Nadler Tushman Congruence Model: NYC Medicaid

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1. We analyze the Medicaid Case Study using the Nadler Tushman Congruence Model.
We first consider the Nadler Tushman Congruence Model Inputs in the Medicaid Case Study. The main input from the environment is the patients (clients) served by the Medicaid offices. The key input is the human resources, both managerial and front level workers. The history of Medicaid offices is that it is a bureaucratic organization that has a hierarchy and is relatively slow in decision making. The strategy for change adopted by the top management was to signal a change and encourage change and not become a champion of change.

The System components:
The basic task of Medicaid offices was to process client (patients). The basic characteristics of individuals in the organization were they were rule following, formal, and specialized. There was a hierarchy in place. Individuals only performed the tasks they were supposed to perform. Decision making and the chain of command were well defined. The formal arrangements were in the form of a succession of tiers from the frontline workers to the top management. Each level at Medicaid offices had clearly defined authority and responsibilities. The informal organization at Medicaid offices also had a narrow focus on special expertise.

The output and performance at Medicaid offices was unsatisfactory. The performance and effectiveness were below standard. The organizational structure at Medicaid office was such that it did not perturb the employees if the problem was outside their expertise. At the same time there was little scope for frontline employees to question the decisions of top management. The top managers often remained unaware of problems that existed several rungs down the organizational ladder. The group and intergroup behavior included conflict and dissatisfaction with the enrollment process of Medicaid. The system functioning at the organizational level was that the goals of Medicaid offices were not attained. The Medicaid offices were inefficient, consumer unfriendly, physically difficult to traverse, long client waiting times, and confusing ...