HCFA and the states: politics and intergovernmental leverage.
In this article, we seek to explain variations in the Health Care Financing Administration's (HCFA) relationship to state governments. After reviewing several alternative models of the policy-making process, we argue that the utility of each model depends on certain issue characteristics, especially salience and conflict. We further argue that HCFA's choice of intergovernmental tools, rooted in a political setting, depends on the same issue characteristics. We illustrate our arguments by examining HCFA's behavior during the Clinton administration and by focusing on four cases: HMO performance measurement, nursing home regulation, lead screening for children, and the Children's Health Insurance Program (CHIP).
Gormley
W T
WT
Georgetown University, USA.
Boccuti
C
C
D014487:Centers for Medicare and Medicaid Services, U.S. / Q000458:organization & administration*; D002648:Child; D002651:Child Advocacy / Q000331:legislation & jurisprudence; D003659:Decision Making, Organizational; D006279:Health Maintenance Organizations / Q000331:legislation & jurisprudence / Q000592:standards; D006801:Humans; D007373:Interinstitutional Relations; D007855:Lead Poisoning / Q000517:prevention & control; D008484:Medicaid / Q000331:legislation & jurisprudence; D008483:Medical Assistance / Q000331:legislation & jurisprudence; D017146:Models, Organizational; D009735:Nursing Homes / Q000331:legislation & jurisprudence / Q000592:standards; D019982:Organizational Case Studies; D011050:Policy Making; D011057:Politics; D013219:State Government; D014481:United States