Dissertation/Thesis Abstract

Policy Alienation: An Analysis of Kentucky Medicaid Region Three Physician Experiences Influencing their Willingness to Implement Kentucky's 2013 Medicaid Policy Strategies
by Carpenter, Rebecca Diane, Ph.D., Sullivan University, 2015, 423; 3729336
Abstract (Summary)

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.

Indexing (document details)
Advisor: Miller, Kenneth R.
Commitee: Malka, Shalom C., Wilkin, LaVena
School: Sullivan University
Department: Strategic Management
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
Publication Number: 3729336
ISBN: 978-1-339-15107-6
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