Reluctant partners: The role of preferences, incentives, and monitoring inprogram compliance

As devolution of responsibilities from higher-level governments to lower-le vel governments and nonprofits continues, more and more attention will be f ocused on implementation, specifically on how to convince reluctant partner s to participate fully in program success. In spite of a considerable body of research on implementation, few systematic efforts have been made to exa mine the predictors of successful compliance. This article provides such an effort, examining five possible predictors to implementation of primary ca re mandates in seven states. Among key factors in successful implementation of these mandates were legislative funding targeted to the program and pro active leadership within the medical schools. Monitoring and oversight were in place in only one state where implementation was judged to have been mo st successful. The wording of the legislative mandate and communication-oft en touted as important elements of successful implementation-were not impor tant in these seven states.