decisions that might harm not only the common good, but their own interests. The most notorious recent example is the United Kingdom’s (UK) vote to exit the European Union. Known as Brexit, the results of the referendum may have profound and long-lasting ill effects on the UK economy. Immediately after the vote, websites explaining its potential consequences received huge numbers of hits and many citizens expressed remorse at having voted “yes” on the initiative.

The rapid expansion of participatory budgeting (PB) in America shows the power of combining the two forms. The steering committee meetings and neighborhood assemblies that occur at the beginning of the PB cycle, the delegate meetings that take place during the proposal development phase and the idea expos held before the final vote can be (but are not always) deliberative; the vote on the proposed ideas at the end of the cycle exemplifies direct democracy. People come out for PB because they feel they will have some authority over how public money will be spent; the process helps ensure that the decisions they make are well-informed and well-considered.

So one way to aid the development of public engagement is simply to expand and improve the practice of PB. (Our friends at the Participatory Budgeting Project are leading the way on that front, supported by Public Agenda’s work to coordinate and summarize the research on PB in North America.)

Another way is to embed direct democracy opportunities into other kinds of engagement. If leaders want to engage citizens in addressing an important issue, is there a specific policy decision on that issue that they are willing to put to a public vote? This could take the form of a ballot initiative or referendum, but it could also be an unofficial, non-binding vote that gives officials a sense of where the community stands. Unofficial votes can still carry a great deal of political weight, as long as voter turnout is high and diverse. After all, most PB votes do not officially bind a city councilmember to adopting the community’s preferred allocation of funding. In almost every case, councilmembers uphold the results of the vote because they agreed to do that in the first place and because they are satisfied with the soundness of the process.

A third way is to organize public deliberation around initiatives and referenda that have already been placed on the ballot. This is the approach of the Oregon Citizens Initiative Review, which convenes a citizens’ panel and an array of other engagement opportunities to help people learn about and make decisions on how they will vote.

As governments struggle to gain the trust of an increasingly educated and skeptical public, more of them may begin offering citizens a greater degree of power and authority over public decisions. PB will probably continue to spread and so may other kinds of processes that give people a direct vote on policy questions. Despite examples like the Brexit vote, these variations on direct democracy could proliferate simply because they give officials a seemingly straightforward way to give the people what they want.

But as the Brexit vote has illustrated, direct democracy doesn’t necessarily lead to smarter, more broadly-supported policy decisions. Incorporating public deliberation in various ways may be critical not only for strengthening policymaking, but also for maximizing public satisfaction with these new forms of participation. Direct democracy assumes citizens can be effective public decision makers, and deliberative democracy assumes they can be effective learners, advisors and volunteers. Those assumptions seem compatible with one another, and in fact, they support and may even require one another.

Comment

10.03 Any Progress Is Better Than None

Tuesday, October 3rd, 2017 | WILL FRIEDMAN, PH.D.



Once again, we sit bowed in tragic disbelief at the senseless slaughter that our fellow Americans regularly visit upon one another. Once again, against the hard wall of partisan dysfunction we hurl soft platitudes and hope things will change.

Yes, there are passionate, valid disagreements and real interests at stake. True, there are no magic answers, every one imaginable will be imperfect. But even incremental progress can save a teen’s life who, just before the bullets riddled her body, was taking in her first concert and feeling the world open before her.

At Public Agenda, our business is to understand, inform, engage and represent the public, among whom there is considerable common ground across partisan lines - obscured though it is by the posturing of politicians and interest groups - for common sense measures that would make it harder for dangerous people to get guns and easier for the mentally ill to receive treatment.

Enacting these points of agreement won't be easy, nor will it solve the entire problem. But with bold leadership, public support can become public will and lead to change. Rather than sit idle while things deteriorate, we should take the pragmatic steps in front of us and then figure things out from there.

Comment

09.29 Engaging Ideas - 9/29/2017

Friday, September 29th, 2017 | PUBLIC AGENDA




Democracy

Fury fuels the modern political climate in US (The Hill)
There have been plenty of times in the nation’s 240-year history in which an evolving economy has produced anxiety. But this time was different.

American Democracy Is Drowning in Money (New York Times)
The tide of money swelling around the American political system continues to rise. In 2016, candidates running for federal office spent a record $6.4 billion on their campaigns, while lobbyists spent $3.15 billion to influence the government in Washington. Both sums are twice that of 2000 levels.

Why Competition in the Politics Industry is Failing America (Harvard Business School)
Too many people are laboring under a misimpression that our political problems are inevitable, or the result of a weakening of the parties, or due to the parties’ ideological incoherence, or because of an increasingly polarized American public. Those who focus on these reasons are looking in the wrong places.


Opportunity/Inequality

American Dream, American Myth: The Decline Of Upward Mobility (KUNC)
For some Americans, it’s become more unlikely that they will out-earn their parents the way their parents out-earned the previous generation. Multiple studies show that while moving up is still possible, it’s either becoming more difficult or it’s harder in the United States than in other countries.

When Prosperity Leads to Disaffection (Foreign Affairs)
The conundrum of broad disaffection in the face of apparent prosperity is by no means limited to American politics. Thousands of miles from Washington, we tested a related hypothesis in rural Pakistan.


Engagement

The Rise of Public-Sector Crowdfunding (Citylab)
Around the country, local governments are soliciting donations for everything from dog parks to public defenders. Is this a practical response to budget cuts or a sign that publicly funded services are in trouble?

Leading Mayors Join Cities of Service Mayors Council to Accelerate Citizen Engagement (Business Insider)
Cities of Service, a national nonprofit that helps more than 200 mayors and city leaders tap into the knowledge, creativity, and service of citizens to solve public problems and create vibrant cities, has launched the Cities of Service Mayors Council.


K12

The Evidence Base for How We Learn: Supporting Students’ Social, Emotional, and Academic Development (Aspen Institute)
Compelling research demonstrates what parents have always known—the success of young people in school and beyond is inextricably linked to healthy social and emotional development.

Wisconsin's schools seek to shorten the workforce pipeline (Wisconsin State Journal)
At Patrick Marsh Middle School in Sun Prairie last week, school counselor Tiffany Kvalheim opened a lesson about academic and career planning with a question. “Why are we talking about careers in seventh grade?” Kvalheim asked.


Higher Ed/Workforce

Colleges need to do more to help students transfer credits, GAO says (Washington Post)
Students lose nearly half of the college credits they earn transferring from one school to another, placing them at risk of exhausting federal grants and loans to repeat courses, according to a report released by the Government Accountability Office Wednesday.

The Department Of Education Cuts Off A Student Loan Watchdog (NPR)
This move leaves 44 million student loan borrowers, owing $1.4 trillion in debt, with potentially less, or at least less-coordinated, oversight of their rights.


Health Care

“The Internet hates secrets”: Clear Health Costs works with newsrooms to bring healthcare costs out of hiding (Nieman Lab)
When New Orleans’ WVUE Fox 8 News invited viewers to get in touch and share their healthcare costs, they weren’t sure what kind of response they’d receive.

Online physician ratings don't reflect quality of care (Modern Healthcare)
Although patients commonly use online physician-rating sites to help select a provider and get a sense for their quality of a care, a new study suggests those tools don't accurately demonstrate physicians' clinical performance.

Comment

09.22 Engaging Ideas - 9/22/2017

Friday, September 22nd, 2017 | PUBLIC AGENDA




Democracy

Fury fuels the modern political climate in US (The Hill)
There have been plenty of times in the nation’s 240-year history in which an evolving economy has produced anxiety. But this time was different.

Facebook Knows More About Russia’s Election Meddling. Shouldn’t We? (New York Times)
Facebook says it is working to prevent a repeat. And it was hardly the only platform that Russia is presumed to have used to disrupt the political debate in America; there were others in the mix as well, particularly Twitter, which has divulged even less than Facebook has. But, in total, there’s a stunning lack of public specificity about an alleged foreign campaign to influence our domestic politics.

Why Competition in the Politics Industry is Failing America (Harvard Business School)
Too many people are laboring under a misimpression that our political problems are inevitable, or the result of a weakening of the parties, or due to the parties’ ideological incoherence, or because of an increasingly polarized American public. Those who focus on these reasons are looking in the wrong places.


Opportunity/Inequality

American Dream, American Myth: The Decline Of Upward Mobility (KUNC)
For some Americans, it’s become more unlikely that they will out-earn their parents the way their parents out-earned the previous generation. Multiple studies show that while moving up is still possible, it’s either becoming more difficult or it’s harder in the United States than in other countries.

When Prosperity Leads to Disaffection (Foreign Affairs)
The conundrum of broad disaffection in the face of apparent prosperity is by no means limited to American politics. Thousands of miles from Washington, we tested a related hypothesis in rural Pakistan.


Engagement

The Rise of Public-Sector Crowdfunding (Citylab)
Around the country, local governments are soliciting donations for everything from dog parks to public defenders. Is this a practical response to budget cuts or a sign that publicly funded services are in trouble?

Leading Mayors Join Cities of Service Mayors Council to Accelerate Citizen Engagement (Business Insider)
Cities of Service, a national nonprofit that helps more than 200 mayors and city leaders tap into the knowledge, creativity, and service of citizens to solve public problems and create vibrant cities, has launched the Cities of Service Mayors Council.


K12

The Evidence Base for How We Learn: Supporting Students’ Social, Emotional, and Academic Development (Aspen Institute)
Compelling research demonstrates what parents have always known—the success of young people in school and beyond is inextricably linked to healthy social and emotional development.

Wisconsin's schools seek to shorten the workforce pipeline (Wisconsin State Journal)
At Patrick Marsh Middle School in Sun Prairie last week, school counselor Tiffany Kvalheim opened a lesson about academic and career planning with a question. “Why are we talking about careers in seventh grade?” Kvalheim asked.


Higher Ed/Workforce

Colleges need to do more to help students transfer credits, GAO says (Washington Post)
Students lose nearly half of the college credits they earn transferring from one school to another, placing them at risk of exhausting federal grants and loans to repeat courses, according to a report released by the Government Accountability Office Wednesday.

The Department Of Education Cuts Off A Student Loan Watchdog (NPR)
This move leaves 44 million student loan borrowers, owing $1.4 trillion in debt, with potentially less, or at least less-coordinated, oversight of their rights.


Health Care

“The Internet hates secrets”: Clear Health Costs works with newsrooms to bring healthcare costs out of hiding (Nieman Lab)
When New Orleans’ WVUE Fox 8 News invited viewers to get in touch and share their healthcare costs, they weren’t sure what kind of response they’d receive.

Comment

09.21 An Amazing Learning Environment for Students and a Great Workplace for Educators

Thursday, September 21st, 2017 | CHLOE RINEHART



I was lucky enough to go to a private school for kindergarten through eighth grade, where the educational philosophy was grounded in community, cooperation and collaboration.

When my school was established in the 1970s in Virginia, the founders literally named it the “new” school, because its model challenged the status quo of the educational system at the time. Instead of structuring the administration as top down, with decision-making power concentrated in the hands of the principal, this school envisioned one where teachers, together with parents, shared in decision making.

Instead of teachers working alone in their classrooms, largely isolated from their colleagues, this school envisioned teachers collaborating closely on curriculum, school policies and procedures, and coordinating classroom schedules to allow space for students who were learning about different subjects at varying levels.

What resulted was, in my opinion, an amazing learning environment for students and a great workplace for teachers, many of whom stayed on to work there for a decade or more.

This collaborative structure was “new” back then, but still today, we find ourselves in an educational landscape where K-12 education is largely dominated by the individualistic model. Even while other sectors are valuing and incorporating collaboration more frequently into their work and operations, we don’t see this type of collaboration happening in our schools very often.

However, there is indication that the K-12 system might increasingly consider reforms in this area. A growing body of research shows that when teachers work more collaboratively, student outcomes can improve, teachers can be more satisfied in their jobs and teacher turnover can decrease.

Public Agenda, in partnership with the Spencer Foundation, is supporting this development in K-12 education through the second installment of our In Perspective web resource series. Like our first on charter schools, our Teacher Collaboration site offers materials that can not only lead to a better-informed conversation on an important education issue, but can result in significant and scalable change.

The Guide to Research on teacher collaboration provides a nonpartisan, nonideological and easily digestible summary of key research on teacher collaboration, including studies that are typically accessible only to academics. The Discussion Guide can help teachers and education leaders make decisions on how to work more collaboratively in their own schools and districts. Critical Questions for Superintendents and School Board Members allows for leaders at the school and district level to examine their own teacher collaboration efforts.

Pursuing policies and encouraging dialogues that allow for increased collaboration among teachers, and between educators and school leadership, are alone not going to solve the problems facing our education system. Indeed, key questions about collaboration remain unanswered. But teachers, leaders and school districts can benefit from an environment that allows for greater collaboration, which is ultimately a win for students too.

Comment (3)

09.15 Engaging Ideas - 9/15/2017

Friday, September 15th, 2017 | PUBLIC AGENDA




Democracy

'Amnesty' fight threatens pursuit of immigration deal (The Hill)
A path to citizenship for “Dreamers” is emerging as the biggest sticking point in the negotiations over an immigration bill, one day after President Trump and Democratic leaders seemed close to a deal.

Why now is such a strange era in American political history (Vox)
The juxtaposition of broadly competitive national elections plus broadly non-competitive state elections is really unusual. And really dangerous.


Opportunity/Inequality

Statistics reveals new, more precise insight into upward mobility between generations (phys.org)
As political rhetoric containing promises of education, social opportunities and other development for disadvantaged people continues to fill the airwaves, economics researchers have developed state-of-the-art statistical methods that uncover the impact of different aspects of upward mobility (or lack thereof), aside from parental income.

This is what happens when Americans are told about rising inequality (Washington Post)
The sharp growth in economic inequality — and its visibility as an issue in both the 2012 and 2016 American political campaigns — has led to an important debate about how to respond.


Engagement

Boosting Civic Trust (And Democracy) With A Location-Based Mapping Platform (Forbes)
Local governments need a lot of solid data about their citizens' concerns to make good decisions. For example,  if you're a municipality--or anyone considering, say, a development project--it's kind of important to know how residents living in the affected neighborhoods feel about your plans.

What’s New in Civic Tech: SF Mayor Encourages Cities Nationwide to Apply for Expanded Startup in Residence Program (Government Technology)
San Francisco Mayor Ed Lee took to the blogosphere this week with some advice for city governments across the country: Apply for the Startup in Residence (STiR) program, which embeds fledgling technology companies in municipal agencies to help bridge the gap between public service and the private sector.


K-12 Education

Certification rules and tests are keeping would-be teachers of color out of America’s classrooms. Here’s how. (Chalkbeat)
Becoming a certified teacher in America usually means navigating a maze of university classes and certification tests — and paying for them.The goal is a high-quality teaching force, and an array of powerful advocates have been pushing to “raise the bar” further. But the rules likely come with a hefty cost: a less diverse profession.

Where Ed Tech Works — and Fails (Real Clear Education)
Thousands of dollars spent outfitting a classroom with laptops might not improve student grades, while a simple series of text messages could inspire a student to attend college.


Higher Ed/Workforce

Half of US millennials would give up right vote to wipe out their student loans (The Independent)
Half of all millennials in the US would give up their right to vote in order to get rid of their student loan, new research has found.

College textbooks are going the way of Netflix (Quartz)
The new software benefits professors by tracking how far students read, how long they spend on each page, how well they absorb the material—so rather than handing out syllabi to tell students what to read or skim in various books, professors can tweak the software to only include topics of crucial interest.


Health Care

Achieving transparency in healthcare (Modern Healthcare)
Pressure is mounting to make healthcare prices available to patients, but there are significant hurdles to doing so.

I’m the perfect person to price shop for an operation. But the process went terribly (STAT)
Encouraging patients to price shop for their health care is one reason employers are switching to high-deductible plans. The theory is that patients will compare prices across different doctors or hospitals and choose the lower-priced one, thereby saving themselves (and their employer) money. But in order to shop, you need to be able to see what something costs beforehand.

Good Data, Better Value-Based Care Can Boost Population Health (RevCycle Intelligence)
Timely data is key to reducing the costs of a hospital’s most expensive high-risk patients, while value-based contracts sustain the population health management efforts.

Comment

09.14 How do you improve diabetes care? Ask a patient.

Thursday, September 14th, 2017 | Danielle Sang



Diabetes is a major public health problem in America, one that affects nearly 10 percent of the population or about 20 million people. This is one of several reasons Public Agenda chose diabetes, specifically type 2, as one of the three particular care situations to examine in new research that looks at how people think about high-quality care.

Diabetes requires constant care. Self-management and a sustained relationship with a medical professional to monitor symptoms and complications are the ideal standard care procedures. But one has to ask themselves: What are the qualities diabetes care patients look for in their doctor? Do they prioritize certain qualities over others? Are patients receiving the care and information they need to adequately manage their health situation?

We set out to explore these among other questions in our research. When it comes to assessing high-quality care, we found research participants in the diabetes group valued doctors’ interpersonal skills over clinical qualities.

This finding becomes even more relevant when you consider the fact that effective management of diabetes requires sustained care with a medical provider. This may suggest that interpersonal skills from a medical provider is critical to proper diabetes care. Without this, rates of negative health outcomes such as heart attacks, strokes, kidney disease, and eye and nerve damage, can increase. This is especially true for black, Hispanic and lower-income people, who tend to have higher rates of complications.

Along with health costs on patients, diabetes also has a high monetary cost. In 2012, the United States spent $176 billion on diabetes. Given the high costs associated with diabetes care, it’s important to note that our research found 31 percent of participants in the diabetes group were unaware doctors’ prices for care vary, while even more were unsure.

A Health Affairs study on price found patients who chose low-price physicians also gained savings in the long term on other medical services, such as lab tests, and had less annual out-of-pocket spending. With its high financial implications, even for those with employer-sponsored insurance, it may be helpful for diabetes patients to know how much one doctor charges for the same services versus another, in addition to weighing interpersonal qualities. Having knowledge on price variance may also be helpful in controlling costs, especially since our research found that, in the diabetes group, most say high prices are not a sign of better-quality care.

Type 2 diabetes affects approximately 9.3 percent of Americans. Blacks, Hispanics, Native Americans and those with less education are disproportionately affected at a rate of 13 percent. Diabetes affects all demographics and will continue to be an issue if not addressed and managed properly. Due to its chronic nature, self-care and working with a trusted provider are key elements for managing diabetes. As our research has found, while a high price may not be seen by those in the diabetes group as the equivalent of high-quality care, the answer to what is may lie in the hands of physicians. With the ability and knowledge to provide guidance on self-management, by referring patients to supplemental care managers such as lifestyle coaches or Certified Diabetes Educators, and by being a listening ear to medical concerns, health care providers may be the answer, in more ways than one, to improving high-quality care for diabetes patients.

Comment (1)

09.08 Engaging Ideas - 9/8/2017

Friday, September 8th, 2017 | PUBLIC AGENDA




Democracy

Immigration reform: Could opposing sides compromise? (The Mercury News)
Santos Aviles, who as a teenager illegally immigrated from El Salvador to the United States, has found it surprising how many conservatives have been open to his suggestions on reforming the country’s tattered immigration laws..

We need political parties. But their rabid partisanship could destroy American democracy (Vox)
We need partisan conflict to organize politics. Without political parties, there is no meaningful democracy. But we are deep into a self-reinforcing cycle of doom-loop partisanship. We need to think hard about how to escape this trap, before it is too late.


Engagement

Metro Nashville should embrace participatory budgeting (Tennessean)
Over a year ago, a Nashville resident met with his local councilman, Fabian Bedne of District 31, to share his thoughts about what a democratic-driven budgetary process could look like for the folks in Nashville. This would help address urban issues, ranging from transportation and public safety to affordable housing and beautification projects.

What Technologies Do Cities Use for Citizen Engagement? (Government Technology)
The civic engagement process has come a long way from bulletin boards and town hall meetings. Or rather, it’s added a lot of technology on top of bulletin boards and town hall meetings.


Opportunity/Inequality

To Understand Rising Inequality, Consider the Janitors at Two Top Companies, Then and Now (The Upshot)
In the 35 years between their jobs as janitors, corporations across America have flocked to a new management theory: Focus on core competence and outsource the rest. The approach has made companies more nimble and more productive, and delivered huge profits for shareholders. It has also fueled inequality and helps explain why many working-class Americans are struggling even in an ostensibly healthy economy.

What city bus systems can tell us about race, poverty and us (Washington Post)
For many in Baltimore, buses are woven deep into daily life. And they also tell an important story about the city and its history, rooted in racial and economic divides that have shaped the course of its development over the decades.


K12

Charter Schools Are Losing the Narrative But Winning the Data (New York Magazine)
The most striking thing about the coverage of charter schools is the contrast between the tone of data journalism and narrative journalism.

New York City unveils universal free lunch in time for the first day of school (Chalkbeat)
After years of lobbying from City Council members and school nutrition advocates, New York City will offer free lunch to all public school students regardless of their families’ income — a change the city expects will result in fewer students missing out on lunch.


Higher Education & Workforce Development

Preparing the Workers of Today for the Labor Needs of Tomorrow (WNYC)
Starting at 14:45, Alison Kadlec talks about job skills and how community colleges and regional universities are working to address the needs of today's students.

Many L.A. students get to college; only a few finish (Los Angeles Times)
A new study has put an exclamation point on a problem that Los Angeles Unified School District officials already acknowledge: too few of their graduates — about one in four — are earning college degrees.


Healthcare

If prices are kept hidden, consumers can’t take more responsibility for their health care costs (Stat News)
My father had no idea how much my mother’s treatment would cost, how much of it would be covered by insurance, if there were alternative treatments that would be covered, or how we would pay for treatments that weren’t covered. Forget about negotiating — how could he negotiate about something whose price he didn’t know?

As large hospital systems buy up independent medical practices, the cost of health care rises (Marketplace)
Northern California, where Azad works, is the most expensive place in the country to have a baby, according to a study by Castlight Health, a San Francisco-based health benefits platform. One important reason is the kind of consolidation that Azad has witnessed over the past decade. The region is dominated by a few large hospital systems that keep buying up doctor practices

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