Dr. Liran Maymoni (p), Dr. Chen Sharony (p)

Background: Israel's National Health Insurance system exhibits persistent regional disparities in health outcomes. In 2010, the government reformed its capitation formula to allocate additional funding to HPs serving peripheral communities, aiming to reduce these disparities.
Objective: This study evaluates the effectiveness of the 2010 capitation reform in narrowing regional health gaps, as measured by self-reported health (SRH).
Methods: Using a difference-in-differences design and longitudinal panel data (15 sub-districts over 21 years, 2002–2022; n=315), we analyzed SRH data from the Israeli Social Survey, which includes approximately 7,500 respondents annually. The peripherality index served as the treatment variable. Regression models included sub-district and year fixed effects, controlling for sociodemographic variables.
Results: Contrary to the reform’s intended goals, regional health disparities between peripheral and non-peripheral areas grew wider after its implementation. While health outcomes in peripheral regions had been gradually catching up prior to the reform, this positive trend reversed in the years that followed. Rather than narrowing the gap, the policy coincided with renewed divergence in self-reported health, suggesting that the additional funding did not translate into meaningful improvements in underserved areas.
Conclusions: The findings highlight the limitations of relying solely on funding formula adjustments to achieve health equity. Without mechanisms that ensure targeted investments and organizational accountability, even well-intentioned reforms risk falling short of their goals. Future policies aiming to reduce regional disparities should prioritize not only equitable allocation but also effective implementation strategies that translate resources into meaningful improvements in service delivery and population health.

Ms Tali Malinoff (p), Dr Lilach Alon

Artificial intelligence (AI) holds significant promise for enhancing efficiency and responsiveness in public organizations, yet its adoption across the public sector remains limited. This qualitative study examines how public sector employees perceive both their own readiness and their organizations’ readiness to adopt AI.
The analysis draws on semi-structured interviews with 17 employees from Israeli government ministries and local municipalities and applies an inductive thematic approach. The findings point to a personal readiness is shaped by tensions between established and emerging professional identities, between recognized potential and everyday integration, and between individual openness and concerns over legitimacy. Organizational readiness is characterized by tensions between regulation and temporary suspension, between technological infrastructure and operational capacity, and between competing priorities and repeated postponements.
These dynamics suggest that while AI is increasingly familiar and experimentally used, it has yet to become embedded in routine public sector practice. The study contributes to emerging debates on public sector digital transformation by conceptualizing readiness as an unsettled, multi-level process and by identifying conditions that may support the transition from experimentation to everyday use of AI.

Dr. Vered Uziel (p), Dr. Chen Sharony (p)

Public-sector innovation has become essential as governments face rising citizen expectations and complex challenges, yet traditional bureaucratic structures that ensure stability and accountability often limit the flexibility required for innovation. This study examines how administrative culture influences digital innovation in Israeli local governments through in-depth interviews with 36 public-sector professionals and managers. The research contributes to the literature by empirically linking administrative culture with public-sector innovation, revealing mechanisms through which cultural factors enable or constrain innovative practices. Israel presents a unique case characterized by high centralization yet marked informality, minimal deference to hierarchy, and reliance on personal influence channels. Four key themes emerged from thematic analysis: collaborative innovation across hierarchical boundaries, informality as both catalyst and potential barrier, trust-building through incremental successes, and structural barriers including centralization and conservatism. Findings reveal that informal networks and relationships facilitate information flow and creative problem-solving, though they risk introducing bias and inconsistency. Trust emerged as fundamental yet dynamic, requiring demonstrated successes rather than promises. Collaborative approaches weakened rigid hierarchies while maintaining bureaucratic frameworks, creating "collaborative hierarchy" models. The study demonstrates that rather than viewing bureaucratic structures as inherently incompatible with innovation, successful public-sector innovation requires strategic navigation of bureaucratic systems while leveraging cultural dynamics supporting change. The Israeli case illustrates how cultural traits like informality and negotiation-based decision-making can enhance innovation capacity when appropriately harnessed. This suggests administrative culture represents a field of tensions where informality, trust, legitimacy, and hierarchy simultaneously hinder and enable innovative practices in public administration.