The difficulties of reducing administrative burden via the nonprofit sector: how sedimented governance stifles care coordination

Care coordination services are designed to reduce administrative burden. However, they may not always achieve this aim. This paper, which draws from care coordination service user experiences, provides insights concerning why policies designed to reduce administrative burden may struggle when embedded in existing institutional systems, and how they might inadvertently contribute to new costs. We thematically analyse a multi-modal dataset concerning dementia care navigation services provided by non-profits in two English counties and find that stakeholders’ efforts to deal with administrative burden-related costs may be unsuccessful and potentially counterproductive: attempts to maximize information provision, reduce psychological costs and avoid compliance costs may obscure the role of a care coordination service so that learning costs remain high or even increase. We show that while studies have argued that non-profits in pluralist, networked governance models can reduce burdens, the ways they interact with sedimented governance logics can stifle such efforts.