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The Use of Nadler-tuchman Congruence Model in Analyzing Medicaid Case Study

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The Use of Nadler-tuchman Congruence Model in Analyzing Medicaid Case Study essay
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The Nadler-Tuchman Congruence Model is an important tool in the transformation process of a company, program, or institution. This model has up to three major steps for use in transformation of a company including analysis of the major transformation elements, analysis of how the specific elements interact and interrelate within the organization and the implementation and maintaining of congruence (Remmé, 2008). The major organizational elements put into consideration during change management include people, nature of work done, organizational structure, and organizational culture. According to this model, increased congruence between the major elements of an organization is the first step towards improved performance and efficiency. The congruence model helps to ensure that both old and new elements in a system work together seamlessly to ensure that there is organizational success. This model also puts into consideration the impact of a new strategy on performance and efficiency of an organization. This ensures that an organization improves its performance after implementation of a new operating strategy (Sharma, 2015).

Analyzing the Medicaid Case Study using the Nadler-Tushman Congruence Model

The Medicaid Case Study presents the best way of implementing the Nadler-Tuchman Congruence Model in a transforming organization. The case study starts by highlighting the analysis of the major elements of the Medicaid program which helps in the identification of the major congruency needs for the program. The case identifies medical personnel, the government, patients, the community members, and sponsors of the program as the major elements in the implementation of Medicaid initiatives (Remmé, 2008). This helps in the identification of the major challenges preventing congruency among the elements including lack of good communication, poor management of funds, and poor allocation of resources, poor service delivery, and poor organizational structure. Identification of the major participants in the transformation process also helped in setting the necessary strategies needed in restoring congruency hence improving efficiency (Sharma, 2015). s

Apart from that, the Nadler-Tuchman Congruence Model helped identification of the major tasks performed in hospitals and in the Medicaid program. The major tasks that were highlighted in health facilities and the Medicaid program include offering extensive care for the old and handicapped, offering improved maternity care services, and delivering cheap medical services to all citizens. Identification of these tasks helped in the identification of the best strategies for implementation and the major stakeholders who will ensure that the Medicaid program will run smoothly (Sharma, 2015).

Application of the Nadler-Tuchman Congruence Model also helped in the restructuring of the organizational structure to ensure that they deliver quality medical services. According to the model, the organizational structure is another major determinant of performance and efficiency. According to Anderson (2012), structuring an organizational structure that will allow for both horizontal and vertical communication is the first step towards improved performance and efficiency. From the case study, the Medicaid program is an amalgamation of many waiver programs and partnerships hence requiring good management and structuring of the independent programs and bodies in order to record universal performance improvement. The major waiver programs run and management under the Medicaid program include the Aid to Families with Dependent Children (AFDC), Home Relief program, Partnership plan, and DSRIP program (Remmé, 2008). Identification of these independent programs under the Medicaid program helps to understand the nature of the organizational structure hence enabling for better restructuring.

Apart from the above steps and initiatives, use of the Nadler-Tuchman Congruence Model helped in the identification of the organizational culture in New York hospitals. This helped in evaluation of the best strategies that will help in improvement of performance and efficiency of medical services. Evaluation of the culture also helped in strategizing on the best waiver programs that will help in restoring performance and efficiency. Identification of the culture of patients and health care personnel helped in the formation of better ways of delivering medical services through waiver programs. Some of the major waiver programs formulated during this period include Affordable Care Act and Medicaid redesign team. Formulation of these waiver programs helped in addressing specific groups of patients and the population hence ensuring that medical services are accessible to all.

In regard to the case study, it is evident that the use of Nadler-Tuchman Congruence Model has many benefits to an organization. It helps in the improvement of performance, reduction of costs, improvement of efficiency, and improvement of office climate (Remmé, 2008). In addition to that, use of this model in organizational transformation helps in boosting employee attitudes, increasing number of clients served per day, and reducing processing time. It helps an organization to improve in performance and efficiency as well as reduce operational and running costs. In addition to this, use of this model has helped in the implementation of value-based payment schemes which help in boosting the quality and value of medical services.

Limitations of the model and how they manifested in the case study

Although the Nadler-Tuchman Congruence Model is the best transformational tool for organizations and companies, it has a number of limitations. The first major limitation of this model is that it is usually a long transformational process. Application of the Nadler-Tuchman Congruence Model requires a systematic process of analyzing the tasks performed in an organization, identification of the major people involved in the daily operations, identification of the organizational structure, and identification of organizational culture which can be time consuming (Sharma, 2015). The process of identifying all the important elements in an organization can be time consuming and can lead to loss of time. In the case study, the process of identifying the major elements in the implementation of the Medicaid program was conducted for over a decade. This allowed for enough time in planning the necessary strategies to be implemented for better performance. Although the Nadler-Tuchman Congruence Model has a complicated process that can be time consuming, it is important that one considers evaluating all steps before embarking on implementation (Sharma, 2007).

Another major limitation of this model is that it is expensive. This model requires studying of the major elements of an organization, analysis of the current performance indicators and step by step strategizing of the best strategies to improve performance. The use of this model in performance improvement in the Medicaid program led to use of $23.24 billion in 2000. This spending has escalated over the years and has reached $46.66 billion in 2013 (Sharma, 2015). Although this escalation in spending can be attributed to population growth, the method used in strategic improvement is very important and can be a determinant of the high costs.

Apart from the above challenges, this method is also technical and requires skilled personnel who can be able to analyze and evaluate all organizational elements before implementation of strategies. Lack of adequate analysis of the major organizational elements and activities can lead to inaccurate decisions hence implementation of poor strategies (Sharma, 2007). Having experienced and skilled personnel for the implementation of the model during change management can also help an organization to cut on costs incurred during changeover and reduce the challenges associated with changeover process.

How to deal with the challenges posed by the model

In order to deal with the above challenges, it is important that one seeks a skilled and experienced personnel to help in guiding and controlling activities during the changeover process (Skipton et al., 2012). Having a skilled personnel will help in minimizing the challenges that occur during changeover and also ensure that there is efficient utilization of available resources. This will help in cutting operational costs during the changeover and also improve the efficiency of the changeover process.

Apart from that, having a skilled implementation personnel will also help in reducing the complexity of the changeover process hence reducing the changeover period. Skilled personnel are able to evaluate and understand the major elements, culture, and organizational structure of an organization with ease. This helps in elimination of lengthy procedures and steps in the changeover process hence ensuring that the process is efficient and fast (Skipton et al., 2012). Apart from that, having skilled changeover personnel will also help an organization to cut on the changeover costs associated with the use of the Nadler-Tuchman Congruence Model. This is because a skilled personnel will help in the identification of challenges, additional running costs, and unnecessary expenses hence giving better ways of conducting the changeover process.


In conclusion, it is evident that the case study depicts a good changeover process using the Nadler-Tuchman Congruence Model. The case also highlights the major medical schemes and programs devised to create an efficient and productive changeover. The case also gives a number of challenges and issues arising during the changeover process including high changeover costs, time consuming process, and need for skilled and experienced changeover personnel (Sharma, 2007).

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