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09.01 Engaging Ideas - 9/1/2017

Friday, September 1st, 2017 | PUBLIC AGENDA


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.


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.


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.


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.


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.


08.24 Engaging Ideas - 8/24/2017

Thursday, August 24th, 2017 | PUBLIC AGENDA


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.


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.


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.


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.


08.21 How Public Engagement Needs to Evolve, Part 3

Monday, August 21st, 2017 | MATT LEIGHNINGER


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, 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.


08.18 Engaging Ideas - 8/18/2017

Friday, August 18th, 2017 | PUBLIC AGENDA


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.


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.


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.


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


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.


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?


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).


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.


08.04 Engaging Ideas - 8/4/2017

Friday, August 4th, 2017 | PUBLIC AGENDA


Minnesota Professor Hopes to Overcome Political Divide (US News & World Report)
A University of Minnesota professor is among those on a mission to mend the hostility between supporters and opponents of President Donald Trump.

Millennials aren’t taking over politics just yet (Washington Post)
At some point, the age of the baby boomer in American politics will end. It’s simple demographics: Boomers keep getting older and older, and that means there are fewer and fewer of them. But, contrary to two recent news articles, the boomer political era hasn’t ended yet — and it won’t end next year, either.

Campus Political Fights Come Home for the Summer (New York Times)
College in the summer: Dorms and quads are quiet, and it seems that the whole community is catching its breath. No marches, sit-ins, shout-downs, protesters giving professors whiplash. No arguments over free speech, Black Lives Matter, Israeli boycotts, abortion, Bernie Sanders, Hillary Clinton, President Trump. But the fighting hasn’t stopped. It has just come home for the summer.


Why Are Government Websites So Bad? (Governing)
Years ago, it took days to get our hands on basic government documents. We’d call someone who could send them to us, hope they would follow through and then wait for the U.S. Postal Service to do its job. When they didn’t arrive in a week or so, we’d repeat the process. These days, like many other researchers, journalists, policymakers and citizens, we rely on the troves of reports, budgets, data and plans that state and local governments post on their websites.

Pols. Take Marathon Subway Ride To Hear Commuter Complaints (New York City Patch)
“There should be more communication between officials and the working stiff," a retired iron worker said.


Americans Aren’t Saving Money Like They Used To (Bloomberg)
American households scaled back their pace of savings to the lowest level in nine years at the end of 2016 as the growth of their wages and salaries slowed, updated government figures show.

The Wealth Gap in the U.S. Is Worse Than In Russia or Iran (Fortune)
There's an widening gulf in the United States between the haves and the have-nots. The columnist points to education and metropolitan zoning restrictions as reinforcement for this unequal system, with statistics to support the argument. But how true is it? We asked urbanist, author, and University of Toronto professor Richard Florida to weigh in.

K-12 Education

One in four D.C. public schools have had at least three principals since 2012 (Washington Post)
More than a quarter of D.C. Public Schools have had at least three principals since August 2012, a pattern of upheaval that worries parents and teachers who say constant change in leadership can generate instability, inhibit trust and stall academic progress.

Do vouchers actually expand school choice? Not necessarily — it depends on how they’re designed (Chalkbeat)
Who benefits most from private school voucher programs: families with few options or the schools themselves? This is a hotly debated question among supporters and critics of school vouchers, and is especially relevant as U.S. Secretary of Education Betsy DeVos has vowed to allow more families to use public dollars to pay for private school tuition. A 2016 study considers this question and comes back with an answer: It depends.

Higher Education & Workforce Development

More Bootcamps Are Quietly Coming to a University Near You (EdSurge)
In the last two years, a surge of nonprofit, four-year institutions have hopped on the bootcamp bandwagon. These programs, often on skills such as software development or data analytics, have arrived in a number of ways—from universities partnering with local for-profit bootcamps, or colleges creating their own intensive training programs completely in-house.

Affirmative Action Battle Has a New Focus: Asian-Americans (New York Times)
Students like Mr. Jia are now the subject of a lawsuit accusing Harvard of discriminating against Asian-Americans in admissions by imposing a penalty for their high achievement and giving preferences to other racial minorities.

Maximizing Mobility (Inside Higher Ed)
Leveraging new data can help low-income students climb the economic ladder, writes Michael Lawrence Collins.

Health Care

We need to treat the causes of high health costs, not the symptoms (The Hill)
As Senate Republicans failed to repeal and replace the Affordable Care Act, the reality is that no measure that was actually considered would actually lower the costs of healthcare.

How to Repair the Health Law (It’s Tricky but Not Impossible) (New York Times)
Stabilizing the market, lowering drug prices and expanding access to

coverage would go a long way to easing millions of Americans’ concerns.

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.

Texas legislators take aim at high maternal mortality rates (Fierce Healthcare)
Maternal death rates are on the rise in some regions, pushing leaders in several states to investigate the trend and putting hospitals on alert.


07.28 When 'Just Google It' Isn't Enough for Health care Quality

Friday, July 28th, 2017 | ANTONIO DIEP

In today’s information-intensive age, we often rely on search engines and websites to gather details with the hope of arriving at an informed decision. I myself do this when deliberating on which new restaurants to try or which cities to visit. Like many others, I am trying to learn about the particular qualities of the establishments and cities that I think are important.

In health care, policy experts and leaders often propose more transparency in quality information, arguing that an informed patient can make smarter decisions about his or her health. Theoretically, such an approach can positively affect a patient’s health outcomes and help with reducing costs. Consumers are increasingly relying on the wisdom of the internet or online tools designed by tech start-ups to search for health information. But do people really want to look for C-section rates and hospital ratings like they do for a new restaurant? When people face a serious medical choice, what kind of information do they look for, whether from the internet or other sources? Do they try to find out about the quality of doctors and hospitals before getting care?

Public Agenda recently surveyed people with three different types of health care needs -- people recently diagnosed with type 2 diabetes, people who recently had joint replacement surgery and women who recently gave birth— to learn more about what qualities of doctors or hospitals they think are important and how, if at all, they try to find information about these qualities. We found that a large majority of people across the three health care situations think that both interpersonal and clinical qualities of doctors and hospitals are important for high-quality care. But does that mean they are looking for information about doctors and hospitals?

In fact, our research shows that more people across these three groups spent time looking for information about the care they needed than spent time looking for information about doctors or hospitals. For instance, 85 percent of women who recently gave birth say they spent a lot of time learning about pregnancy and birth, but only 43 percent say they spent a lot of time finding out everything they could about different OB-GYNs/midwives and hospitals.

This finding raises the question: If people say qualities of doctors and hospitals matter, why don’t they take the time to learn about them? Our findings suggest several potential reasons. For example, we found that few people are aware that quality varies across doctors or across hospitals. Some people don’t think or know if they have much choice among hospitals in particular.

Looking for information about qualities just may not be top of mind for many people: We found that most women who recently gave birth did not know or try to find out about important qualities because it did not occur to them to do so. Only about one quarter to one third of people across the three groups we surveyed say there is not enough information about the quality of doctors or hospitals for their respective type of care.

Information and tools are not necessarily enough to help people arrive at sensible health care decisions, much less produce better outcomes. While searching for information can be great for planning your next dinner or destination, people need support and guidance in making more decisions about health care. Online tools can help unlock information. But simply having access to quality information isn’t enough if people aren’t looking for it or understand it when they find it. This is particularly concerning when it impacts something as consequential as medical care. This is where doctors, insurers, medical experts and leaders can step in to make sure that people are not only well informed but also have support navigating the system before receiving care.

For more insights into what qualities matter in diabetes care, joint replacement surgery and maternity care, check out our report, “Qualities that Matter.”


07.28 Engaging Ideas - 7/28/2017

Friday, July 28th, 2017 | PUBLIC AGENDA


Politicians can’t seem to do it, but these citizens are learning how to find common ground (Washington Post)
Like so many Americans, most of Donna Murphy’s social circle shared her politics. So when she, a self-described liberal, was tasked with putting together a weekend-long event with an equal number of Democrats and Republicans, she needed to broaden her bubble. To aid in her search, Murphy visited one of the most personally uncomfortable, but almost assuredly conservative places she could think of: Local gun shops.

City Releases Latest Progress on Open Data Plan (Gotham Gazette)
The city released its annual update to its Open Data plan on July 15, detailing the progress by city agencies to release all of their public data by 2018. The initiative, originally launched in 2012 under former Mayor Michael Bloomberg, was expanded by the de Blasio administration two years ago under its Open Data for All plan, which aimed to make the data more accessible to everyday New Yorkers. City agencies periodically add data sets to the portal for public access.

Funders must join forces to defend civil society (@lliance)
Accustomed to being relatively invisible, philanthropy doesn’t just have a role to play in trying to get money to those most in need; it has a role to play in seeking to influence powerful actors, and to help uphold the fundamental values of everything that we do.


Women create fewer online petitions than men — but they’re more successful (Washington Post)
Hillary Clinton’s candidacy for U.S. president reignited debate about gender inclusiveness in politics and the rate at which women participate. Many studies have shown that women do not participate as much as men in many aspects of offline politics. Yet this may be changing as a result of new technology.

Puerto Rico as a Blueprint for Voter Engagement (Pacific Standard)
Extraordinary efforts to bolster access to voting and participation in civic life have led to a high level of political engagement in Puerto Rico.

Public participation at City Council meetings begins — within limits (Chicago Sun Times)
Chicago residents finally got their individual three minutes of fame today in the City Council chambers, as a flashing digital clock on the wall counted down to zero. At the start of the 30-minute public comment session — a City Council first — George Blakemore boomed: “This is historic — you are now allowed to speak at City Council.” Three minutes later, the clock cut him off.


Americans: Getting By, But Not Getting Ahead (Next Avenue)
Despite a growing economy and the lowest U.S. unemployment rate in 16 years, things aren’t looking up for many Americans — financial fragility is especially an issue for people with low incomes and for minorities, according to the new 2017 Prosperity Now Scorecard.

Rural internet can help shrink economic gap (Seattle Times)
Microsoft wants to connect rural areas to better digital service. It’s a welcome initiative from an industry that, aside from locating some data centers in the hinterlands, tends to focus on metro areas. But the economic divide is long-standing and won’t be easily bridged.

One big reason millions are locked out of the American dream (MarketWatch)
Millions of families are living in perpetual financial insecurity. Low-income families are still unable to accrue enough savings to see themselves through a period of joblessness.

K-12 Education

A Career Pathway To Educational And Employment Success (Forbes)
How can our schools transform education to make it applicable and adaptable to the future? How can they foster the capacity for lifelong learning that young people entering the workforce today need for future success? Stephen Spahn, chancellor of New York’s preschool-12 Dwight School, has been asking these questions for 50 years.

Please keep this guy away from rousing charter school debate (Washington Post)
Along with many Americans, I enjoy intense arguments about charter schools, the tax-supported institutions independent of school districts. I happily air my biases and skewer the squishy defenses of my foes. People like me have to watch out for Zachary W. Oberfield, an associate professor of political science at Haverford College. He spoils our fun. On the charter school issue he is scholarly, precise and balanced.

How Colorado could see more “blended learning,” combining online courses and traditional teaching (Chalkbeat)
A new guide released Monday seeks to help Colorado schools successfully introduce blending learning, a growing practice combining traditional classroom instruction with online coursework.  

Higher Education & Workforce Development

College Degrees Lead to 'Good Jobs' (Inside Higher Ed)
The college degree has solidified its role as the best ticket to the middle class. With the title “Good Jobs That Pay Without a B.A.,” new research from Georgetown University’s Center on Education and the Workforce would seem to offer some solace for job seekers with only a high school credential. But not much, as the study shows that an increasing share of well-paying jobs have shifted to workers who hold four-year or associate degrees.

For-Profit Graduate Schools Popular With Black Women (Inside Higher Ed)
Graduate student enrollment is declining at for-profit institutions, but the sector continues to resonate with one particular demographic -- black women.

Private colleges play a key role in diversifying America's workforce (The Hill)
What may be surprising is that private colleges serve a higher proportion of first-generation and low-income students than public and private doctoral universities. At private nonprofit colleges 17 percent are first generation, and at private doctoral-granting universities, 11 percent are first generation.

What Makes a Good Free College Plan? (Inside Higher Ed)
We have recently witnessed the introduction of a growing number of diverse plans for free public college. But what we’ve not seen -- and what must be done -- is to determine a set of criteria to judge the effectiveness and the viability of these various financial aid models.

Health Care

What do patients value in healthcare? (Modern Healthcare Executive)
When defining quality, it is important to understand that patients value different qualities of care depending on their health needs, according to a new survey from Public Agenda, supported by the Robert Wood Johnson Foundation.

Universal Health Insurance? Why? (Health Affairs)
The Congressional health care debate has become a war between two seemingly irreconcilable extremes, coverage versus budget control. Health care is a right, thunders Bernie Sanders (I-VT). There’s no free lunch, roars back Rand Paul (R-KY). We think both sides miss the boat.

Which Metrics on Hospital Quality Should Patients Pay Attention To? (The Upshot)
The relatively recent movements toward transparency and quality in health care have collided to produce dozens of publicly available hospital quality metrics. You might consider studying them in advance of your next hospital visit. But how do you know if the metrics actually mean anything?


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