commonplace term in government lexicon, accountability has escaped precise definition, leaving managers at a disadvantage when trying to monitor the performance of their programs.Including more than 300 programs, over 60,000 employees, and a budget of over $400 billion, the U.S. Department of Health and Human Services is an ideal canvas for starkly illustrating competing accountability demands. With a bird?s-eye view of the agency?s inner workings, Radin tackles big issues such as strategies of centralization and decentralization, coordination with states and localities, leadership, and program design, while using the apt analogy of a juggler to show how managers must keep in the air disparate demands and developments.

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