Measuring the Performance of the Hollow State is the first in-depth look at the influence of performance measurement on the effectiveness of the federal government. To do this, the authors examine the influence of the Government Performance and Results Act of 1993 (with consideration of the later Program Assessment Rating Tool of 2002) on federal performance measurement, agency performance, and program outcomes. They focus a systematic examination on five agencies in the U.S. Department of Health and Human Services—the Food and Drug Administration, the Centers for Medicare and Medicaid Services, the Health Resources and Services Administration, the National Institutes of Health, and the Indian Health Service. Besides representing a wide range of federal government organizational structures and program formats, these agencies offer a diverse array of third-party arrangements including states, native American tribes, scientists, medical schools, and commercial and nonprofit health care intermediaries and carriers.

Exploring the development of performance measures in light of widely varying program mandates, the authors look at issues that affect the quality of this measurement and particularly the influence of program performance by third parties. They consider factors such as goal conflict and ambiguity, politics, and the critical role of intergovernmental relations in federal program performance and performance measurement. Through their findings, they offer illumination to two major questions in public management today—what are the uses and limitations of performance measurement as a policy and management tool and how does performance measurement work when applied to the management of third-party government?

While scholars and students in public administration and governmental reform will find this book of particular interest, it will also be of use to anyone working in the public sector who would like to have a better understanding of performance measurement.

David G. Frederickson is a program specialist in the program planning and results center in the U. S. Department of Labor. He has taught at Indiana University, George Washington University, and American University; worked as a visiting scholar at the Congressional Budget Office; and served as a White House intern. H. George Frederickson is the Edwin O. Stene Distinguished Professor of Public Administration at the University of Kansas. He has received the John Gaus Award, the Charles Levine Award, the Dwight Waldo Award, and the University of Kansas Irwin Youngbeng Award. In 2003-2004 he was the John G. Winant Visiting Professor of American Government at the University of Oxford and a fellow of Balliol College, Oxford. Among his publications are The Spirit of Public Administration, The Public Administration Theory Primer (coauthored with Kevin Smith), and Ethics in Public Management (coedited with Richard K. Ghere).

"David and George Frederickson have added some real depth to our understanding of the challenges of measuring performance in the public sector. It is about time that someone systematically examined the implications for performance implicit in the development of third-party approaches to governance. With its well-developed theoretical framework and illuminating case studies, Measuring the Performance of the Hollow State will be a welcome and valuable resource for students and practitioners alike. Everyone who is interested in government management—and especially federal management—should read this book."

IllustrationsAcknowledmentsAbbreviations and Acronyms

1. Introduction: Federal Performance Measurement

2. Setting the Stage: Third Parties, Fiscal Federalsim, and Accountability

3. Performance Measurement as Political and Administrative Reform

4. Performance as Grants to Third-Party Service Providers: The Health Resources and Services Administration

5.Performance as the Provision of Health Financial Security: The Centers for Medicare and Medicaid

6. Performance as Grants to Third Party Research Providers: The National Institutes of Health

7. Measuring the Health Performance of Sovereign Tribes as Third Parties: The Indian Health Service

8. Performance as Regulation: The Food and Drug Administration

9. Measuring Performance and Results in Theory and Practice

10. After the Government Performance and Results Act: Performance Measurement, Performance Budgeting, and Performance Management

APPENDIXES

A: Discussion Guide

B: Science Advance from the National Institute of Mental Health FY2000

C: Science Capsule from the National Instistute of Mental Health FY2000

D: Stories of Discovery from the National Institute of Mental Health FY2001

E: The Conduct of Research

References Index