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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.

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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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09.01 Engaging Ideas - 9/1/2017

Friday, September 1st, 2017 | PUBLIC AGENDA




Democracy

Voters Are Strongly Divided Over Media’s Role in Dividing Us (Rasmussen Reports)
Voters admit America is a more divided place these days, and Trump supporters overwhelmingly agree with the president that the media is to blame. But Trump opponents just as strongly disagree.

What Would It Take for Democrats and Republicans to Work Together? (The Atlantic)
Bipartisanship most often occurs in moments when one party has deep internal divisions, or when there are strong political incentives to cooperate.

The political lessons Americans should learn from Hurricane Harvey (Washington Post)
We’ve been hearing for years now that we Americans are fixated on our tribal divisions. We have nothing in common anymore, we’re told. The old civic spirit that once so impressed foreign visitors is gone, eroded by echo chambers and social media navel-gazing and geographic self-selection. We’re Balkanized, incapable of talking to each other, hopelessly sliced and diced according to the dictates of identity politics. Now take a look at those pictures from southeast Texas.


Engagement

Town halls are in the spotlight, but are they effective in communicating with lawmakers? (Post-Crescent)
Since the 2016 election, town halls hosted by federal lawmakers, or even citizens looking to question their representatives, have provoked angst and anger nationwide. Now, the state of the traditional town hall — one that is open to the public and not by invitation only, scheduled in advance, and willing to take questions on any topic — is at a crossroads, after a particularly antagonistic election and changes in technology and social media

Boulder council hears citizen group's advice for improving public engagement (CityLab)
After meeting more than 30 times between September and May, a citizen advisory group determined that the local government's process of public engagement is broken to the point that a "culture change" is required.


Opportunity/Inequality

Income Inequality Is Making Rent Even Less Affordable (CityLab)
It’s not news that both income inequality and rents have hit record highs, especially in expensive superstar cities and leading tech hubs. But to what extent do income inequality and rising rents go together?

American Cities Losing the Most Jobs (24/7 Wall St.)
While the United States has experienced years of rapid post-recession economic growth, the recovery has eluded some parts of the country. Approximately 1 in 5 U.S. metro areas lost jobs over the past 12 months, and the number of employed persons has decreased by at least 1% in 25 of the country’s 388 metropolitan areas.


K12

Schools with more students of color are more likely to be shut down — and three other things to know about a big new study (Chalkbeat)
Shutting down schools with low test scores doesn’t help student learning and disproportionately affects students of color, according to one of the largest studies ever of school closures.

How one Chicago high school turned the corner using full-time internships (Hechinger Report)
Real-World Learning gets real: Could the key to school success be spending less time in school?


Higher Education & Workforce Development

The Biggest Misconception About Today’s College Students (New York Times)
You might think the typical college student lives in a state of bliss, spending each day moving among classes, parties and extracurricular activities. But the reality is that an increasingly small population of undergraduates enjoys that kind of life.

Most Americans say K-12 schools have a lot of responsibility in workforce preparation (Pew Research)
As millions of U.S. students start school, and economists and educators grapple with how best to prepare workers for jobs in today’s economy, there is evidence that a majority of Americans look to elementary and secondary schools to provide the building blocks people need for a successful career.


Healthcare

When given the chance, will patients choose cheaper prescription drugs? (Managed Healthcare Executive)
Significant cost savings and changes in drug selection has been linked to reference pricing, which leverages insurer/employer contributions to encourage patients to select cheaper drugs that are as effective as their name-brand counterparts, according to a new study.

Why Patient-Reported Outcomes Data is Key to Healthcare Quality (Health IT Analytics)
Patient-reported outcomes data is at the heart of truly effective value-based care and quality improvement, says the National Quality Forum.

Want Single-Payer? Start Calling It Something Else (Vice)
Progressives are pushing for a new healthcare system. But they need to think about the branding.

Comment

08.24 Engaging Ideas - 8/24/2017

Thursday, August 24th, 2017 | PUBLIC AGENDA




Democracy

Trump’s demand to build border wall could upend sensitive negotiations on Capitol Hill (Washington Post)
During a campaign rally in Phoenix on Tuesday night, Trump leveled his latest threat about blocking new government funding if it doesn’t include the $1.6 billion he wants to partially construct a new wall along the Mexico border. Government operations are only funded through Sept. 30, which is the end of the federal fiscal year. If Congress and the White House don’t agree on new funding levels by then, there will be a partial government shutdown. It will close national parks, suspend many government operations and send hundreds of thousands of federal workers — many of them in the Washington area — home without pay on “furlough.”

The Showdown Over How We Define Fringe Views in America (New York Times)
Today in the United States, sweeping majorities of the public say they support fair housing laws and the ideal of integrated schools. Nine in 10 say they would back a black candidate for president from their own party, and the same say they approve of marriage between blacks and whites. That last issue has undergone one of the greatest transformations in polling over the last 50 years. In 1960, just 4 percent of Americans approved.


Opportunity/Inequality

Violent Crime's Toll on Economic Mobility (CityLab)
A new study shows just how much growing up in a violent neighborhood can harm an individual’s economic prospects later in life.

Can a Decades-Old Immigration Proposal Pass Under Trump? (The Atlantic)
When President Trump publicly backed a bill to curb legal immigration, he placed a decades-old idea—that until now had been largely sidelined—back into the mainstream. Earlier this month, Trump threw his weight behind a modified version of the Reforming American Immigration for a Strong Economy Act, a measure first introduced by Republican Senators Tom Cotton and David Perdue in February that would cut legal immigration to the United States by 50 percent over a decade. “Finally, the reforms in the RAISE Act will help ensure that newcomers to our wonderful country will be assimilated, will succeed, and will achieve the American Dream,” Trump said in an announcement from the White House.


K12

New study deepens nation’s school turnaround mystery, finding little success in Rhode Island (Chalkbeat)
The country’s smallest state tried to accomplish a big task in 2012: improve its struggling schools without firing principals or making other dramatic changes. Instead, Rhode Island gave schools the option to do things like add common planning time for teachers, institute culturally appropriate instruction for students, and expand outreach to families.

City Will Move Sidelined Teachers From Limbo to Classrooms (New York Times)
For a dozen years, hundreds of New York City teachers have been paid despite not having permanent jobs, sidelined in most cases because of disciplinary problems, bad teaching records or because they had worked in poorly performing schools that were closed or where enrollment declined.

Grade Inflation Is Greater in Wealthier Schools, Study Says (Education Week)
Students in suburban public schools and private schools have benefited from grade inflation more than their less-affluent counterparts in urban schools, according to new research. The College Board examined the grade point averages of students who took the SAT between 1998 and 2016. They compared those GPAs for students at private and suburban schools—settings that tend to have larger shares of affluent students—and at urban public schools, which typically enroll more low-income students.


Higher Education

Religious University and 2-Year College (Inside Higher Ed)
A handful of religious institutions across the country are establishing or expanding two-year degree programs to provide a gateway to low-income students or an alternative for students looking for a nonsecular education as they pursue an associate degree. Private two-year colleges are rare, with just about 200 in the country. Even rarer are private universities that offer associate degree programs.

Challenging the ‘Productivity Paradox’ (Inside Higher Ed)
Now, a recent study in The Journal of Higher Education has found that investments in technology do indeed appear to lead to increases in productivity for institutions -- but not for all institutions in the same way.


Healthcare

Not-for-profit providers' rising expenses, dwindling revenue could spur mergers (Modern Healthcare)
Not-for-profit providers saw their annual expenses eclipse annual revenue growth in 2016, which will narrow margins and could spur merger-and-acquisition activity. After several years of cost containment among not-for-profit providers, annual expense growth of 7.2% outpaced annual revenue gains of 6%.

The Right Way to Reform Health Care (Foreign Affairs)
Perhaps no U.S. law has been more passionately opposed by Republicans than the Affordable Care Act. For the past eight years, they have repeatedly pledged to abolish Obamacare, with the House of Representatives voting more than 50 times to repeal it. U.S. President Donald Trump took office promising to do just that. In May, after months of heated negotiations, including two failures to corral votes within their own party, House Republicans managed—barely—to pass their first real replacement, the American Health Care Act.

Comment

08.21 How Public Engagement Needs to Evolve, Part 3

Monday, August 21st, 2017 | MATT LEIGHNINGER



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How can public engagement evolve in order to meet the challenges and conditions of 2017? My previous post argued for making engagement more social, versatile, convenient and fun. This time, I’ll explore the need to deal with the challenge of scale, so that people can be heard on state and federal issues, not just local ones.

Though we need people weighing in on national problems like the federal budget and global challenges like climate change, engagement remains largely local. Of the thousands of engagement processes conducted each year, the majority occur in cities, towns and neighborhoods. This is especially true of “thick” forms of engagement, in which people spend time in small groups learning, deliberating and planning for action. Thick engagement is productive, but intensive.

Local engagement is more common because these initiatives typically require a diverse, critical mass of participants to succeed, and the number of people required to create this diverse, critical mass is smaller at the local level. You need a sufficiently large web of relationships so that potential participants are approached by people they already know, and you need to give people some assurance that their participation will make an impact. Both things are easier to achieve in communities, towns and neighborhoods.

Twenty years ago, when widespread internet use began to reshape how we organized and thought about engagement, it was tempting to assume that online communication would immediately solve the problem of scale. But while some examples of digital engagement have managed to involve tens of thousands of people, those numbers don’t always seem to matter. When faced with these kinds of situations, Members of Congress usually ask if their constituents are taking part, and whether those people are a small, like-minded group or a large and diverse one.

Being able to show where the participants came from – which political jurisdictions they belong to – might help. But another difficulty is that social media activity is often an extremely “thin” form of engagement; it is fast and easy, but it doesn’t require much thought, research or ongoing commitment from the participant, and it doesn’t always provide opportunities or encouragement for people who want to dig deeper. “Thick engagement doesn’t scale, and thin engagement doesn’t stick,” laments Micah Sifry of Civic Hall.

Some of the newer types of engagement, such as the SMS-enabled discussions I described in the previous post, blend thick and thin in a way that overcomes the limitations of each. Large numbers of people can participate – “Text, Talk, Act” has involved 50,000 so far – but the experience sticks with people enough that they are more likely to take action and remain engaged afterward.

Another approach to scale is to follow the thinking of Thomas Jefferson, who argued that we should “Divide the country into wards,” each of them small enough for successful participation, but sufficiently linked to one another that they could function as a nation. And, suddenly, we may actually have a country of linkable wards: local online networks such as neighborhood email listservs, local Facebook group pages, e-democracy.org forums and NextDoor neighborhoods now cover huge swaths of the population. (NextDoor, which is a private, localized social network, now has over 100 users in 40% of all American neighborhoods.)

Local online networks combine the convenience of thin engagement with the potential for thick. People stay involved in these virtual spaces for many reasons: they are convenient, they allow for interaction, they deepen and complement face-to-face relationships, they are adaptable by the participants, and they give people a powerful sense of membership. They also help people solve basic daily challenges: members may talk about what the school board did or what the mayor said, but they also ask questions like “Who knows a good plumber they can recommend?”

By themselves, local online networks will not revitalize democracy or solve the problem of scale. Sometimes the discussion threads become too heated, and the network doesn’t have a good way to facilitate dialogue around a controversial topic. Online networks can also encourage thinly veiled racism, as people contribute concerned posts about “those people” or “those kids” who are hanging out on the corner of the street. And so far, there is no coherent strategy for linking thousands of local networks to make an impact on state, federal or global problems.

So, there seem to be several directions for innovation, several ways that engagement can evolve to address the challenge of scale:

  • Find new strategies of connecting different kinds of engagement opportunities – so that people who click “like” on a Facebook page or sign an online petition find out about a meeting happening in their community or an online network they can join (digital strategist Abhi Nemani calls this the “civic upsell”.
  • Create new ways of helping members of Congress and other decision-makers understand the nature and extent of online engagement among their constituents – and help those people connect with their public officials.
  • Develop new experiments that use SMS-enabled discussion to involve people in state or federal policy questions.
  • Help the organizers and members of local online networks use good engagement practices – like shared ground rules, policies on anonymity and relationships with decision-makers – to make their networks more participatory, effective and connected.
  • Organize processes that invite people from local online networks to deliberate and engage on an issue of state or national importance.

The internet did not by itself solve the problem of how to scale public engagement. It does, however, provide some incredible capabilities that, when combined with some of our other knowledge about how people like to engage, may help make engagement far more viral, prevalent and powerful.

Want to learn more about public engagement strategies? Join us in Chicago on October 19 for our Public Engagement Strategy Workshop to work on revamping and strengthening your engagement efforts. Click here for more information and to register.

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08.18 Engaging Ideas - 8/18/2017

Friday, August 18th, 2017 | PUBLIC AGENDA




Democracy

Understanding a Divided America (PBS)
Following the violent clashes between white nationalists and counter-protesters in Charlottesville, Virginia, PBS presents four films that take a closer look at the nation's divide.

The Senate subway: The new epicenter of American democracy? (Washington Post)
It’s a slightly comical transportation system in the bowels of the U.S. Capitol that few Americans know exists: the Senate subway system. Not subway like Metro — but two sets of tracks that carry underground trams ferrying lawmakers from Senate chambers to their office buildings, less than a third of a mile away. And it’s the unlikely backdrop to the tumultuous Capitol Hill legislative goings-on of the past seven months.

My road trip with a Republican: 2 strangers spend 14 hours in a car to talk through America’s political divide (Salon)
To combat the hate I saw on the 2016 campaign trail, I went looking for common ground. Dave signed on for the ride.


Engagement

OPINION: How I learned that civic engagement isn’t as easy as it should be (Denverite)
I’ve always been an active voter in both national and municipal elections, but it wasn’t until recently that I figured out just how much of the day-to-day decision-making by entities like City Council is open to the public.

Could Innovation in Democratic Participation Shake us Out of Our Civil Disillusionment? (Pacific Standard)
History proves that, when governments listen, citizens reward them both politically and financially.


Opportunity/Inequality

Children of the 1% are 77 times more likely to attend an Ivy League school than poor Americans (Business Insider)
"Access to colleges varies greatly by parent income," writes Raj Chetty of Stanford University and four co-authors. "Children whose parents are in the top 1% of the income distribution are 77 times more likely to attend an Ivy League college than those whose parents are in the bottom income quintile."

When Families Lead Themselves Out of Poverty (New York Times)
Seventeen years ago, Mauricio Lim Miller, a leader in the field of social services, received a phone call from Jerry Brown, who was the mayor of Oakland, Calif., at the time, that set him on a quest to understand how families really overcome poverty.

5 Figures That Define the Middle Class (Madison News)
The middle class is often thought of as the backbone of the American economy -- and decades ago it was. Today, however, the American middle class has become a shadow of what it once was. A number of changes and challenges, including poor saving habits, stagnant wage growth, and growing income inequality, has altered the shape of middle-class America.


K-12 Education

A New Kind of Classroom: No Grades, No Failing, No Hurry (New York Times)
Moheeb is part of a new program that is challenging the way teachers and students think about academic accomplishments, and his school is one of hundreds that have done away with traditional letter grades inside their classrooms.

How community trauma can harm student learning — and what that might mean for Charlottesville (Chalkbeat)
Among the many consequences of this weekend’s events in Charlottesville: teachers are wondering how the violent displays of racism will affect their students.


Higher Education & Workforce Development

Colleges ponder: Are remedial classes the best way to help? (Christian Science Monitor)
Lulu Matute still remembers the sinking sensation she felt when she heard the news. It was the fall of 2012, and Ms. Matute had just taken the placement exam that gauged every prospective college student’s skill in math and English. She had hoped to earn her associate’s degree at the City College of San Francisco (CCSF) and transfer to a four-year institution within two years. “But based on the layout my counselor gave me, I was going to be there for three and a half, because I was starting at the lowest-level math,” she says.

Work-Force Training in an Anti-College Climate (Inside Higher Ed)
Community colleges stress their role in providing work-force opportunities amid doubts from some working-class people that college won't benefit them or their children.


Health Care

Can Healthcare Price Transparency Tools Cut Costs for Payers? (HealthPayer Intelligence)
Healthcare price transparency tools may only offer savings to payers if insurance companies improve utilization rates.

Diagnosing America's Health Care Mess: Part 3 (Forbes)
Today we will examine the consequences of this outsized growth in health spending: health care spending absorbs an ever-growing fraction of the economy and government spending.

Doctors Coming Around To Single-Payer Healthcare (Forbes)
Citing simplicity, fewer hassles with insurers and more stable coverage for patients, U.S. physicians increasingly support a single-payer healthcare system, new reports indicate.

Comment

08.18 Reflections From a Public Engagement Workshop

Friday, August 18th, 2017 | JENNIFER ORELLANA



Before joining Public Agenda, I knew little about the different types of community engagement available to those who wish to play a greater role in the decision making that happens in their community. Outside of volunteering at local churches and programs sponsored by community organizations like the Boys and Girls Club of Harlem where my own daughter participates, I was unaware of the many other ways people can become more involved in their neighborhoods.

That changed when I volunteered at a recent Public Agenda strategy workshop in New York City on public engagement. The workshop was a two-day event designed for leaders who want to revamp and strengthen their engagement strategies. Being there gave me a new understanding of how engagement works as well as an overview of the tools and resources available.

One interesting topic we discussed was Participatory Budgeting, a democratic type of engagement that allows members of a community to be involved in micro-decisions made for their neighborhood by voting on how to spend a portion of the public budget allocated to them. Types of projects that fall under Participatory Budgeting can include improvements to schools, parks, libraries, public housing and other public or community spaces.

A great example of a project funded through participatory budgeting happened in Council District 39 (Carroll Garden, Brooklyn), where PS 58, The Carroll Garden School, was able to replace fixtures and flushing mechanisms for eight of their bathrooms. Voted on in 2013, this project garnered 1,100 votes, had a budget of $110,000 and was funded in 2014.

Among the many resources which were discussed, two were of particular interest to me: SeeClickFix, an app designed to bring communities together to resolve local issues, and LocalWiki, a site that gives users the opportunity to learn more about where they live. Many more tools were presented at the strategy workshop, all of which have the potential to make significant impacts in communities across the world.

My experience at Public Agenda's strategy workshop was fun and enlightening. From learning about effective engagement tools and resources to directly participating in an exercise (based on a real case study) where teams had to build a sustainable engagement plan for a Bronx community, I now have a better understanding about engagement and am inspired to get involved with participatory budgeting in my neighborhood.

If you’re in the Chicago area on October 19 and want assistance with organizing and sustaining productive public engagement and bringing together a diverse critical mass of people, I highly recommend you attend the next Public Engagement strategy workshop. You can sign up for more information and register here.

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08.11 Engaging Ideas - 8/11/2017

Friday, August 11th, 2017 | PUBLIC AGENDA




Democracy

Some of those hot-button issues of the Trump-backed immigration bill aren’t so controversial to the public (Washington Post)
Surveys over the past decade show Americans think it’s important for immigrants to possess several attributes prioritized by the new bill, including speaking English, having a job and a high level of education — but there’s mixed opinion on reducing the number of immigrants granted entry to the United States.

Readers write: What does 'winning' in politics mean? (Christian Science Monitor)
Sometimes winning isn’t about winning. That’s essentially what Sen. John McCain (R) of Arizona said in a speech from the Senate floor last week, calling on his colleagues to stop being so focused on chalking up wins for one’s party that you lose sight of the bigger issue: solving problems for Americans. His speech prompted us to ask you – our readers – how you would define winning in politics. The answers reflected a thoughtful tone, in contrast to the intense partisanship we’re seeing in American politics.

Political Parties Near Realignment After 20 Years of Sorting (NBC News)
On the surface, the American political system looks fairly steady, with two well-known behemoths, the Democratic and Republican parties, fighting for control. But those two parties have changed a lot in recent years and those changes have remade American politics.


Engagement

Facebook Is Testing a New Way for Users to Connect With Their Elected Officials (AdWeek)
Facebook is testing a new way to perform its civic duty, as some users are seeing “This Week in Your Government” posts in their News Feeds, featuring recent posts from their local elected officials.

A Civics Lesson for Facebook (Slate)
As CEO Mark Zuckerberg laid out in a sizable manifesto earlier this year, Facebook has grand ambitions to create a platform that goes beyond just connecting family and friends. More than social media, it wants to create the social infrastructure that powers communities from niche interest groups to nations. But can tools to improve civic engagement from a clickbait-driven company really be good for democracy?


Opportunity/Inequality

Our Broken Economy, in One Simple Chart (New York Times)
Many Americans can’t remember anything other than an economy with skyrocketing inequality, in which living standards for most Americans are stagnating and the rich are pulling away. It feels inevitable. But it’s not.

To Boost Income Mobility, Reform Our Bail System (The Federalist)
Beyond shrinking our overly expanded incarcerated population, bail reform would boost the United States’ stagnating income mobility by reforming a system that traps the poor in poverty.

Why It’s So Hard to Get Ahead in the South (The Atlantic)
In Charlotte and other Southern cities, poor children have the lowest odds of making it to the top income bracket of kids anywhere in the country. Why?


K-12 Education

A new study shows why it’s so hard to improve teacher preparation (Chalkbeat)
Dramatically reshaping how teachers are trained — by emulating great teacher preparation programs and shutting down ineffective ones — has been a key priority of many states and even, under the Obama administration, the federal government.

What should America do about its worst public schools? States still don’t seem to know. (Washington Post)
Two years after Congress scrapped federal formulas for fixing troubled schools, states for the most part are producing only the vaguest of plans to address persistent educational failure. So far, 16 states and the District of Columbia have submitted proposals for holding schools accountable under the 2015 law known as the Every Student Succeeds Act. With few exceptions, the blueprints offer none of the detailed prescriptions for intervention, such as mass teacher firings or charter-school conversions, that were once standard elements of school reform.


Higher Education & Workforce Development

Why Men Are the New College Minority (The Atlantic)
Jessica Smith raised an arm and pointed across the lobby of the university student center like an ornithologist who had just spied a rare breed in the underbrush. “There’s one,” she said. It was, in fact, an unusual bird that Smith had spotted, especially on this campus: masculum collegium discipulus. A male college student. This fall, women will comprise more than 56 percent of students on campuses nationwide, according to the U.S. Department of Education. Some 2.2 million fewer men than women will be enrolled in college this year. And the trend shows no sign of abating. By 2026, the department estimates, 57 percent of college students will be women.

Students of for-profit colleges struggle the most repaying loans (The Buffalo News)
Students who attended for-profit institutions struggled the most to pay down the principal on their student loans. For-profit schools also produced lower shares of students who earned annual incomes of at least $25,000.

Cuomo to Give Colleges $7 Million for Courses in Prisons (New York Times)
Moving ahead with a plan that has drawn criticism from conservatives, the administration of Gov. Andrew M. Cuomo is awarding more than $7 million in grants to a variety of colleges around the state to offer courses to prisoners.


Health Care

To Save Money On Health Costs, Try Putting Away Your Insurance Card (Forbes)
Psst: You might pay less for health care if you put away your insurance card. Like most of us, you probably think your insurance policy gives you access to better prices. But that’s not always true.

Here's What a Bipartisan Health Care Plan Would Look Like (Money Magazine)
After Senate Republicans failed to pass a strictly partisan repeal of the Affordable Care Act, a group from the House of Representatives from both sides of the aisle have presented a plan to bring down costs and keep protections in place for people with pre-existing conditions.

Physicians with high-risk patients struggle under value-based pay model (Modern Healthcare)
Physicians who serve low-income patients with complex conditions are more vulnerable to financial losses in value-based payment models, according to a new study that found these providers, many of them safety-net providers, didn't have the technological infrastructure to report the necessary data.

Studies Find That Getting Patients to Shop for Health Care Is a “Tough Sell” (Managed Care Magazine)
Americans extol price shopping for health care as a prudent idea, yet few actually do it even when given the means to, according to the findings of two separate studies led by investigators at Harvard Medical School (HMS).

Comment

08.08 What Physician and Hospital Qualities Do Consumers Value?

Tuesday, August 8th, 2017 | Megan Collado



This blog post originally appeared on Aug 1, 2017 and is reposted with permission from AcademyHealth.

While the future of healthcare reform in the United States remains uncertain, every day consumers continue to make decisions about their health and healthcare, and they are doing so in a rapidly evolving healthcare environment. Some are receiving care in new settings, such as retail clinics or virtual office visits. Many are navigating new health insurance benefit designs, including high deductible health plans that expose consumers to greater cost-sharing in exchange for lower monthly premiums. And some are shopping for doctors and hospitals to provide treatment for a range of “shoppable” conditions.

In response to this evolving landscape, the Robert Wood Johnson Foundation wanted to better understand how consumers are navigating the healthcare system, with a particular focus on their experiences, preferences, and values. Under a funding opportunity managed by AcademyHealth, they awarded 11 research studies in 2015 that sought to generate evidence on what consumers value in different care delivery settings, when they are buying and using insurance, and when they are shopping for healthcare.

These grants are wrapping up this year, and two grantees found unique insights into how patients perceive and value physician and hospital quality. David Schleifer, Ph.D., director of research at Public Agenda, and colleagues explored perspectives on quality among people who have experienced one of three common types of healthcare: type 2 diabetes care, joint replacement surgery and maternity care. They found that across all three groups, people value both interpersonal and clinical qualities of doctors and hospitals. The most common interpersonal quality that people across these three groups say is very important is that the doctor makes time for patients’ questions and concerns.

Interestingly, the researchers found differences between the three groups’ rating of interpersonal and clinical qualities (i.e. as very important, somewhat important, not too important, or not at all important). While most people recently diagnosed with type 2 diabetes and women who recently gave birth rated interpersonal qualities as very important, fewer rated clinical qualities as very important. Most people who recently had a joint replacement rated both interpersonal and clinical qualities as very important. Schleifer and colleagues conclude that it’s important to understand that people value different qualities of care depending on their health needs. The full findings from Public Agenda are detailed in a recently released report.

David Auerbach, Ph.D., director of research at the Massachusetts Health Policy Commission, and colleagues provide some additional insight into consumer perspectives on the value of different care settings (specifically community health systems versus academically-affiliated systems). They conducted focus groups with consumers finding that quality scores for physicians and hospitals mattered more for procedures that patients considered “risky,” such as cancer treatment or surgery. This observation aligns with Schleifer and colleagues’ finding that people who recently had a joint replacement surgery viewed clinical quality as very important, whereas for more routine care that perhaps was perceived as less risky, fewer patients rated clinical qualities as very important. In the case of more routine procedures, Auerbach and colleagues found that patients were more influenced by physician referrals and cost when choosing between community and academic settings.

While both studies found that patients do value clinical quality information about their doctors and hospitals, both also found that more work is needed to educate consumers about what’s included in clinical quality measures as well as how to find this information about doctors and hospitals. Schleifer and colleagues note that while many patients viewed clinical qualities as important, only some knew or tried to find out whether a doctor or hospital had these qualities.

The findings described here are a sneak peek of the full portfolio of grantees that will continue to come out over the next year. As these findings emerge, they will provide important evidence about how consumers are navigating new delivery settings, how they are buying and using health insurance and shopping for care, and how they are using information to make decisions to improve their health. Findings and publications will be posted on the program website.

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