title: Making the Health Insurance Flexibility and Accountability (HIFA) waiver work through collaborative governance.
abstract: This paper argues that collaborative governance should be an essential component in any HIFA waiver proposal, due to the fact that the health care system is moving away from a federal and hierarchical program design and implementation towards a more local, collaborative approach. As several current collaborative projects demonstrate, collaboration may overcome barriers to health expansion program success, such as stakeholder buy-in, notice, and state access to private health coverage information. Furthermore, collaboration within the context of the HIFA waiver process may maximize the strengths of current collaborations, such as providing: (a) access to greater and more stable funding sources; (b) access to a facilitator that can collect and distribute data; and (c) an avenue for accountability. Multiple challenges in ensuring collaborative governance are reviewed. Ms. Zabawa argues that these challenges are not insurmountable if states adopt a truly collaborative approach to designing and implementing programs under the HIFA waiver; there may be hope in expanding and improving health coverage, since collaboration is the most appropriate mechanism to address the complexity of health system reform.
authors.affiliation: bjzabawa@law.wisc.edu
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Zabawa
mesh_terms: D014487:Centers for Medicare and Medicaid Services, U.S.; D018672:Community Health Planning / Q000458:organization & administration; D003299:Cooperative Behavior; D017047:Cost Sharing / Q000331:legislation & jurisprudence; D004608:Eligibility Determination / Q000331:legislation & jurisprudence; D004651:Employment / Q000331:legislation & jurisprudence*; D018166:Health Care Reform / Q000331:legislation & jurisprudence*; D006801:Humans; D019458:Insurance Coverage / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D007373:Interinstitutional Relations; D008484:Medicaid / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D010865:Pilot Projects; D017149:Private Sector / Q000458:organization & administration; D017150:Public Sector / Q000458:organization & administration; D013221:State Health Plans / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D014481:United States