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Toward a Culture of Consequences

Toward a Culture of Consequences: Performance-Based Accountability Systems for Public Services

Brian M. Stecher
Frank Camm
Cheryl L. Damberg
Laura S. Hamilton
Kathleen J. Mullen
Christopher Nelson
Paul Sorensen
Martin Wachs
Allison Yoh
Gail L. Zellman
with Kristin J. Leuschner
Copyright Date: 2010
Published by: RAND Corporation
Pages: 272
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  • Book Info
    Toward a Culture of Consequences
    Book Description:

    Performance-based accountability systems (PBASs) link incentives to measured performance to improve services to the public. Research suggests that PBASs influence provider behaviors, but little is known about PBAS effectiveness at achieving performance goals. This study examines nine PBASs that are drawn from five sectors: child care, education, health care, public health emergency preparedness, and transportation.

    eISBN: 978-0-8330-5083-0
    Subjects: Education, Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-ii)
  2. Preface
    (pp. iii-iv)
  3. Table of Contents
    (pp. v-xii)
  4. Figure and Tables
    (pp. xiii-xiv)
  5. Summary
    (pp. xv-xxx)
  6. Acknowledgments
    (pp. xxxi-xxxii)
  7. Abbreviations
    (pp. xxxiii-xxxvi)
  8. CHAPTER ONE Introduction
    (pp. 1-18)

    With much fanfare, the No Child Left Behind Act of 2001 (NCLB) (Pub. L. 107-110) initiated an era ofperformance-based accountabilityin federal education policy. In an unusual display of bipartisan support, Democrats (led by Sen. Edward Kennedy and Rep. George Miller) and Republicans (including President George W. Bush) carved out a strategy to hold schools accountable for the performance of their students. The legislation set the lofty goal of all students being proficient in reading and mathematics by 2014. States were required to adopt grade-level standards in reading and mathematics, test all students (grades 3–8 and one high-school...

  9. CHAPTER TWO A Historical Perspective on Performance-Based Accountability Systems
    (pp. 19-34)

    Today’s PBASs grew out of efforts over many years and many countries to manage the private and public organizations that were growing too large to be overseen by a single manager who knew what everyone was doing. The innovative approaches that were tried focused on measuring performance, which was originally defined fairly narrowly. As these efforts developed, notions about what aspects of performance most mattered broadened and changed over time. By the 1980s, government organizations were linking performance to incentives in an effort to motivate and direct individual performance and improve organizational outcomes. The PBASs on which this book focuses...

  10. CHAPTER THREE Problem Recognition and Adoption
    (pp. 35-52)

    We now begin our detailed examination of nine examples of PBASs drawn from five sectors. This chapter focuses on the process by which concerns about service production are recognized and PBASs adopted to address those deficiencies. It also examines some of the most important features of the political, governance, and organizational context into which PBASs are born. The conditions that lead to the adoption and design of a PBAS might be expected to affect its eventual implementation and impact. Furthermore, it is important to evaluate PBASs, at least in part, in terms of the goals they seek to achieve. Thus,...

  11. CHAPTER FOUR The Design of an Incentive Structure to Motivate Behavioral Change
    (pp. 53-72)

    As noted in previous chapters, a PBAS is designed to change service providers’ behavior by creating incentives for change that are linked to performance measures. This chapter focuses on the incentive structure, or the decisions required in assigning rewards and sanctions to individuals or organizations. Incentives can include (1) the potential effect on a service provider’s reputation of reporting its performance, (2) specific resources made available to the organization based on the service provider’s level of performance, (3) specific promotion and training opportunities or bonuses made available to individual employees who work within the service-provider organization, and (4) sanctions for...

  12. CHAPTER FIVE The Design of Measures That Link Performance to Incentives
    (pp. 73-102)

    As discussed in Chapter Four, a key task for the designers of a PBAS is to identify the individuals or organizations that, through strategic changes in behavior, should be capable of improving the quality of delivered services. Next, the PBAS designers must develop (a) a set of incentives to motivate the intended behavioral changes and (b) a set of measures to gauge the performance of service providers and serve as a basis for the application of the incentives. Chapter Four considered the question of incentive structures; in this chapter, we turn our attention to the development of performance measures.¹


  13. CHAPTER SIX Implementation and Monitoring
    (pp. 103-120)

    Between the design of a PBAS and its full operation, there is a period of implementation when a number of important activities must take place, including establishing rules governing how the system will operate in its particular setting, creating systems to collect data to support necessary measures of performance, installing incentive structures, designing and operating a data reporting system for providers, and possibly creating an audit system to monitor the ongoing functioning of the PBAS. Because these implementation decisions will affect the operation of the PBAS, they deserve attention. This chapter examines the implementation process associated with a PBAS, including...

  14. CHAPTER SEVEN Effectiveness of Performance-Based Accountability Systems
    (pp. 121-138)

    As noted in previous chapters, PBASs arise out of a desire to improve services that, if well-delivered, are posited to lead to the attainment of desired goals. But how effective have PBASs been in achieving these goals? This chapter examines empirical findings concerning the degree to which PBASs in the five sectors have been effective in improving services and whether those enhanced services have led to the achievement of desired system goals. As with so many other aspects of PBASs, the nine cases we investigated differ in terms of the amount of data available. We also draw on the relevant...

  15. CHAPTER EIGHT Motivating and Improving System Evaluation
    (pp. 139-164)

    Despite the recent increase in the use of PBASs to manage public service programs, there has been little rigorous research about their implementation or impact in the cases we examined, as documented in Chapter Seven. Given that PBASs are designed to promote accountability through performance measurement, it is somewhat ironic that there are very few studies across the sectors that measure the performance of PBASs themselves, either in terms of their implementation and processes or in terms of their outcomes. As we explored PBASs in this study, we developed a number of hypotheses about why PBASs are implemented more often...

  16. CHAPTER NINE Conclusions
    (pp. 165-188)

    We are now witnessing, across multiple service sectors, the development of PBASs, in which those responsible for overseeing a service-delivery activity establish a set of measures for gauging the quality of the service and a set of incentives—rewards or sanctions or a combination thereof—applied to service providers on the basis of measured performance, as a means of stimulating improvement.

    The management literature is replete with normative, and often theoretical, advice on the institutional structuring of PBASs and the design of measures and incentives. Additionally, although to a lesser extent, the literature includes critical examinations of specific PBAS cases...

  17. APPENDIX A The Five Sectors
    (pp. 189-208)
  18. APPENDIX B Designs for Evaluation
    (pp. 209-216)
  19. Bibliography
    (pp. 217-236)
  20. Back Matter
    (pp. 237-237)