IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v68y2009i11p1926-1934.html
   My bibliography  Save this article

The influence of national policy change on subnational policymaking: Medicaid nursing facility reimbursement in the American states

Author

Listed:
  • Miller, Edward Alan
  • Wang, Lili

Abstract

This study proposes that exogenous shocks emanating from national governments can significantly change health policy processes among subnational units. The relevance of this insight for comparative health policy research is examined in the context of Medicaid nursing facility reimbursement policymaking in the American states. Event history techniques are used to model state adoption of case-mix methods for reimbursing nursing homes under Medicaid from 1980 to 2004. Case-mix adjusts Medicaid nursing home payments for patient acuity, thereby enabling states to pay more for residents with higher care needs and to pay less for residents with lower care needs. The goal is to improve access for more resource intensive Medicaid beneficiaries and to distribute payments more equitably across the providers who serve them. The most noteworthy national policy changes affecting case-mix implementation by state governments were adoption of nursing home quality reform with the Omnibus Budget Reconciliation Act (OBRA) of 1987 and case-mix by Medicare with the Balanced Budget Act (BBA) of 1997. In light of the 1990 and 1999 implementation of OBRA 1987 and the BBA, respectively, five models were estimated, which in addition to covering the entire time period studied (1980-2004) include pre-/post-BBA comparisons (1980-1998, 1999-2004) and pre-/post-OBRA 1987 comparisons (1980-1989, 1990-1998). Results suggest that in contrast to early adoption, which tended to be grounded in the capabilities of innovative states, later adoption tended to take place among less capable states influenced more by the changing federal policy environment. They also highlight the salience of programmatic and fiscal conditions but during the middle of the adoption cycle only. Future research should clarify the ways in which national policy changes influence health policy adoption at the subnational level, both in other nations and across different levels of government.

Suggested Citation

  • Miller, Edward Alan & Wang, Lili, 2009. "The influence of national policy change on subnational policymaking: Medicaid nursing facility reimbursement in the American states," Social Science & Medicine, Elsevier, vol. 68(11), pages 1926-1934, June.
    • Handle: RePEc:eee:socmed:v:68:y:2009:i:11:p:1926-1934
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(09)00175-0
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Gray, Virginia, 1973. "Innovation in the States: A Diffusion Study," American Political Science Review, Cambridge University Press, vol. 67(4), pages 1174-1185, December.
    2. Edward Alan Miller, 2008. "Federal Administrative and Judicial Oversight of Medicaid: Policy Legacies and Tandem Institutions under the Boren Amendment," Publius: The Journal of Federalism, CSF Associates Inc., vol. 38(2), pages 315-342, Spring.
    3. Walker, Jack L., 1969. "The Diffusion of Innovations among the American States," American Political Science Review, Cambridge University Press, vol. 63(3), pages 880-899, September.
    4. Colleen M. Grogan, 0. "The Influence of Federal Mandates on State Medicaid and AFDC Decision-Making," Publius: The Journal of Federalism, CSF Associates Inc., vol. 29(3), pages 1-30.
    5. Edward Alan Miller & Jane Banaszak-Holl, 2005. "Cognitive and Normative Determinants of State Policymaking Behavior: Lessons from the Sociological Institutionalism," Publius: The Journal of Federalism, CSF Associates Inc., vol. 35(2), pages 191-216, Spring.
    6. Pierson, Paul, 2000. "Increasing Returns, Path Dependence, and the Study of Politics," American Political Science Review, Cambridge University Press, vol. 94(2), pages 251-267, June.
    7. Walker, Jack L., 1969. "The Diffusion of Innovations among the American States," American Political Science Review, Cambridge University Press, vol. 63(3), pages 880-899, September.
    8. Edward Alan Miller, 2005. "State health policy making determinants, theory, and methods: A synthesis," Social Science & Medicine, Elsevier, vol. 61(12), pages 2639-2657, December.
    9. Berry, Frances Stokes & Berry, William D., 1990. "State Lottery Adoptions as Policy Innovations: An Event History Analysis," American Political Science Review, Cambridge University Press, vol. 84(2), pages 395-415, June.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Timothy Callaghan & Lawrence R. Jacobs, 2014. "Process Learning and the Implementation of Medicaid Reform," Publius: The Journal of Federalism, CSF Associates Inc., vol. 44(4), pages 541-563.
    2. Felix Strebel & Thomas Widmer, 2012. "Visibility and facticity in policy diffusion: going beyond the prevailing binarity," Policy Sciences, Springer;Society of Policy Sciences, vol. 45(4), pages 385-398, December.
    3. Xiaohan Li & Yang Lv & Md Nazirul Islam Sarker & Xun Zeng, 2022. "Assessment of Critical Diffusion Factors of Public–Private Partnership and Social Policy: Evidence from Mainland Prefecture-Level Cities in China," Land, MDPI, vol. 11(3), pages 1-15, February.
    4. Weixing Liu & Hongtao Yi, 2020. "What Affects the Diffusion of New Energy Vehicles Financial Subsidy Policy? Evidence from Chinese Cities," IJERPH, MDPI, vol. 17(3), pages 1-15, January.
    5. Saatvika Rai, 2020. "Policy Adoption and Policy Intensity: Emergence of Climate Adaptation Planning in U.S. States," Review of Policy Research, Policy Studies Organization, vol. 37(4), pages 444-463, July.
    6. Fabrizio Gilardi, 2010. "Who Learns from What in Policy Diffusion Processes?," American Journal of Political Science, John Wiley & Sons, vol. 54(3), pages 650-666, July.
    7. Jolley, G. Jason, 2023. "The Political Economy of Local Government Enterprise Zone Designation," Journal of Regional Analysis and Policy, Mid-Continent Regional Science Association, vol. 53(2), September.
    8. Lanahan, Lauren & Feldman, Maryann P., 2015. "Multilevel innovation policy mix: A closer look at state policies that augment the federal SBIR program," Research Policy, Elsevier, vol. 44(7), pages 1387-1402.
    9. Suk Joon Hwang & Frances Berry, 2019. "Deterring Drunk Driving: Why Some States Go Further Than Others in Policy Innovation," IJERPH, MDPI, vol. 16(10), pages 1-18, May.
    10. Conghu Wang & Xiaoming Li & Wenjuan Ma & Xiaopeng Wang, 2020. "Diffusion models over the life cycle of an innovation: A bottom‐up and top‐down synthesis approach," Public Administration & Development, Blackwell Publishing, vol. 40(2), pages 105-118, May.
    11. Yi, Hongtao & Feiock, Richard C. & Berry, Frances S., 2017. "Overcoming collective action barriers to energy sustainability: A longitudinal study of climate protection accord adoption by local governments," Renewable and Sustainable Energy Reviews, Elsevier, vol. 79(C), pages 339-346.
    12. Yingchao Ji & Jie Yin, 2022. "Diffusion Characteristics and Driving Factors of the Smart Tourism City Policy—Event History Analysis," Sustainability, MDPI, vol. 14(11), pages 1-15, May.
    13. Yuanyuan Huang & Lizhen Wei & Guiwen Liu & Wenjing Cui & Fangyun Xie & Xun Deng, 2022. "“Inspiring” Policy Transfer: Analysis of Urban Renewal in Four First-Tier Chinese Cities," Land, MDPI, vol. 12(1), pages 1-31, December.
    14. Valente, Thomas W. & Pitts, Stephanie & Wipfli, Heather & Vega Yon, George G., 2019. "Network influences on policy implementation: Evidence from a global health treaty," Social Science & Medicine, Elsevier, vol. 222(C), pages 188-197.
    15. Jäkel Tim, 2019. "Performance Gaps, Peer Effects, and Comparative Behaviour: Empirical Evidence from Swedish Local Government," Statistics, Politics and Policy, De Gruyter, vol. 10(1), pages 27-53, June.
    16. Kaveh Rashidi & Anthony Patt, 2018. "Subsistence over symbolism: the role of transnational municipal networks on cities’ climate policy innovation and adoption," Mitigation and Adaptation Strategies for Global Change, Springer, vol. 23(4), pages 507-523, April.
    17. Valente, Thomas W. & Dyal, Stephanie R. & Chu, Kar-Hai & Wipfli, Heather & Fujimoto, Kayo, 2015. "Diffusion of innovations theory applied to global tobacco control treaty ratification," Social Science & Medicine, Elsevier, vol. 145(C), pages 89-97.
    18. Zhirong Zhao, 2005. "Motivations, Obstacles, and Resources: The Adoption Of The General-Purpose Local Option Sales Tax in Georgia Counties," Public Finance Review, , vol. 33(6), pages 721-746, November.
    19. Strebel, Felix, 2011. "Inter-governmental institutions as promoters of energy policy diffusion in a federal setting," Energy Policy, Elsevier, vol. 39(1), pages 467-476, January.
    20. Manuel P. Teodoro, 2009. "Bureaucratic Job Mobility and The Diffusion of Innovations," American Journal of Political Science, John Wiley & Sons, vol. 53(1), pages 175-189, January.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:68:y:2009:i:11:p:1926-1934. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.