This quantitative research was conducted to identify and examine what variables contributed to Kentucky Medicaid Region Three physicians’ experience of policy alienation (PA) and subsequently influenced their willingness to implement Kentucky’s 2013 Medicaid policy strategies (WI). This research was a modification and expansion of the original study of policy alienation (PA) conducted by Tummers (2012a) testing the concept on another segment of healthcare professionals (Medicaid participating physicians) in Kentucky. Giddens’ structuration theory (1984) provided the theoretical foundation for this study. Findings indicated top down and bottom up (“street-level”) structural and material constraints influenced physician willingness to implement. Results supported all hypotheses and were consistent with the previous findings of Tummers (2012a). Finding in regards to physicians, what needs to be considered in the strategic management of Medicaid policy change are: 1. The influence of personalities, 2. The often unique aspects of Medicaid policies, 3. The often changing healthcare environment in which the policy is developed and implemented, and 4. Those unforeseen events that occur often disrupting even the best thought out strategies. Policy developers need to tailor and adjust strategies for policy implementation at each level of the hierarchy, acknowledging and recognizing a combination of factors influence successful policy strategy implementation and realizing strategies with the goal of instituting behavioral change at the “street-level” may not be effective in all regions.
|Advisor:||Miller, Kenneth R.|
|Commitee:||Malka, Shalom C., Wilkin, LaVena|
|School Location:||United States -- Kentucky|
|Source:||DAI-A 77/03(E), Dissertation Abstracts International|
|Subjects:||Management, Public administration, Public policy|
|Keywords:||Kentucky medicaid, Medicaid policy, Policy alienation, Strategic management, Structuration theory, Willingness to implement|
Copyright in each Dissertation and Thesis is retained by the author. All Rights Reserved
The supplemental file or files you are about to download were provided to ProQuest by the author as part of a
dissertation or thesis. The supplemental files are provided "AS IS" without warranty. ProQuest is not responsible for the
content, format or impact on the supplemental file(s) on our system. in some cases, the file type may be unknown or
may be a .exe file. We recommend caution as you open such files.
Copyright of the original materials contained in the supplemental file is retained by the author and your access to the
supplemental files is subject to the ProQuest Terms and Conditions of use.
Depending on the size of the file(s) you are downloading, the system may take some time to download them. Please be