ABSTRACT
International developments in working across boundaries have been observed with interest in Austria's public sector, and, together with the challenge of complex public needs, have paved the way for new modes of public governance. Starting with an overview of the organization and structures of the Austrian health system, we clarify why cross-boundary strategic management and service delivery has emerged in one of the most complex policy fields, and then we explain how it has been implemented. This contribution explores the various levels of innovation that have been enabled by new governance structures, as well as their role in overcoming the historic service delivery gaps that have existed in health care in Austria. This allows us to provide an answer to the enduring question of whether working across boundaries leads to more efficient and effective service delivery. This is provided by an analysis of the impact of collaborative reform pool projects on different health system target fields, reflecting the system's performance, and ultimately, comprising efficient and effective health care delivery. Drawing on this research, we develop an innovation level/impact type framework for the assessment of the projects, before discussing the role of radical innovations in working across boundaries. The chapter concludes with critical views on the findings and implications for future research.
