I had an interesting discussion this week. A foundation is looking at investing dollars for technical assistance and management into local community-based provider organizations, to ready those organizations for health care reform and changes to Medicaid in their state. The foundation director's questions to me – How do we know which organizations to select? Which of them will actually change and put the consultation recommendations in place?
Selecting the right organizations is not an easy task, but there is a very straightforward answer. Whether an organization (or a program, or a department) will change is completely dependent on its . . .

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