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Sample records for incentive payment program

  1. 41 CFR 302-14.100 - How should we administer our home marketing incentive payment program?

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false How should we administer our home marketing incentive payment program? 302-14.100 Section 302-14.100 Public Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES RESIDENCE TRANSACTION ALLOWANCES...

  2. Avoided electricity subsidy payments can finance substantial appliance efficiency incentive programs: Case study of Mexico

    Energy Technology Data Exchange (ETDEWEB)

    Leventis, Greg [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Gopal, Anand [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Rue du Can, Stephane de la [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Phadke, Amol [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2013-03-01

    Numerous countries use taxpayer funds to subsidize residential electricity for a variety of socioeconomic objectives. These subsidies lower the value of energy efficiency to the consumer while raising it for the government. Further, while it would be especially helpful to have stringent Minimum Energy Performance Standards (MEPS) for appliances and buildings in this environment, they are hard to strengthen without imposing a cost on ratepayers. In this secondbest world, where the presence of subsidies limits the government’s ability to strengthen standards, we find that avoided subsidies are a readily available source of financing for energy efficiency incentive programs. Here, we introduce the LBNL Energy Efficiency Revenue Analysis (LEERA) model to estimate the appliance efficiency improvements that can be achieved in Mexico by the revenue neutral financing of incentive programs from avoided subsidy payments. LEERA uses the detailed techno-economic analysis developed by LBNL for the Super-efficient Equipment and Appliance Deployment (SEAD) Initiative to calculate the incremental costs of appliance efficiency improvements. We analyze Mexico’s tariff structures and the long-run marginal cost of supply to calculate the marginal savings for the government from appliance efficiency. We find that avoided subsidy payments alone can finance incentive programs that cover the full incremental cost of refrigerators that are 27% more efficient and TVs that are 32% more efficient than baseline models. We find less substantial market transformation potential for room ACs primarily because AC energy savings occur at less subsidized tariffs.

  3. Incentives and provider payment methods.

    Science.gov (United States)

    Barnum, H; Kutzin, J; Saxenian, H

    1995-01-01

    The mode of payment creates powerful incentives affecting provider behavior and the efficiency, equity and quality outcomes of health finance reforms. This article examines provider incentives as well as administrative costs, and institutional conditions for successful implementation associated with provider payment alternatives. The alternatives considered are budget reforms, capitation, fee-for-service, and case-based reimbursement. We conclude that competition, whether through a regulated private sector or within a public system, has the potential to improve the performance of any payment method. All methods generate both adverse and beneficial incentives. Systems with mixed forms of provider payment can provide tradeoffs to offset the disadvantages of individual modes. Low-income countries should avoid complex payment systems requiring higher levels of institutional development.

  4. 41 CFR 302-14.101 - What policies must we establish to govern our home marketing incentive payment program?

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false What policies must we establish to govern our home marketing incentive payment program? 302-14.101 Section 302-14.101 Public Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES RESIDENCE...

  5. 77 FR 67449 - Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program...

    Science.gov (United States)

    2012-11-09

    ... (ESRD) prospective payment system (PPS) for calendar year (CY) 2013. This rule also sets forth... Disease (ESRD) Prospective Payment System (PPS) 2. ESRD QIP 3. Reductions to Bad Debt Payments for All... Major Provisions 1. ESRD PPS 2. ESRD QIP 3. Reductions to Bad Debt Payments for All Medicare Providers...

  6. Medicare program; end-stage renal disease prospective payment system, quality incentive program, and durable medical equipment, prosthetics, orthotics, and supplies.

    Science.gov (United States)

    2013-12-02

    This rule updates and makes revisions to the End-Stage Renal Disease (ESRD) prospective payment system (PPS) for calendar year (CY) 2014. This rule also sets forth requirements for the ESRD quality incentive program (QIP), including for payment year (PY) 2016 and beyond. In addition, this rule clarifies the grandfathering provision related to the 3-year minimum lifetime requirement (MLR) for Durable Medical Equipment (DME), and provides clarification of the definition of routinely purchased DME. This rule also implements budget-neutral fee schedules for splints and casts, and intraocular lenses (IOLs) inserted in a physician's office. Finally, this rule makes a few technical amendments and corrections to existing regulations related to payment for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) items and services.

  7. Avoiding unintended incentives in ACO payment models.

    Science.gov (United States)

    Douven, Rudy; McGuire, Thomas G; McWilliams, J Michael

    2015-01-01

    One goal of the Medicare Shared Savings Program for accountable care organizations (ACOs) is to reduce Medicare spending for ACOs' patients relative to the organizations' spending history. However, we found that current rules for setting ACO spending targets (or benchmarks) diminish ACOs' incentives to generate savings and may even encourage higher instead of lower Medicare spending. Spending in the three years before ACOs enter or renew a contract is weighted unequally in the benchmark calculation, with a high weight of 0.6 given to the year just before a new contract starts. Thus, ACOs have incentives to increase spending in that year to inflate their benchmark for future years and thereby make it easier to obtain shared savings from Medicare in the new contract period. We suggest strategies to improve incentives for ACOs, including changes to the weights used to determine benchmarks and new payment models that base an ACO's spending target not only on its own past performance but also on the performance of other ACOs or Medicare providers. Project HOPE—The People-to-People Health Foundation, Inc.

  8. 76 FR 70227 - Medicare Program; End-Stage Renal Disease Prospective Payment System and Quality Incentive...

    Science.gov (United States)

    2011-11-10

    ... specified co-morbidities. A home or self-care dialysis training payment adjustment of $33.44 per treatment... (NHSN) Dialysis Event Reporting Measure viii. Patient Experience of Care Survey Usage Measure ix... Productivity NHSN National Healthcare Safety Network NQF National Quality Forum PD Peritoneal Dialysis PFS...

  9. Medicare program; End-Stage Renal Disease prospective payment system, quality incentive program, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies. Final rule.

    Science.gov (United States)

    2014-11-06

    This final rule will update and make revisions to the End-Stage Renal Disease (ESRD) prospective payment system (PPS) for calendar year (CY) 2015. This rule also finalizes requirements for the ESRD quality incentive program (QIP), including for payment years (PYs) 2017 and 2018. This rule will also make a technical correction to remove outdated terms and definitions. In addition, this final rule sets forth the methodology for adjusting Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) fee schedule payment amounts using information from the Medicare DMEPOS Competitive Bidding Program (CBP); makes alternative payment rules for certain DME under the Medicare DMEPOS CBP; clarifies the statutory Medicare hearing aid coverage exclusion and specifies devices not subject to the hearing aid exclusion; will not update the definition of minimal self-adjustment; clarifies the Change of Ownership (CHOW) and provides for an exception to the current requirements; revises the appeal provisions for termination of a CBP contract, including the beneficiary notification requirement under the Medicare DMEPOS CBP, and makes a technical change to the regulation related to the conditions for awarding contracts for furnishing infusion drugs under the Medicare DMEPOS CBP.

  10. Voluntary Separation Incentive Anniversary Payments

    National Research Council Canada - National Science Library

    Rau, Russell

    1995-01-01

    The overall audit objective was to determine whether the Voluntary Separation Incentive Trust Fund's FY 1994 financial statements were presented fairly in accordance with generally accepted accounting...

  11. Economic potential of agroforestry and forestry in the lower Mississippi Alluvial Valley with incentive programs and carbon payments

    Science.gov (United States)

    Gregory E. Frey; D. Evan Mercer; Frederick W. Cubbage; Robert C. Abt

    2011-01-01

    Conversion of bottomland hardwood forests in the Lower Mississippi Alluvial Valley (LMAV) to agricultural land has caused a loss of ecosystem services. The primary approaches to reverse this have been the Wetlands Reserve Program and the Conservation Reserve Program, which provide financial incentives to landowners to reforest. However, other forest production regimes...

  12. When and why do university managers use publication incentive payments?

    DEFF Research Database (Denmark)

    Opstrup, Niels

    2017-01-01

    in Denmark that use publication incentive payments. Most often it is used when heads of department outside the humanities think it is a good idea to reward scholars financially for publications. In-depth analysis of the cases reveals, however, that department heads cannot only be divided between ‘believers......’ and ‘non-believers’. Almost half expressed confidence in that publication incentive payments motivate researchers to perform better, not because of the monetary reward, but because of the positive feedback signalled by the pay supplement...

  13. 42 CFR 495.104 - Incentive payments to eligible hospitals.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Incentive payments to eligible hospitals. 495.104... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY... hospitals. (a) General rule. A qualifying hospital (as defined in this subpart) must receive the special...

  14. EHR Incentive Programs - Data and Reports

    Data.gov (United States)

    U.S. Department of Health & Human Services — As of March 2013, more than 259,000 health care providers received payment for participating in the Medicare and Medicaid Electronic Health Record (EHR) Incentive...

  15. Medicare. Physician Incentive Payments by Hospitals Could Lead to Abuse.

    Science.gov (United States)

    1986-07-01

    Controlling Program Abuse 9 Objectives, Scope, and Methodology 12 Chapter 2 14 Features of Physician Paracelsus Plan 14 MeSH Physician Incentive Plan...Pasadena General Hospital, Pasadena, Texas, would likely violate the Medicare anti-kickback statute. Paracelsus Plan While the details of the physician...incentive plans used at the 14 hospi- tals in the Paracelsus Healthcare Corporation chain vary somewhat, they are basically similar. In each hospital

  16. Merit-Based Incentive Payment System (MIPS): Harsh Choices For Interventional Pain Management Physicians.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Helm Ii, Standiford; Benyamin, Ramsin M; Hirsch, Joshua A

    2016-01-01

    The Merit-based Incentive Payment System (MIPS) was created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) to improve the health of all Americans by providing incentives and policies to improve patient health outcomes. MIPS combines 3 existing programs, Meaningful Use (MU), now called Advancing Care Information (ACI), contributing 25% of the composite score; Physician Quality Reporting System (PQRS), changed to Quality, contributing 50% of the composite score; and Value-based Payment (VBP) system to Resource Use or cost, contributing 10% of the composite score. Additionally, Clinical Practice Improvement Activities (CPIA), contributing 15% of the composite score, create multiple strategic goals to design incentives that drive movement toward delivery system reform principles with inclusion of Advanced Alternative Payment Models (APMs). Under the present proposal, the Centers for Medicare and Medicaid Services (CMS) has estimated approximately 30,000 to 90,000 providers from a total of over 761,000 providers will be exempt from MIPS. About 87% of solo practitioners and 70% of practitioners in groups of less than 10 will be subjected to negative payments or penalties ranging from 4% to 9%. In addition, MIPS also will affect a provider's reputation by making performance measures accessible to consumers and third-party physician rating Web sites.The MIPS composite performance scoring method, at least in theory, utilizes weights for each performance category, exceptional performance factors to earn bonuses, and incorporates the special circumstances of small practices.In conclusion, MIPS has the potential to affect practitioners negatively. Interventional Pain Medicine practitioners must understand the various MIPS measures and how they might participate in order to secure a brighter future. Medicare Access and CHIP Reauthorization Act of 2015, merit-based incentive payment system, quality performance measures, resource use, clinical practice

  17. Future considerations for clinical dermatology in the setting of 21st century American policy reform: The Medicare Access and Children's Health Insurance Program Reauthorization Act and the Merit-based Incentive Payment System.

    Science.gov (United States)

    Barbieri, John S; Miller, Jeffrey J; Nguyen, Harrison P; Forman, Howard P; Bolognia, Jean L; VanBeek, Marta J

    2017-06-01

    As the implementation of the Medicare Access and Children's Health Insurance Program Reauthorization Act begins, many dermatologists who provide Medicare Part B services will be subject to the reporting requirements of the Merit-based Incentive Payment System (MIPS). Clinicians subject to MIPS will receive a composite score based on performance across 4 categories: quality, advancing care information, improvement activities, and cost. Depending on their overall MIPS score, clinicians will be eligible for a positive or negative payment adjustment. Quality will replace the Physician Quality Reporting System and clinicians will report on 6 measures from a list of over 250 options. Advancing care information will replace meaningful use and will assess clinicians on activities related to integration of electronic health record technology into their practice. Improvement activities will require clinicians to attest to completion of activities focused on improvements in care coordination, beneficiary engagement, and patient safety. Finally, cost will be determined automatically from Medicare claims data. In this article, we will provide a detailed review of the Medicare Access and Children's Health Insurance Program Reauthorization Act with a focus on MIPS and briefly discuss the potential implications for dermatologists. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  18. Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System Policy Changes and Fiscal Year 2016 Rates; Revisions of Quality Reporting Requirements for Specific Providers, Including Changes Related to the Electronic Health Record Incentive Program; Extensions of the Medicare-Dependent, Small Rural Hospital Program and the Low-Volume Payment Adjustment for Hospitals. Final rule; interim final rule with comment period.

    Science.gov (United States)

    2015-08-17

    We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2016. Some of these changes implement certain statutory provisions contained in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act), the Pathway for Sustainable Growth Reform(SGR) Act of 2013, the Protecting Access to Medicare Act of 2014, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Medicare Access and CHIP Reauthorization Act of 2015, and other legislation. We also are addressing the update of the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits for FY 2016.As an interim final rule with comment period, we are implementing the statutory extensions of the Medicare dependent,small rural hospital (MDH)Program and changes to the payment adjustment for low-volume hospitals under the IPPS.We also are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) for FY 2016 and implementing certain statutory changes to the LTCH PPS under the Affordable Care Act and the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2013 and the Protecting Access to Medicare Act of 2014.In addition, we are establishing new requirements or revising existing requirements for quality reporting by specific providers (acute care hospitals,PPS-exempt cancer hospitals, and LTCHs) that are participating in Medicare, including related provisions for eligible hospitals and critical access hospitals participating in the Medicare Electronic Health Record (EHR)Incentive Program. We also are updating policies relating to the

  19. Medicare incentive payments for meaningful use of electronic health records: accounting and reporting developments.

    Science.gov (United States)

    2012-02-01

    The Healthcare Financial Management Association through its Principles and Practices (P&P) Board publishes issue analyses to provide short-term practical assistance on emerging issues in healthcare financial management. In a new issue analysis excerpted in this article, HFMA's P&P Board provides some clarity to the healthcare industry on certain accounting and reporting issues resulting from incentive payments under the Medicare program for the meaningful use of electronic health record (EHR) technology. Consultation on these matters with independent auditors is highly recommended.

  20. A human-centered framework for innovation in conservation incentive programs.

    Science.gov (United States)

    Sorice, Michael G; Donlan, C Josh

    2015-12-01

    The promise of environmental conservation incentive programs that provide direct payments in exchange for conservation outcomes is that they enhance the value of engaging in stewardship behaviors. An insidious but important concern is that a narrow focus on optimizing payment levels can ultimately suppress program participation and subvert participants' internal motivation to engage in long-term conservation behaviors. Increasing participation and engendering stewardship can be achieved by recognizing that participation is not simply a function of the payment; it is a function of the overall structure and administration of the program. Key to creating innovative and more sustainable programs is fitting them within the existing needs and values of target participants. By focusing on empathy for participants, co-designing program approaches, and learning from the rapid prototyping of program concepts, a human-centered approach to conservation incentive program design enhances the propensity for discovery of novel and innovative solutions to pressing conservation issues.

  1. Incentives, Program Configuration, and Employee Uptake of Workplace Wellness Programs.

    Science.gov (United States)

    Huang, Haijing; Mattke, Soeren; Batorsky, Benajmin; Miles, Jeremy; Liu, Hangsheng; Taylor, Erin

    2016-01-01

    The aim of this study was to determine the effect of wellness program configurations and financial incentives on employee participation rate. We analyze a nationally representative survey on workplace wellness programs from 407 employers using cluster analysis and multivariable regression analysis. Employers who offer incentives and provide a comprehensive set of program offerings have higher participation rates. The effect of incentives differs by program configuration, with the strongest effect found for comprehensive and prevention-focused programs. Among intervention-focused programs, incentives are not associated with higher participation. Wellness programs can be grouped into distinct configurations, which have different workplace health focuses. Although monetary incentives can be effective in improving employee participation, the magnitude and significance of the effect is greater for some program configurations than others.

  2. The Theory of Value-Based Payment Incentives and Their Application to Health Care.

    Science.gov (United States)

    Conrad, Douglas A

    2015-12-01

    To present the implications of agency theory in microeconomics, augmented by behavioral economics, for different methods of value-based payment in health care; and to derive a set of future research questions and policy recommendations based on that conceptual analysis. Original literature of agency theory, and secondarily behavioral economics, combined with applied research and empirical evidence on the application of those principles to value-based payment. Conceptual analysis and targeted review of theoretical research and empirical literature relevant to value-based payment in health care. Agency theory and secondarily behavioral economics have powerful implications for design of value-based payment in health care. To achieve improved value-better patient experience, clinical quality, health outcomes, and lower costs of care-high-powered incentives should directly target improved care processes, enhanced patient experience, and create achievable benchmarks for improved outcomes. Differing forms of value-based payment (e.g., shared savings and risk, reference pricing, capitation, and bundled payment), coupled with adjunct incentives for quality and efficiency, can be tailored to different market conditions and organizational settings. Payment contracts that are "incentive compatible"-which directly encourage better care and reduced cost, mitigate gaming, and selectively induce clinically efficient providers to participate-will focus differentially on evidence-based care processes, will right-size and structure incentives to avoid crowd-out of providers' intrinsic motivation, and will align patient incentives with value. Future research should address the details of putting these and related principles into practice; further, by deploying these insights in payment design, policy makers will improve health care value for patients and purchasers. © Health Research and Educational Trust.

  3. Payment incentives and integrated care delivery: levers for health system reform and cost containment.

    Science.gov (United States)

    Korda, Holly; Eldridge, Gloria N

    The Patient Protection and Affordable Care Act encourages use of payment methods and incentives to promote integrated care delivery models including patient-centered medical homes, accountable care organizations, and primary care and behavioral health integration. These models rely on interdisciplinary provider teams to coordinate patient care; health information and other technologies to assure, monitor, and assess quality, and payment and financial incentives such as bundling, pay-for-performance, and gain-sharing to encourage value-based health care. In this paper, we review evidence about integrated care delivery, payment methods, and financial incentives to improve value in health care purchasing, and address how these approaches can be used to advance health system change.

  4. 41 CFR 302-14.7 - Are there tax consequences when I receive a home marketing incentive payment?

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false Are there tax... Property Management Federal Travel Regulation System RELOCATION ALLOWANCES RESIDENCE TRANSACTION ALLOWANCES 14-HOME MARKETING INCENTIVE PAYMENTS Payment of Incentive to the Employee § 302-14.7 Are there tax...

  5. 75 FR 8854 - Teacher Incentive Fund Program

    Science.gov (United States)

    2010-02-26

    ... outside of the PBCS (such as salaries of a school's master, mentor or lead teacher) could conceivably be... instead on a single salary schedule that pays all teachers and principals the same based on experience and... Teacher Incentive Fund Program AGENCY: Office of Elementary and Secondary Education, Department of...

  6. 76 FR 7935 - Advanced Biofuel Payment Program

    Science.gov (United States)

    2011-02-11

    ...-Cooperative Service Rural Utilities Service 7 CFR Part 4288 Advanced Biofuel Payment Program; Interim Rule #0... Part 4288 RIN 0570-AA75 Advanced Biofuel Payment Program AGENCY: Rural Business-Cooperative Service and... Business-Cooperative Service (Agency) is establishing the Advanced Biofuel Payment Program authorized under...

  7. Beyond Widgets -- Systems Incentive Programs for Utilities

    Energy Technology Data Exchange (ETDEWEB)

    Regnier, Cindy [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Mathew, Paul [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Robinson, Alastair [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Schwartz, Peter [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Walter, Travis [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2017-08-15

    Utility incentive programs remain one of the most significant means of deploying commercialized, but underutilized building technologies to scale. However, these programs have been largely limited to component-based products (e.g., lamps, RTUs). While some utilities do provide ‘custom’ incentive programs with whole building and system level technical assistance, these programs require deeper levels of analysis, resulting in higher program costs. This results in custom programs being restricted to utilities with greater resources, and are typically applied mainly to large or energy-intensive facilities, leaving much of the market without cost effective access and incentives for these solutions. In addition, with increasingly stringent energy codes, cost effective component-based solutions that achieve significant savings are dwindling. Building systems (e.g., integrated façade, HVAC and/or lighting solutions) can deliver higher savings that translate into large sector-wide savings if deployed at the scale of these programs. However, systems application poses a number of challenges – baseline energy use must be defined and measured; the metrics for energy and performance must be defined and tested against; in addition, system savings must be validated under well understood conditions. This paper presents a sample of findings of a project to develop validated utility incentive program packages for three specific integrated building systems, in collaboration with Xcel Energy (CO, MN), ComEd, and a consortium of California Public Owned Utilities (CA POUs) (Northern California Power Agency(NCPA) and the Southern California Public Power Authority(SCPPA)). Furthermore, these program packages consist of system specifications, system performance, M&V protocols, streamlined assessment methods, market assessment and implementation guidance.

  8. 41 CFR 302-14.3 - Am I eligible to receive a home marketing incentive payment?

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false Am I eligible to receive a home marketing incentive payment? 302-14.3 Section 302-14.3 Public Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES RESIDENCE TRANSACTION ALLOWANCES 14-HOME...

  9. 41 CFR 302-14.2 - What is the purpose of a home marketing incentive payment?

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false What is the purpose of a home marketing incentive payment? 302-14.2 Section 302-14.2 Public Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES RESIDENCE TRANSACTION ALLOWANCES 14-HOME MARKETING...

  10. Medicare program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system and fiscal year 2015 rates; quality reporting requirements for specific providers; reasonable compensation equivalents for physician services in excluded hospitals and certain teaching hospitals; provider administrative appeals and judicial review; enforcement provisions for organ transplant centers; and electronic health record (EHR) incentive program. Final rule.

    Science.gov (United States)

    2014-08-22

    are participating in Medicare. We are updating policies relating to the Hospital Value-Based Purchasing (VBP) Program, the Hospital Readmissions Reduction Program, and the Hospital-Acquired Condition (HAC) Reduction Program. In addition, we are making technical corrections to the regulations governing provider administrative appeals and judicial review; updating the reasonable compensation equivalent (RCE) limits, and revising the methodology for determining such limits, for services furnished by physicians to certain teaching hospitals and hospitals excluded from the IPPS; making regulatory revisions to broaden the specified uses of Medicare Advantage (MA) risk adjustment data and to specify the conditions for release of such risk adjustment data to entities outside of CMS; and making changes to the enforcement procedures for organ transplant centers. We are aligning the reporting and submission timelines for clinical quality measures for the Medicare HER Incentive Program for eligible hospitals and critical access hospitals (CAHs) with the reporting and submission timelines for the Hospital IQR Program. In addition, we provide guidance and clarification of certain policies for eligible hospitals and CAHs such as our policy for reporting zero denominators on clinical quality measures and our policy for case threshold exemptions. In this document, we are finalizing two interim final rules with comment period relating to criteria for disproportionate share hospital uncompensated care payments and extensions of temporary changes to the payment adjustment for low-volume hospitals and of the Medicare-Dependent, Small Rural Hospital (MDH) Program.

  11. 25 CFR 20.321 - Does TWEP allow an incentive payment?

    Science.gov (United States)

    2010-04-01

    ....321 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Tribal Work Experience Program (twep) § 20.321 Does... expenses, but as grant assistance payments under §§ 20.320 through 20.323. (b) The approved payment will...

  12. 25 CFR 20.322 - Who can receive a TWEP incentive payment?

    Science.gov (United States)

    2010-04-01

    ... ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Tribal Work Experience Program (twep) § 20.322 Who... assistance payment. (b) The social services worker can designate a spouse or other adult in the assistance group to receive the TWEP assistance payment. The social services worker will do this only if: (1) The...

  13. 7 CFR 701.45 - Forestry Incentives Program (FIP) contracts.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Forestry Incentives Program (FIP) contracts. 701.45 Section 701.45 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY... RELATED PROGRAMS PREVIOUSLY ADMINISTERED UNDER THIS PART § 701.45 Forestry Incentives Program (FIP...

  14. Asset-building payments for ecosystem services: assessing landowner perceptions of reforestation incentives in Lebanon

    Directory of Open Access Journals (Sweden)

    Arbi J. Sarkissian

    2017-10-01

    Full Text Available Aim of study: Incentivising landowners to supply ecosystem services remains challenging, especially when this requires long-term investments such as reforestation. We investigated how landowners perceive, and would respond to, distinct types of incentives for planting diverse native trees on private lands in Lebanon. Our aim was to understand landowners’ attitudes towards hypothetical Payments for Ecosystem Services (PES contracts options; their likely participation; and the potential additionality they would provide.  Area of study: Highland villages situated within eight of Lebanon’s 20 Important Plant Areas  Materials and methods: Mixed-methods surveys were conducted with 34 landowners to determine past, present and future land-use strategies. Study participants were presented with three differently structured reforestation contract options (or schemes. The three schemes (results-based loan, action-based grant, and results-based payments differed in their expected risks and benefits to landowners. Qualitative debriefing questions followed each of the schemes presented.  Main results: Although the results-based loan did deter uptake relative to the lower risk action-based grant, results-based payments did not significantly increase uptake or planting area, suggesting asymmetric attitudes to risk. Qualitative probing revealed economic, social (e.g. trust and institutional factors (e.g. legal implications of planting forest trees on private land that limited willingness to participate in the results-based contract option.  Research highlights: This study demonstrates the importance of combining qualitative and quantitative methods to better understand landowner perceptions of incentives and risks, particularly in challenging socio-political contexts.

  15. Asset-building payments for ecosystem services: assessing landowner perceptions of reforestation incentives in Lebanon

    Energy Technology Data Exchange (ETDEWEB)

    Sarkissian, A.J.; Brook, R.M.; Talhouk, S.N.; Hockley, N.J.

    2017-11-01

    Aim of study: Incentivising landowners to supply ecosystem services remains challenging, especially when this requires long-term investments such as reforestation. We investigated how landowners perceive, and would respond to, distinct types of incentives for planting diverse native trees on private lands in Lebanon. Our aim was to understand landowners’ attitudes towards hypothetical Payments for Ecosystem Services (PES) contracts options; their likely participation; and the potential additionality they would provide. Area of study: Highland villages situated within eight of Lebanon’s 20 Important Plant Areas Materials and methods: Mixed-methods surveys were conducted with 34 landowners to determine past, present and future land-use strategies. Study participants were presented with three differently structured reforestation contract options (or schemes). The three schemes (results-based loan, action-based grant, and results-based payments) differed in their expected risks and benefits to landowners. Qualitative debriefing questions followed each of the schemes presented. Main results: Although the results-based loan did deter uptake relative to the lower risk action-based grant, results-based payments did not significantly increase uptake or planting area, suggesting asymmetric attitudes to risk. Qualitative probing revealed economic, social (e.g. trust) and institutional factors (e.g. legal implications of planting forest trees on private land) that limited willingness to participate in the results-based contract option. Research highlights: This study demonstrates the importance of combining qualitative and quantitative methods to better understand landowner perceptions of incentives and risks, particularly in challenging socio-political contexts.

  16. Asset-building payments for ecosystem services: assessing landowner perceptions of reforestation incentives in Lebanon

    International Nuclear Information System (INIS)

    Sarkissian, A.J.; Brook, R.M.; Talhouk, S.N.; Hockley, N.J.

    2017-01-01

    Aim of study: Incentivising landowners to supply ecosystem services remains challenging, especially when this requires long-term investments such as reforestation. We investigated how landowners perceive, and would respond to, distinct types of incentives for planting diverse native trees on private lands in Lebanon. Our aim was to understand landowners’ attitudes towards hypothetical Payments for Ecosystem Services (PES) contracts options; their likely participation; and the potential additionality they would provide. Area of study: Highland villages situated within eight of Lebanon’s 20 Important Plant Areas Materials and methods: Mixed-methods surveys were conducted with 34 landowners to determine past, present and future land-use strategies. Study participants were presented with three differently structured reforestation contract options (or schemes). The three schemes (results-based loan, action-based grant, and results-based payments) differed in their expected risks and benefits to landowners. Qualitative debriefing questions followed each of the schemes presented. Main results: Although the results-based loan did deter uptake relative to the lower risk action-based grant, results-based payments did not significantly increase uptake or planting area, suggesting asymmetric attitudes to risk. Qualitative probing revealed economic, social (e.g. trust) and institutional factors (e.g. legal implications of planting forest trees on private land) that limited willingness to participate in the results-based contract option. Research highlights: This study demonstrates the importance of combining qualitative and quantitative methods to better understand landowner perceptions of incentives and risks, particularly in challenging socio-political contexts.

  17. Financial Recruitment Incentive Programs for Nursing Personnel in Canada.

    Science.gov (United States)

    Mathews, Maria; Ryan, Dana

    2015-03-01

    Financial incentives are increasingly offered to recruit nursing personnel to work in underserved communities. The authors describe and compare the characteristics of federal, provincial and territorial financial recruitment incentive programs for registered nurses (RNs), nurse practitioners (NPs), licensed practical nurses (LPNs), registered practical nurses or registered psychiatric nurses. The authors identified incentive programs from government, health ministry and student aid websites and by contacting program officials. Only government-funded recruitment programs providing funding beyond the normal employee wages and benefits and requiring a service commitment were included. The authors excluded programs offered by hospitals, regional or private firms, and programs that rewarded retention. All provinces and territories except QC and NB offer financial recruitment incentive programs for RNs; six provinces (BC, AB, SK, ON, QC and NL) offer programs for NPs, and NL offers a program for LPNs. Programs include student loan forgiveness, tuition forgiveness, education bursaries, signing bonuses and relocation expenses. Programs target trainees, recent graduates and new hires. Funding and service requirements vary by program, and service requirements are not always commensurate with funding levels. This snapshot of government-funded recruitment incentives provides program managers with data to compare and improve nursing workforce recruitment initiatives. Copyright © 2015 Longwoods Publishing.

  18. Payments for Ecosystem Services

    DEFF Research Database (Denmark)

    Chan, Kai M.A; Anderson, Emily K.; Chapman, Mollie

    2017-01-01

    Payments for ecosystem services (PES) programs are one prominent strategy to address economic externalities of resource extraction and commodity production, improving both social and ecological outcomes. But do PES and related incentive programs achieve that lofty goal? Along with considerable...

  19. Commercial Midstream Energy Efficiency Incentive Programs: Guidelines for Future Program Design, Implementation, and Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Milostan, Catharina [Argonne National Lab. (ANL), Argonne, IL (United States); Levin, Todd [Argonne National Lab. (ANL), Argonne, IL (United States); Muehleisen, Ralph T. [Argonne National Lab. (ANL), Argonne, IL (United States); Guzowski, Leah Bellah B. [Argonne National Lab. (ANL), Argonne, IL (United States)

    2017-01-01

    Many electric utilities operate energy efficiency incentive programs that encourage increased dissemination and use of energy-efficient (EE) products in their service territories. The programs can be segmented into three broad categories—downstream incentive programs target product end users, midstream programs target product distributors, and upstream programs target product manufacturers. Traditional downstream programs have had difficulty engaging Small Business/Small Portfolio (SBSP) audiences, and an opportunity exists to expand Commercial Midstream Incentive Programs (CMIPs) to reach this market segment instead.

  20. 42 CFR 413.88 - Incentive payments under plans for voluntary reduction in number of medical residents.

    Science.gov (United States)

    2010-10-01

    ... training year in which the plan is effective; (3) FTE counts for the base number of residents, as defined... period; and (B) It wishes to adjust future annual targets for the remaining years of the plan in order to... SKILLED NURSING FACILITIES Specific Categories of Costs § 413.88 Incentive payments under plans for...

  1. 42 CFR 495.316 - State monitoring and reporting regarding activities required to receive an incentive payment.

    Science.gov (United States)

    2010-10-01

    ... incentive payment. (a) Subject to § 495.332 the State is responsible for tracking and verifying the... addressed individuals with unique needs such as children. (2) Subject to § 495.332, the State may propose a... electronic data to immunization registries or immunization information systems and actual submission in...

  2. Design of capacity incentive and energy compensation for demand response programs

    Science.gov (United States)

    Liu, Zhoubin; Cui, Wenqi; Shen, Ran; Hu, Yishuang; Wu, Hui; Ye, Chengjin

    2018-02-01

    Variability and Uncertainties caused by renewable energy sources have called for large amount of balancing services. Demand side resources (DSRs) can be a good alternative of traditional generating units to provide balancing service. In the areas where the electricity market has not been fully established, e.g., China, DSRs can help balance the power system with incentive-based demand response programs. However, there is a lack of information about the interruption cost of consumers in these areas, making it hard to determine the rational amount of capacity incentive and energy compensation for the participants of demand response programs. This paper proposes an algorithm to calculate the amount of capacity incentive and energy compensation for demand response programs when there lacks the information about interruption cost. Available statistical information of interruption cost in referenced areas is selected as the referenced data. Interruption cost of the targeted area is converted from the referenced area by product per electricity consumption. On this basis, capacity incentive and energy compensation are obtained to minimize the payment to consumers. Moreover, the loss of consumers is guaranteed to be covered by the revenue they earned from load serving entities.

  3. Designing PV Incentive Programs to Promote System Performance: AReview of Current Practice

    Energy Technology Data Exchange (ETDEWEB)

    Barbose, Galen; Wiser, Ryan; Bolinger, Mark

    2006-11-12

    rather than the rated capacity of the modules or system, are often suggested as one possible strategy. Somewhat less recognized are the many other program design options also available, each with its particular advantages and disadvantages. To provide a point of reference for assessing the current state of the art, and to inform program design efforts going forward, we examine the approaches to encouraging PV system performance - including, but not limited to, PBIs - used by 32 prominent PV incentive programs in the U.S. (see Table 1).1 We focus specifically on programs that offer an explicit subsidy payment for customer-sited PV installations. PV support programs that offer other forms of financial support or that function primarily as a mechanism for purchasing renewable energy credits (RECs) through energy production-based payments are outside the scope of our review.2 The information presented herein is derived primarily from publicly available sources, including program websites and guidebooks, programs evaluations, and conference papers, as well as from a limited number of personal communications with program staff. The remainder of this report is organized as follows. The next section presents a simple conceptual framework for understanding the issues that affect PV system performance and provides an overview of the eight general strategies to encourage performance used among the programs reviewed in this report. The subsequent eight sections discuss in greater detail each of these program design strategies and describe how they have been implemented among the programs surveyed. Based on this review, we then offer a series of recommendations for how PV incentive programs can effectively promote PV system performance.

  4. 76 FR 54953 - Medicare Program; Changes to the Electronic Prescribing (eRx) Incentive Program

    Science.gov (United States)

    2011-09-06

    ... exemption categories for the 2012 eRx payment adjustment. While we appreciate the commenters' feedback... commenters' feedback. We are working to address differences, where appropriate, between the eRx Incentive... that this change merely expands on the definition of a ``qualified'' electronic prescribing system...

  5. Research incentive program for clinical surgical faculty associated with increases in research productivity.

    Science.gov (United States)

    Schroen, Anneke T; Thielen, Monika J; Turrentine, Florence E; Kron, Irving L; Slingluff, Craig L

    2012-11-01

    To develop a research productivity scoring program within an academic department of surgery that would help realign incentives to encourage and reward research. Although research is highly valued in the academic mission, financial incentives are generally aligned to reward clinical productivity. A formula assigning points for publications and extramural grants was created and used to award a research incentive payment proportional to the research productivity score, beginning July 2007. Publication points reflect journal impact factor, author role, and manuscript type. Grant points reflect total funding and percentage of effort. Publication data were gathered from Web of Science/PubMed/Medline and grants data from the departmental grants office. An annual award is presented to the person with the greatest improvement. The research productivity score data after July 2007 were compared with control data for the 2 preceding years. A 33-question survey to 28 clinical faculty was conducted after the first year to measure satisfaction and solicit constructive feedback. The mean annual point scores increased from the preresearch productivity score to the postresearch productivity score academic years (2180 vs 3389, respectively, P = .08), with a significant change in the grant component score (272 vs 801, P = .03). Since research productivity score implementation, the operative case volumes increased 4.3% from 2006 to 2011. With a response rate of 89%, the survey indicated that 76% of the faculty wished to devote more time to research and 52% believed 1 or more research-related behaviors would change because of the research productivity score program. An objective, transparent research incentive program, through both monetary incentives and recognition, can stimulate productivity and was well-received by faculty. Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  6. DESIGNING GREEN SUPPORT: INCENTIVE COMPATIBILITY AND THE COMMODITY PROGRAMS

    OpenAIRE

    Runge, C. Ford

    1994-01-01

    The purpose of this brief analysis is to consider the potential points of contact between a program of "green support" and the existing commodity programs in U.S. agriculture. These points of contact may take the form of conflict, complementarity, or neutrality. We shall assume initially that green support is "added" to the programs as they exist in 1994. Five main commodity program areas are considered: A. Deficiency payments resulting from the loan rate/target price structure B. Acreage red...

  7. 76 FR 74121 - Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment; Ambulatory Surgical...

    Science.gov (United States)

    2011-11-30

    ... Business Administration SCH Sole Community Hospital SDP Single Drug Pricer SI Status Indicator TEP... Programs: Hospital Outpatient Prospective Payment; Ambulatory Surgical Center Payment; Hospital Value-Based... Programs: Hospital Outpatient Prospective Payment; Ambulatory Surgical Center Payment; Hospital Value-Based...

  8. Effect of incentive payments on chronic disease management and health services use in British Columbia, Canada: Interrupted time series analysis.

    Science.gov (United States)

    Lavergne, M Ruth; Law, Michael R; Peterson, Sandra; Garrison, Scott; Hurley, Jeremiah; Cheng, Lucy; McGrail, Kimberlyn

    2018-02-01

    We studied the effects of incentive payments to primary care physicians for the care of patients with diabetes, hypertension, and Chronic Obstructive Pulmonary Disease (COPD) in British Columbia, Canada. We used linked administrative health data to examine monthly primary care visits, continuity of care, laboratory testing, pharmaceutical dispensing, hospitalizations, and total h ealth care spending. We examined periods two years before and two years after each incentive was introduced, and used segmented regression to assess whether there were changes in level or trend of outcome measures across all eligible patients following incentive introduction, relative to pre-intervention periods. We observed no increases in primary care visits or continuity of care after incentives were introduced. Rates of ACR testing and antihypertensive dispensing increased among patients with hypertension, but none of the other modest increases in laboratory testing or prescriptions dispensed reached statistical significance. Rates of hospitalizations for stroke and heart failure among patients with hypertension fell relative to pre-intervention patterns, while hospitalizations for COPD increased. Total hospitalizations and hospitalizations via the emergency department did not change. Health care spending increased for patients with hypertension. This large-scale incentive scheme for primary care physicians showed some positive effects for patients with hypertension, but we observe no similar changes in patient management, reductions in hospitalizations, or changes in spending for patients with diabetes and COPD. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  9. Do heart failure disease management programs make financial sense under a bundled payment system?

    Science.gov (United States)

    Eapen, Zubin J; Reed, Shelby D; Curtis, Lesley H; Hernandez, Adrian F; Peterson, Eric D

    2011-05-01

    Policy makers have proposed bundling payments for all heart failure (HF) care within 30 days of an HF hospitalization in an effort to reduce costs. Disease management (DM) programs can reduce costly HF readmissions but have not been economically attractive for caregivers under existing fee-for-service payment. Whether a bundled payment approach can address the negative financial impact of DM programs is unknown. Our study determined the cost-neutral point for the typical DM program and examined whether published HF DM programs can be cost saving under bundled payment programs. We used a decision analytic model using data from retrospective cohort studies, meta-analyses, 5 randomized trials evaluating DM programs, and inpatient claims for all Medicare beneficiaries discharged with an HF diagnosis from 2001 to 2004. We determined the costs of DM programs and inpatient care over 30 and 180 days. With a baseline readmission rate of 22.9%, the average cost for readmissions over 30 days was $2,272 per patient. Under base-case assumptions, a DM program that reduced readmissions by 21% would need to cost $477 per patient to be cost neutral. Among evaluated published DM programs, 2 of the 5 would increase provider costs (+$15 to $283 per patient), whereas 3 programs would be cost saving (-$241 to $347 per patient). If bundled payments were broadened to include care over 180 days, then program saving estimates would increase, ranging from $419 to $1,706 per patient. Proposed bundled payments for HF admissions provide hospitals with a potential financial incentive to implement DM programs that efficiently reduce readmissions. Copyright © 2011 Mosby, Inc. All rights reserved.

  10. Maximizing Energy Savings Reliability in BC Hydro Industrial Demand-side Management Programs: An Assessment of Performance Incentive Models

    Science.gov (United States)

    Gosman, Nathaniel

    For energy utilities faced with expanded jurisdictional energy efficiency requirements and pursuing demand-side management (DSM) incentive programs in the large industrial sector, performance incentive programs can be an effective means to maximize the reliability of planned energy savings. Performance incentive programs balance the objectives of high participation rates with persistent energy savings by: (1) providing financial incentives and resources to minimize constraints to investment in energy efficiency, and (2) requiring that incentive payments be dependent on measured energy savings over time. As BC Hydro increases its DSM initiatives to meet the Clean Energy Act objective to reduce at least 66 per cent of new electricity demand with DSM by 2020, the utility is faced with a higher level of DSM risk, or uncertainties that impact the costeffective acquisition of planned energy savings. For industrial DSM incentive programs, DSM risk can be broken down into project development and project performance risks. Development risk represents the project ramp-up phase and is the risk that planned energy savings do not materialize due to low customer response to program incentives. Performance risk represents the operational phase and is the risk that planned energy savings do not persist over the effective measure life. DSM project development and performance risks are, in turn, a result of industrial economic, technological and organizational conditions, or DSM risk factors. In the BC large industrial sector, and characteristic of large industrial sectors in general, these DSM risk factors include: (1) capital constraints to investment in energy efficiency, (2) commodity price volatility, (3) limited internal staffing resources to deploy towards energy efficiency, (4) variable load, process-based energy saving potential, and (5) a lack of organizational awareness of an operation's energy efficiency over time (energy performance). This research assessed the capacity

  11. The influence of financial incentive programs in promoting sustainable forestry on the nation's family forests

    Science.gov (United States)

    Michael A. Kilgore; John L. Greene; Michael G. Jacobson; Thomas J. Straka; Steven E. Daniels

    2006-01-01

    Financial incentive programs were evaluated to assess their contribution to promoting sustainable forestry practices on the nation’s family forests. The evaluation consisted of an extensive review of the literature on financial incentive programs, a mail survey of the lead administrator of financial incentive programs in each state forestry agency, and focus groups...

  12. Medicaid Stage 1 Meaningful Use EHR Incentive Payments Are Associated With Higher Quality but Not Improvements in Quality.

    Science.gov (United States)

    Grinspan, Zachary M; Bao, Yuhua; Edwards, Alison; Johnson, Phyllis; Kaushal, Rainu; Kern, Lisa M

    This was a retrospective cohort study of ambulatory care quality by physicians who received payment for Medicaid Stage 1 Meaningful Use (MU) in 2012 using New York State Medicaid Claims (2010-2013). Eight quality measures were used to compare performance of physicians who received payments to Adopt, Implement, or Use (AIU) an electronic health record in 2011 but not for MU in 2012 (AIU-only group) and physicians who cared for Medicaid patients but received no payments (no-incentive group), using propensity score-weighted difference-in-difference logistic regression analyses, clustering by physician. In all, 13 697 physicians and 913 476 patients were studied. In 2010, the MU group scored higher than both groups (vs AIU-only in 3 of 8 measures, 0.8-1.3 adjusted percentage points; vs no-incentive, 2 of 8 measures, 0.9-2.0 adjusted percentage points). The difference-in-difference analysis found no additional improvements in quality over time relative to either control group. Longer follow-up is needed to determine the effects of Stage 2 MU.

  13. Comparison of energy efficiency incentive programs: Rebates and white certificates

    Energy Technology Data Exchange (ETDEWEB)

    Transue, Morghan; Felder, Frank A. [Center for Energy, Economic, and Environmental Policy, Rutgers the State University of New Jersey, Bloustein School of Planning and Public Policy, 33 Livingston Avenue, New Brunswick, NJ 08901 (United States)

    2010-06-15

    With increased interest in energy efficiency in recent years, energy efficiency portfolio standards (EEPS) have gained popularity in state policymaking. This analysis employed New Jersey specific data to compare two incentive based approaches to EEPS implementation: rebates and white certificates. Quantitative modeling suggests that white certificate approaches that depend on market-clearing prices generate much larger upfront incentive outlays than rebate programs. They do not however increase societal burden. Both programs overcome high upfront efficiency measure costs and both recoup the expenses over the long run. Administration costs and participation rates can affect this dynamic however and require additional research to determine which approaches are most cost effective for various energy efficiency measures. (author)

  14. Dissemination of Technology to Evaluate Healthy Food Incentive Programs.

    Science.gov (United States)

    Freedman, Darcy A; Hunt, Alan R; Merritt, Katie; Shon, En-Jung; Pike, Stephanie N

    2017-03-01

    Federal policy supports increased implementation of monetary incentive interventions for chronic disease prevention among low-income populations. This study describes how a Prevention Research Center, working with a dissemination partner, developed and distributed technology to support nationwide implementation and evaluation of healthy food incentive programming focused on Supplemental Nutrition Assistance Program recipients. FM Tracks, an iOS-based application and website, was developed to standardize evaluation methods for healthy food incentive program implementation at direct-to-consumer markets. This evaluation examined diffusion and adoption of the technology over 9 months (July 2015-March 2016). Data were analyzed in 2016. FM Tracks was disseminated to 273 markets affiliated with 37 regional networks in 18 states and Washington, DC. All markets adopted the sales transaction data collection feature, with nearly all recording at least one Supplemental Nutrition Assistance Program (99.3%) and healthy food incentive (97.1%) transaction. A total of 43,493 sales transactions were recorded. By the ninth month of technology dissemination, markets were entering individual sales transactions using the application (34.5%) and website (29.9%) and aggregated transactions via website (35.6%) at similar rates. Use of optional evaluation features like recording a customer ID with individual transactions increased successively with a low of 22.2% during the first month to a high of 69.2% in the ninth month. Systematic and widely used evaluation technology creates possibilities for pragmatic research embedded within ongoing, real-world implementation of food access interventions. Technology dissemination requires supportive technical assistance and continuous refinement that can be advanced through academic-practitioner partnerships. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  15. 76 FR 24343 - Advanced Biofuel Payment Program; Correction

    Science.gov (United States)

    2011-05-02

    ...-AA75 Advanced Biofuel Payment Program; Correction AGENCY: Rural Business-Cooperative Service; Rural... Federal Register of February 11, 2011, establishing the Advanced Biofuel Payment Program authorized under... this Program, the Agency will enter into contracts with advanced biofuel producers to pay such...

  16. Increasing participation in incentive programs for biodiversity conservation.

    Science.gov (United States)

    Sorice, Michael G; Oh, Chi-Ok; Gartner, Todd; Snieckus, Mary; Johnson, Rhett; Donlan, C Josh

    2013-07-01

    Engaging private landowners in conservation activities for imperiled species is critical to maintaining and enhancing biodiversity. Market-based approaches can incentivize conservation behaviors on private lands by shifting the benefit-cost ratio of engaging in activities that result in net conservation benefits for target species. In the United States and elsewhere, voluntary conservation agreements with financial incentives are becoming an increasingly common strategy. While the influence of program design and delivery of voluntary conservation programs is often overlooked, these aspects are critical to achieving the necessary participation to attain landscape-scale outcomes. Using a sample of family-forest landowners in the southeast United States, we show how preferences for participation in a conservation program to protect an at-risk species, the gopher tortoise (Gopherus polyphemus), are related to program structure, delivery, and perceived efficacy. Landowners were most sensitive to programs that are highly controlling, require permanent conservation easements, and put landowners at risk for future regulation. Programs designed with greater levels of compensation and that support landowners' autonomy to make land management decisions can increase participation and increase landowner acceptance of program components that are generally unfavorable, like long-term contracts and permanent easements. There is an inherent trade-off between maximizing participation and maximizing the conservation benefits when designing a conservation incentive program. For conservation programs targeting private lands to achieve landscape-level benefits, they must attract a critical level of participation that creates a connected mosaic of conservation benefits. Yet, programs with attributes that strive to maximize conservation benefits within a single agreement (and reduce risks of failure) are likely to have lower participation, and thus lower landscape benefits. Achieving

  17. Characterization of a forest incentive program in Minas Gerais state

    Directory of Open Access Journals (Sweden)

    José Luiz Pereira de Rezende

    2009-09-01

    Full Text Available The IEF-Asiflor forest incentive program is the result of a joint endeavor that channeled forest restoration funds to promote, according to effective legislation, silvicultural activity in Minas Gerais state. The above partnership was implemented in 2003. In this work we aimed to outline the incentive program per participating IEF administrative region, and to georeference and quantify implemented forest stands according to property size class. To that end, we searched data records of all producers benefiting from the program. We then compiled and processed the data, using ArcMap® application to georeference the rural properties making up the sample. The observations concerning number of assisted properties and area reforested in each property per administrative region was based on seven property size classes, according to the 1996 agricultural census classification of the Brazilian Institute of Geography and Statistics (IBGE. The administrative unit showing the largest assisted area was Centro Norte regional office, with 3,872.25 ha, although Zona da Mata regional office had the largest number of benefiting producers, with 449 producers. Featured among the steel producing hubs concentrating the largest number of Asiflor member plants, Sete Lagoas had the largest reforested area, being closer to the actual plants. The most assisted property size class, both in quantity and in area reforested, was class B, except in Centro Norte regional office where Class E showed a larger area reforested.

  18. 5 CFR 576.102 - Voluntary Separation Incentive Payment implementation plans.

    Science.gov (United States)

    2010-01-01

    ... eliminated, identified by organizational unit, geographic location, occupational series, grade level and any... offered incentives identified by organizational unit, geographic location, occupational series, grade level and any other factors, such as skills, knowledge, or retirement eligibility (as discussed in...

  19. Incentive payments are not related to expected health gain in the pay for performance scheme for UK primary care: cross-sectional analysis.

    Science.gov (United States)

    Fleetcroft, Robert; Steel, Nicholas; Cookson, Richard; Walker, Simon; Howe, Amanda

    2012-04-16

    The General Medical Services primary care contract for the United Kingdom financially rewards performance in 19 clinical areas, through the Quality and Outcomes Framework. Little is known about how best to determine the size of financial incentives in pay for performance schemes. Our aim was to test the hypothesis that performance indicators with larger population health benefits receive larger financial incentives. We performed cross sectional analyses to quantify associations between the size of financial incentives and expected health gain in the 2004 and 2006 versions of the Quality and Outcomes Framework. We used non-parametric two-sided Spearman rank correlation tests. Health gain was measured in expected lives saved in one year and in quality adjusted life years. For each quality indicator in an average sized general practice we tested for associations first, between the marginal increase in payment and the health gain resulting from a one percent point improvement in performance and second, between total payment and the health gain at the performance threshold for maximum payment. Evidence for lives saved or quality adjusted life years gained was found for 28 indicators accounting for 41% of the total incentive payments. No statistically significant associations were found between the expected health gain and incentive gained from a marginal 1% increase in performance in either the 2004 or 2006 version of the Quality and Outcomes Framework. In addition no associations were found between the size of financial payment for achievement of an indicator and the expected health gain at the performance threshold for maximum payment measured in lives saved or quality adjusted life years. In this subgroup of indicators the financial incentives were not aligned to maximise health gain. This disconnection between incentive and expected health gain risks supporting clinical activities that are only marginally effective, at the expense of more effective activities

  20. The use of incentives for fertility reduction.

    Science.gov (United States)

    Wishik, S M

    1978-02-01

    Incentives, i.e., either monetary or other benefits, can be used to reward couples for limiting their fertility; disincentives, or penalties, can be imposed for excessive fertility. Examples of the use of incentives or disincentives by the governments of India, Singapore, and Hawaii are cited. Direct cash payments or tax exemptions (timed variously) are the most common incentive used. The effectiveness and the morality of incentive/disincentive programs are discussed. It is felt that incentives should only be used after a social consensus has been reached and after family planning services have been made available to all groups in the society.

  1. 42 CFR 495.370 - Appeals process for a Medicaid provider receiving electronic health record incentive payments.

    Science.gov (United States)

    2010-10-01

    ... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the... provide that the provider (whether individual or entity) is also given any additional appeals rights that...

  2. Getting Incentives Right? The Impact of Hospital Capitation Payment in Vietnam.

    Science.gov (United States)

    Nguyen, Ha Thi Hong; Bales, Sarah; Wagstaff, Adam; Dao, Huyen

    2017-02-01

    This paper evaluates the impact on cost and utilization of a shift from fee-for-service to capitation payment of district hospitals by Vietnam's social health insurance agency. Hospital fixed effects analysis suggests that capitation leads to reduced costs. Hospitals also increased service provision to the uninsured who continue to pay out-of-pocket on a fee-for-service basis. The study points to the need to anticipate unintended effects of payment reforms, especially in the context of a multiple purchaser system. Copyright © The World Bank Health Economics © 2015 John Wiley & Sons, Ltd. Copyright © The World Bank Health Economics © 2015 John Wiley & Sons, Ltd.

  3. Payment vs. compensation for ecosystem services : do words have a voice in the design of environmental conservation programs ?

    OpenAIRE

    Clot, S.; Grolleau, G.; Méral, Philippe

    2017-01-01

    We examine whether and how word choice can affect individual perceptions about a proposed Payments for Ecosystem Services (PES) program when objective outcomes are similar. From a traditional economic perspective, this type of manipulation would be considered unlikely to affect perceptions and behaviour, especially in the presence of pecuniary incentives and repeated decisions among sophisticated agents. From a behaviourally informed perspective, however, psychological and political theories ...

  4. Impact of financial incentives on behavior change program participation and risk reduction in worksite health promotion.

    Science.gov (United States)

    Gingerich, Stefan B; Anderson, David R; Koland, Heidi

    2012-01-01

    To examine the impact of financial incentives on behavior change program registration, completion, and risk improvement rates. Retrospective cohort study conducted to observe the relationship between financial incentives and behavior change program registration, completion, and risk improvement rates. Large public- or private-sector employers. Twenty-four organizations (n = 511,060 eligible employees) that offered comprehensive worksite health promotion (WHP) programs. Financial incentives offered for completion of a behavior change program as part of a WHP program. Behavior change program registration and completion data were obtained from standard reports. Company-level risk change was calculated from the average per-person number of risks on baseline and follow-up health risk assessments. Incentive design was determined from questionnaires completed by WHP program managers. Average registration rates, program completion rates, and risk improvement rates were compared using t-tests for companies that did versus did not offer incentives. Comparisons were also made between companies with incentives of less than $100 and those with incentives of $100 or more. Correlations between incentive value and outcome variables were assessed using Pearson correlations. Companies that offered incentives had significantly higher health coaching completion rates than companies not offering an incentive (82.9% vs. 76.4%, respectively, p = .017) but there was no significant association with registration (p = .384) or risk improvement rates (p = .242). Incentive values were not significantly associated with risk improvement rates (p = .240). Offering incentives for completing behavior change programs may increase completion rates, but increased health improvement does not necessarily follow.

  5. 46 CFR 310.7 - Federal student subsistence allowances and student incentive payments.

    Science.gov (United States)

    2010-10-01

    ... established freshmen subsidy allocation for each School, the school shall select the individuals in its new... Federal student subsistence payments for uniforms, textbooks and subsistence as provided in the 1958 Act. The freshman subsidy allocations for each school are as follows: California Maritime Academy 99; Maine...

  6. Understanding the Relationship Between Incentive Design and Participation in U.S. Workplace Wellness Programs.

    Science.gov (United States)

    Batorsky, Benjamin; Taylor, Erin; Huang, Crystal; Liu, Hangsheng; Mattke, Soeren

    2016-01-01

    We aimed to understand how employer characteristics relate to the use of incentives to promote participation in wellness programs and to explore the relationship between incentive type and participation rates. A cross-sectional analysis of nationally representative survey data combined with an administrative business database was employed. Random sampling of U.S. companies within strata based on industry and number of employees was used to determine a final sample of 3000 companies. Of these, 19% returned completed surveys. The survey asked about employee participation rate, incentive type, and gender composition of employees. Incentive types included any incentives, high-value rewards, and rewards plus penalties. Logistic regressions of incentive type on employer characteristics were used to determine what types of employers are more likely to offer which type of incentives. A generalized linear model of participation rate was used to determine the relationship between incentive type and participation. Employers located in the Northeast were 5 to 10 times more likely to offer incentives. Employers with a large number of employees, particularly female employees, were up to 1.25 times more likely to use penalties. Penalty and high-value incentives were associated with participation rates of 68% and 52%, respectively. Industry or regional characteristics are likely determinants of incentive use for wellness programs. Penalties appear to be effective, but attention should be paid to what types of employees they affect.

  7. Do family physicians need more payment for working better? Financial incentives in primary care.

    Science.gov (United States)

    Kolozsvári, László Róbert; Orozco-Beltran, Domingo; Rurik, Imre

    2014-05-01

    Financial incentives are widely used in health services to improve the quality of care or to reach some specific targets. Pay for performance systems were also introduced in the primary health care systems of many European countries. Our study aims to describe and compare recent existing primary care indicators and related financing in European countries. Literature search was performed and questionnaires were sent to primary care experts of different countries within the European General Practice Research Network. Ten countries have published primary care quality indicators (QI) associated with financial incentives. The number of QI varies from 1 to 134 and can modify the finances of physicians with up to 25% of their total income. The implementations of these schemes should be critically evaluated with continuous monitoring at national or regional level; comparison is required between targets and their achievements, health gains and use of resources as well. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  8. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Inpatient & Outpatient Rules Physician Quality Reporting System (PQRS) Value-Based Payment Modifier Accountable Care Organizations Regulatory Burden ... Records (EHR) Incentive Program Physician Quality Reporting System Value-Based Payment Modifier Quality and Resource Use Reports ...

  9. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... and Participation Medicare Inpatient & Outpatient Rules Physician Quality Reporting System (PQRS) Value-Based Payment Modifier Accountable Care ... Electronic Health Records (EHR) Incentive Program Physician Quality Reporting System Value-Based Payment Modifier Quality and Resource ...

  10. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Inpatient & Outpatient Rules Physician Quality Reporting System (PQRS) Value-Based Payment Modifier Accountable Care Organizations Stark Law ... Records (EHR) Incentive Program Physician Quality Reporting System Value-Based Payment Modifier Quality and Resource Use Reports ...

  11. 75 FR 1843 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program

    Science.gov (United States)

    2010-01-13

    ..., P.O. Box 8013, Baltimore, MD 21244-8013. Please allow sufficient time for mailed comments to be... CMS employees are not able to report to work at the CMS headquarters. CMS wishes to ensure that public... INFORMATION section. FOR FURTHER INFORMATION CONTACT: Elizabeth Holland, (410) 786-1309, EHR incentive program...

  12. Designing PV Incentive Programs to Promote Performance: A Reviewof Current Practice

    Energy Technology Data Exchange (ETDEWEB)

    Barbose, Galen; Wiser, Ryan; Bolinger, Mark

    2007-06-01

    Increasing levels of financial support for customer-sited photovoltaic (PV) systems, provided through publicly-funded incentive programs, has heightened concerns about the long-term performance of these systems. Given the barriers that customers face to ensuring that their PV systems perform well, and the responsibility that PV incentive programs bear to ensure that public funds are prudently spent, these programs should, and often do, play a critical role in ensuring that PV systems receiving incentives perform well. To provide a point of reference for assessing the current state of the art, and to inform program design efforts going forward, we examine the approaches to encouraging PV system performance used by 32 prominent PV incentive programs in the U.S. We identify eight general strategies or groups of related strategies that these programs have used to address performance issues, and highlight important differences in the implementation of these strategies among programs.

  13. Incentive Elasticity of Demand for Bike/Walk Program

    Science.gov (United States)

    2008-12-29

    The primary objective of this research is to estimate the "incentive" (price) elasticity of demand for using non-motorized transportation (specifically walking and bicycling) to work. Results can be used directly in the formation of local policies to...

  14. Distributed Solar Incentive Programs: Recent Experience and Best Practices for Design and Implementation

    Energy Technology Data Exchange (ETDEWEB)

    Bird, L.; Reger, A.; Heeter, J.

    2012-12-01

    Based on lessons from recent program experience, this report explores best practices for designing and implementing incentives for small and mid-sized residential and commercial distributed solar energy projects. The findings of this paper are relevant to both new incentive programs as well as those undergoing modifications. The report covers factors to consider in setting and modifying incentive levels over time, differentiating incentives to encourage various market segments, administrative issues such as providing equitable access to incentives and customer protection. It also explores how incentive programs can be designed to respond to changing market conditions while attempting to provide a longer-term and stable environment for the solar industry. The findings are based on interviews with program administrators, regulators, and industry representatives as well as data from numerous incentive programs nationally, particularly the largest and longest-running programs. These best practices consider the perspectives of various stakeholders and the broad objectives of reducing solar costs, encouraging long-term market viability, minimizing ratepayer costs, and protecting consumers.

  15. Design of incentive programs for accelerating penetration of energy-efficient appliances

    International Nuclear Information System (INIS)

    Rue du Can de la, Stephane; Leventis, Greg; Phadke, Amol; Gopal, Anand

    2014-01-01

    Incentives are policy tools that sway purchase, retail stocking, and production decisions toward energy-efficient products. Incentives complement mandatory standards and labeling policies by accelerating market penetration of products that are more energy efficient than required by existing standards and by preparing the market for more stringent future mandatory requirements. Incentives can be directed at different points in the appliance's supply chain; one point may be more effective than another depending on the technology's maturity and market penetration. This paper seeks to inform future policy and program design by categorizing the main elements of incentive programs from around the world. We identify advantages and disadvantages of program designs through a qualitative overview of incentive programs worldwide. We find that financial incentive programs have greater impact when they target highly efficient technologies with a small market share, and that program designs depend on the market barriers addressed, the target equipment, and the local market context. No program design is inherently superior to another. The key to successful program design and implementation is a thorough understanding of the market and identification of the most important local obstacles to the penetration of energy-efficient technologies. - Highlights: • We researched incentive programs design and implementation worldwide. • This paper seeks to inform future policy and program design. • We identify design and identify advantages and disadvantages. • We find that incentive programs have greater impact when they target highly efficient products. • Program designs depend on the market barriers addressed and the local market context

  16. 75 FR 55801 - Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing...

    Science.gov (United States)

    2010-09-14

    ... 0938-AP87 Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing... Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2011.'' DATES: Effective... illustrate the skilled nursing facility (SNF) prospective payment system (PPS) payment rate computations for...

  17. Impact of a patient incentive program on receipt of preventive care.

    Science.gov (United States)

    Mehrotra, Ateev; An, Ruopeng; Patel, Deepak N; Sturm, Roland

    2014-06-01

    Patient financial incentives are being promoted as a mechanism to increase receipt of preventive care, encourage healthy behavior, and improve chronic disease management. However, few empirical evaluations have assessed such incentive programs. In South Africa, a private health plan has introduced a voluntary incentive program which costs enrollees approximately $20 per month. In the program, enrollees earn points when they receive preventive care. These points translate into discounts on retail goods such as airline tickets, movie tickets, or cell phones. We chose 8 preventive care services over the years 2005 to 2011 and compared the change between those who entered the incentive program and those that did not. We used multivariate regression models with individual random effects to try to address selection bias. Of the 4,186,047 unique individuals enrolled in the health plan, 65.5% (2,742,268) voluntarily enrolled in the incentive program. Joining the incentive program was associated with statistically higher odds of receiving all 8 preventive care services. The odds ratio (and estimated percentage point increase) for receipt of cholesterol testing was 2.70 (8.9%); glucose testing 1.51 (4.7%); glaucoma screening 1.34 (3.9%); dental exam 1.64 (6.3%); HIV test 3.47 (2.6%); prostate specific antigen testing 1.39 (5.6%); Papanicolaou screening 2.17 (7.0%); and mammogram 1.90 (3.1%) (P < .001 for all 8 services). However, preventive care rates among those in the incentive program was still low. Voluntary participation in a patient incentive program was associated with a significantly higher likelihood of receiving preventive care, though receipt of preventive care among those in the program was still lower than ideal.

  18. CMS Medicare and Medicaid EHR Incentive Program, Electronic Health Record Products Used for Attestation

    Data.gov (United States)

    U.S. Department of Health & Human Services — Data set merges information about the Centers for Medicare and Medicaid Services, Medicare and Medicaid EHR Incentive Programs attestations with the Office of the...

  19. 75 FR 41397 - Asparagus Revenue Market Loss Assistance Payment Program

    Science.gov (United States)

    2010-07-16

    ... DEPARTMENT OF AGRICULTURE Commodity Credit Corporation 7 CFR Part 1429 RIN 0560-AI02 Asparagus... to implement the new Asparagus Revenue Market Loss Assistance Payment (ALAP) Program authorized by... compensate domestic asparagus producers for marketing losses resulting from imports during the 2004 through...

  20. 75 FR 66686 - Defense Federal Acquisition Regulation Supplement; Balance of Payments Program Exemption for...

    Science.gov (United States)

    2010-10-29

    ... Regulation Supplement; Balance of Payments Program Exemption for Commercial Information Technology... Agreements, the exemption from the Balance of Payments Program for construction material that is commercial... Acquisition Regulation Supplement (DFARS) to implement the exemption from the Balance of Payments Program for...

  1. Three essays on the incentive structure of energy conservation programs

    Science.gov (United States)

    Okwelum, Edson Ogochukwu

    This dissertation is comprised of three related essays examining the potential effectiveness of government energy efficiency programs from both the producer and consumer perspectives. The first chapter is based on a paper I coauthored with Corey Lang. In this manuscript, I address the question of whether strategic behavior by consumers could result in the erosion of energy savings in a demand response program. Understanding how the strategic behavior of consumers affects the net benefits from a demand response program has policy implications because of the increasing importance that demand response has come to play in utility load and reliability management during peak times. Using data from a large field experiment in California in 2007, we test the hypothesis that under a technology program, consumers' strategic behavior results in outcomes that are opposite what is obtainable under a program with price incentive or based of behavior. Chapter II is also an empirical study which explores how the preferences of consumers for large and heavy vehicles imposes costs on society in the form of external costs of accident. This chapter looks at how fleet changes in weight distribution due to corporate average fuel economy and consumer demand for heavier vehicles results in fatalities. It is important to understand how consumer behavior affects the accident rates so that one can obtain unbiased estimates of accident costs that go into benefit-cost analysis of the impact of regulations in automobiles. Chapter three addresses how unobserved heterogeneity and sorting affect the estimates of the consumer willingness to pay for reduction in future gasoline costs. This tradeoff is important to policy makers and manufactures because it could help explain why manufacturers fail to adopt technologies for which the fuel savings far outweigh the costs. The remainder of the abstract provides a more detailed outlines of the three essays. Chapter 1 explores strategic behavior by

  2. Incentives for private sector engagement in pro-poor programming ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2012-10-31

    Oct 31, 2012 ... So-called “pull mechanisms,” where new sources of funding are used in innovative ways to fund market-generated solutions to solve problems of hunger and malnutrition. The World Economic Forum's New Vision for Agriculture is an example of this approach. Results-based payments are popular with ...

  3. Provider perceptions of the electronic health record incentive programs: a survey of eligible professionals who have and have not attested to meaningful use.

    Science.gov (United States)

    Weeks, Douglas L; Keeney, Benjamin J; Evans, Peggy C; Moore, Quincy D; Conrad, Douglas A

    2015-01-01

    The HITECH Act of 2009 enabled the Centers for Medicare & Medicaid Services (CMS) to provide financial incentives to health care providers who demonstrate "meaningful use" (MU) of their electronic health records (EHRs). Despite stakeholder involvement in the rule-making phase, formal input about the MU program from a cross section of providers has not been reported since incentive payments began. To examine the perspectives and experiences of a random sample of health care professionals eligible for financial incentives (eligible professionals or EPs) for demonstrating meaningful use of their EHRs. It was hypothesized that EPs actively participating in the MU program would generally view the purported benefits of MU more positively than EPs not yet participating in the incentive program. Survey data were collected by mail from a random sample of EPs in Washington State and Idaho. Two follow-up mailings were made to non-respondents. The sample included EPs who had registered for incentive payments or attested to MU (MU-Active) and EPs not yet participating in the incentive program (MU-Inactive). The survey assessed perceptions of general realities and influences of MU on health care; views on the influence of MU on clinics; and personal views about MU. EP opinions were assessed with close- and open-ended items. Close-ended responses indicated that MU-Active providers were generally more positive about the program than MU-Inactive providers. However, the majority of respondents in both groups felt that MU would not reduce care disparities or improve the accuracy of patient information. The additional workload on EPs and their staff was viewed as too great a burden on productivity relative to the level of reimbursement for achieving MU goals. The majority of open-ended responses in each group reinforced the general perception that the MU program diverted attention from treating patients by imposing greater reporting requirements. Survey results indicate the need by

  4. A Simulation Modeling Framework to Optimize Programs Using Financial Incentives to Motivate Health Behavior Change.

    Science.gov (United States)

    Basu, Sanjay; Kiernan, Michaela

    2016-01-01

    While increasingly popular among mid- to large-size employers, using financial incentives to induce health behavior change among employees has been controversial, in part due to poor quality and generalizability of studies to date. Thus, fundamental questions have been left unanswered: To generate positive economic returns on investment, what level of incentive should be offered for any given type of incentive program and among which employees? We constructed a novel modeling framework that systematically identifies how to optimize marginal return on investment from programs incentivizing behavior change by integrating commonly collected data on health behaviors and associated costs. We integrated "demand curves" capturing individual differences in response to any given incentive with employee demographic and risk factor data. We also estimated the degree of self-selection that could be tolerated: that is, the maximum percentage of already-healthy employees who could enroll in a wellness program while still maintaining positive absolute return on investment. In a demonstration analysis, the modeling framework was applied to data from 3000 worksite physical activity programs across the nation. For physical activity programs, the incentive levels that would optimize marginal return on investment ($367/employee/year) were higher than average incentive levels currently offered ($143/employee/year). Yet a high degree of self-selection could undermine the economic benefits of the program; if more than 17% of participants came from the top 10% of the physical activity distribution, the cost of the program would be expected to always be greater than its benefits. Our generalizable framework integrates individual differences in behavior and risk to systematically estimate the incentive level that optimizes marginal return on investment. © The Author(s) 2015.

  5. Evaluation of the Work Incentives Planning and Assistance (WIPA) Program: Beneficiaries Served, Services Provided, and Program Costs

    OpenAIRE

    Jody Schimmel; Bonnie O'Day; Allison Roche; Gina Livermore; Dominic Harris

    2010-01-01

    This report presents findings on the activities of the 103 organizations receiving Social Security Administration grants under the Work Incentives Planning and Assistance (WIPA) program, established in 2006 to disseminate information on work incentives and support beneficiaries in their efforts to return to work. This report focuses on short- and intermediate-term outcomes for beneficiaries receiving services as well as program variations in outputs and costs.

  6. Teacher Incentive Pay Programs in the United States: Union Influence and District Characteristics

    Directory of Open Access Journals (Sweden)

    Guodong Liang

    2015-06-01

    Full Text Available This study examined the characteristics of teacher incentive pay programs in the United States. Using the 2007–08 SASS data set, it found an inverse relationship between union influence and districts’ incentive pay offerings. Large and ethnically diverse districts in urban areas that did not meet the requirements for Adequate Yearly Progress as defined under the No Child Left Behind Act are more likely to offer a larger number of economic incentives. Although rural districts are likely to reward teachers in hard-to-staff schools, they are not more likely to reward teachers who are certified by the National Board or who teach in the subject areas of shortage, nor are they more likely to offer multiple financial incentives.

  7. Physician practice responses to financial incentive programs: exploring the concept of implementation mechanisms.

    Science.gov (United States)

    Cohen, Genna R; Erb, Natalie; Lemak, Christy Harris

    2012-01-01

    To develop a framework for studying financial incentive program implementation mechanisms, the means by which physician practices and physicians translate incentive program goals into their specific office setting. Understanding how new financial incentives fit with the structure of physician practices and individual providers' work may shed some insight on the variable effects of physician incentives documented in numerous reviews and meta-analyses. Reviewing select articles on pay-for-performance evaluations to identify and characterize the presence of implementation mechanisms for designing, communicating, implementing, and maintaining financial incentive programs as well as recognizing participants' success and effects on patient care. Although uncommonly included in evaluations, evidence from 26 articles reveals financial incentive program sponsors and participants utilized a variety of strategies to facilitate communication about program goals and intentions, to provide feedback about participants' progress, and to assist-practices in providing recommended services. Despite diversity in programs' geographic locations, clinical targets, scope, and market context, sponsors and participants deployed common strategies. While these methods largely pertained to communication between program sponsors and participants and the provision of information about performance through reports and registries, they also included other activities such as efforts to engage patients and ways to change staff roles. This review covers a limited body of research to develop a conceptual framework for future research; it did not exhaustively search for new articles and cannot definitively link particular implementation mechanisms to outcomes. Our results underscore the effects implementation mechanisms may have on how practices incorporate new programs into existing systems of care which implicates both the potential rewards from small changes as well as the resources which may be

  8. Financial incentive programs' influence in promoting sustainable forestry in the northern region

    Science.gov (United States)

    Michael G. Jacobson; Thomas J. Straka; John L. Greene; Michael A. Kilgore; Steven E. Daniels

    2009-01-01

    Selected forestry officials in each of the 20 northern states were surveyed concerning their opinions on the public and private financial incentive programs available to nonindustrial private forest owners in their state. The officials were asked to name and describe the programs and to assess forest owners' awareness of each one, its appeal among the owners aware...

  9. Accomplishments and economic evaluations of the Forestry Incentives Program: A review

    Science.gov (United States)

    Deborah A. Gaddis; Barry D. New; Fredrick W. Cubbage; Robert C. Abt; Robert J. Moulton

    1995-01-01

    The Forestry Incentives Program (FIP) is a federal financial cost-share program that is intended to increase the nation's timber supply by increasing tree planting and timber stand improvement on nonindustrial private forest lands. Timber harvest reductions on public lands in the West, environmental constraints on private lands throughout the U.S., and increased...

  10. 40 CFR Appendix X to Part 51 - Examples of Economic Incentive Programs

    Science.gov (United States)

    2010-07-01

    ... time. The common feature of such programs is that sources have an ongoing incentive to reduce pollution... neutral,” meaning that the pollution control agency does not receive any net revenues. One way to design a... vehicle conversions, starting shuttle bus or van pool programs, and mass transit fare subsidies. Subsidy...

  11. Reducing Food Insecurity and Improving Fruit and Vegetable Intake Among Farmers' Market Incentive Program Participants.

    Science.gov (United States)

    Savoie-Roskos, Mateja; Durward, Carrie; Jeweks, Melanie; LeBlanc, Heidi

    2016-01-01

    To determine whether participation in a farmers' market incentive pilot program had an impact on food security and fruit and vegetable (F&V) intake of participants. Participants in the Supplemental Nutrition Assistance Program were eligible to receive a dollar-per-dollar match up to $10/wk in farmers' market incentives. The researchers used a pretest-posttest design to measure F&V intake and food security status of 54 adult participants before and after receiving farmers' market incentives. The 6-item Behavior Risk Factor Surveillance System questionnaire and US Household Food Security Survey Module were used to measure F&V intake and food security, respectively. Wilcoxon signed-rank test was used to compare scores of F&V intake. After receiving incentives, fewer individuals reported experiencing food insecurity-related behaviors. A significantly increased intake (P market incentive program was positively related to greater food security and intake of select vegetables among participants in the Supplemental Nutrition Assistance Program. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  12. Calculations of Financial Incentives for Providers in a Pay-for-Performance Program: Manual Review Versus Data From Structured Fields in Electronic Health Records.

    Science.gov (United States)

    Urech, Tracy H; Woodard, LeChauncy D; Virani, Salim S; Dudley, R Adams; Lutschg, Meghan Z; Petersen, Laura A

    2015-10-01

    Hospital report cards and financial incentives linked to performance require clinical data that are reliable, appropriate, timely, and cost-effective to process. Pay-for-performance plans are transitioning to automated electronic health record (EHR) data as an efficient method to generate data needed for these programs. To determine how well data from automated processing of structured fields in the electronic health record (AP-EHR) reflect data from manual chart review and the impact of these data on performance rewards. Cross-sectional analysis of performance measures used in a cluster randomized trial assessing the impact of financial incentives on guideline-recommended care for hypertension. A total of 2840 patients with hypertension assigned to participating physicians at 12 Veterans Affairs hospital-based outpatient clinics. Fifty-two physicians and 33 primary care personnel received incentive payments. Overall, positive and negative agreement indices and Cohen's kappa were calculated for assessments of guideline-recommended antihypertensive medication use, blood pressure (BP) control, and appropriate response to uncontrolled BP. Pearson's correlation coefficient was used to assess how similar participants' calculated earnings were between the data sources. By manual chart review data, 72.3% of patients were considered to have received guideline-recommended antihypertensive medications compared with 65.0% by AP-EHR review (κ=0.51). Manual review indicated 69.5% of patients had controlled BP compared with 66.8% by AP-EHR review (κ=0.87). Compared with 52.2% of patients per the manual review, 39.8% received an appropriate response by AP-EHR review (κ=0.28). Participants' incentive payments calculated using the 2 methods were highly correlated (r≥0.98). Using the AP-EHR data to calculate earnings, participants' payment changes ranged from a decrease of $91.00 (-30.3%) to an increase of $18.20 (+7.4%) for medication use (interquartile range, -14.4% to 0

  13. A Global Review of Incentive Programs to Accelerate Energy-Efficient Appliances and Equipment

    Energy Technology Data Exchange (ETDEWEB)

    de la Rue du Can, Stephane; Phadke, Amol; Leventis, Greg; Gopal, Anand

    2013-08-01

    Incentive programs are an essential policy tool to move the market toward energy-efficient products. They offer a favorable complement to mandatory standards and labeling policies by accelerating the market penetration of energy-efficient products above equipment standard requirements and by preparing the market for increased future mandatory requirements. They sway purchase decisions and in some cases production decisions and retail stocking decisions toward energy-efficient products. Incentive programs are structured according to their regulatory environment, the way they are financed, by how the incentive is targeted, and by who administers them. This report categorizes the main elements of incentive programs, using case studies from the Major Economies Forum to illustrate their characteristics. To inform future policy and program design, it seeks to recognize design advantages and disadvantages through a qualitative overview of the variety of programs in use around the globe. Examples range from rebate programs administered by utilities under an Energy-Efficiency Resource Standards (EERS) regulatory framework (California, USA) to the distribution of Eco-Points that reward customers for buying efficient appliances under a government recovery program (Japan). We found that evaluations have demonstrated that financial incentives programs have greater impact when they target highly efficient technologies that have a small market share. We also found that the benefits and drawbacks of different program design aspects depend on the market barriers addressed, the target equipment, and the local market context and that no program design surpasses the others. The key to successful program design and implementation is a thorough understanding of the market and effective identification of the most important local factors hindering the penetration of energy-efficient technologies.

  14. Designing PV Incentive Programs to Promote Performance: A Reviewof Current Practice in the U.S.

    Energy Technology Data Exchange (ETDEWEB)

    Barbose, Galen; Wiser, Ryan; Bolinger, Mark

    2006-10-06

    In the U.S., the increasing financial support for customer-sited photovoltaic (PV) systems provided through publicly-funded incentive programs has heightened concerns about the long-term performance of these systems. Given the barriers that customers face to ensuring that their PV systems perform well, and the responsibility that PV incentive programs bear to ensure that public funds are prudently spent, these programs should, and often do, play a critical role in addressing PV system performance. To provide a point of reference for assessing the current state of the art, and to inform program design efforts going forward, we examine the approaches to encouraging PV system performance used by 32 prominent PV incentive programs in the U.S. We identify eight general strategies or groups of related strategies that these programs have used to address factors that affect performance, and describe key implementation details. Based on this review, we then offer recommendations for how PV incentive programs can be effectively designed to mitigate potential performance issues.

  15. DSM shareholder incentives: Current designs and economic theory

    International Nuclear Information System (INIS)

    Stoft, S.; Eto, J.; Kito, S.

    1995-01-01

    This report reviews recent DSM shareholder incentive designs and performance at 10 US utilities identifies opportunities for regulators to improve the design of DSM shareholder incentive mechanisms to increase the procurement of cost-effective DSM resources. We develop six recommendations: (1) apply shared-savings incentives to DSM resource programs; (2) use markup incentives for individual programs only when net benefits are difficult to measure, but are known to be positive; (3) set expected incentive payments based on covering a utility's open-quotes hidden costs,close quotes which include some transitional management and risk-adjusted opportunity costs; (4) use higher marginal incentives rates than are currently found in practice, but limit total incentive payments by adding a fixed charge; (5) mitigate risks to regulators and utilities by lowering marginal incentive rates at high and low performance levels; and (6) use an aggregate incentive mechanism for all DSM resource programs, with limited exceptions (e.g., information programs where markups are more appropriate)

  16. Evaluating the impact of three incentive programs on the economics of cofiring willow biomass with coal in New York State

    International Nuclear Information System (INIS)

    Tharakan, P.J.; Volk, T.A.; Lindsey, C.A.; Abrahamson, L.P.; White, E.H.

    2005-01-01

    Plantations of fast-growing willow shrubs are being promoted as a source quality biomass feedstock for bioenergy and bioproducts in New York State (NY). In the near-term, cofiring of the feedstock--in combination with other woody biomass--with coal in existing utility power boilers is considered to be the most promising conversion method for energy generation. Despite the clear technological viability and associated environmental benefits, cofiring of willow has not been widely adopted. The relatively high production cost of the willow feedstock, which is over twice that of coal, is the primary reason for this lack of interest. Taxes that account for some of the social costs of using coal and/or incentives that appropriate value for some of the social benefits of using willow are essential for eliminating most or the entire current price differential. This paper presents an integrated analysis of the economics of power generation from cofiring willow biomass feedstock with coal, from the perspective of the grower, aggregator and the power plant. Emphasis is placed on analyzing the relative impact of a green premium price, a closed-loop biomass tax credit, and payments to growers under the proposed Conservation Reserve Program (CRP) harvesting exemption policy. The CRP payments reduced the delivered cost of willow by 36-35%, to $1.90 GJ -1 and $1.70 GJ -1 , under current and increased yield conditions, respectively. These prices are still high, relative to coal. Other incentives are required to ensure commercial viability. The required levels of green premium price (0.4-1.0 cents kWh -1 ) and biomass tax credit (0.75-2.4 cents kWh -1 ) vary depending on whether the incentives were being applied by themselves or in combination, and whether current yield or potential increased yields were being considered. In the near term, cofiring willow biomass and coal can be an economically viable option for power generation in NY if the expected overall beneficial effects

  17. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Policy Updates Selected Research Findings Quality Program Initiatives Communications to the Profession Advocacy Advocacy Overview Quality Payment ... My OR EHR Incentive Program Global Codes and Data Collection New Medicare Card Project Medicare Enrollment and ...

  18. 75 FR 42745 - Production Incentives for Cellulosic Biofuels: Notice of Program Intent

    Science.gov (United States)

    2010-07-22

    ... Cellulosic Biofuels: Notice of Program Intent AGENCY: Office of Energy Efficiency and Renewable Energy...). Through this notice, biofuels producers and other interested parties are invited to submit pre-auction..., ``Production Incentives for Cellulosic Biofuels; Reverse Auction Procedures and Standards,'' (74 FR 52867...

  19. Early Retirement Incentive Programs for Teachers. Policy Issue Series No. 6.

    Science.gov (United States)

    Tarter, Scott; McCarthy, Martha

    The first section of this policy paper provides an overview of the historical development of early retirement incentive programs (ERIPs), the legal status of ERIPs under the Age Discrimination in Employment Act (ADEA), cost/benefit analyses involving ERIPs, and consideration of ERIPs in Indiana. The second section contains a brief synopsis of…

  20. Influence and effectiveness of financial incentive programs in promoting sustainable forestry in the south

    Science.gov (United States)

    Michael G. Jacobson; John L. Greene; Thomas J. Straka; Steven E. Daniels; Michael A. Kilgore

    2009-01-01

    State forestry officials responsible for forestry incentive programs in each of the 13 southern states were surveyed concerning their opinions on financial incentiveprograms available to nonindustrial private forest owners. The forestry officials were asked to name and describe the public and...

  1. 76 FR 14379 - Advanced Placement Incentive Program; Office of Elementary and Secondary Education; Overview...

    Science.gov (United States)

    2011-03-16

    ... Education; Overview Information; Advanced Placement Incentive Program; Notice Inviting Applications for New... attending high-poverty schools. Priorities: This competition includes two absolute priorities and one... through the introduction of advanced courses in high-poverty middle and high schools as well as other...

  2. The Best Laid Plans: Pay for Performance Incentive Programs for School Leaders

    Science.gov (United States)

    Goff, Peter; Goldring, Ellen; Canney, Melissa

    2016-01-01

    In an era of heightened accountability and limited fiscal resources, school districts have sought novel ways to increase the effectiveness of their principals in an effort to increase student proficiency. To address these needs, some districts have turned to pay-for-performance programs, aligning leadership goals with financial incentives to…

  3. Initiation and Maintenance of Fitness Center Utilization in an Incentive-Based Employer Wellness Program.

    Science.gov (United States)

    Abraham, Jean Marie; Crespin, Daniel J; Rothman, Alexander J

    2015-09-01

    To investigate the initiation and maintenance of participation in an employer-based wellness program that provides financial incentives for fitness center utilization. Using multivariate analysis, we investigated how employees' demographics, health status, exercise-related factors, and lifestyle change preferences affect program participation. Forty-two percent of eligible employees participated in the program, and 24% earned a $20 incentive at least once by utilizing a gym eight times or more in a month. On average, participants utilized fitness centers 7.0 months each year and earned credit 4.5 months. Participants' utilization diminished after their first year in the program. Factors associated with initiation and maintenance of fitness center utilization were similar. Declining utilization over time raises concern about the long-run effectiveness of fitness-focused wellness programs. Employers may want to consider additional levers to positively reinforce participation.

  4. Monetary Incentives to Reinforce Engagement and Achievement in a Job-Skills Training Program for Homeless, Unemployed Adults

    Science.gov (United States)

    Koffarnus, Mikhail N.; Wong, Conrad J.; Fingerhood, Michael; Svikis, Dace S.; Bigelow, George E.; Silverman, Kenneth

    2013-01-01

    The current study examined whether monetary incentives could increase engagement and achievement in a job-skills training program for unemployed, homeless, alcohol-dependent adults. Participants (n?=?124) were randomized to a no-reinforcement group (n?=?39), during which access to the training program was provided but no incentives were given; a…

  5. Engagement in health and wellness: An online incentive-based program.

    Science.gov (United States)

    Gibson, Teresa B; Maclean, J Ross; Carls, Ginger S; Moore, Brian J; Ehrlich, Emily D; Fener, Victoria; Goldberg, Jordan; Mechanic, Elaine; Baigel, Colin

    2017-09-01

    Increasingly, corporate health promotion programs are implementing wellness programs integrating principles of behavioral economics. Employees of a large firm were provided a customized online incentive program to design their own commitments to meet health goals. This study examines patterns of program participation and engagement in health promotion activities. Subjects were US-based employees of a large, nondurable goods manufacturing firm who were enrolled in corporate health benefits in 2010 and 2011. We assessed measures of engagement with the workplace health promotion program (e.g., incentive points earned, weight loss). To further examine behaviors indicating engagement in health promotion activities, we constructed an aggregate, employee-level engagement index. Regression models were employed to assess the association between employee characteristics and the engagement index, and the engagement index and spending. 4220 employees utilized the online program and made 25,716 commitments. Male employees age 18-34 had the highest level of engagement, and male employees age 55-64 had the lowest level of engagement overall. Prior year health status and prior year spending did not show a significant association with the level of engagement with the program ( p  > 0.05). Flexible, incentive-based behavioral health and lifestyle programs may reach the broader workforce including those with chronic conditions and higher levels of health spending.

  6. Engagement in health and wellness: An online incentive-based program

    Directory of Open Access Journals (Sweden)

    Teresa B. Gibson

    2017-09-01

    Full Text Available Increasingly, corporate health promotion programs are implementing wellness programs integrating principles of behavioral economics. Employees of a large firm were provided a customized online incentive program to design their own commitments to meet health goals. This study examines patterns of program participation and engagement in health promotion activities. Subjects were US-based employees of a large, nondurable goods manufacturing firm who were enrolled in corporate health benefits in 2010 and 2011. We assessed measures of engagement with the workplace health promotion program (e.g., incentive points earned, weight loss. To further examine behaviors indicating engagement in health promotion activities, we constructed an aggregate, employee-level engagement index. Regression models were employed to assess the association between employee characteristics and the engagement index, and the engagement index and spending. 4220 employees utilized the online program and made 25,716 commitments. Male employees age 18–34 had the highest level of engagement, and male employees age 55–64 had the lowest level of engagement overall. Prior year health status and prior year spending did not show a significant association with the level of engagement with the program (p > 0.05. Flexible, incentive-based behavioral health and lifestyle programs may reach the broader workforce including those with chronic conditions and higher levels of health spending.

  7. 42 CFR 495.204 - Incentive payments to qualifying MA organizations for MA-EPs and MA-affiliated eligible hospitals.

    Science.gov (United States)

    2010-10-01

    ... for MA-EPs and MA-affiliated eligible hospitals. 495.204 Section 495.204 Public Health CENTERS FOR... CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to...-EPs and MA-affiliated eligible hospitals. (a) General rule. A qualifying MA organization receives an...

  8. Review of financial incentive, low-income, elderly and multifamily residential conservation programs

    Energy Technology Data Exchange (ETDEWEB)

    Berry, L.; Hubbard, M.; White, D.

    1986-09-01

    This report describes thirty-nine utility-sponsored residential conservation programs for four types of markets. The program types considered are: (1) financial incentive programs for the general residential market, (2) programs for low-income households, (3) programs for the elderly, and (4) programs for the multifamily market. Each program description contains information on incentive terms, eligibility, conservation measures, program history, design and marketing, and the utility/agency motivation for operating the program. The names, addresses and phone numbers of contact persons also are included. Two methods were used to select the programs to be described. First, nominations of successful programs of each type were solicited from experts on residential energy conservation. Second, managers of the programs on this initial list were asked to describe their programs and to suggest other successful programs that should be included in the sample. Because of the selection process used, this report covers mainly the best known and most frequently studied programs that are aimed at the four market types.

  9. Monetary incentives to reinforce engagement and achievement in a job-skills training program for homeless, unemployed adults.

    Science.gov (United States)

    Koffarnus, Mikhail N; Wong, Conrad J; Fingerhood, Michael; Svikis, Dace S; Bigelow, George E; Silverman, Kenneth

    2013-01-01

    The current study examined whether monetary incentives could increase engagement and achievement in a job-skills training program for unemployed, homeless, alcohol-dependent adults. Participants (n=124) were randomized to a no-reinforcement group (n=39), during which access to the training program was provided but no incentives were given; a training reinforcement group (n=42), during which incentives were contingent on attendance and performance; or an abstinence and training reinforcement group (n=43), during which incentives were contingent on attendance and performance, but access was granted only if participants demonstrated abstinence from alcohol. abstinence and training reinforcement and training reinforcement participants advanced further in training and attended more hours than no-reinforcement participants. Monetary incentives were effective in promoting engagement and achievement in a job-skills training program for individuals who often do not take advantage of training programs. © Society for the Experimental Analysis of Behavior.

  10. 78 FR 40835 - Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program...

    Science.gov (United States)

    2013-07-08

    ... evaluate anemia management: [cir] Hemoglobin Greater Than 12 g/dL, a clinical measure [cir] Patient... designed to represent a minimum threshold for determination of durability for equipment that is consistent...

  11. 78 FR 72155 - Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program...

    Science.gov (United States)

    2013-12-02

    .... Hypercalcemia c. Use of Iron Therapy for Pediatric Patients Reporting Measure d. NHSN Bloodstream Infection in... utilization of other injectable drugs and biologicals (such as iron sucrose and doxercalciferol) and any oral..., American Samoa and the Northern Mariana Islands (the Pacific Rim), even though facilities in the Pacific...

  12. 77 FR 40951 - Medicare Program; End-Stage Renal Disease Prospective Payment System, Quality Incentive Program...

    Science.gov (United States)

    2012-07-11

    ... patient utilization year), updated to CY 2011, and represented the average per treatment Medicare... persons without Federal government identification, commenters are encouraged to leave their comments in.... Estimating Growth in Expenditures for Drugs and Biologicals in CY 2013 ii. Estimating per Patient Growth iii...

  13. Parental Preferences for the Organization of Preschool Vaccination Programs Including Financial Incentives: A Discrete Choice Experiment

    Directory of Open Access Journals (Sweden)

    Darren Flynn PhD

    2017-05-01

    Full Text Available Objective: To establish preferences of parents and guardians of preschool children for the organization of preschool vaccination services, including financial incentives. Design: An online discrete choice experiment. Participants: Parents and guardians of preschool children (up to age 5 years who were (n = 259 and were not (n = 262 classified as at high risk of incompletely vaccinating their children. High risk of incomplete vaccination was defined as any of the following: aged less than 20 years, single parents, living in one of the 20% most deprived areas in England, had a preschool child with a disability, or had more than three children. Main Outcome Measures: Participant preferences expressed as positive (utility or negative (disutility on eight attributes and levels describing the organization of preschool vaccination programs. Results: There was no difference in preference for parental financial incentives compared to no incentive in parents “not at high risk” of incomplete vaccination. Parents who were “at high risk” expressed utility for cash incentives. Parents “at high risk” of incomplete vaccination expressed utility for information on the risks and benefits of vaccinations to be provided as numbers rather than charts or pictures. Both groups preferred universally available, rather than targeted, incentives. Utility was identified for shorter waiting times, and there were variable preferences for who delivered vaccinations. Conclusions: Cash incentives for preschool vaccinations in England would be welcomed by parents who are “at high risk” of incompletely vaccinating their children. Further work is required on the optimal mode and form of presenting probabilistic information on vaccination to parents/guardians, including preferences on mandatory vaccination schemes.

  14. EXPORT INCENTIVE PROGRAMS: A STUDY ABOUT BRAZILIAN SME’S FROM SANTA CATARINA STATE

    Directory of Open Access Journals (Sweden)

    Izabel Regina de Souza

    2012-01-01

    Full Text Available The reality of the Brazilian economy during the last decade has influenced many companies to get new markets to expand to other parameters of competition. The export incentive programs created by the government, is an example of this, and he has performed positively, strengthening the relationship of resources and capacity to develop sales strategies and relationships with the external market. With the use of financial incentive programs for export, companies can enjoy the competitiveness and advantages related to cost of goods or services, and thus help them achieve a satisfactory goal with the export activity. Careful to promote exports, the Brazilian government creates lines of financial incentives that can meet the needs of Brazilian companies. These floor plane are known as advances on exchange contracts (ACC, Advances on foreign exchange delivered (ACE, Program for Export – (Proex among others. Santa Catarina has been active in the export process of the country, accounting for significant numbers for the trade balance. The target of this study is to understand the reactions of the business of Santa Catarina in the use of financial incentives for export. The research method adopted, as to the purposes of research, the research was exploratory and the means of investigation was a qualitative field research through interviews. The results showed that the reasons these companies entering in the international market, have been opening new markets, new business opportunities and increase the export volume. Financial incentives are most commonly used by companies to Advance on Export Contracts (ACC and Advances on Foreign Exchange Delivered (ACE.

  15. 48 CFR 970.5215-3 - Conditional payment of fee, profit, and other incentives-facility management contracts

    Science.gov (United States)

    2010-10-01

    ... performed within their specified cost constraint and must not adversely impact the costs of performing..., profit, or share of cost savings under this contract is dependent upon— (i) The Contractor's or.... Financial incentives for timely mission accomplishment or cost effectiveness shall never compromise or...

  16. 76 FR 71934 - Tobacco Transition Payment Program; Availability of Current Assessment Methods Determination...

    Science.gov (United States)

    2011-11-21

    ... DEPARTMENT OF AGRICULTURE Farm Service Agency Tobacco Transition Payment Program; Availability of... Payment Program (TTPP). It is in response to challenges raised in two lawsuits--Prime Time International Co. v. Vilsack et al. and Philip Morris USA Inc. v. Vilsack et al.-- involving the terms and...

  17. Past Performance in Supplier Certification Programs: A Study of Current Certification and Incentive Practices in Certified Supplier Programs

    National Research Council Canada - National Science Library

    Ambrose, Matthew

    1997-01-01

    ... are: requiring a high level of past quality performance for certification, giving certified contractors more future business as an incentive for participation, and using ISO 9001 as the common standard for quality management processes. By adopting these techniques, the Army can improve CP(2) and make it an even more valuable program.

  18. Future considerations for clinical dermatology in the setting of 21st century American policy reform: The Medicare Access and Children's Health Insurance Program Reauthorization Act and Alternative Payment Models in dermatology.

    Science.gov (United States)

    Barbieri, John S; Miller, Jeffrey J; Nguyen, Harrison P; Forman, Howard P; Bolognia, Jean L; VanBeek, Marta J

    2017-06-01

    With the introduction of the Medicare Access and Children's Health Insurance Program Reauthorization Act, clinicians who are not eligible for an exemption must choose to participate in 1 of 2 new reimbursement models: the Merit-based Incentive Payment System or Alternative Payment Models (APMs). Although most dermatologists are expected to default into the Merit-based Incentive Payment System, some may have an interest in exploring APMs, which have associated financial incentives. However, for dermatologists interested in the APM pathway, there are currently no options other than joining a qualifying Accountable Care Organization, which make up only a small subset of Accountable Care Organizations overall. As a result, additional APMs relevant to dermatologists are needed to allow those interested in the APMs to explore this pathway. Fortunately, the Medicare Access and Children's Health Insurance Program Reauthorization Act establishes a process for new APMs to be approved and the creation of bundled payments for skin diseases may represent an opportunity to increase the number of APMs available to dermatologists. In this article, we will provide a detailed review of APMs under the Medicare Access and Children's Health Insurance Program Reauthorization Act and discuss the development and introduction of APMs as they pertain to dermatology. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  19. The Navy’s Superior Supplier Incentive Program: Analysis of Supplier Proposed Benefits

    Science.gov (United States)

    2015-12-01

    similar successes as in Japan . In a survey conducted in 2003 to measure buyer-supplier relations in the U.S. automobile industry , “Toyota and Honda were...quality management; (b) industry -specific, such as QS 9000, a quality-assurance system that is specific to the automobile industry suppliers; and (c...Incentive Program in 2013 to adopt industry best practices on supply and supplier management and to explore opportunities to provide the high

  20. Financial incentives for generic drugs: case study on a reimbursement program

    Directory of Open Access Journals (Sweden)

    Marcos Inocencio

    2010-06-01

    Full Text Available Objective: To discuss the use of financial incentives in choice of medication and to assess the economic results concerning the use of financial incentives to promote the use of genetic medication in lieu of reference drugs in a company with a reimbursement program. Methods: A case study was carried out in a large supermarket. The data was obtained in the company responsible for managing medication. The study reached 83,625 users between August 2005 and July 2007. The data was submitted to regressions in order to analyze trends and hypothesis tests to assess differences in medication consumption. The results were compared with general data regarding medication consumption of five other organizations and also with data about the national consumption of generic medication in Brazil. Results: The use of financial incentives to replace brand medications for generics, in the company studied, increased the consumption of generic drugs without reducing the company expenses with the reimbursement programs. Conclusions: This study show the occurrence of unplanned results (increase in the consumption of medications and the positive consequences of the reimbursement program concerning access to medication.

  1. 48 CFR 252.225-7036 - Buy American Act-Free Trade Agreements-Balance of Payments Program.

    Science.gov (United States)

    2010-10-01

    ... Trade Agreements-Balance of Payments Program. 252.225-7036 Section 252.225-7036 Federal Acquisition... Trade Agreements—Balance of Payments Program. As prescribed in 225.1101(11)(i), use the following clause: Buy American Act—Free Trade Agreements—Balance of Payments Program (JUL 2009) (a) Definitions. As used...

  2. 48 CFR 252.225-7035 - Buy American Act-Free Trade Agreements-Balance of Payments Program Certificate.

    Science.gov (United States)

    2010-10-01

    ... Trade Agreements-Balance of Payments Program Certificate. 252.225-7035 Section 252.225-7035 Federal... Trade Agreements—Balance of Payments Program Certificate. As prescribed in 225.1101(10), use the following provision: Buy American Act—Free Trade Agreements—Balance of Payments Program Certificate (DEC...

  3. Motivation for Participating in a Weight Loss Program and Financial Incentives: An Analysis from a Randomized Trial

    Science.gov (United States)

    Crane, Melissa M.; Tate, Deborah F.; Finkelstein, Eric A.; Linnan, Laura A.

    2012-01-01

    This analysis investigated if changes in autonomous or controlled motivation for participation in a weight loss program differed between individuals offered a financial incentive for weight loss compared to individuals not offered an incentive. Additionally, the same relationships were tested among those who lost weight and either received or did not receive an incentive. This analysis used data from a year-long randomized worksite weight loss program that randomly assigned employees in each worksite to either a low-intensity weight loss program or the same program plus small financial incentives for weight loss ($5.00 per percentage of initial weight lost). There were no differences in changes between groups on motivation during the study, however, increases in autonomous motivation were consistently associated with greater weight losses. This suggests that the small incentives used in this program did not lead to increases in controlled motivation nor did they undermine autonomous motivation. Future studies are needed to evaluate the magnitude and timing of incentives to more fully understand the relationship between incentives and motivation. PMID:22577524

  4. An assessment of the safe delivery incentive program at a tertiary level hospital in Nepal.

    Science.gov (United States)

    Baral, G

    2012-05-01

    Maternity incentive program of Nepal known as Safe Delivery Incentive Program (SDIP) was introduced nationwide in 2005 with the intention of increasing utilization of professional care at childbirth. The program provided both childbirth service as well as 'cash' to women giving birth in a health facility in addition to incentives to health provider for each delivery attended, either at home or the facility. Due to a lack of uniformity in its implementation and administrative delays, the program was reformed and even extended to many not-for-profit health institutions in early 2007, and implemented as a 'Safer Mother Program' popularly known as "Aama-Suraksha-Karyakram" since January 2009. This is a system research with observational and analytical components. Plausibility design is selected to evaluate the performance-based funding (PBF) as a system level intervention of maternity care using two instruments: Pay-For-Performance and Conditional-Cash-Transfer. It uses interrupted time-series to control for the natural trend. Research tools used are interviews, the focus group discussions and literature review. Numerical data are presented in simple graphs. While online random number generator was used partly, the purposive sampling was used for qualitative data. There is a gross discrepancy in non-targeted service delivery at the tertiary level health facility. Overflooding of maternity cases has hampered gynecological admission and surgical management delaying subspecialty care and junior physicians' training. With the same number and quality of physical facility and human resource, the additional program has put more strains to service providers and administrators. There should be adequate planning and preparation at all levels of health facilities; implementing a new program should not adversely affect another existing service delivery system. For the optional implementation, hospital organogram should be revised; and physical facilities and the low-risk birthing

  5. Financial incentives and accountability for integrated medical care in Department of Veterans Affairs mental health programs.

    Science.gov (United States)

    Kilbourne, Amy M; Greenwald, Devra E; Hermann, Richard C; Charns, Martin P; McCarthy, John F; Yano, Elizabeth M

    2010-01-01

    This study assessed the extent to which mental health leaders perceive their programs as being primarily accountable for monitoring general medical conditions among patients with serious mental illness, and it assessed associations with modifiable health system factors. As part of the Department of Veterans Affairs (VA) 2007 national Mental Health Program Survey, 108 mental health program directors were queried regarding program characteristics. Perceived accountability was defined as whether their providers, as opposed to external general medical providers, were primarily responsible for specific clinical tasks related to serious mental illness treatment or high-risk behaviors. Multivariable logistic regression was used to determine whether financial incentives or other system factors were associated with accountability. Thirty-six percent of programs reported primary accountability for monitoring diabetes and cardiovascular risk after prescription of second-generation antipsychotics, 10% for hepatitis C screening, and 17% for obesity screening and weight management. In addition, 18% and 27% of program leaders, respectively, received financial bonuses for high performance for screening for risk of diabetes and cardiovascular disease and for alcohol misuse. Financial bonuses for diabetes and cardiovascular screening were associated with primary accountability for such screening (odds ratio=5.01, pFinancial incentives to improve quality performance may promote accountability in monitoring diabetes and cardiovascular risk assessment within mental health programs. Integrated care strategies (co-location) might be needed to promote management of high-risk behaviors among patients with serious mental illness.

  6. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... of Certification Quality Quality Quality Electronic Health Records (EHR) Incentive Program Physician Quality Reporting System Value-Based Payment Modifier Quality and Resource Use Reports Physician Compare Website Phases of Surgical Care S- ...

  7. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Health Records (EHR) Incentive Program Physician Quality Reporting System Value-Based Payment Modifier Quality and Resource Use Reports Physician Compare Website Phases of Surgical Care S-CAHPS ...

  8. 78 FR 47274 - National School Lunch, Special Milk, and School Breakfast Programs, National Average Payments...

    Science.gov (United States)

    2013-08-05

    ... School Breakfast Programs, National Average Payments/Maximum Reimbursement Rates Correction In notice... HAWAII: PAID 0.08 REDUCED PRICE 0.47 FREE 0.94 *Payment listed for Free and Reduced Price Lunches include both section 4 and section 11 funds. [FR Doc. C1-2013-17990 Filed 8-2-13; 8:45 am] BILLING CODE 1501-01...

  9. Using Behavioral Economics to Design Physician Incentives That Deliver High-Value Care.

    Science.gov (United States)

    Emanuel, Ezekiel J; Ubel, Peter A; Kessler, Judd B; Meyer, Gregg; Muller, Ralph W; Navathe, Amol S; Patel, Pankaj; Pearl, Robert; Rosenthal, Meredith B; Sacks, Lee; Sen, Aditi P; Sherman, Paul; Volpp, Kevin G

    2016-01-19

    Behavioral economics provides insights about the development of effective incentives for physicians to deliver high-value care. It suggests that the structure and delivery of incentives can shape behavior, as can thoughtful design of the decision-making environment. This article discusses several principles of behavioral economics, including inertia, loss aversion, choice overload, and relative social ranking. Whereas these principles have been applied to motivate personal health decisions, retirement planning, and savings behavior, they have been largely ignored in the design of physician incentive programs. Applying these principles to physician incentives can improve their effectiveness through better alignment with performance goals. Anecdotal examples of successful incentive programs that apply behavioral economics principles are provided, even as the authors recognize that its application to the design of physician incentives is largely untested, and many outstanding questions exist. Application and rigorous evaluation of infrastructure changes and incentives are needed to design payment systems that incentivize high-quality, cost-conscious care.

  10. 7 CFR 226.11 - Program payments for centers.

    Science.gov (United States)

    2010-01-01

    ... the State agency's financial management system. [47 FR 36527, Aug. 20, 1982, as amended at 48 FR 21530... payments for centers. (a) Requirement for agreements. Payments must be made only to institutions operating... approved child care centers, at-risk afterschool care centers, adult day care centers, emergency shelters...

  11. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Quality Quality Quality Electronic Health Records (EHR) Incentive Program Physician Quality Reporting System Value-Based Payment Modifier Quality ... Bulletin Articles CPT Coding Workshops ICD-10 Coding ... Primers and Compendiums Quality Payment Program AMA House of Delegates ACS in the AMA ...

  12. Fair Market Rents For The Section 8 Housing Assistance Payments Program

    Data.gov (United States)

    Department of Housing and Urban Development — Fair Market Rents (FMRs) are primarily used to determine payment standard amounts for the Housing Choice Voucher program, to determine initial renewal rents for some...

  13. 75 FR 21191 - Subpart B-Advanced Biofuel Payment Program; Correction

    Science.gov (United States)

    2010-04-23

    ... Service 7 CFR Part 4288 RIN 0570-AA75 Subpart B--Advanced Biofuel Payment Program; Correction AGENCY... for producers of advanced biofuels to supporting existing advanced biofuel production and to encourage...

  14. 75 FR 44313 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program

    Science.gov (United States)

    2010-07-28

    ... MCO Managed Care Organization MITA Medicaid Information Technology Architecture MMIS Medicaid... ARRA amends Titles XVIII and XIX of the Social Security Act (the Act) by establishing incentive... require EPs, eligible hospitals, and CAHs to perform functions for which standards have not been...

  15. Predictors of middle school students' interest in participating in an incentive-based tobacco prevention and cessation program in connecticut.

    Science.gov (United States)

    Morean, Meghan E; Camenga, Deepa R; Kong, Grace; Cavallo, Dana A; Schepis, Ty S; Krishnan-Sarin, Suchitra

    2014-01-01

    Behavioral incentives have been used to encourage smoking cessation in older adolescents, but the acceptability of incentives to promote a smoke-free lifestyle in younger adolescents is unknown. To inform the development of novel, effective, school-based interventions for youth, we assessed middle school students' interest in participating in an incentive-based tobacco abstinence program. We surveyed 988 students (grades 6-8) attending three Connecticut middle schools to determine whether interest in program participation varied as a function of (1) intrapersonal factors (i.e., demographic characteristics (sex, age, race), smoking history, and trait impulsivity) and/or (2) aspects of program design (i.e., prize type, value, and reward frequency). Primary analyses were conducted using multiple regression. A majority of students (61.8%) reported interest in program participation. Interest did not vary by gender, smoking risk status, or offering cash prizes. However, younger students, non-Caucasian students, behaviorally impulsive students, and students with higher levels of self-regulation were more likely to report interest. Inexpensive awards (e.g., video games) offered monthly motivated program interest. In sum, middle school students reported high levels of interest in an incentive-based program to encourage a tobacco-free lifestyle. These formative data can inform the design of effective, incentive-based smoking cessation and prevention programs in middle schools.

  16. Predictors of Middle School Students’ Interest in Participating in an Incentive-Based Tobacco Prevention and Cessation Program in Connecticut

    Directory of Open Access Journals (Sweden)

    Meghan E. Morean

    2014-01-01

    Full Text Available Behavioral incentives have been used to encourage smoking cessation in older adolescents, but the acceptability of incentives to promote a smoke-free lifestyle in younger adolescents is unknown. To inform the development of novel, effective, school-based interventions for youth, we assessed middle school students’ interest in participating in an incentive-based tobacco abstinence program. We surveyed 988 students (grades 6–8 attending three Connecticut middle schools to determine whether interest in program participation varied as a function of (1 intrapersonal factors (i.e., demographic characteristics (sex, age, race, smoking history, and trait impulsivity and/or (2 aspects of program design (i.e., prize type, value, and reward frequency. Primary analyses were conducted using multiple regression. A majority of students (61.8% reported interest in program participation. Interest did not vary by gender, smoking risk status, or offering cash prizes. However, younger students, non-Caucasian students, behaviorally impulsive students, and students with higher levels of self-regulation were more likely to report interest. Inexpensive awards (e.g., video games offered monthly motivated program interest. In sum, middle school students reported high levels of interest in an incentive-based program to encourage a tobacco-free lifestyle. These formative data can inform the design of effective, incentive-based smoking cessation and prevention programs in middle schools.

  17. 75 FR 23105 - Medicare Program; Inpatient Psychiatric Facilities Prospective Payment System Payment-Update for...

    Science.gov (United States)

    2010-04-30

    ... accepted actuarial practices and consistent with the assumptions made in other PPSs, we assumed in... payment increases by 5 percent. We applied this actuarial assumption, which is based on our historical... resource demands, has occurred under the PPS. B. Update of the Federal Per Diem Base Rate and...

  18. Financial Incentives and Physician Practice Participation in Medicare's Value-Based Reforms.

    Science.gov (United States)

    Markovitz, Adam A; Ramsay, Patricia P; Shortell, Stephen M; Ryan, Andrew M

    2017-07-26

    To evaluate whether greater experience and success with performance incentives among physician practices are related to increased participation in Medicare's voluntary value-based payment reforms. Publicly available data from Medicare's Physician Compare (n = 1,278; January 2012 to November 2013) and nationally representative physician practice data from the National Survey of Physician Organizations 3 (NSPO3; n = 907,538; 2013). We used regression analysis to examine practice-level relationships between prior exposure to performance incentives and participation in key Medicare value-based payment reforms: accountable care organization (ACO) programs, the Physician Quality Reporting System ("Physician Compare"), and the Meaningful Use of Health Information Technology program ("Meaningful Use"). Prior experience and success with financial incentives were measured as (1) the percentage of practices' revenue from financial incentives for quality or efficiency; and (2) practices' exposure to public reporting of quality measures. We linked physician participation data from Medicare's Physician Compare to the NSPO3 survey. There was wide variation in practices' exposure to performance incentives, with 64 percent exposed to financial incentives, 45 percent exposed to public reporting, and 2.2 percent of practice revenue coming from financial incentives. For each percentage-point increase in financial incentives, there was a 0.9 percentage-point increase in the probability of participating in ACOs (standard error [SE], 0.1, p Financial incentives were not associated with participation in Physician Compare. Among ACO participants, a 1 percentage-point increase in incentives was associated with a 0.7 percentage-point increase in the probability of being "very well" prepared to utilize cost and quality data (SE, 0.1, p financial incentives with additional efforts to address the needs of practices with less experience with such incentives to promote value-based payment

  19. Medicare program; prospective payment system and consolidated billing for skilled nursing facilities--HCFA. Interim final rule with comment period.

    Science.gov (United States)

    1998-05-12

    This interim final rule implements provisions in section 4432 of the Balanced Budget Act of 1997 related to Medicare payment for skilled nursing facility services. These include the implementation of a Medicare prospective payment system for skilled nursing facilities, consolidated billing, and a number of related changes. The prospective payment system described in this rule replaces the retrospective reasonable cost-based system currently utilized by Medicare for payment of skilled nursing facility services under Part A of the program.

  20. 42 CFR 62.11 - When can a scholarship program payment obligation be discharged in bankruptcy?

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false When can a scholarship program payment obligation... HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING NATIONAL HEALTH SERVICE CORPS SCHOLARSHIP AND LOAN REPAYMENT PROGRAMS National Health Service Corps Scholarship Program § 62.11 When can a...

  1. Cost Conscious: Incentive and Discount Programs Help Students Meet the Rising Cost of a Community College Education

    Science.gov (United States)

    Ullman, Ellen

    2013-01-01

    Aware that rising costs could force some community colleges to compromise their long-standing open-door policies, administrators have put in place programs and incentives to offset the higher price of the average community college education. This article features ideas and programs to help struggling community colleges cope with rising costs such…

  2. Incentive-Based Conservation Programs in Developing Countries: A Review of Some Key Issues and Suggestions for Improvements

    Science.gov (United States)

    Spiteri, Arian; Nepalz, Sanjay K.

    2006-01-01

    Biodiversity conservation in developing countries has been a challenge because of the combination of rising human populations, rapid technological advances, severe social hardships, and extreme poverty. To address the social, economic, and ecological limitations of people-free parks and reserves, incentives have been incorporated into conservation programs in the hopes of making conservation meaningful to local people. However, such incentive-based programs have been implemented with little consideration for their ability to fulfill promises of greater protection of biodiversity. Evaluations of incentive-based conservation programs indicate that the approach continually falls short of the rhetoric. This article provides an overview of the problems associated with incentive-based conservation approaches in developing countries. It argues that existing incentive-based programs (IBPs) have yet to realize that benefits vary greatly at different “community” scales and that a holistic conceptualization of a community is essential to incorporate the complexities of a heterogeneous community when designing and implementing the IBPs. The spatial complexities involved in correctly identifying the beneficiaries in a community and the short-term focus of IBPs are two major challenges for sustaining conservation efforts. The article suggests improvements in three key areas: accurate identification of “target” beneficiaries, greater inclusion of marginal communities, and efforts to enhance community aptitudes.

  3. Addressing maternal healthcare through demand side financial incentives: experience of Janani Suraksha Yojana program in India

    Directory of Open Access Journals (Sweden)

    Gopalan Saji S

    2012-09-01

    Full Text Available Abstract Background Demand side financing (DSF is a widely employed strategy to enhance utilization of healthcare. The impact of DSF on health care seeking in general and that of maternal care in particular is already known. Yet, its effect on financial access to care, out-of-pocket spending (OOPS and provider motivations is not considerably established. Without such evidence, DSFs may not be recommendable to build up any sustainable healthcare delivery approach. This study explores the above aspects on India’s Janani Suraksha Yojana (JSY program. Methods This study employed design and was conducted in three districts of Orissa, selected through a three-stage stratified sampling. The quantitative method was used to review the Health Management Information System (HMIS. The qualitative methods included focus groups discussions with beneficiaries (n = 19 and community intermediaries (n = 9, and interviews (n = 7 with Ministry of Health officials. HMIS data enabled to review maternal healthcare utilization. Group discussions and interviews explored the perceived impact of JSY on in-facility delivery, OOPS, healthcare costs, quality of care and performance motivation of community health workers. Results The number of institutional deliveries, ante-and post-natal care visits increased after the introduction of JSY with an annual net growth of 18.1%, 3.6% and 5% respectively. The financial incentive provided partial financial risk-protection as it could cover only 25.5% of the maternal healthcare cost of the beneficiaries in rural areas and 14.3% in urban areas. The incentive induced fresh out-of-pocket spending for some mothers and it could not address maternal care requirements comprehensively. An activity-based community worker model was encouraging to augment maternal healthcare consumption. However, the existing level of financial incentives and systemic support were inadequate to motivate the volunteers optimally on their

  4. Addressing maternal healthcare through demand side financial incentives: experience of Janani Suraksha Yojana program in India.

    Science.gov (United States)

    Gopalan, Saji S; Durairaj, Varatharajan

    2012-09-15

    Demand side financing (DSF) is a widely employed strategy to enhance utilization of healthcare. The impact of DSF on health care seeking in general and that of maternal care in particular is already known. Yet, its effect on financial access to care, out-of-pocket spending (OOPS) and provider motivations is not considerably established. Without such evidence, DSFs may not be recommendable to build up any sustainable healthcare delivery approach. This study explores the above aspects on India's Janani Suraksha Yojana (JSY) program. This study employed design and was conducted in three districts of Orissa, selected through a three-stage stratified sampling. The quantitative method was used to review the Health Management Information System (HMIS). The qualitative methods included focus groups discussions with beneficiaries (n = 19) and community intermediaries (n = 9), and interviews (n = 7) with Ministry of Health officials. HMIS data enabled to review maternal healthcare utilization. Group discussions and interviews explored the perceived impact of JSY on in-facility delivery, OOPS, healthcare costs, quality of care and performance motivation of community health workers. The number of institutional deliveries, ante-and post-natal care visits increased after the introduction of JSY with an annual net growth of 18.1%, 3.6% and 5% respectively. The financial incentive provided partial financial risk-protection as it could cover only 25.5% of the maternal healthcare cost of the beneficiaries in rural areas and 14.3% in urban areas. The incentive induced fresh out-of-pocket spending for some mothers and it could not address maternal care requirements comprehensively. An activity-based community worker model was encouraging to augment maternal healthcare consumption. However, the existing level of financial incentives and systemic support were inadequate to motivate the volunteers optimally on their performance. Demand side financial incentive could enhance financial

  5. Progress report 5. Alternative Payment for Mobility program. Reporting period January 1, 2010 - June 30, 2010

    International Nuclear Information System (INIS)

    2010-01-01

    The Alternative Payment for Mobility program of the Dutch Ministry of Transport, Public Works and Water Management regulates the introduction of the price per kilometer (a levy on the use of the road infrastructure based on time and location, which is also known by the name of a comparable previous plan: road-pricing). This report describes the developments of the project Alternative Payment for Mobility in the period January 1, 2010 - June 30, 2010. [nl

  6. Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2017, SNF Value-Based Purchasing Program, SNF Quality Reporting Program, and SNF Payment Models Research. Final rule.

    Science.gov (United States)

    2016-08-05

    This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2017. In addition, it specifies a potentially preventable readmission measure for the Skilled Nursing Facility Value-Based Purchasing Program (SNF VBP), and implements requirements for that program, including performance standards, a scoring methodology, and a review and correction process for performance information to be made public, aimed at implementing value-based purchasing for SNFs. Additionally, this final rule includes additional polices and measures in the Skilled Nursing Facility Quality Reporting Program (SNF QRP). This final rule also responds to comments on the SNF Payment Models Research (PMR) project.

  7. Has incentive payment improved venous thrombo-embolism risk assessment and treatment of hospital in-patients? [v1; ref status: indexed, http://f1000r.es/8k

    Directory of Open Access Journals (Sweden)

    Sue Child

    2013-02-01

    Full Text Available This paper focuses on financial incentives rewarding successful implementation of guidelines in the UK National Health Service (NHS. In particular, it assesses the implementation of National Institute for Health and Clinical Excellence (NICE venous thrombo-embolism (VTE guidance in 2010 on the risk assessment and secondary prevention of VTE in hospital in-patients and the financial incentives driving successful implementation introduced by the Commissioning for Quality and Innovation for Payment Framework (CQUIN for 2010-2011. We systematically compared the implementation of evidence-based national guidance on VTE prevention across two specialities (general medicine and orthopaedics in four hospital sites in the greater South West of England by auditing and evaluating VTE prevention activity for 2009 (i.e. before the 2010 NICE guideline and late 2010 (almost a year after the guideline was published. Analysis of VTE prevention activity reported in 816 randomly selected orthopaedic and general medical in-patient medical records was complemented by a qualitative study into the practical responses to revised national guidance. This paper’s contribution to knowledge is to suggest that by financially rewarding the implementation of national guidance on VTE prevention, paradoxes and contradictions have become apparent between the ‘payment by volume system’ of Healthcare Resource Groups and the ‘payment by results’ system of CQUIN.

  8. Released potential: a qualitative study of the Mental Health Nurse Incentive Program in Australia.

    Science.gov (United States)

    Hurley, John; Browne, Graeme; Lakeman, Richard; Angking, DoRhen; Cashin, Andrew

    2014-02-01

    The Mental Health Nurse Incentive Program (MHNIP) is a Commonwealth Government funded scheme that supports people living with a mental illness. Despite its significance, the program has received little attention from researchers nor critical discussion within the published work. This paper first critically examines the MHNIP from the contexts of identities, autonomy, and capabilities of mental health nurses (MHN) and then reports on findings from a qualitative study that explored the experiences of staff working in the MHNIP. Key findings from this qualitative study include four main themes indicating that both the program and the nurses working within it are addressing the unmet needs of people living with a mental illness. They achieve these ends by adopting holistic and consumer-centred approaches and by providing a wide range of therapeutic interventions. As well, the MHN in this study valued the freedom and autonomy of their practice outside public health services and the respect received from colleagues working in other disciplines. Findings suggest that MHN within the study were experienced as having autonomous identities and roles that may be in contrast to the restrictive understandings of MHN capability within the program's funding rules. © 2013 The Authors; International Journal of Mental Health Nursing © 2013 Australian College of Mental Health Nurses Inc.

  9. 75 FR 46169 - Medicare Program; Proposed Changes to the Hospital Outpatient Prospective Payment System and CY...

    Science.gov (United States)

    2010-08-03

    ... Administration Services IX. Proposed OPPS Payment for Hospital Outpatient Visits A. Background B. Proposed... Centers for Medicare and Medicaid 42 CFR Parts 410, 416 and 419 Medicare Program: Changes to the Hospital..., 419, 482, and 489 [CMS-1504-P] RIN 0938-AP82 Medicare Program; Proposed Changes to the Hospital...

  10. 77 FR 53257 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2012-08-31

    ..., Hospital Inpatient Quality Reporting and Hospital Value-Based Purchasing--Program Administration... for Medicare & Medicaid Services 42 CFR Parts 412, 413, 424, et al. Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective...

  11. Breaking Ground: Analysis of the Assessment System and Impact of Mexico's Teacher Incentive Program "Carrera Magisterial." Technical Report

    Science.gov (United States)

    Santibanez, Lucrecia; Martinez, Jose Felipe; Datar, Ashlesha; McEwan, Patrick J.; Setodji, Claude Messan; Basurto-Davila, Ricardo

    2007-01-01

    Mexico's Carrera Magisterial (CM) is one of the pioneer teacher incentive programs in the world. It was instituted in 1992 and designed jointly by the federal education authorities, state authorities, and the teachers' union as a horizontal promotion system that rewards teachers with salary bonuses on the basis of their performance. Teacher…

  12. Examining the compatibility between forestry incentive programs in the US and the practice of sustainable forest management

    Science.gov (United States)

    Steven E Daniels; Michael A Kilgore; Michael G Jacobson; John L Greene; Thomas J Straka

    2010-01-01

    This research explores the intersection between the various federal and state forestry incentive programs and the adoption of sustainable forestry practices on nonindustrial private forest (NIPF) lands in the US. The qualitative research reported here draws upon a series of eight focus groups of NIPF landowners (two each in Minnesota, Oregon, Pennsylvania, and South...

  13. Goal-oriented incentive payment in CUDAM institution and variation in medical visit indicators in children under one and pregnant women

    Directory of Open Access Journals (Sweden)

    Marcelo Morales

    2011-11-01

    % (117 additional pregnant respectively. Insitucional monthly income for the goal 1 was $1,915,200 (US$1 = $20.Average income/month was $1,637 and $2,364 per child and pregnant women respectively. We conclude that the target incentive payment of 1 allowed to significantly improve the indicators of child and maternal control of CUDAM.

  14. Payment Schemes in Conditional Cash Transfer Programs: The Case of 4Ps in the Davao Region, Philippines

    Directory of Open Access Journals (Sweden)

    Ma Cecilia Catubig

    2015-11-01

    Full Text Available This paper evaluates current payment schemes employed by the Pantawid Pamilyang Pilipino Program (4Ps in the Philippines using six assessment criteria: transaction cost, security/risks, speed and timeliness, acceptability, resilience and flexibility. Employing data collected at the regional level, we establish four main findings: (1 all 4Ps payment conduits present trade-offs; (2 a payment approach that uses mainstream financial infrastructure is beneficial if cost, speed and simplicity of the payment system are critical; (3 competition for 4Ps contracts for Payment Service Providers (PSPs has improved the quality of payment services and minimized costs; and (4 the efficiency of the program is greatly influenced by the commitment of the PSP to deliver the cash benefits to the recipients in a timely manner rather than by maximizing conduit branches.

  15. 77 FR 46213 - Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing...

    Science.gov (United States)

    2012-08-02

    ....383 percent of the total rate. This percentage reflects the labor-related relative importance for FY... Vol. 77 Thursday, No. 149 August 2, 2012 Part IV Department of Health and Human Services Center for Medicare & Medicaid Services Medicare Program; Prospective Payment System and Consolidated Billing...

  16. 75 FR 30917 - Medicare Program; Supplemental Proposed Changes to the Hospital Inpatient Prospective Payment...

    Science.gov (United States)

    2010-06-02

    ... the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of... quality of care or patient safety as a result of the implementation of the system; and Provides for a... Program; Prospective Payment Systems; 2010 and 2011 Rates; Wage Indices; Proposed Rule and Notice #0;#0...

  17. 77 FR 43232 - National School Lunch, Special Milk, and School Breakfast Programs, National Average Payments...

    Science.gov (United States)

    2012-07-24

    ... average cost of a half-pint of milk (the total cost of all milk purchased during the claim period divided... schools and residential child care institutions for the period July 1, 2012 through June 30, 2013 reflect... for afterschool snacks served in afterschool care programs; the breakfast National Average Payment...

  18. 48 CFR 252.225-7044 - Balance of Payments Program-Construction Material.

    Science.gov (United States)

    2010-10-01

    ... Program-Construction Material. 252.225-7044 Section 252.225-7044 Federal Acquisition Regulations System...—Construction Material. As prescribed in 225.7503(a), use the following clause: Balance of Payments Program—Construction Material (JAN 2009) (a) Definitions. As used in this clause— Commercially available off-the-shelf...

  19. 76 FR 31547 - Medicare Program; Proposed Changes to the Electronic Prescribing (eRx) Incentive Program

    Science.gov (United States)

    2011-06-01

    ...) of the Social Security Act (the Act). We understand that the term ``eligible professional'' is used... electronic prescriptions via a third party network such as Surescripts), the eligible professional or group... impacted will in fact be lower. In 2009, 92,132 eligible professionals participated in the eRx program and...

  20. 76 FR 44573 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2011-07-26

    ... DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates... 65 [FR Doc. C1-2011-18257 Filed 7-25-11; 8:45 am] BILLING CODE 1505-01-P ...

  1. 78 FR 31560 - Medicare Program; Public Meeting in Calendar Year 2013 for New Clinical Laboratory Test Payment...

    Science.gov (United States)

    2013-05-24

    ... for coding and payment determinations for new clinical diagnostic laboratory tests under Part B of..., and amount of, payment for any clinical diagnostic laboratory test with respect to which a new or... [CMS-1451-N] Medicare Program; Public Meeting in Calendar Year 2013 for New Clinical Laboratory Test...

  2. Benefits, costs, and livelihood implications of a regional payment for ecosystem service program

    Science.gov (United States)

    Zheng, Hua; Robinson, Brian E.; Liang, Yi-Cheng; Polasky, Stephen; Ma, Dong-Chun; Wang, Feng-Chun; Ruckelshaus, Mary; Ouyang, Zhi-Yun; Daily, Gretchen C.

    2013-01-01

    Despite broad interest in using payment for ecosystem services to promote changes in the use of natural capital, there are few expost assessments of impacts of payment for ecosystem services programs on ecosystem service provision, program cost, and changes in livelihoods resulting from program participation. In this paper, we evaluate the Paddy Land-to-Dry Land (PLDL) program in Beijing, China, and associated changes in service providers’ livelihood activities. The PLDL is a land use conversion program that aims to protect water quality and quantity for the only surface water reservoir that serves Beijing, China’s capital city with nearly 20 million residents. Our analysis integrates hydrologic data with household survey data and shows that the PLDL generates benefits of improved water quantity and quality that exceed the costs of reduced agricultural output. The PLDL has an overall benefit–cost ratio of 1.5, and both downstream beneficiaries and upstream providers gain from the program. Household data show that changes in livelihood activities may offset some of the desired effects of the program through increased expenditures on agricultural fertilizers. Overall, however, reductions in fertilizer leaching from land use change dominate so that the program still has a positive net impact on water quality. This program is a successful example of water users paying upstream landholders to improve water quantity and quality through land use change. Program evaluation also highlights the importance of considering behavioral changes by program participants. PMID:24003160

  3. Incentive drilling contracts

    International Nuclear Information System (INIS)

    Moomjian, C.A. Jr.

    1992-01-01

    Incentive drilling contracts historically have been based on the footage and turnkey concepts. Because these concepts have not been used widely in the international and offshore arenas, this paper discusses other innovative approaches to incentive contracts. Case studies of recently completed or current international and offshore contracts are presented to describe incentive projects based on a performance bonus (Case 1), lump sum per well (Case 2), target time and cap for a specified hole section (Case 3), and per-well target time (Case 4). This paper concludes with a review and comparison of the case studies and a general discussion of factors that produce successful innovative incentive programs that enhance drilling efficiency

  4. 77 FR 24215 - Section 8 Housing Assistance Payments Program-Fiscal Year (FY) 2012 Inflation Factors for Public...

    Science.gov (United States)

    2012-04-23

    ... Payments Program--Fiscal Year (FY) 2012 Inflation Factors for Public Housing Agency (PHA) Renewal Funding... the tenant-based rental assistance voucher program or housing choice voucher (HCV) program of each PHA..., Housing Voucher Programs, Office of Public Housing and Voucher Programs, Office of Public and Indian...

  5. Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2018, SNF Value-Based Purchasing Program, SNF Quality Reporting Program, Survey Team Composition, and Correction of the Performance Period for the NHSN HCP Influenza Vaccination Immunization Reporting

    Science.gov (United States)

    2017-08-04

    This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2018. It also revises and rebases the market basket index by updating the base year from 2010 to 2014, and by adding a new cost category for Installation, Maintenance, and Repair Services. The rule also finalizes revisions to the SNF Quality Reporting Program (QRP), including measure and standardized resident assessment data policies and policies related to public display. In addition, it finalizes policies for the Skilled Nursing Facility Value-Based Purchasing Program that will affect Medicare payment to SNFs beginning in FY 2019. The final rule also clarifies the regulatory requirements for team composition for surveys conducted for investigating a complaint and aligns regulatory provisions for investigation of complaints with the statutory requirements. The final rule also finalizes the performance period for the National Healthcare Safety Network (NHSN) Healthcare Personnel (HCP) Influenza Vaccination Reporting Measure included in the End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP) for Payment Year 2020.

  6. Financial incentives and purchase restrictions in a food benefit program affect the types of foods and beverages purchased: results from a randomized trial.

    Science.gov (United States)

    French, Simone A; Rydell, Sarah A; Mitchell, Nathan R; Michael Oakes, J; Elbel, Brian; Harnack, Lisa

    2017-09-16

    This research evaluated the effects of financial incentives and purchase restrictions on food purchasing in a food benefit program for low income people. Participants (n=279) were randomized to groups: 1) Incentive- 30% financial incentive for fruits and vegetables purchased with food benefits; 2) Restriction- no purchase of sugar-sweetened beverages, sweet baked goods, or candies with food benefits; 3) Incentive plus Restriction; or 4) Control- no incentive or restrictions. Participants received a study-specific debit card where funds were added monthly for 12-weeks. Food purchase receipts were collected over 16 weeks. Total dollars spent on grocery purchases and by targeted food categories were computed from receipts. Group differences were examined using general linear models. Weekly purchases of fruit significantly increased in the Incentive plus Restriction ($4.8) compared to the Restriction ($1.7) and Control ($2.1) groups (p beverage purchases significantly decreased in the Incentive plus Restriction (-$0.8 per week) and Restriction ($-1.4 per week) groups compared to the Control group (+$1.5; pfoods and beverages purchased with food program funds may support more healthful food purchases compared to no incentives or restrictions. Clinicaltrials.gov Identifier: NCT02643576 .

  7. Evaluating Safeguards in a Conservation Incentive Program: Participation, Consent, and Benefit Sharing in Indigenous Communities of the Ecuadorian Amazon

    Directory of Open Access Journals (Sweden)

    Torsten Krause

    2013-12-01

    Full Text Available Critics suggest that Reducing Emissions from Deforestation and forest Degradation (REDD+ may not generate improvements in well-being for participating stakeholders, and may in fact undermine indigenous rights. To ensure positive social benefits from REDD+ projects, the United Nations REDD Programme has proposed core safeguards, including local stakeholder participation; free, prior, and informed consent; and equitable distribution of benefits. However, there is little experience to date in implementing and evaluating these safeguards. We apply these core safeguards as a framework to study how people in indigenous communities in the Ecuadorian Amazon perceive and benefit from Programa Socio Bosque, a conservation incentive program in Ecuador's national REDD+ Programme portfolio. We interviewed 101 individuals in five communities that had participated in the Programa Socio Bosque for at least 18 months. Close to 80% of respondents reported that the decision to join Socio Bosque was made democratically, that they were familiar with the conservation goals of Socio Bosque, and that they were aware which area their community had selected for conservation. However, only 17% were familiar with the overall terms of the conservation agreement, implying that they were either not fully informed of or did not fully understand what they were consenting to in joining the program. Although the terms of the program require a community investment plan to be democratically developed by community members, less than half of respondents were aware of the existence of the investment plan, and fewer than 20% had participated in its development. The majority of respondents (61% reported that they did not know the amount of incentives that their community currently receives, and only 44% stated that incentives were managed democratically in communal assemblies. Moreover, although a slight majority (53% said they had noticed benefits to the community from participating in

  8. National Low-Level Radioactive Waste Management Program. Use of compensation and incentives in siting Low-Level Radioactive Waste Disposal Facilities. Revision 1

    International Nuclear Information System (INIS)

    1985-10-01

    This document was prepared to increase understanding of compensation and incentives as they pertain to the siting of Low-Level Radioactive Waste Disposal Facilities. Compensation and incentives are discussed as methods to facilitate siting Low-Level Radioactive Waste Facilities. Compensations may be in the form of grants to enable host communities to evaluate potential impacts of the proposed facility. Compensations may also include reimbursements to the host community for costs incurred during facility construction, operation and closure. These may include required improvements to local roads, new equipment, and payments for revenue losses in local property taxes when disposal sites are removed from the tax base. Incentives provide benefits to the community beyond the costs directly related to the operation of the facility. Greater local control over waste facilities can be a powerful incentive. Local officials may be more willing to accept a facility if they have some control over the operation and monitoring associated with the facility. Failure to secure new disposal sites may cause such problems as illegal dumping which would create public health hazards. Also, lack of disposal capacity may restrict research and medical use of radioactive materials. The use of compensation and incentives may increase acceptance of communities for hosting a low-level waste disposal facility

  9. Financial Incentives: Only One Piece of the Workplace Wellness Puzzle; Comment on “Corporate Wellness Programs: Implementation Challenges in the Modern American Workplace”

    Directory of Open Access Journals (Sweden)

    Kristin Van Busum

    2013-11-01

    Full Text Available In this commentary, we argue that financial incentives are only one of many key components that employers should consider when designing and implementing a workplace wellness program. Strategies such as social encouragement and providing token rewards may also be effective in improving awareness and engagement. Should employers choose to utilize financial incentives, they should tailor them to the goals for the program as well as the targeted behaviors and health outcomes.

  10. Medicare FFS Physician Feedback Program Value-Based Payment

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Physician Feedback - Value-Based Modifier Program provides comparative performance information to physicians as one part of Medicares efforts to improve the...

  11. 7 CFR 226.10 - Program payment procedures.

    Science.gov (United States)

    2010-01-01

    ... at-risk afterschool snack component of the Program must not be considered in determining this... facility has been approved to serve the types of meals claimed; (2) Compare the number of children enrolled...

  12. Effects of incentive programs to stimulate safety belt use : A meta-analysis

    NARCIS (Netherlands)

    Hagenzieker, Marjan P.; Bijleveld, Frits D.; Davidse, Ragnhild J.

    1997-01-01

    The effects of campaigns using tangible incentives (rewards) to promote safety belt usage have been evaluated by means of a meta-analytic approach. Two coders extracted a total number of 136 short-term and 114 long-term effect sizes and coded many other variables from 34 journal articles and

  13. An analysis of the impacts of economic incentive programs on commercial nuclear power plant operations and maintenance costs

    International Nuclear Information System (INIS)

    Kavanaugh, D.C.; Monroe, W.H.; Wood, R.S.

    1996-02-01

    Operations and Maintenance (O and M) expenditures by nuclear power plant owner/operators possess a very logical and vital link in considerations relating to plant safety and reliability. Since the determinants of O and M outlays are considerable and varied, the potential linkages to plant safety, both directly and indirectly, can likewise be substantial. One significant issue before the US Nuclear Regulatory Commission is the impact, if any, on O and M spending from state programs that attempt to improve plant operating performance, and how and to what extent these programs may affect plant safety and pose public health risks. The purpose of this study is to examine the role and degree of impacts from state promulgated economic incentive programs (EIPs) on plant O and M spending. A multivariate regression framework is specified, and the model is estimated on industry data over a five-year period, 1986--1990. Explanatory variables for the O and M spending model include plant characteristics, regulatory effects, financial strength factors, replacement power costs, and the performance incentive programs. EIPs are found to have statistically significant effects on plant O and M outlays, albeit small in relation to other factors. Moreover, the results indicate that the relatively financially weaker firms are more sensitive in their O and M spending to the presence of such programs. Formulations for linking spending behavior and EIPs with plant safety performance remains for future analysis

  14. 76 FR 6313 - Asparagus Revenue Market Loss Assistance Payment Program

    Science.gov (United States)

    2011-02-04

    ... DEPARTMENT OF AGRICULTURE Commodity Credit Corporation 7 CFR Part 1429 RIN 0560-AI02 Asparagus... Agency, USDA. ACTION: Final rule. SUMMARY: This rule implements the Asparagus Revenue Market Loss... Bill). The ALAP Program will compensate domestic asparagus producers for marketing losses resulting...

  15. 76 FR 68011 - Medicare Program; Advanced Payment Model

    Science.gov (United States)

    2011-11-02

    ... Vol. 76 Wednesday, No. 212 November 2, 2011 Part IV Department of Health and Human Services... HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-5505-N] Medicare Program... at the start of the first performance year and end at the settlement scheduled at the end of that...

  16. Military Recruiting: Army National Guard Needs to Continue Monitoring, Collect Better Data, and Assess Incentives Programs

    Science.gov (United States)

    2015-11-01

    stations, and misconduct or juvenile major misconduct for drug use, possession, or drug paraphernalia, to include marijuana . DOD agreed in its comments...isolated incident. The way in which a soldier’s discharge is characterized affects certain benefits , such as future reenlistment into military...service, obtaining civilian employment, and receipt of veteran’s benefits . In addition, the ARNG may recoup incentives from soldiers who received unearned

  17. Advancing the application of systems thinking in health: provider payment and service supply behaviour and incentives in the Ghana National Health Insurance Scheme – a systems approach

    OpenAIRE

    Agyepong, Irene A; Aryeetey, Geneieve C; Nonvignon, Justice; Asenso-Boadi, Francis; Dzikunu, Helen; Antwi, Edward; Ankrah, Daniel; Adjei-Acquah, Charles; Esena, Reuben; Aikins, Moses; Arhinful, Daniel K

    2014-01-01

    Background Assuring equitable universal access to essential health services without exposure to undue financial hardship requires adequate resource mobilization, efficient use of resources, and attention to quality and responsiveness of services. The way providers are paid is a critical part of this process because it can create incentives and patterns of behaviour related to supply. The objective of this work was to describe provider behaviour related to supply of health services to insured ...

  18. Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2017 Rates; Quality Reporting Requirements for Specific Providers; Graduate Medical Education; Hospital Notification Procedures Applicable to Beneficiaries Receiving Observation Services; Technical Changes Relating to Costs to Organizations and Medicare Cost Reports; Finalization of Interim Final Rules With Comment Period on LTCH PPS Payments for Severe Wounds, Modifications of Limitations on Redesignation by the Medicare Geographic Classification Review Board, and Extensions of Payments to MDHs and Low-Volume Hospitals. Final rule.

    Science.gov (United States)

    2016-08-22

    We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2017. Some of these changes will implement certain statutory provisions contained in the Pathway for Sustainable Growth Reform Act of 2013, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Notice of Observation Treatment and Implications for Care Eligibility Act of 2015, and other legislation. We also are providing the estimated market basket update to apply to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits for FY 2017. We are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) for FY 2017. In addition, we are making changes relating to direct graduate medical education (GME) and indirect medical education payments; establishing new requirements or revising existing requirements for quality reporting by specific Medicare providers (acute care hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric facilities), including related provisions for eligible hospitals and critical access hospitals (CAHs) participating in the Electronic Health Record Incentive Program; updating policies relating to the Hospital Value-Based Purchasing Program, the Hospital Readmissions Reduction Program, and the Hospital-Acquired Condition Reduction Program; implementing statutory provisions that require hospitals and CAHs to furnish notification to Medicare beneficiaries, including Medicare Advantage enrollees, when the beneficiaries receive outpatient observation services for more than 24 hours; announcing the implementation of the Frontier Community Health Integration Project Demonstration; and

  19. Incentive-based demand response programs designed by asset-light retail electricity providers for the day-ahead market

    DEFF Research Database (Denmark)

    Fotouhi Ghazvini, Mohammad Ali; Faria, Pedro; Ramos, Sergio

    2015-01-01

    Following the deregulation experience of retail electricity markets in most countries, the majority of the new entrants of the liberalized retail market were pure REP (retail electricity providers). These entities were subject to financial risks because of the unexpected price variations, price...... spikes, volatile loads and the potential for market power exertion by GENCO (generation companies). A REP can manage the market risks by employing the DR (demand response) programs and using its' generation and storage assets at the distribution network to serve the customers. The proposed model suggests...... to hedge the financial losses in the market. A two-stage stochastic programming problem is formulated. It aims to establish the financial incentive-based DR programs and the optimal dispatch of the DG units and ESSs. The uncertainty of the forecasted day-ahead load demand and electricity price is also...

  20. Applying economic incentives to increase effectiveness of an outpatient weight loss program (TRIO) - A randomized controlled trial.

    Science.gov (United States)

    Finkelstein, Eric A; Tham, Kwang-Wei; Haaland, Benjamin A; Sahasranaman, Aarti

    2017-07-01

    The prevalence of overweight and obesity has more than doubled in the past three decades, leading to rising rates of non-communicable diseases. This study tests whether adding a payment/rewards (term reward) program to an existing evidence-based weight loss program can increase weight loss and weight loss maintenance. We conducted a parallel-group randomized controlled trial from October 2012 to October 2015 with 161 overweight or obese individuals randomized to either control or reward arm in a 1:2 ratio. Control and reward arm participants received a four month weight loss program at the LIFE (Lifestyle Improvement and Fitness Enhancement) Centre at Singapore General Hospital. Those in the reward arm paid a fee of S$165.00 (1US$ = 1.35S$) to access a program that provided rewards of up to S$660 for meeting weight loss and physical activity goals. Participants could choose to receive rewards as guaranteed cash payments or a lottery ticket with a 1 in 10 chance of winning but with the same expected value. The primary outcome was weight loss at months 4, 8, and 12. 161 participants were randomized to control (n = 54) or reward (n = 107) arms. Average weight loss was more than twice as great in the reward arm compared to the control arm at month 4 when the program concluded (3.4 kg vs 1.4 kg, p loss and weight loss maintenance when combined with an evidence-based weight loss program. Future efforts should attempt to replicate this approach and identify how to cost effectively expand these programs to maximize their reach. This study is registered at www.clinicaltrials.gov (Identifier: NCT01533454). Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Incentive-based demand response programs designed by asset-light retail electricity providers for the day-ahead market

    International Nuclear Information System (INIS)

    Fotouhi Ghazvini, Mohammad Ali; Faria, Pedro; Ramos, Sergio; Morais, Hugo; Vale, Zita

    2015-01-01

    Following the deregulation experience of retail electricity markets in most countries, the majority of the new entrants of the liberalized retail market were pure REP (retail electricity providers). These entities were subject to financial risks because of the unexpected price variations, price spikes, volatile loads and the potential for market power exertion by GENCO (generation companies). A REP can manage the market risks by employing the DR (demand response) programs and using its' generation and storage assets at the distribution network to serve the customers. The proposed model suggests how a REP with light physical assets, such as DG (distributed generation) units and ESS (energy storage systems), can survive in a competitive retail market. The paper discusses the effective risk management strategies for the REPs to deal with the uncertainties of the DAM (day-ahead market) and how to hedge the financial losses in the market. A two-stage stochastic programming problem is formulated. It aims to establish the financial incentive-based DR programs and the optimal dispatch of the DG units and ESSs. The uncertainty of the forecasted day-ahead load demand and electricity price is also taken into account with a scenario-based approach. The principal advantage of this model for REPs is reducing the risk of financial losses in DAMs, and the main benefit for the whole system is market power mitigation by virtually increasing the price elasticity of demand and reducing the peak demand. - Highlights: • Asset-light electricity retail providers subject to financial risks. • Incentive-based demand response program to manage the financial risks. • Maximizing the payoff of electricity retail providers in day-ahead market. • Mixed integer nonlinear programming to manage the risks

  2. Financial incentives, quality improvement programs, and the adoption of clinical information technology.

    Science.gov (United States)

    Robinson, James C; Casalino, Lawrence P; Gillies, Robin R; Rittenhouse, Diane R; Shortell, Stephen S; Fernandes-Taylor, Sara

    2009-04-01

    Physician use of clinical information technology (CIT) is important for the management of chronic illness, but has lagged behind expectations. We studied the role of health insurers' financial incentives (including pay-for-performance) and quality improvement initiatives in accelerating adoption of CIT in large physician practices. National survey of all medical groups and independent practice association (IPA) physician organizations with 20 or more physicians in the United States in 2006 to 2007. The response rate was 60.3%. Use of 19 CIT capabilities was measured. Multivariate statistical analysis of financial and organizational factors associated with adoption and use of CIT. Use of information technology varied across physician organizations, including electronic access to laboratory test results (medical groups, 49.3%; IPAs, 19.6%), alerts for potential drug interactions (medical groups, 33.9%; IPAs, 9.5%), electronic drug prescribing (medical groups, 41.9%; IPAs, 25.1%), and physician use of e-mail with patients (medical groups, 34.2%; IPAs, 29.1%). Adoption of CIT was stronger for physician organizations evaluated by external entities for pay-for-performance and public reporting purposes (P = 0.042) and for those participating in quality improvement initiatives (P < 0.001). External incentives and participation in quality improvement initiatives are associated with greater use of CIT by large physician practices.

  3. 28 CFR 544.43 - Incentives.

    Science.gov (United States)

    2010-07-01

    ... Mandatory English-as-a-Second Language Program (ESL) § 544.43 Incentives. The Warden or designee shall establish a system of incentives to encourage an inmate to meet the mandatory ESL program requirements. ...

  4. Interpersonal Communication and Smoking Cessation in the Context of an Incentive-Based Program: Survey Evidence From a Telehealth Intervention in a Low-Income Population.

    Science.gov (United States)

    Parks, Michael J; Slater, Jonathan S; Rothman, Alexander J; Nelson, Christina L

    2016-01-01

    The tobacco epidemic disproportionately affects low-income populations, and telehealth is an evidence-based strategy for extending tobacco cessation services to underserved populations. A public health priority is to establish incentive-based interventions at the population level in order to promote long-term smoking cessation in low-income populations. Yet randomized clinical trials show that financial incentives tend to encourage only short-term steps of cessation, not continuous smoking abstinence. One potential mechanism for increasing long-term cessation is interpersonal communication (IPC) in response to population-level interventions. However, more research is needed on IPC and its influence on health behavior change, particularly in the context of incentive-based, population-level programs. This study used survey data gathered after a population-level telehealth intervention that offered $20 incentives to low-income smokers for being connected to Minnesota's free quitline in order to examine how perceived incentive importance and IPC about the incentive-based program relate to both short-term and long-term health behavior change. Results showed that IPC was strongly associated with initial quitline utilization and continuous smoking abstinence as measured by 30-day point prevalence rates at 7-month follow-up. Perceived incentive importance had weak associations with both measures of cessation, and all associations were nonsignificant in models adjusting for IPC. These results were found in descriptive analyses, logistic regression models, and Heckman probit models that adjusted for participant recruitment. In sum, a behavioral telehealth intervention targeting low-income smokers that offered a financial incentive inspired IPC, and this social response was strongly related to utilization of intervention services as well as continuous smoking abstinence.

  5. 48 CFR 1852.216-88 - Performance incentive.

    Science.gov (United States)

    2010-10-01

    ... credit the next payment voucher for the amount due, as directed by the Contracting Officer. (2) When the performance level exceeds the standard level, the Contractor may request payment of the incentive amount associated with a given level of performance, provided that such payments shall not be more frequent than...

  6. Improving environmental and social targeting through adaptive management in Mexico's payments for hydrological services program.

    Science.gov (United States)

    Sims, Katharine R E; Alix-Garcia, Jennifer M; Shapiro-Garza, Elizabeth; Fine, Leah R; Radeloff, Volker C; Aronson, Glen; Castillo, Selene; Ramirez-Reyes, Carlos; Yañez-Pagans, Patricia

    2014-10-01

    Natural resource managers are often expected to achieve both environmental protection and economic development even when there are fundamental trade-offs between these goals. Adaptive management provides a theoretical structure for program administrators to balance social priorities in the presence of trade-offs and to improve conservation targeting. We used the case of Mexico's federal Payments for Hydrological Services program (PSAH) to illustrate the importance of adaptive management for improving program targeting. We documented adaptive elements of PSAH and corresponding changes in program eligibility and selection criteria. To evaluate whether these changes resulted in enrollment of lands of high environmental and social priority, we compared the environmental and social characteristics of the areas enrolled in the program with the characteristics of all forested areas in Mexico, all areas eligible for the program, and all areas submitted for application to the program. The program successfully enrolled areas of both high ecological and social priority, and over time, adaptive changes in the program's criteria for eligibility and selection led to increased enrollment of land scoring high on both dimensions. Three factors facilitated adaptive management in Mexico and are likely to be generally important for conservation managers: a supportive political environment, including financial backing and encouragement to experiment from the federal government; availability of relatively good social and environmental data; and active participation in the review process by stakeholders and outside evaluators. © 2014 Society for Conservation Biology.

  7. Open Payments Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — Open Payments (otherwise known as the Sunshine Act) - Open Payments is a Congressionally-mandated transparency program that increases awareness of financial...

  8. Examining the types and payments of the disabilities of the insurants in the National Farmers' Health Insurance program in Taiwan.

    Science.gov (United States)

    Wang, Jiun-Hao; Chang, Hung-Hao

    2010-10-26

    In contrast to the considerable body of literature concerning the disabilities of the general population, little information exists pertaining to the disabilities of the farm population. Focusing on the disability issue to the insurants in the Farmers' Health Insurance (FHI) program in Taiwan, this paper examines the associations among socio-demographic characteristics, insured factors, and the introduction of the national health insurance program, as well as the types and payments of disabilities among the insurants. A unique dataset containing 1,594,439 insurants in 2008 was used in this research. A logistic regression model was estimated for the likelihood of received disability payments. By focusing on the recipients, a disability payment and a disability type equation were estimated using the ordinary least squares method and a multinomial logistic model, respectively, to investigate the effects of the exogenous factors on their received payments and the likelihood of having different types of disabilities. Age and different job categories are significantly associated with the likelihood of receiving disability payments. Compared to those under age 45, the likelihood is higher among recipients aged 85 and above (the odds ratio is 8.04). Compared to hired workers, the odds ratios for self-employed and spouses of farm operators who were not members of farmers' associations are 0.97 and 0.85, respectively. In addition, older insurants are more likely to have eye problems; few differences in disability types are related to insured job categories. Results indicate that older farmers are more likely to receive disability payments, but the likelihood is not much different among insurants of various job categories. Among all of the selected types of disability, a highest likelihood is found for eye disability. In addition, the introduction of the national health insurance program decreases the likelihood of receiving disability payments. The experience in Taiwan can

  9. Examining the types and payments of the disabilities of the insurants in the national farmers' health insurance program in Taiwan

    Directory of Open Access Journals (Sweden)

    Chang Hung-Hao

    2010-10-01

    Full Text Available Abstract Background In contrast to the considerable body of literature concerning the disabilities of the general population, little information exists pertaining to the disabilities of the farm population. Focusing on the disability issue to the insurants in the Farmers' Health Insurance (FHI program in Taiwan, this paper examines the associations among socio-demographic characteristics, insured factors, and the introduction of the national health insurance program, as well as the types and payments of disabilities among the insurants. Methods A unique dataset containing 1,594,439 insurants in 2008 was used in this research. A logistic regression model was estimated for the likelihood of received disability payments. By focusing on the recipients, a disability payment and a disability type equation were estimated using the ordinary least squares method and a multinomial logistic model, respectively, to investigate the effects of the exogenous factors on their received payments and the likelihood of having different types of disabilities. Results Age and different job categories are significantly associated with the likelihood of receiving disability payments. Compared to those under age 45, the likelihood is higher among recipients aged 85 and above (the odds ratio is 8.04. Compared to hired workers, the odds ratios for self-employed and spouses of farm operators who were not members of farmers' associations are 0.97 and 0.85, respectively. In addition, older insurants are more likely to have eye problems; few differences in disability types are related to insured job categories. Conclusions Results indicate that older farmers are more likely to receive disability payments, but the likelihood is not much different among insurants of various job categories. Among all of the selected types of disability, a highest likelihood is found for eye disability. In addition, the introduction of the national health insurance program decreases the

  10. Structuring economic incentives to reduce emissions from deforestation within Indonesia.

    Science.gov (United States)

    Busch, Jonah; Lubowski, Ruben N; Godoy, Fabiano; Steininger, Marc; Yusuf, Arief A; Austin, Kemen; Hewson, Jenny; Juhn, Daniel; Farid, Muhammad; Boltz, Frederick

    2012-01-24

    We estimate and map the impacts that alternative national and subnational economic incentive structures for reducing emissions from deforestation (REDD+) in Indonesia would have had on greenhouse gas emissions and national and local revenue if they had been in place from 2000 to 2005. The impact of carbon payments on deforestation is calibrated econometrically from the pattern of observed deforestation and spatial variation in the benefits and costs of converting land to agriculture over that time period. We estimate that at an international carbon price of $10/tCO(2)e, a "mandatory incentive structure," such as a cap-and-trade or symmetric tax-and-subsidy program, would have reduced emissions by 163-247 MtCO(2)e/y (20-31% below the without-REDD+ reference scenario), while generating a programmatic budget surplus. In contrast, a "basic voluntary incentive structure" modeled after a standard payment-for-environmental-services program would have reduced emissions nationally by only 45-76 MtCO(2)e/y (6-9%), while generating a programmatic budget shortfall. By making four policy improvements--paying for net emission reductions at the scale of an entire district rather than site-by-site; paying for reductions relative to reference levels that match business-as-usual levels; sharing a portion of district-level revenues with the national government; and sharing a portion of the national government's responsibility for costs with districts--an "improved voluntary incentive structure" would have been nearly as effective as a mandatory incentive structure, reducing emissions by 136-207 MtCO(2)e/y (17-26%) and generating a programmatic budget surplus.

  11. Structuring economic incentives to reduce emissions from deforestation within Indonesia

    Science.gov (United States)

    Busch, Jonah; Lubowski, Ruben N.; Godoy, Fabiano; Steininger, Marc; Yusuf, Arief A.; Austin, Kemen; Hewson, Jenny; Juhn, Daniel; Farid, Muhammad; Boltz, Frederick

    2012-01-01

    We estimate and map the impacts that alternative national and subnational economic incentive structures for reducing emissions from deforestation (REDD+) in Indonesia would have had on greenhouse gas emissions and national and local revenue if they had been in place from 2000 to 2005. The impact of carbon payments on deforestation is calibrated econometrically from the pattern of observed deforestation and spatial variation in the benefits and costs of converting land to agriculture over that time period. We estimate that at an international carbon price of $10/tCO2e, a “mandatory incentive structure,” such as a cap-and-trade or symmetric tax-and-subsidy program, would have reduced emissions by 163–247 MtCO2e/y (20–31% below the without-REDD+ reference scenario), while generating a programmatic budget surplus. In contrast, a “basic voluntary incentive structure” modeled after a standard payment-for-environmental-services program would have reduced emissions nationally by only 45–76 MtCO2e/y (6–9%), while generating a programmatic budget shortfall. By making four policy improvements—paying for net emission reductions at the scale of an entire district rather than site-by-site; paying for reductions relative to reference levels that match business-as-usual levels; sharing a portion of district-level revenues with the national government; and sharing a portion of the national government's responsibility for costs with districts—an “improved voluntary incentive structure” would have been nearly as effective as a mandatory incentive structure, reducing emissions by 136–207 MtCO2e/y (17–26%) and generating a programmatic budget surplus. PMID:22232665

  12. A novel and cost-effective monitoring approach for outcomes in an Australian biodiversity conservation incentive program.

    Science.gov (United States)

    Lindenmayer, David B; Zammit, Charles; Attwood, Simon J; Burns, Emma; Shepherd, Claire L; Kay, Geoff; Wood, Jeff

    2012-01-01

    We report on the design and implementation of ecological monitoring for an Australian biodiversity conservation incentive scheme - the Environmental Stewardship Program. The Program uses competitive auctions to contract individual land managers for up to 15 years to conserve matters of National Environmental Significance (with an initial priority on nationally threatened ecological communities). The ecological monitoring was explicitly aligned with the Program's policy objective and desired outcomes and was applied to the Program's initial Project which targeted the critically endangered White Box-Yellow Box-Blakely's Red Gum Grassy Woodland and Derived Native Grassland ecological community in south eastern Australia. These woodlands have been reduced to monitoring sites on 153 farms located over 172,232 sq km. On each farm we established a monitoring site within the woodland patch funded for management and, wherever possible, a matched control site. The monitoring has entailed gathering data on vegetation condition, reptiles and birds. We also gathered data on the costs of experimental design, site establishment, field survey, and data analysis. The costs of monitoring are approximately 8.5% of the Program's investment in the first four years and hence are in broad accord with the general rule of thumb that 5-10% of a program's funding should be invested in monitoring. Once initial monitoring and site benchmarking are completed we propose to implement a novel rotating sampling approach that will maintain scientific integrity while achieving an annual cost-efficiency of up to 23%. We discuss useful lessons relevant to other monitoring programs where there is a need to provide managers with reliable early evidence of program effectiveness and to demonstrate opportunities for cost-efficiencies.

  13. A novel and cost-effective monitoring approach for outcomes in an Australian biodiversity conservation incentive program.

    Directory of Open Access Journals (Sweden)

    David B Lindenmayer

    Full Text Available We report on the design and implementation of ecological monitoring for an Australian biodiversity conservation incentive scheme - the Environmental Stewardship Program. The Program uses competitive auctions to contract individual land managers for up to 15 years to conserve matters of National Environmental Significance (with an initial priority on nationally threatened ecological communities. The ecological monitoring was explicitly aligned with the Program's policy objective and desired outcomes and was applied to the Program's initial Project which targeted the critically endangered White Box-Yellow Box-Blakely's Red Gum Grassy Woodland and Derived Native Grassland ecological community in south eastern Australia. These woodlands have been reduced to <3% of their original extent and persist mostly as small remnants of variable condition on private farmland. We established monitoring sites on 153 farms located over 172,232 sq km. On each farm we established a monitoring site within the woodland patch funded for management and, wherever possible, a matched control site. The monitoring has entailed gathering data on vegetation condition, reptiles and birds. We also gathered data on the costs of experimental design, site establishment, field survey, and data analysis. The costs of monitoring are approximately 8.5% of the Program's investment in the first four years and hence are in broad accord with the general rule of thumb that 5-10% of a program's funding should be invested in monitoring. Once initial monitoring and site benchmarking are completed we propose to implement a novel rotating sampling approach that will maintain scientific integrity while achieving an annual cost-efficiency of up to 23%. We discuss useful lessons relevant to other monitoring programs where there is a need to provide managers with reliable early evidence of program effectiveness and to demonstrate opportunities for cost-efficiencies.

  14. How effective are biodiversity conservation payments in Mexico?

    OpenAIRE

    Costedoat, Sébastien; Corbera, Esteve; Ezzine de Blas, Driss; Honey-Rosés, Jordi; Baylis, Kathy; Castillo-Santiago, Miguel Angel

    2015-01-01

    We assess the additional forest cover protected by 13 rural communities located in the southern state of Chiapas, Mexico, as a result of the economic incentives received through the country's national program of payments for biodiversity conservation. We use spatially explicit data at the intra-community level to define a credible counterfactual of conservation outcomes.We use covariate-matching specifications associated with spatially explicit variables and difference-in-difference estimator...

  15. 77 FR 70619 - Incentives for Nondiscriminatory Wellness Programs in Group Health Plans

    Science.gov (United States)

    2012-11-26

    ... require an individual to pay for the cost of the program. If the reasonable alternative standard is a diet... notes that cost sharing may vary based on participation in a diabetes wellness program, without...

  16. Irregular incentives

    International Nuclear Information System (INIS)

    Cicchetti, M.A.

    1993-01-01

    Public utility regulation lacks a formal proxy for the economic profits that can be earned in an effectively competitive market if a firm is efficient or innovative. After all, public utility regulation operated on cost-plus basis. If a utility is efficient or innovative and lowers its costs, its typical reward is to have its rates reduced. This is a perverse incentive to motivate a utility to produce at the most efficient level. In addition, since regulation operates on this cost-plus basis, a utility can increase its net income, all other things being equal, by overinvesting in (or open-quotes gold-platingclose quotes) its system, another perverse incentive. Recognizing these flaws of regulation, academicians, utility executives, regulators, and legislators have tried over the last several years to implement incentive regulation plans that correct such perverse incentives. However, under many of the earnings-sharing or price-regulation incentive plans, the rewards for efficient production are not tied directly to measures under a company's control. In fact, such plans could prove highly detrimental to ratepayers and competitors of the regulated company and its affiliates. An incentive regulation plan that ties an appropriate reward for efficient production to specific efficiency gains is a better proxy of an effectively competitive environment. What's more, it is superior to an incentive plan that rewards circumstances beyond the company's control or self-serving manipulation. This is particularly true if no earnings cap is associated with the reward for efficiency. Rewards for efficient production should be tied to specific actions. A suitable incentive plan does not preclude appropriately derived flexible prices for certain products or services where warranted

  17. Peace Incentives

    DEFF Research Database (Denmark)

    Emmanuel, Nikolas G.

    2015-01-01

    How does economic assistance influence the success or failure of peace processes in Africa? Can economic assistance act as an incentive to facilitate an end to conflict? The literature largely ignores aid as a factor supporting peace processes. In addressing this topic, the current study tries...... to assess the impact of donor economic aid on recent African peace processes. This research points to the conclusion that international assistance can be a positive incentive for lasting peace....

  18. Incentive Pay Programs Do Not Affect Teacher Motivation or Reported Practices: Results from Three Randomized Studies

    Science.gov (United States)

    Yuan, Kun; Le, Vi-Nhuan; McCaffrey, Daniel F.; Marsh, Julie A.; Hamilton, Laura S.; Stecher, Brian M.; Springer, Matthew G.

    2013-01-01

    This study drew on teacher survey responses from randomized experiments exploring three different pay-for-performance programs to examine the extent to which these programs motivated teachers to improve student achievement and the impact of such programs on teachers' instruction, number of hours worked, job stress, and collegiality. Results showed…

  19. 78 FR 33157 - Incentives for Nondiscriminatory Wellness Programs in Group Health Plans

    Science.gov (United States)

    2013-06-03

    ... maximum permissible reward to 50 percent for wellness programs designed to prevent or reduce tobacco use. These regulations also include other clarifications regarding the reasonable design of health-contingent... into two general categories: Participatory wellness programs and health- contingent wellness programs...

  20. 76 FR 13292 - Medicare Program: Changes to the Hospital Outpatient Prospective Payment System and CY 2011...

    Science.gov (United States)

    2011-03-11

    ... Graduate Medical Education Costs; Physician Self-Referral Rules and Related Changes to Provider Agreement Regulations; Payment for Certified Registered Nurse Anesthetist Services Furnished in Rural Hospitals and... and CY 2011 Payment Rates; Changes to Payments to Hospitals for Graduate Medical Education Costs...

  1. Payments for carbon sequestration to alleviate development pressure in a rapidly urbanizing region

    Science.gov (United States)

    Smith, Jordan W.; Dorning, Monica; Shoemaker, Douglas A.; Méley, Andréanne; Dupey, Lauren; Meentemeyer, Ross K.

    2017-01-01

    The purpose of this study was to determine individuals' willingness to enroll in voluntary payments for carbon sequestration programs through the use of a discrete choice experiment delivered to forest owners living in the rapidly urbanizing region surrounding Charlotte, North Carolina. We examined forest owners' willingness to enroll in payments for carbon sequestration policies under different levels of financial incentives (annual revenue), different contract lengths, and different program administrators (e.g., private companies versus a state or federal agency). We also examined the influence forest owners' sense of place had on their willingness to enroll in hypothetical programs. Our results showed a high level of ambivalence toward participating in payments for carbon sequestration programs. However, both financial incentives and contract lengths significantly influenced forest owners' intent to enroll. Neither program administration nor forest owners' sense of place influenced intent to enroll. Although our analyses indicated that payments from carbon sequestration programs are not currently competitive with the monetary returns expected from timber harvest or property sales, certain forest owners might see payments for carbon sequestration programs as a viable option for offsetting increasing tax costs as development encroaches and property values rise.

  2. 7 CFR 1416.504 - Payment calculation.

    Science.gov (United States)

    2010-01-01

    ... PROGRAMS Tropical Fruit Disaster Program § 1416.504 Payment calculation. (a) Payments are calculated by... payment rate for insured or NAP covered tropical fruit is a flat rate of $5000 per acre. The rate for...

  3. Effect of prize-based incentives on outcomes in stimulant abusers in outpatient psychosocial treatment programs: a national drug abuse treatment clinical trials network study.

    Science.gov (United States)

    Petry, Nancy M; Peirce, Jessica M; Stitzer, Maxine L; Blaine, Jack; Roll, John M; Cohen, Allan; Obert, Jeanne; Killeen, Therese; Saladin, Michael E; Cowell, Mark; Kirby, Kimberly C; Sterling, Robert; Royer-Malvestuto, Charlotte; Hamilton, John; Booth, Robert E; Macdonald, Marilyn; Liebert, Marc; Rader, Linda; Burns, Raynetta; DiMaria, Joan; Copersino, Marc; Stabile, Patricia Quinn; Kolodner, Ken; Li, Rui

    2005-10-01

    Contingency management interventions that provide tangible incentives based on objective indicators of drug abstinence are efficacious in improving outcomes in substance abusers, but these treatments have rarely been implemented in community-based settings. To evaluate the efficacy of an abstinence-based contingency management intervention as an addition to usual care in community treatment settings. Random assignment to usual care or usual care plus abstinence-based incentives for 12 weeks. Eight community-based outpatient psychosocial drug abuse treatment programs. A total of 415 cocaine or methamphetamine users beginning outpatient substance abuse treatment. All participants received standard care, and those assigned to the abstinence-based incentive condition also earned chances to win prizes for submitting substance-free urine samples; the chances of winning prizes increased with continuous time abstinent. Retention, counseling attendance, total number of substance-free samples provided, percentage of stimulant- and alcohol-free samples submitted, and longest duration of confirmed stimulant abstinence. Participants assigned to the abstinence-based incentive condition remained in treatment for a mean +/- SD of 8.0 +/- 4.2 weeks and attended a mean +/- SD of 19.2 +/- 16.8 counseling sessions compared with 6.9 +/- 4.4 weeks and 15.7 +/- 14.4 sessions for those assigned to the usual care condition (P<.02 for all). Participants in the abstinence-based incentive condition also submitted significantly more stimulant- and alcohol-free samples (P<.001). The abstinence-based incentive group was significantly more likely to achieve 4, 8, and 12 weeks of continuous abstinence than the control group, with odds ratios of 2.5, 2.7, and 4.5, respectively. However, the percentage of positive samples submitted was low overall and did not differ between conditions. The abstinence-based incentive procedure, which provided a mean of 203 dollars in prizes per participant, was

  4. Surveillance in Programming Plagiarism beyond Techniques: An Incentive-Based Fishbone Model

    Science.gov (United States)

    Wang, Yanqing; Chen, Min; Liang, Yaowen; Jiang, Yu

    2013-01-01

    Lots of researches have showed that plagiarism becomes a severe problem in higher education around the world, especially in programming learning for its essence. Therefore, an effective strategy for plagiarism surveillance in program learning is much essential. Some literature focus on code similarity algorithm and the related tools can help to…

  5. A Little Now for a Lot Later: A Look at a Texas Advanced Placement Incentive Program

    Science.gov (United States)

    Jackson, C. Kirabo

    2010-01-01

    I analyze a program implemented in Texas schools serving underprivileged populations that pays both students and teachers for passing grades on Advanced Placement (AP) examinations. Using a difference-in-differences strategy, I find that program adoption is associated with increased AP course and exam taking, increases in the number of students…

  6. Workforce Downsizing and Restructuring in the Department of Defense: The Voluntary Separation Incentive Payment Program Versus Involuntary Separation

    Science.gov (United States)

    2016-01-01

    provided a “ soft landing” and helped agencies avoid the problems that are perceived to be associated with layoffs, including workplace turmoil, morale...policy based on voluntary separation also avoids workplace turmoil that occurs under a policy of involuntary separation. VSIP, accompanied by VERA...around in this way can generate uncertainty, delays in workflow, and skills /competency gaps for organizations. Evidence from past studies indicates

  7. Beyond case studies: Quantitative effects of recycling, incentive, and diversion program choices

    Energy Technology Data Exchange (ETDEWEB)

    Skumatz, L.A. [Skumatz Economic Research Associates, Seattle, WA (United States)

    1997-12-31

    Communities, facing tight budgets, volatile markets, and the recycling backlash are turning their attention to making their programs more efficient and effective. Unfortunately, communities have very little quantitative information available to help them improve their programs. This is despite the fact that the majority of recycling programs have been running for over 6 years. Further, the author found that there are many thousands of curbside and dropoff recycling programs across the nation, as well as thousands of yard waste and variable rate programs. Still, with all these years of operating experience across the nation, at conferences, when planners ask about the likely impacts of possible program improvements, the answers usually begin, ``well, the City of [fill in the blank] made that change and found...``. Answers like this are seldom transferable to other communities. Similarly, most published information also relies on one or a few (less than ten) case studies, and published case studies usually describe programs that are outstanding in some way, making the information even less transferable. This type of information is wholly inadequate to derive information that is transferable to any other community. Can one really expect information from the City of San Jose, California, to transfer directly to the Village of Hartland, Wisconsin? That is the level of information that has been available thus far to planners. This study uses specially collected data from over 500 communities across North America as the basis for a statistical analysis of those programmatic and socio-demographic factors that contribute most to higher levels of recycling diversion. The work is unique in that it provides the first reliable quantitative information for use by community program planners in analyzing impacts of alternative programs and their cost-effectiveness to design sustainable, appropriate programs to improve diversion.

  8. 20 CFR 408.1235 - How does the State transfer funds to SSA to administer its recognition payment program?

    Science.gov (United States)

    2010-04-01

    ... administer its recognition payment program? 408.1235 Section 408.1235 Employees' Benefits SOCIAL SECURITY... fifth business day following such date. (b) Accounting of State funds. (1) As soon as feasible after the... balance of the State's cash on deposit with SSA. (2) SSA will provide the State with an accounting of...

  9. 76 FR 73025 - Medicare Program; Payment Policies Under the Physician Fee Schedule, Five-Year Review of Work...

    Science.gov (United States)

    2011-11-28

    ... Visit BBA Balanced Budget Act of 1997 (Pub. L. 105-33) BBRA [Medicare, Medicaid and State Child Health Insurance Program] Balanced Budget Refinement Act of 1999 (Pub. L. 106-113) BIPA Medicare, Medicaid, and... MCMP Medicare Care Management Performance MCP Monthly Capitation Payment MDRD Modification of Diet in...

  10. 75 FR 73169 - Medicare Program; Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B...

    Science.gov (United States)

    2010-11-29

    ... Association AWP Average wholesale price AWV Annual Wellness Visit BBA Balanced Budget Act of 1997 (Pub. L. 105-33) BBRA [Medicare, Medicaid and State Child Health Insurance Program] Balanced Budget Refinement Act... Monthly Capitation Payment MDRD Modification of Diet in Renal Disease MedCAC Medicare Evidence Development...

  11. 48 CFR 752.225-9 - Buy American Act-Trade Agreements Act-Balance of Payments Program.

    Science.gov (United States)

    2010-10-01

    ... CLAUSES Texts of Provisions and Clauses 752.225-9 Buy American Act—Trade Agreements Act—Balance of... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Buy American Act-Trade Agreements Act-Balance of Payments Program. 752.225-9 Section 752.225-9 Federal Acquisition Regulations...

  12. Quality-based financial incentives in health care: can we improve quality by paying for it?

    Science.gov (United States)

    Conrad, Douglas A; Perry, Lisa

    2009-01-01

    This article asks whether financial incentives can improve the quality of health care. A conceptual framework drawn from microeconomics, agency theory, behavioral economics, and cognitive psychology motivates a set of propositions about incentive effects on clinical quality. These propositions are evaluated through a synthesis of extant peer-reviewed empirical evidence. Comprehensive financial incentives--balancing rewards and penalties; blending structure, process, and outcome measures; emphasizing continuous, absolute performance standards; tailoring the size of incremental rewards to increasing marginal costs of quality improvement; and assuring certainty, frequency, and sustainability of incentive payoffs--offer the prospect of significantly enhancing quality beyond the modest impacts of prevailing pay-for-performance (P4P) programs. Such organizational innovations as the primary care medical home and accountable health care organizations are expected to catalyze more powerful quality incentive models: risk- and quality-adjusted capitation, episode of care payments, and enhanced fee-for-service payments for quality dimensions (e.g., prevention) most amenable to piece-rate delivery.

  13. Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2018 Rates; Quality Reporting Requirements for Specific Providers; Medicare and Medicaid Electronic Health Record (EHR)

    Science.gov (United States)

    2017-08-14

    We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2018. Some of these changes implement certain statutory provisions contained in the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2013, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Medicare Access and CHIP Reauthorization Act of 2015, the 21st Century Cures Act, and other legislation. We also are making changes relating to the provider-based status of Indian Health Service (IHS) and Tribal facilities and organizations and to the low-volume hospital payment adjustment for hospitals operated by the IHS or a Tribe. In addition, we are providing the market basket update that will apply to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits for FY 2018. We are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) for FY 2018. In addition, we are establishing new requirements or revising existing requirements for quality reporting by specific Medicare providers (acute care hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric facilities). We also are establishing new requirements or revising existing requirements for eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) participating in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. We are updating policies relating to the Hospital Value-Based Purchasing (VBP) Program, the Hospital Readmissions Reduction Program, and the Hospital-Acquired Condition (HAC) Reduction Program. We also are making changes relating to transparency of accrediting organization survey

  14. Electronic Health Record Vendors Reported by Health Care Providers Participating in Federal EHR Incentive Programs

    Data.gov (United States)

    U.S. Department of Health & Human Services — This public use file combines registration data compiled from two federal programs that are on-going since February 2009 – the Centers for Medicare & Medicaid...

  15. 34 CFR 226.3 - What regulations apply to the State Charter School Facilities Incentive program?

    Science.gov (United States)

    2010-07-01

    ... part 98 (Student Rights in Research, Experimental Programs, and Testing). (12) 34 CFR part 99 (Family... (Definitions that Apply to Department Regulations). (4) 34 CFR part 79 (Intergovernmental Review of Department...

  16. COST-SHARE INCENTIVES AND BEST MANAGEMENT PRACTICES IN A PILOT WATER QUALITY PROGRAM

    OpenAIRE

    Houston, Jack E.; Sun, Henglun

    1999-01-01

    This study integrates three biophysical simulators to predict crop yields, water-soil pollution emissions, and farmers' net returns under uncertain weather and market conditions. Multiple-objective programming incorporates farmer attitudes toward voluntary participation under alternate rates of government cost-share subsidies to search for efficient pollution abatement solutions as best management practices (BMPs). Net returns decline an estimated 9.6% when farmers adopt a cost-share program ...

  17. Peace Incentives

    DEFF Research Database (Denmark)

    Emmanuel, Nikolas G.

    2015-01-01

    How does economic assistance influence the success or failure of peace processes in Africa? Can economic assistance act as an incentive to facilitate an end to conflict? The literature largely ignores aid as a factor supporting peace processes. In addressing this topic, the current study tries to...... to assess the impact of donor economic aid on recent African peace processes. This research points to the conclusion that international assistance can be a positive incentive for lasting peace.......How does economic assistance influence the success or failure of peace processes in Africa? Can economic assistance act as an incentive to facilitate an end to conflict? The literature largely ignores aid as a factor supporting peace processes. In addressing this topic, the current study tries...

  18. College diversity and investment incentives

    OpenAIRE

    Gall, Thomas; Legros, Patrick; Newman, Andrew

    2015-01-01

    This paper studies the aggregate economic effects of diversity policies such as affirmative action in college admission. If agents are constrained in the side payments they can make, the free market allocation displays excessive segregation relative to the first-best. Affirmative action policies can restore diversity within colleges but also affect incentives to invest in pre-college scholastic achievement. Affirmative action policies that are achievement-based can increase aggregate investme...

  19. A Novel and Cost-Effective Monitoring Approach for Outcomes in an Australian Biodiversity Conservation Incentive Program

    Science.gov (United States)

    Lindenmayer, David B.; Zammit, Charles; Attwood, Simon J.; Burns, Emma; Shepherd, Claire L.; Kay, Geoff; Wood, Jeff

    2012-01-01

    We report on the design and implementation of ecological monitoring for an Australian biodiversity conservation incentive scheme – the Environmental Stewardship Program. The Program uses competitive auctions to contract individual land managers for up to 15 years to conserve matters of National Environmental Significance (with an initial priority on nationally threatened ecological communities). The ecological monitoring was explicitly aligned with the Program’s policy objective and desired outcomes and was applied to the Program’s initial Project which targeted the critically endangered White Box-Yellow Box-Blakely's Red Gum Grassy Woodland and Derived Native Grassland ecological community in south eastern Australia. These woodlands have been reduced to <3% of their original extent and persist mostly as small remnants of variable condition on private farmland. We established monitoring sites on 153 farms located over 172,232 sq km. On each farm we established a monitoring site within the woodland patch funded for management and, wherever possible, a matched control site. The monitoring has entailed gathering data on vegetation condition, reptiles and birds. We also gathered data on the costs of experimental design, site establishment, field survey, and data analysis. The costs of monitoring are approximately 8.5% of the Program’s investment in the first four years and hence are in broad accord with the general rule of thumb that 5–10% of a program’s funding should be invested in monitoring. Once initial monitoring and site benchmarking are completed we propose to implement a novel rotating sampling approach that will maintain scientific integrity while achieving an annual cost-efficiency of up to 23%. We discuss useful lessons relevant to other monitoring programs where there is a need to provide managers with reliable early evidence of program effectiveness and to demonstrate opportunities for cost-efficiencies. PMID:23236399

  20. The Effects of Incentives on Families' Long-Term Outcome in a Parenting Program

    Science.gov (United States)

    Heinrichs, Nina; Jensen-Doss, Amanda

    2010-01-01

    To examine the impact of paying for participation in a preventive parenting program on treatment outcomes, 197 families with preschool-aged children were randomized to paid or unpaid conditions. Although both groups improved on nearly all measures, paid families showed less improvement on 3 of 10 variables, including father-reported child…

  1. Medicare program; prospective payment system and consolidated billing for skilled nursing facilities--update. Final rule.

    Science.gov (United States)

    2002-08-04

    This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs), for fiscal year (FY) 2004. Annual updates to the PPS rates are required by section 1888(e) of the Social Security Act (the Act), as amended by the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 (BBRA), and the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA), relating to Medicare payments and consolidated billing for SNFs.

  2. Using prescription monitoring program data to characterize out-of-pocket payments for opioid prescriptions in a state Medicaid program.

    Science.gov (United States)

    Hartung, Daniel M; Ahmed, Sharia M; Middleton, Luke; Van Otterloo, Joshua; Zhang, Kun; Keast, Shellie; Kim, Hyunjee; Johnston, Kirbee; Deyo, Richard A

    2017-09-01

    Out-of-pocket payment for prescription opioids is believed to be an indicator of abuse or diversion, but few studies describe its epidemiology. Prescription drug monitoring programs (PDMPs) collect controlled substance prescription fill data regardless of payment source and thus can be used to study this phenomenon. To estimate the frequency and characteristics of prescription fills for opioids that are likely paid out-of-pocket by individuals in the Oregon Medicaid program. Cross-sectional analysis using Oregon Medicaid administrative claims and PDMP data (2012 to 2013). Continuously enrolled nondually eligible Medicaid beneficiaries who could be linked to the PDMP with two opioid fills covered by Oregon Medicaid. Patient characteristics and fill characteristics for opioid fills that lacked a Medicaid pharmacy claim. Fill characteristics included opioid name, type, and association with indicators of high-risk opioid use. A total of 33 592 Medicaid beneficiaries filled a total of 555 103 opioid prescriptions. Of these opioid fills, 74 953 (13.5%) could not be matched to a Medicaid claim. Hydromorphone (30%), fentanyl (18%), and methadone (15%) were the most likely to lack a matching claim. The 3 largest predictors for missing claims were opioid fills that overlapped with other opioids (adjusted odds ratio [aOR] 1.37; 95% confidence interval [CI], 1.34-1.4), long-acting opioids (aOR 1.52; 95% CI, 1.47-1.57), and fills at multiple pharmacies (aOR 1.45; 95% CI, 1.39-1.52). Prescription opioid fills that were likely paid out-of-pocket were common and associated with several known indicators of high-risk opioid use. Copyright © 2017 John Wiley & Sons, Ltd.

  3. Risk-Based Two-Stage Stochastic Optimization Problem of Micro-Grid Operation with Renewables and Incentive-Based Demand Response Programs

    Directory of Open Access Journals (Sweden)

    Pouria Sheikhahmadi

    2018-03-01

    Full Text Available The operation problem of a micro-grid (MG in grid-connected mode is an optimization one in which the main objective of the MG operator (MGO is to minimize the operation cost with optimal scheduling of resources and optimal trading energy with the main grid. The MGO can use incentive-based demand response programs (DRPs to pay an incentive to the consumers to change their demands in the peak hours. Moreover, the MGO forecasts the output power of renewable energy resources (RERs and models their uncertainties in its problem. In this paper, the operation problem of an MGO is modeled as a risk-based two-stage stochastic optimization problem. To model the uncertainties of RERs, two-stage stochastic programming is considered and conditional value at risk (CVaR index is used to manage the MGO’s risk-level. Moreover, the non-linear economic models of incentive-based DRPs are used by the MGO to change the peak load. The numerical studies are done to investigate the effect of incentive-based DRPs on the operation problem of the MGO. Moreover, to show the effect of the risk-averse parameter on MGO decisions, a sensitivity analysis is carried out.

  4. 78 FR 9803 - Tennessee Abandoned Mine Land Program

    Science.gov (United States)

    2013-02-12

    ... restoring land and water resources adversely affected by past mining. This program is funded by a... aside accounts, water supply projects, State share payments, re-mining incentives, and minimum program... Program; Part 879, Management and Disposition of Lands and Water; Part 882, Reclamation on Private Land...

  5. Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Short Inpatient Hospital Stays; Transition for Certain Medicare-Dependent, Small Rural Hospitals Under the Hospital Inpatient Prospective Payment System; Provider Administrative Appeals and Judicial Review. Final rule with comment period; final rule.

    Science.gov (United States)

    2015-11-13

    This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2016 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program. Further, this document includes certain finalized policies relating to the hospital inpatient prospective payment system: Changes to the 2-midnight rule under the short inpatient hospital stay policy; and a payment transition for hospitals that lost their status as a Medicare-dependent, small rural hospital (MDH) because they are no longer in a rural area due to the implementation of the new Office of Management and Budget delineations in FY 2015 and have not reclassified from urban to rural before January 1, 2016. In addition, this document contains a final rule that finalizes certain 2015 proposals, and addresses public comments received, relating to the changes in the Medicare regulations governing provider administrative appeals and judicial review relating to appropriate claims in provider cost reports.

  6. Using financial incentives to improve value in orthopaedics.

    Science.gov (United States)

    Lansky, David; Nwachukwu, Benedict U; Bozic, Kevin J

    2012-04-01

    A variety of reforms to traditional approaches to provider payment and benefit design are being implemented in the United States. There is increasing interest in applying these financial incentives to orthopaedics, although it is unclear whether and to what extent they have been implemented and whether they increase quality or reduce costs. We reviewed and discussed physician- and patient-oriented financial incentives being implemented in orthopaedics, key challenges, and prerequisites to payment reform and value-driven payment policy in orthopaedics. We searched the MEDLINE database using as search terms various provider payment and consumer incentive models. We retrieved a total of 169 articles; none of these studies met the inclusion criteria. For incentive models known to the authors to be in use in orthopaedics but for which no peer-reviewed literature was found, we searched Google for further information. Provider financial incentives reviewed include payments for reporting, performance, and patient safety and episode payment. Patient incentives include tiered networks, value-based benefit design, reference pricing, and value-based purchasing. Reform of financial incentives for orthopaedic surgery is challenged by (1) lack of a payment/incentive model that has demonstrated reductions in cost trends and (2) the complex interrelation of current pay schemes in today's fragmented environment. Prerequisites to reform include (1) a reliable and complete data infrastructure; (2) new business structures to support cost sharing; and (3) a retooling of patient expectations. There is insufficient literature reporting the effects of various financial incentive models under implementation in orthopaedics to know whether they increase quality or reduce costs. National concerns about cost will continue to drive experimentation, and all anticipated innovations will require improved collaboration and data collection and reporting.

  7. 75 FR 31118 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and...

    Science.gov (United States)

    2010-06-02

    ... basket index for IPPS hospitals in all areas less 2.0 percentage for hospitals that fail to submit...: Final Fiscal Year 2010 Wage Indices and Payment Rates Implementing the Affordable Care Act AGENCY... final wage indices, hospital reclassifications, payment rates, impacts, and other related tables...

  8. 75 FR 49029 - Medicare Program; End-Stage Renal Disease Prospective Payment System

    Science.gov (United States)

    2010-08-12

    ...-Neutrality Adjustment F. Regression Model Used To Develop Final Payment Adjustment Factors 1. Regression... Railroad Retirement Board RRT Renal replacement therapy SAF Standard analytical file SB Separately billable... standard techniques of multiple regression analysis to yield case-mix adjusted payments per treatment. The...

  9. 75 FR 21329 - Medicaid Program; State Allotments for Payment of Medicare Part B Premiums for Qualifying...

    Science.gov (United States)

    2010-04-23

    ... includes payment for premiums for Medicare Part B. Section 4732 of the Balanced Budget Act of 1997 (BBA... year. Section 1933(c) of the Act limits the total amount of Federal funds available for payment of Part... for expenditures up to the amount of the State's allotment. No Federal funds are available for...

  10. Field Experiments of Family Planning Incentives.

    Science.gov (United States)

    Rogers, Everett M.

    A review of four quasi-experiments on family planning incentives in three Asian nations is presented, and a multi-national comparative field experiment on family planning incentives is proposed. Experiments include: (1) The Ernakulam vasectomy campaigns, (2) Indian Tea Estates retirement bond incentive program, (3) Taiwan educational bond…

  11. Farm Programs: Changes to the Marketing Assistance Loan Program Have Had Little Impact on Payments

    National Research Council Canada - National Science Library

    2001-01-01

    .... Department of Agriculture (USDA). This program was designed originally to provide short-term financing so that farmers could pay their bills right after harvest and spread their sales over the entire marketing year...

  12. 24 CFR 983.352 - Vacancy payment.

    Science.gov (United States)

    2010-04-01

    ... PROJECT-BASED VOUCHER (PBV) PROGRAM Payment to Owner § 983.352 Vacancy payment. (a) Payment for move-out month. If an assisted family moves out of the unit, the owner may keep the housing assistance payment... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Vacancy payment. 983.352 Section...

  13. How effective are biodiversity conservation payments in Mexico?

    Science.gov (United States)

    Costedoat, Sébastien; Corbera, Esteve; Ezzine-de-Blas, Driss; Honey-Rosés, Jordi; Baylis, Kathy; Castillo-Santiago, Miguel Angel

    2015-01-01

    We assess the additional forest cover protected by 13 rural communities located in the southern state of Chiapas, Mexico, as a result of the economic incentives received through the country's national program of payments for biodiversity conservation. We use spatially explicit data at the intra-community level to define a credible counterfactual of conservation outcomes. We use covariate-matching specifications associated with spatially explicit variables and difference-in-difference estimators to determine the treatment effect. We estimate that the additional conservation represents between 12 and 14.7 percent of forest area enrolled in the program in comparison to control areas. Despite this high degree of additionality, we also observe lack of compliance in some plots participating in the PES program. This lack of compliance casts doubt on the ability of payments alone to guarantee long-term additionality in context of high deforestation rates, even with an augmented program budget or extension of participation to communities not yet enrolled.

  14. Impact of an incentive-based mobility program, "Motivated and Moving," on physiologic and quality of life outcomes in a stem cell transplant population.

    Science.gov (United States)

    Brassil, Kelly J; Szewczyk, Nicholas; Fellman, Bryan; Neumann, Joyce; Burgess, Jessica; Urbauer, Diana; LoBiondo-Wood, Geri

    2014-01-01

    Research suggests that patients experience increased fatigue, reduced physical activity, and diminished quality of life (QOL) after hematopoietic stem cell transplantation (HSCT). Structured exercise during hospitalization has been shown to maintain or improve fatigue. Incentive-based interventions have not been tested to encourage physical activity maintenance. The study's aim was to evaluate the effect of participation in an incentive-based mobility program on fatigue, physical conditioning, performance status, and QOL in individuals undergoing allogeneic HSCT. We hypothesized that program participation would affect these variables and that time spent engaged in physical activity would correlate with improved outcomes. A 1-group repeated-measures design used the Brief Fatigue Inventory, 6-minute walk test, and the Functional Assessment of Cancer Therapy-Bone Marrow Transplant Scale to assess study variables. Repeated-measures models assessed the effect of participation time on these variables. Individuals with higher participation (minutes) significantly increased 6-minute walk test scores throughout hospitalization but had no significant changes in Brief Fatigue Inventory and Functional Assessment of Cancer Therapy-Bone Marrow Transplant Scale scores. Fatigue and QOL decreased over hospitalization but improved by discharge. Subjects who demonstrated higher participation averaged fewer hospital days (R = 1.65; P = .005). This study is unique in examining the impact of an incentive-based mobility program, participation in which may decrease length of hospital stay for HSCT patients. Randomized trials are needed to further validate these findings and assess additional variables that can influence outcomes. An incentive-based mobility program during hospitalization for HSCT has the potential to minimize fatigue and stabilize, if not improve, QOL.

  15. Medicare program; prospective payment system and consolidated billing for skilled nursing facilities; correction--HCFA. Correction of interim final rule with comment period.

    Science.gov (United States)

    1998-10-05

    This document corrects technical errors that appeared in the interim final rule with comment period published in the Federal Register on May 12, 1998 entitled "Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities."

  16. 78 FR 48233 - Medicare Program; FY 2014 Hospice Wage Index and Payment Rate Update; Hospice Quality Reporting...

    Science.gov (United States)

    2013-08-07

    ... program. Part 418, subpart G, provides for a per diem payment in one of four prospectively- determined... Disease......... 28,787 4 6 436 CVA/Stroke 26,897 4 7 185 Prostate Cancer 20,262 3 8 783.7 Adult Failure......... 37,667 4 8 436 CVA/Stroke 31,800 3 9 429.9 Heart Disease Unspecified... 22,170 2 10 185 Prostate...

  17. Layoffs as part of an optimal incentive mix:

    DEFF Research Database (Denmark)

    Frederiksen, Anders; Takáts, Elöd

    Firms offer highly complex contracts to their employees. These contracts contain a mix of incentives, such as fixed wages, bonus payments, promotion options, and layoff threats. In general, economists understand how incentives motivate employees but not why a particular mix should be used. In thi...

  18. Perceptions of incentives offered in a community-based malaria diagnosis and treatment program in the Highlands of Papua New Guinea.

    Science.gov (United States)

    Burkot, Camilla; Naidi, Laura; Seehofer, Liesel; Miles, Kevin

    2017-10-01

    What motivates community-based health workers to provide care in rural and remote areas, often on a voluntary or casual basis, is a key question for program managers and public health officials. This paper examines how a range of incentives offered as part of the Marasin Stoa Kipa program, a community-based malaria diagnosis and treatment program that has been implemented since 2007 within a major oil and gas development area in Papua New Guinea, are perceived and critiqued by community-based health workers. Nineteen interviews and seven focus group discussions with the workers who deliver services and members of the communities served by the program, conducted between November 4 and 25, 2015, reveal a pattern of mixed motivations and changes in motivation over time. This can be attributed partly to the unique social and economic circumstances in which the program is operating. Changes in the burden of disease as well as in global and national health services policy with implications for local level program operations also had an impact, as did the nature of relationships between program managers, community-based health workers, and program beneficiaries. Overall, the findings suggest that while financial and in-kind incentives can be a useful tool to motivate voluntary or minimally-compensated community-based health workers, they must be carefully structured to align with local social, economic, and epidemiological realities over the long-term. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Medicare program; prospective payment system and consolidated billing for skilled nursing facilities--update. Health Care Financing Administration (HCFA), HHS. Final rule.

    Science.gov (United States)

    2000-07-31

    This final rule sets forth updates to the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs), for fiscal year 2001. Annual updates to the PPS rates are required by section 1888(e) of the Social Security Act, as amended by the Medicare, Medicaid and State Child Health Insurance Program Balanced Budget Refinement Act of 1999, related to Medicare payments and consolidated billing for SNFs. In addition, this rule sets forth certain conforming revisions to the regulations that are necessary in order to implement amendments made to the Act by section 103 of the Medicare, Medicaid and State Child Health Insurance Program Balanced Budget Refinement Act of 1999.

  20. The Payments for Environmental Services Program in Costa Rica: an Assessment of the Program’s Early Years

    Directory of Open Access Journals (Sweden)

    Carolina Antony Fonseca

    2015-04-01

    Full Text Available Costa Rica’s Payment for Environmental Services Program–PESP was launched in 1997. It is a market-oriented policy instrument designed to stimulate forest conservation by making monetary payments to landowners who choose not to engage in deforestation or to engage in forest recovery or plantations on their properties. This article focuses on the basic concepts and on the early years of the program’s performance, using data published by the program’s management agency as well as data and analysis published in a limited number of the numerous texts that examine this pioneering experience in payments for environmental services. Findings show that in its early years (between 1997 and approximately 2003 the program managed to reverse a severe process of deforestation and even expand the total area of forested lands in Costa Rica. It corrected market failures and created trade opportunities linked to the market of environmental services. It benefitted larger landowners in a more than proportional manner, a fact that precluded it from being simultaneously a poverty alleviation program. The conclusion is that the program, if targeted more precisely at small landowners, can serve as a model for comparable forest protection policies in developing countries, reducing deforestation rates, changing land uses and expanding forest cover, besides mitigating rural poverty.

  1. DietBet: A Web-Based Program that Uses Social Gaming and Financial Incentives to Promote Weight Loss.

    Science.gov (United States)

    Leahey, Tricia; Rosen, Jamie

    2014-02-07

    Web-based commercial weight loss programs are increasing in popularity. Despite their significant public health potential, there is limited research on the effectiveness of such programs. The objective of our study was to examine weight losses produced by DietBet and explore whether baseline and engagement variables predict weight outcomes. DietBet is a social gaming website that uses financial incentives and social influence to promote weight loss. Players bet money and join a game. All players have 4 weeks to lose 4% of their initial body weight. At enrollment, players can choose to share their participation on Facebook. During the game, players interact with one another and report their weight loss on the DietBet platform. At week 4, all players within each game who lose at least 4% of initial body weight are declared winners and split the pool of money bet at the start of the game. Official weigh-in procedures are used to verify weights at the start of the game and at the end. From December 2012 to July 2013, 39,387 players (84.04% female, 33,101/39,387; mean weight 87.8kg, SD 22.6kg) competed in 1934 games. The average amount bet was US $27 (SD US $22). A total of 65.63% (25,849/39,387) provided a verified weight at the end of the 4-week competition. The average intention-to-treat weight loss was 2.6% (SD 2.3%). Winners (n=17,171) won an average of US $59 (SD US $35) and lost 4.9% (SD 1.0%) of initial body weight, with 30.68% (5268/17,171) losing 5% or more of their initial weight. Betting more money at game entry, sharing on Facebook, completing more weigh-ins, and having more social interactions during the game predicted greater weight loss and greater likelihood of winning (Psgames (P<.001), suggesting that players influenced each others' weight outcomes. DietBet, a social gaming website, reached nearly 40,000 individuals in just 7 months and produced excellent 4-week weight loss results. Given its reach and potential public health impact, future research

  2. 76 FR 9283 - Medicaid Program; Payment Adjustment for Provider-Preventable Conditions Including Health Care...

    Science.gov (United States)

    2011-02-17

    ... Options'' tab. 2. By regular mail. You may mail written comments to the following address ONLY: Centers... provide for payment that is consistent with efficiency, economy, and quality of care. With the...

  3. 76 FR 24213 - Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal...

    Science.gov (United States)

    2011-04-29

    ... payments, and updates to the rural, low-income percentage (LIP), and high-cost outlier adjustments... document, we are providing the following table of contents. I. Background A. Historical Overview of the... 24215

  4. 78 FR 61202 - Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing...

    Science.gov (United States)

    2013-10-03

    ... Billing for Skilled Nursing Facilities for FY 2014; Correction AGENCY: Centers for Medicare & Medicaid...; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2014.'' DATES: These...

  5. Incentives for smoking cessation.

    Science.gov (United States)

    Cahill, Kate; Hartmann-Boyce, Jamie; Perera, Rafael

    2015-05-18

    Material or financial incentives are widely used in an attempt to precipitate or reinforce behaviour change, including smoking cessation. They operate in workplaces, in clinics and hospitals, and to a lesser extent within community programmes. In this third update of our review we now include trials conducted in pregnant women, to reflect the increasing activity and resources now targeting this high-risk group of smokers. To determine whether incentives and contingency management programmes lead to higher long-term quit rates. We searched the Cochrane Tobacco Addiction Group Specialised Register, with additional searches of MEDLINE, EMBASE, CINAHL and PsycINFO. The most recent searches were in December 2014, although we also include two trials published in 2015. We considered randomised controlled trials, allocating individuals, workplaces, groups within workplaces, or communities to experimental or control conditions. We also considered controlled studies with baseline and post-intervention measures. We include studies in a mixed-population setting (e.g. community-, work-, institution-based), and also, for this update, trials in pregnant smokers. One author (KC) extracted data and a second (JH-B) checked them. We contacted study authors for additional data where necessary. The main outcome measure in the mixed-population studies was abstinence from smoking at longest follow-up, and at least six months from the start of the intervention. In the trials of pregnant smokers abstinence was measured at the longest follow-up, and at least to the end of the pregnancy. Twenty-one mixed-population studies met our inclusion criteria, covering more than 8400 participants. Ten studies were set in clinics or health centres, one in Thai villages served by community health workers, two in academic institutions, and the rest in worksites. All but six of the trials were run in the USA. The incentives included lottery tickets or prize draws, cash payments, vouchers for goods and

  6. Incentives for students

    DEFF Research Database (Denmark)

    Ostermaier, Andreas

    2018-01-01

    This study examines the effects of certificates and deadlines on student performance. It exploits time lags in reforms of two similar degree programs at a business school, which create quasi-experimental settings. Students’ performance is found to increase if certificates are awarded to them early...... in their program. Deadlines to pass exams prevent them from submitting blank sheets to fail and resit exams. Both effects are stronger among average students compared to high-ability or low-ability students. These findings show that the policies that govern degree programs can create incentives for students...

  7. Incentives and Big E Engagement.

    Science.gov (United States)

    Terry, Paul E

    2017-11-01

    The kind of engagement industrial psychologists have shown can produce optimal performance relates more to a state of mind than to increasing participation in programs or motivating a workforce with financial incentives. In the context of quality improvement methodologies, the health promotion profession has yet to discover when, where and how large financial incentives should be and how they best fit in our processes. That is, there is no "standard work" for the use of extrinsic motivators. Yet, to argue against incentives given evidence to date has more to do with polemics than science.

  8. 7 CFR 784.5 - Payment eligibility.

    Science.gov (United States)

    2010-01-01

    ... SPECIAL PROGRAMS 2004 EWE LAMB REPLACEMENT AND RETENTION PAYMENT PROGRAM § 784.5 Payment eligibility. (a) Payments can be made, as agreed to by FSA and subject to the availability of funds, for eligible ewe lambs... eligible sheep and lamb operations for breeding purposes. Payments may be made for eligible ewe lambs held...

  9. Payments for ecosystem services and rural development: Landowners' preferences and potential participation in western Mexico

    OpenAIRE

    MacMillan, Douglas C.

    2013-01-01

    Incentive-based mechanisms cancontribute to rural development and deliver environmental services, but need to be attractive to landowners and communities to ensure their participation.Here we study the views of landowners and agrarian communities(ejidos)from central Jalisco in Mexico to identify characteristics that payment for environmental services (PES)programs conserving/enhancing forest cover could include in their design. A choice experiment was applied to 161 landowners and ejido-lando...

  10. 78 FR 74825 - Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical...

    Science.gov (United States)

    2013-12-10

    ... Radiosurgery TEP Technical Expert Panel TMS Transcranial Magnetic Stimulation Therapy TOPs Transitional... Determination and Subsequent Years f. Data Submission Requirements for Measure Data Submitted via Web-Based Tool... Online Data Submission Tool a. Background for the CY 2015 Payment Determination and Subsequent Years b...

  11. 78 FR 43533 - Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical...

    Science.gov (United States)

    2013-07-19

    ... Skilled Nursing Facility SRS Stereotactic Radiosurgery TEP Technical Expert Panel TMS Transcranial...-Based Tool for the CY 2016 Payment Determination and Subsequent Years g. Proposed Data Submission... and Subsequent Years 5. Proposed Requirements for Data Submitted Via a CMS Online Data Submission Tool...

  12. 76 FR 34633 - Medicare Program; Proposed Changes to the Hospital Inpatient Prospective Payment Systems for...

    Science.gov (United States)

    2011-06-14

    ..., lines 4 through 12, the sentence ``We are proposing to add one additional structural measure for the FY... proposing to add one additional structural measure for the FY 2014 payment determination, Participation in a... as one of the tables that will be available only through the Internet. The version of Table 2 that...

  13. 76 FR 25787 - Medicare Program; Proposed Changes to the Hospital Inpatient Prospective Payment Systems for...

    Science.gov (United States)

    2011-05-05

    ... Electronic medical record FAH Federation of Hospitals FDA Food and Drug Administration FFY Federal fiscal... Health Care Financing Administration HCO High-cost outlier HCRIS Hospital Cost Report Information System... Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital...

  14. 76 FR 26363 - Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing...

    Science.gov (United States)

    2011-05-06

    ... Productivity Adjustment Into the Market Basket Update D. Federal Rate Update Factor VII. Consolidated Billing... payments entirely on the adjusted Federal per diem rates, we no longer include adjustment factors related... for FY 2012. A more detailed discussion of the SNF market basket index and related issues appears in...

  15. 76 FR 32815 - Medicaid Program; Payment Adjustment for Provider-Preventable Conditions Including Health Care...

    Science.gov (United States)

    2011-06-06

    ... conformity with all Federal requirements. The Federal government pays its share of medical assistance... policies through some other authority like State law or administrative procedures will be required to... collaboratively to develop policies and implement reporting systems that would complement existing payment...

  16. 78 FR 46733 - Medicare Program; Inpatient Psychiatric Facilities Prospective Payment System-Update for Fiscal...

    Science.gov (United States)

    2013-08-01

    ... through an adjustment is commonly known as a behavioral offset. Based on accepted actuarial practices and... this actuarial assumption, which is based on our historical experience with new payment systems, to the... reflect real increases in underlying resource demands, has occurred under the PPS. B. Update of the...

  17. 77 FR 47223 - Medicare Program; Inpatient Psychiatric Facilities Prospective Payment System-Update for Fiscal...

    Science.gov (United States)

    2012-08-07

    ... through an adjustment is commonly known as a behavioral offset. Based on accepted actuarial practices and... this actuarial assumption, which is based on our historical experience with new payment systems, to the... diagnoses, which may not reflect real increases in underlying resource demands, has occurred under the PPS...

  18. 78 FR 61191 - Medicare Program; FY 2014 Inpatient Prospective Payment Systems: Changes to Certain Cost...

    Science.gov (United States)

    2013-10-03

    ... spanning two Federal fiscal years would be the pro rata share of the uncompensated care payment associated with each Federal fiscal year. This pro rata share would be determined based on the proportion of the... hospital's cost report for the cost reporting period beginning on January 1, 2013 against a pro rata share...

  19. 78 FR 45178 - National School Lunch, Special Milk, and School Breakfast Programs, National Average Payments...

    Science.gov (United States)

    2013-07-26

    ... average cost of a half-pint of milk (the total cost of all milk purchased during the claim period divided... schools and residential child care institutions for the period July 1, 2013 through June 30, 2014 reflect... Child Nutrition Act of 1966 (42 U.S.C. 1773) establishes National Average Payment Factors for free...

  20. 78 FR 74229 - Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule, Clinical...

    Science.gov (United States)

    2013-12-10

    ... determination NCQDIS National Coalition of Quality Diagnostic Imaging Services NP Nurse practitioner NPI... Social Security Act (Act) requires us to establish payments under the PFS based on national uniform... resource-based, and the PE and MP RVUs were based on average allowable charges. Section 121 of the Social...

  1. 75 FR 14606 - Medicare Program; Request for Nominations to the Advisory Panel on Ambulatory Payment...

    Science.gov (United States)

    2010-03-26

    ... payment for, drugs and medical devices, as well as other forms of relevant expertise. It is not necessary... September 30, 2010.) E. L. Hambrick, M.D., J.D., Chair, a CMS Medical Officer Ruth L. Bush, M.D., M.P.H... of the following: Geography; rural or urban practice; race, ethnicity, sex, and disability; medical...

  2. Liquidity-saving mechanisms in collateral-based RTGS payment systems

    OpenAIRE

    Jurgilas, Marius; Martin, Antoine

    2010-01-01

    This paper studies banks' incentives for choosing the timing of their payment submissions in a collateral-based real-time gross settlement payment system and the way in which these incentives change with the introduction of a liquidity-saving mechanism (LSM). We show that an LSM allows banks to economize on collateral while also providing incentives to submit payments earlier. The reason is that, in our model, an LSM allows payments to be matched and offset, helping to settle payment cycles i...

  3. Inequalities in institutional delivery uptake and maternal mortality reduction in the context of cash incentive program, Janani Suraksha Yojana: results from nine states in India.

    Science.gov (United States)

    Randive, Bharat; San Sebastian, Miguel; De Costa, Ayesha; Lindholm, Lars

    2014-12-01

    Proportion of women giving birth in health institutions has increased sharply in India since the introduction of cash incentive program, Janani Suraksha Yojana (JSY) in 2005. JSY was intended to benefit disadvantaged population who had poor access to institutional care for childbirth and who bore the brunt of maternal deaths. Increase in institutional deliveries following the implementation of JSY needs to be analysed from an equity perspective. We analysed data from nine Indian states to examine the change in socioeconomic inequality in institutional deliveries five years after the implementation of JSY using the concentration curve and concentration index (CI). The CI was then decomposed in order to understand pathways through which observed inequalities occurred. Disparities in access to emergency obstetric care (EmOC) and in maternal mortality reduction among different socioeconomic groups were also assessed. Slope and relative index of inequality were used to estimate absolute and relative inequalities in maternal mortality ratio (MMR). Results shows that although inequality in access to institutional delivery care persists, it has reduced since the introduction of JSY. Nearly 70% of the present inequality was explained by differences in male literacy, EmOC availability in public facilities and poverty. EmOC in public facilities was grossly unavailable. Compared to richest division in nine states, poorest division has 135 more maternal deaths per 100,000 live births in 2010. While MMR has decreased in all areas since JSY, it has declined four times faster in richest areas compared to the poorest, resulting in increased inequalities. These findings suggest that in order for the cash incentive to succeed in reducing the inequalities in maternal health outcomes, it needs to be supported by the provision of quality health care services including EmOC. Improved targeting of disadvantaged populations for the cash incentive program could be considered. Copyright

  4. Effectiveness of coping strategies used by hospitals in response to implementation of a case-based payment system by the National Health Insurance program.

    Science.gov (United States)

    Huang, Ching Chaw; Chung, Kuo-Piao; Kuo, Nien-Chen; Hung, Chia-Ling

    2005-07-01

    The introduction of the case-based payment system by the Bureau of National Health Insurance resulted in greatly increased pressure on the health care industry in Taiwan. This study examined the relationship between the coping strategies adopted and the results attained by accredited teaching hospitals and non-teaching regional hospitals when responding to this regulatory change. A cross-sectional survey was conducted using a structured questionnaire to assess the hospitals' characteristics, and coping strategies at the technical, managerial and institutional levels in response to the case-based payment system, and to compare these strategies with self-evaluation of the effectiveness of these strategies. The questionnaire was sent in early October 2000 to the superintendents of the 129 hospitals that were accredited at the medical center, regional hospital, and district teaching hospital levels in the year 2000. Factor analysis was applied to group the strategies into categories and stepwise regression analysis was used to explore the relationship between the reported coping strategies adopted and their effectiveness as evaluated by participants. Among the selected hospitals, 89 responded with complete data, a 69% response rate. The following 7 factors were extracted from 30 coping strategies: information and financial analysis; service shifting and unbundling; service integration and quality improvement; service specialization and strengthening; education and training; financial incentives; and claim submission skill. After adjusting for accreditation level or ownership status, 2 main findings were noted. First, hospitals that implemented financial incentives strategies such as holding physicians responsible for all or part of the shortfall between actual claim submissions and actual reimbursements, and reducing or withholding payment to physicians beyond the standard length of stay, tended to increase medical revenue (odds ratio, 1.21). Second, hospitals that

  5. 46 CFR 296.41 - Payment procedures.

    Science.gov (United States)

    2010-10-01

    ... OPERATORS MARITIME SECURITY PROGRAM (MSP) Billing and Payment Procedures § 296.41 Payment procedures. (a... 46 Shipping 8 2010-10-01 2010-10-01 false Payment procedures. 296.41 Section 296.41 Shipping... payment equal to $2,600,000 for FY 2006, FY 2007, FY 2008; $2,900,000 for FY 2009, FY 2010, FY 2011; and...

  6. 46 CFR 295.30 - Payment.

    Science.gov (United States)

    2010-10-01

    ... SECURITY PROGRAM (MSP) Payment and Billing Procedures § 295.30 Payment. (a) Amount payable. A MSP Operating... 46 Shipping 8 2010-10-01 2010-10-01 false Payment. 295.30 Section 295.30 Shipping MARITIME... effect, for each Agreement Vessel, an annual payment of $2,100,000 for each fiscal year. This amount...

  7. Effects of payments for ecosystem services on wildlife habitat recovery.

    Science.gov (United States)

    Tuanmu, Mao-Ning; Viña, Andrés; Yang, Wu; Chen, Xiaodong; Shortridge, Ashton M; Liu, Jianguo

    2016-08-01

    Conflicts between local people's livelihoods and conservation have led to many unsuccessful conservation efforts and have stimulated debates on policies that might simultaneously promote sustainable management of protected areas and improve the living conditions of local people. Many government-sponsored payments-for-ecosystem-services (PES) schemes have been implemented around the world. However, few empirical assessments of their effectiveness have been conducted, and even fewer assessments have directly measured their effects on ecosystem services. We conducted an empirical and spatially explicit assessment of the conservation effectiveness of one of the world's largest PES programs through the use of a long-term empirical data set, a satellite-based habitat model, and spatial autoregressive analyses on direct measures of change in an ecosystem service (i.e., the provision of wildlife species habitat). Giant panda (Ailuropoda melanoleuca) habitat improved in Wolong Nature Reserve of China after the implementation of the Natural Forest Conservation Program. The improvement was more pronounced in areas monitored by local residents than those monitored by the local government, but only when a higher payment was provided. Our results suggest that the effectiveness of a PES program depends on who receives the payment and on whether the payment provides sufficient incentives. As engagement of local residents has not been incorporated in many conservation strategies elsewhere in China or around the world, our results also suggest that using an incentive-based strategy as a complement to command-and-control, community- and norm-based strategies may help achieve greater conservation effectiveness and provide a potential solution for the park versus people conflict. © 2016 Society for Conservation Biology.

  8. The payment for environmental services (pes programs addressed to agroecology: the emergency of european experience and the absence of mechanisms in brazil.

    Directory of Open Access Journals (Sweden)

    Felipe Franz Wienke

    2016-12-01

    Full Text Available The Brazilian agricultural production is characterized by the adoption of unsustainable practices. The lack of political-legal instruments capable to promote a change in the productive bases is noticeable. The experiences of Payment for Environmental Services (PES programs have reached repercussions on environmental law, presenting a significant potential for an agroecological transition. The Common Agricultural Policy (CAP provides subsidies for the formulation of a Payment for Environmental Services (PES program to promote the agroecological transition in the Brazilian context, an objective already consolidated in the scope of public policies, but with still modest results.

  9. Assessing the effects of regional payment for watershed services program on water quality using an intervention analysis model.

    Science.gov (United States)

    Lu, Yan; He, Tian

    2014-09-15

    Much attention has been recently paid to ex-post assessments of socioeconomic and environmental benefits of payment for ecosystem services (PES) programs on poverty reduction, water quality, and forest protection. To evaluate the effects of a regional PES program on water quality, we selected chemical oxygen demand (COD) and ammonia-nitrogen (NH3-N) as indicators of water quality. Statistical methods and an intervention analysis model were employed to assess whether the PES program produced substantial changes in water quality at 10 water-quality sampling stations in the Shaying River watershed, China during 2006-2011. Statistical results from paired-sample t-tests and box plots of COD and NH3-N concentrations at the 10 stations showed that the PES program has played a positive role in improving water quality and reducing trans-boundary water pollution in the Shaying River watershed. Using the intervention analysis model, we quantitatively evaluated the effects of the intervention policy, i.e., the watershed PES program, on water quality at the 10 stations. The results suggest that this method could be used to assess the environmental benefits of watershed or water-related PES programs, such as improvements in water quality, seasonal flow regulation, erosion and sedimentation, and aquatic habitat. Copyright © 2014 Elsevier B.V. All rights reserved.

  10. 48 CFR 252.232-7005 - Reimbursement of subcontractor advance payments-DoD pilot mentor-protege program.

    Science.gov (United States)

    2010-10-01

    ... sole financial responsibility of the Contractor. (b) For a fixed price type contract, advance payments..., reimbursement of advance payments shall be made via public voucher. The Contractor shall show the amounts of advance payments made to each protege on the public voucher, in the form and detail directed by the...

  11. 75 FR 41793 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2010-07-19

    ... Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations of Day Care Homes for the Period July 1, 2010 Through June 30, 2011... payment rates for meals and snacks served in day care homes; and the administrative reimbursement rates...

  12. 76 FR 43254 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2011-07-20

    ... Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations of Day Care Homes for the Period July 1, 2011 Through June 30, 2012... payment rates for meals and snacks served in day care homes; and the administrative reimbursement rates...

  13. 78 FR 45176 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2013-07-26

    ... Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations of Day Care Homes for the Period July 1, 2013 Through June 30, 2014... payment rates for meals and snacks served in day care homes; and the administrative reimbursement rates...

  14. 76 FR 10600 - Medicare Program; Public Meeting in Calendar Year 2011 for New Clinical Laboratory Tests Payment...

    Science.gov (United States)

    2011-02-25

    ... payment determinations for new clinical diagnostic laboratory tests under Part B of title XVIII of the... amount of, payment for any clinical diagnostic laboratory tests with respect to which a new or... Year 2011 for New Clinical Laboratory Tests Payment Determinations AGENCY: Centers for Medicare...

  15. The Effects of Incentives on Reading.

    Science.gov (United States)

    McQuillan, Jeff

    1997-01-01

    States that reading incentives have not been critically examined as to their effectiveness in promoting positive attitudes toward reading, more frequent reading, or increased proficiency. Examines available evidence on the effect of reading incentives in school and library programs for students. Concludes there is no clear causal relationship…

  16. 75 FR 57907 - Teacher Incentive Fund

    Science.gov (United States)

    2010-09-23

    ... 1810-AB08 Teacher Incentive Fund ACTION: Interim final requirements; request for comments. SUMMARY: The Secretary of Education (Secretary) amends the final requirements for the Teacher Incentive Fund program to authorize the Department to select more than sixteen high-need schools per local educational agency (LEA...

  17. Payment - State

    Data.gov (United States)

    U.S. Department of Health & Human Services — Payment measures – state data. This data set includes state-level data for the payment measures associated with an episode of care for heart attack, heart failure,...

  18. Payment - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — Payment measures – national data. This data set includes national-level data for the payment measures associated with an episode of care for heart attack, heart...

  19. Payment - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — Payment measures – national data. This data set includes national-level data for the payment measures associated with an episode of care for heart attack, heart...

  20. Payment - State

    Data.gov (United States)

    U.S. Department of Health & Human Services — Payment measures – state data. This data set includes state-level data for the payment measures associated with an episode of care for heart attack, heart failure,...

  1. 42 CFR 447.55 - Standard co-payment.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Standard co-payment. 447.55 Section 447.55 Public...) MEDICAL ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payments: General Provisions Deductible, Coinsurance, Co-Payment Or Similar Cost-Sharing Charge § 447.55 Standard co-payment. (a) The plan may provide for a...

  2. 42 CFR 447.57 - Restrictions on payments to providers.

    Science.gov (United States)

    2010-10-01

    ... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payments: General Provisions Deductible, Coinsurance, Co-Payment Or Similar Cost-Sharing Charge § 447.57 Restrictions on payments to... 42 Public Health 4 2010-10-01 2010-10-01 false Restrictions on payments to providers. 447.57...

  3. The push to increase the use of EHR technology by hospitals and physicians in the United States through the HITECH Act and the Medicare incentive program.

    Science.gov (United States)

    Pipersburgh, Jessica

    2011-01-01

    This article reviews key health care spending and electronic health records (EHR) statistics in the United States (Section II); highlights positive and negative aspects of EHR technology (Sections III and IV); briefly reviews the passage of the Health Information Technology for Economic and Clinical Health Act (HITECH) (Section V); discusses the rule passed by the Office of the National Coordinator for Health Information Technology (ONCHIT) and to implement the goals of HITECH (Section VI); discusses the rule passed by the Centers for Medicare & Medicaid Services (CMS) to implement the goals of HITECH and focuses on significant requirements of the Medicare incentive program rule as it applies to hospitals and physicians (Section VII); and finally, concludes by highlighting certain issues that have been raised regarding the goals of HITECH (Section VIII).

  4. 20 CFR 411.580 - Can an EN receive payments for milestones or outcome payment months that occur before the...

    Science.gov (United States)

    2010-04-01

    ....580 Employees' Benefits SOCIAL SECURITY ADMINISTRATION THE TICKET TO WORK AND SELF-SUFFICIENCY PROGRAM Employment Network Payment Systems § 411.580 Can an EN receive payments for milestones or outcome payment...

  5. A Supermarket Double-Dollar Incentive Program Increases Purchases of Fresh Fruits and Vegetables Among Low-Income Families With Children: The Healthy Double Study.

    Science.gov (United States)

    Polacsek, Michele; Moran, Alyssa; Thorndike, Anne N; Boulos, Rebecca; Franckle, Rebecca L; Greene, Julie C; Blue, Dan J; Block, Jason P; Rimm, Eric B

    2018-03-01

    To carry out a pilot study to determine whether a supermarket double-dollar fruit and vegetable (F&V) incentive increases F&V purchases among low-income families. Randomized controlled design. Purchases were tracked using a loyalty card that provided participants with a 5% discount on all purchases during a 3-month baseline period followed by the 4-month intervention. A supermarket in a low-income rural Maine community. A total of 401 low-income and Supplemental Nutrition Assistance Program (SNAP) supermarket customers. Same-day coupon at checkout for half-off eligible fresh, frozen, or canned F&V over 4 months. Weekly spending in dollars on eligible F&V. A linear model with random intercepts accounted for repeated transactions by individuals to estimate change in F&V spending per week from baseline to intervention. Secondary analyses examined changes among SNAP-eligible participants. Coupons were redeemed among 53% of eligible baskets. Total weekly F&V spending increased in the intervention arm compared with control ($1.83; 95% confidence interval [CI], $0.29 to $3.88). The largest increase was for fresh F&V ($1.97; 95% CI, $0.49 to $3.44). Secondary analyses revealed greater increases in F&V spending among SNAP-eligible participants who redeemed coupons ($5.14; 95% CI, $1.93 to $8.34) than among non-SNAP eligible participants who redeemed coupons ($3.88; 95% CI, $1.67 to $6.08). A double-dollar pricing incentive increased F&V spending in a low-income community despite the moderate uptake of the coupon redemption. Customers who were eligible for SNAP saw the greatest F&V spending increases. Financial incentives for F&V are an effective strategy for food assistance programs to increase healthy purchases and improve dietary intake in low-income families. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  6. 20 CFR 411.525 - What payments are available under each of the EN payment systems?

    Science.gov (United States)

    2010-04-01

    ... EN payment systems? 411.525 Section 411.525 Employees' Benefits SOCIAL SECURITY ADMINISTRATION THE TICKET TO WORK AND SELF-SUFFICIENCY PROGRAM Employment Network Payment Systems § 411.525 What payments... beneficiary. For each month during the beneficiary's outcome payment period for which Social Security...

  7. Using Incentives to Change How Teenagers Spend Their Time: The Effects of New York City's Conditional Cash Transfer Program

    Science.gov (United States)

    Morris, Pamela; Aber, J. Lawrence; Wolf, Sharon; Berg, Juliette

    2012-01-01

    This report presents the results of an innovative study designed to provide a more detailed understanding of how parents and their teenage children were affected by the Opportunity NYC-Family Rewards program, a comprehensive conditional cash transfer program. The three-year program, launched by the Center for Economic Opportunity in the Mayor's…

  8. Fee-for-service will remain a feature of major payment reforms, requiring more changes in Medicare physician payment.

    Science.gov (United States)

    Ginsburg, Paul B

    2012-09-01

    Many health policy analysts envision provider payment reforms currently under development as replacements for the traditional fee-for-service payment system. Reforms include per episode bundled payment and elements of capitation, such as global payments or accountable care organizations. But even if these approaches succeed and are widely adopted, the core method of payment to many physicians for the services they provide is likely to remain fee-for-service. It is therefore critical to address the current shortcomings in the Medicare physician fee schedule, because it will affect physician incentives and will continue to play an important role in determining the payment amounts under payment reform. This article reviews how the current payment system developed and is applied, and it highlights areas that require careful review and modification to ensure the success of broader payment reform.

  9. Development and Feasibility of Bundled Payments for the Multidisciplinary Treatment of Head and Neck Cancer: A Pilot Program.

    Science.gov (United States)

    Spinks, Tracy; Guzman, Alexis; Beadle, Beth M; Lee, Seohyun; Jones, Delrose; Walters, Ron; Incalcaterra, Jim; Hanna, Ehab; Hessel, Amy; Weber, Randal; Denney, Sandra; Newcomer, Lee; Feeley, Thomas W

    2018-02-01

    Despite growing interest in bundled payments to reduce the costs of care, this payment method remains largely untested in cancer. This 3-year pilot tested the feasibility of a 1-year bundled payment for the multidisciplinary treatment of head and neck cancers. Four prospective treatment-based bundles were developed for patients with selected head and neck cancers. These risk-adjusted bundles covered 1 year of care that began with primary cancer treatment. Manual processes were developed for patient identification, enrollment, billing, and payment. Patients were prospectively identified and enrolled, and bundled payments were made at treatment start. Operational metrics tracked incremental effort for pilot processes and average payment cycle time compared with fee-for-service (FFS) payments. This pilot confirmed the feasibility of a 1-year prospective bundled payment for head and neck cancers. Between November 2014 and October 2016, 88 patients were enrolled successfully with prospective bundled payments. Through September 2017, 94% of patients completed the pilot with 6% still enrolled. Manual pilot processes required more effort than anticipated; claims processing was the most time-consuming activity. The production of a bundle bill took an additional 15 minutes versus FFS billing. The average payment cycle time was 37 days (range, 15 to 141 days) compared with a 15-day average under FFS. Prospective bundled payments were successfully implemented in this pilot. Additional pilots should study this payment method in higher-volume cancers. Robust systems are needed to automate patient identification, enrollment, billing, and payment along with policies that reduce administrative burden and allow for the introduction of novel cancer therapies.

  10. Medicare program; prospective payment system and consolidated billing for skilled nursing facilities for FY 2009. Final rule.

    Science.gov (United States)

    2008-08-08

    This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs), for fiscal year (FY) 2009. It also discusses our ongoing analysis of nursing home staff time measurement data collected in the Staff Time and Resource Intensity Verification (STRIVE) project. Finally, this final rule makes technical corrections in the regulations text with respect to Medicare bad debt payments to SNFs and the reference to the definition of urban and rural as applied to SNFs.

  11. Behavioral Therapy, Incentives Enhance Addiction Treatment

    Science.gov (United States)

    ... that people who are trying to end their addiction to marijuana can benefit from a treatment program that combines motivational incentives with cognitive-behavioral therapy. "Marijuana remains one of the most widely used ...

  12. Commercialization of biomass energy projects: Outline for maximizing use of valuable tax credits and incentives

    International Nuclear Information System (INIS)

    Sanderson, G.A.

    1994-01-01

    The Federal Government offers a number of incentives designed specifically to promote biomass energy. These incentives include various tax credits, deductions and exemptions, as well as direct subsidy payments and grants. Additionally, equipment manufacturers and project developers may find several other tax provisions useful, including tax incentives for exporting U.S. good and engineering services, as well as incentives for the development of new technologies. This paper outlines the available incentives, and also addresses ways to coordinate the use of tax breaks with government grants and tax-free bond financing in order to maximize benefits for biomass energy projects

  13. 76 FR 37121 - Medicare Program; Second Semi-Annual Meeting of the Advisory Panel on Ambulatory Payment...

    Science.gov (United States)

    2011-06-24

    ... state their relationship to the organization that they are representing in the presentation. Note... OPPS conversion factor, charge compression, revisions to the cost report, pass-through payments...

  14. 78 FR 47859 - Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal...

    Science.gov (United States)

    2013-08-06

    ... 95 CMGs using rehabilitation impairment categories (RICs), functional status (both motor and.... Generally, the software product includes patient classification programming called the GROUPER software. The... MAC processes the claim through its software system. This software system includes pricing programming...

  15. Perceptions, Knowledge, Incentives, and Barriers of Brain Donation among African American Elders Enrolled in an Alzheimer's Research Program

    Science.gov (United States)

    Lambe, Susan; Cantwell, Nicole; Islam, Fareesa; Horvath, Kathy; Jefferson, Angela L.

    2011-01-01

    Purpose: To learn about African American older adults' knowledge and perceptions of brain donation, factors that relate to participating or not participating in a brain donation research program, and methods to increase African American brain donation commitment rates in the context of an Alzheimer's disease (AD) research program. Design and…

  16. Medicare program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system and Fiscal Year 2014 rates; quality reporting requirements for specific providers; hospital conditions of participation; payment policies related to patient status. Final rules.

    Science.gov (United States)

    2013-08-19

    We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems. Some of the changes implement certain statutory provisions contained in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act) and other legislation. These changes will be applicable to discharges occurring on or after October 1, 2013, unless otherwise specified in this final rule. We also are updating the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. The updated rate-of-increase limits will be effective for cost reporting periods beginning on or after October 1, 2013. We also are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) and implementing certain statutory changes that were applied to the LTCH PPS by the Affordable Care Act. Generally, these updates and statutory changes will be applicable to discharges occurring on or after October 1, 2013, unless otherwise specified in this final rule. In addition, we are making a number of changes relating to direct graduate medical education (GME) and indirect medical education (IME) payments. We are establishing new requirements or have revised requirements for quality reporting by specific providers (acute care hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric facilities (IPFs)) that are participating in Medicare. We are updating policies relating to the Hospital Value-Based Purchasing (VBP) Program and the Hospital Readmissions Reduction Program. In addition, we are revising the conditions of participation (CoPs) for hospitals relating to the

  17. 78 FR 12245 - Supplemental Nutrition Assistance Program: Suspension of SNAP Benefit Payments to Retailers

    Science.gov (United States)

    2013-02-22

    ... ongoing basis regarding program implementation and policy issues. This arrangement allows State agencies... support Departmental efforts to enhance retailer integrity. Nature of Concerns and the Need To Issue This... Supplemental Nutrition Assistance Program (SNAP) is the largest program in the domestic hunger safety net. SNAP...

  18. Payment Error Rate Measurement (PERM)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The PERM program measures improper payments in Medicaid and CHIP and produces error rates for each program. The error rates are based on reviews of the...

  19. 41 CFR 302-14.1 - What is a “homesale program'?

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false What is a âhomesale program'? 302-14.1 Section 302-14.1 Public Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES RESIDENCE TRANSACTION ALLOWANCES 14-HOME MARKETING INCENTIVE PAYMENTS...

  20. Salary administration as part of employee incentive system at industrial enterprises

    Directory of Open Access Journals (Sweden)

    Sagandykov Michail

    2017-01-01

    Full Text Available The article analyses the financial staff incentives at industrial enterprises. The paper concludes that the incentive system should be developed taking into account the developed staff motivation. The only efficient target of influence is the existing staff motivation components. A 3-element employee incentive framework for industrial enterprises is suggested. The article presents the critical analysis of the existing payroll systems of several industrial enterprises, elicits the common flaws of the incentive payments, and develops requirements for such systems. The paper also provides an industrial enterprise needs matrix and an incentive payment types matrix required to build up a rational monetary staff incentive system. These matrices can be adapted for any industrial enterprise with regard to its long-term objectives.

  1. Do Financial Incentives Increase the Use of Electronic Health Records? Findings from an Experiment

    OpenAIRE

    Lorenzo Moreno; Suzanne Felt-Lisk; Stacy Dale

    2013-01-01

    This working paper reviews impacts of the Electronic Health Records Demonstration implemented by the Centers for Medicare & Medicaid Services, finding that moderate incentive payments did not lead to universal electronic health record (EHR) adoption and use in a two-year time frame. However, the demonstration showed that incentives can influence physician use of EHRs.

  2. Participation in fitness-related activities of an incentive-based health promotion program and hospital costs: a retrospective longitudinal study.

    Science.gov (United States)

    Patel, Deepak; Lambert, Estelle V; da Silva, Roseanne; Greyling, Mike; Kolbe-Alexander, Tracy; Noach, Adam; Conradie, Jaco; Nossel, Craig; Borresen, Jill; Gaziano, Thomas

    2011-01-01

    A retrospective, longitudinal study examined changes in participation in fitness-related activities and hospital claims over 5 years amongst members of an incentivized health promotion program offered by a private health insurer. A 3-year retrospective observational analysis measuring gym visits and participation in documented fitness-related activities, probability of hospital admission, and associated costs of admission. A South African private health plan, Discovery Health and the Vitality health promotion program. 304,054 adult members of the Discovery medical plan, 192,467 of whom registered for the health promotion program and 111,587 members who were not on the program. Members were incentivised for fitness-related activities on the basis of the frequency of gym visits. Changes in electronically documented gym visits and registered participation in fitness-related activities over 3 years and measures of association between changes in participation (years 1-3) and subsequent probability and costs of hospital admission (years 4-5). Hospital admissions and associated costs are based on claims extracted from the health insurer database. The probability of a claim modeled by using linear logistic regression and costs of claims examined by using general linear models. Propensity scores were estimated and included age, gender, registration for chronic disease benefits, plan type, and the presence of a claim during the transition period, and these were used as covariates in the final model. There was a significant decrease in the prevalence of inactive members (76% to 68%) over 5 years. Members who remained highly active (years 1-3) had a lower probability (p gym visits per week (odds ratio, .87; 95% confidence interval [CI], .801-.949). We observed an increase in fitness-related activities over time amongst members of this incentive-based health promotion program, which was associated with a lower probability of hospital admission and lower hospital costs in the

  3. Payment Platform

    DEFF Research Database (Denmark)

    Hjelholt, Morten; Damsgaard, Jan

    2012-01-01

    Payment transactions through the use of physical coins, bank notes or credit cards have for centuries been the standard formats of exchanging money. Recently online and mobile digital payment platforms has entered the stage as contenders to this position and possibly could penetrate societies...... applies a co-evolutionary multilevel perspective to model the interplay and processes between technology and society wherein digital payment platforms potentially will substitute other payment platforms just like the credit card negated the check. On this basis this paper formulate a multilevel conceptual...... framework and shows, through examples of new digital payment platforms, how transitions and substitutions might occur. Finally we discuss how possible venues and routes of transitions appear in the genesis and evolution of digital payment platforms....

  4. How Financial and Reputational Incentives Can Be Used to Improve Medical Care.

    Science.gov (United States)

    Roland, Martin; Dudley, R Adams

    2015-12-01

    Narrative review of the impact of pay-for-performance (P4P) and public reporting (PR) on health care outcomes, including spillover effects and impact on disparities. The impact of P4P and PR is dependent on the underlying payment system (fee-for-service, salary, capitation) into which these schemes are introduced. Both have the potential to improve care, but they can also have substantial unintended consequences. Evidence from the behavioral economics literature suggests that individual physicians will vary in how they respond to incentives. We also discuss issues to be considered when including patient-reported outcome measures (PROMs) or patient-reported experience measures into P4P and PR schemes. We provide guidance to payers and policy makers on the design of P4P and PR programs so as to maximize their benefits and minimize their unintended consequences. These include involving clinicians in the design of the program, taking into account the payment system into which new incentives are introduced, designing the structure of reward programs to maximize the likelihood of intended outcomes and minimize the likelihood of unintended consequences, designing schemes that minimize the risk of increasing disparities, providing stability of incentives over some years, and including outcomes that are relevant to patients' priorities. In addition, because of the limitations of PR and P4P as effective interventions in their own right, it is important that they are combined with other policies and interventions intended to improve quality to maximize their likely impact. © Health Research and Educational Trust.

  5. The European platform for financial education as incentive for the national efforts in implementing financial literacy programs: The case of the Association of Serbian Banks

    Directory of Open Access Journals (Sweden)

    Sredojević Slađana

    2017-01-01

    Full Text Available A sustainable financial system relies on two pillars: the functional and healthy financial institutions, as well as the financially competent customers-investors-entrepreneurs. The responsibility for the implementation of training programs and preparation for the well-informed choice does not lie only with the natural persons and legal entities. This is a shared responsibility of different stakeholders: individuals, families, small and medium enterprises, public administration, the Ministry of Education, the financial services sector, employers and representatives of trade unions and consumer protection organizations as well as other civil society initiatives. A prime example of such an integrated approach towards the same goal is the European Platform for Financial Education, an initiative launched by the European Banking Federation, the European Banking Training Network and other institutions (professional associations, in February 2017 in Brussels as an incentive for the national level efforts in implementing the respective financial literacy programs. In this paper we analyzed the importance and role of the European Platform for Financial Education in the case of the Serbian banking sector through the activities of the Association of Serbian Banks. These activities will be implemented by the Association of Banks of Serbia continuously throughout the year, and after the celebration of the European Money Week on 27-31 March 2017.

  6. Family forest stewardship: do owners need a financial incentive?

    Science.gov (United States)

    Michael A. Kilgore; Stephanie Snyder; Steven Taff; Joseph Schertz

    2008-01-01

    This study assessed family forest owner interest in formally committing to the types of land use and management practices that characterize good stewardship if compensated for doing so, using Minnesota's Sustainable Forest Incentives Act (SFIA) as a proxy measure of forest stewardship. The SFIA provides an annual payment in return for obtaining and using a forest...

  7. 77 FR 70447 - Medicare Program; Semi-Annual Meeting of the Advisory Panel on Hospital Outpatient Payment (HOP...

    Science.gov (United States)

    2012-11-26

    ... limited to, the conversion factor, charge compression, revisions to the cost report, pass-through payments... relationship to the organization that they represent must also be clearly listed. [cir] The form is now... compression, revisions to the cost report, pass-through payments, correct coding, new technology applications...

  8. 77 FR 60315 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2012-10-03

    ... grammatical error in our discussion of the Agency for Healthcare Research and Quality (AHRQ) indicators. On... Hospital Quality Reporting Program (PCHQR), we made a grammatical error. On page 53601, in the table... requirements for the LTCH Quality Reporting Program, we made a grammatical error in our response to a comment...

  9. 77 FR 44618 - Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal...

    Science.gov (United States)

    2012-07-30

    ... 95 CMGs using rehabilitation impairment categories (RICs), functional status (both motor and... classification programming called the GROUPER software. The GROUPER software uses specific IRF-PAI data elements... processes the claim through its software system. This software system includes pricing programming called...

  10. 75 FR 10645 - Low Pathogenic Avian Influenza; Voluntary Control Program and Payment of Indemnity

    Science.gov (United States)

    2010-03-09

    ... breeding flocks, hatcheries, and dealers must first qualify as ``U.S. Pullorum-Typhoid Clean'' as a condition for participating in the other Plan programs. The Plan identifies States, flocks, hatcheries... chickens, and meat-type turkeys. The provisions of this program were established in a new part 146. The...

  11. Is it all about the money? A qualitative exploration of the effects of performance-based financial incentives on Zimbabwe's voluntary male medical circumcision program.

    Directory of Open Access Journals (Sweden)

    Caryl Feldacker

    Full Text Available In 2013, Zimbabwe's voluntary medical male circumcision (VMMC program adopted performance-based financing (PBF to speed progress towards ambitious VMMC targets. The $25 USD PBF intended to encourage low-paid healthcare workers to remain in the public sector and to strengthen the public healthcare system. The majority of the incentive supports healthcare workers (HCWs who perform VMMC alongside other routine services; a small portion supports province, district, and facility levels.This qualitative study assessed the effect of the PBF on HCW motivation, satisfaction, and professional relationships. The study objectives were to: 1 Gain understanding of the advantages and disadvantages of PBF at the HCW level; 2 Gain understanding of the advantages and disadvantages of PBF at the site level; and 3 Inform scale up, modification, or discontinuation of PBF for the national VMMC program. Sixteen focus groups were conducted: eight with HCWs who received PBF for VMMC and eight with HCWs in the same clinics who did not work in VMMC and, therefore, did not receive PBF. Fourteen key informant interviews ascertained administrator opinion.Findings suggest that PBF appreciably increased motivation among VMMC teams and helped improve facilities where VMMC services are provided. However, PBF appears to contribute to antagonism at the workplace, creating divisiveness that may reach beyond VMMC. PBF may also cause distortion in the healthcare system: HCWs prioritized incentivized VMMC services over other routine duties. To reduce workplace tension and improve the VMMC program, participants suggested increasing HCW training in VMMC to expand PBF beneficiaries and strengthening integration of VMMC services into routine care.In the low-resource, short-staffed context of Zimbabwe, PBF enabled rapid VMMC scale up and achievement of ambitious targets; however, side effects make PBF less advantageous and sustainable than envisioned. Careful consideration is warranted in

  12. Is it all about the money? A qualitative exploration of the effects of performance-based financial incentives on Zimbabwe's voluntary male medical circumcision program.

    Science.gov (United States)

    Feldacker, Caryl; Bochner, Aaron F; Herman-Roloff, Amy; Holec, Marrianne; Murenje, Vernon; Stepaniak, Abby; Xaba, Sinokuthemba; Tshimanga, Mufata; Chitimbire, Vuyelwa; Makaure, Shingirai; Hove, Joseph; Barnhart, Scott; Makunike, Batsirai

    2017-01-01

    In 2013, Zimbabwe's voluntary medical male circumcision (VMMC) program adopted performance-based financing (PBF) to speed progress towards ambitious VMMC targets. The $25 USD PBF intended to encourage low-paid healthcare workers to remain in the public sector and to strengthen the public healthcare system. The majority of the incentive supports healthcare workers (HCWs) who perform VMMC alongside other routine services; a small portion supports province, district, and facility levels. This qualitative study assessed the effect of the PBF on HCW motivation, satisfaction, and professional relationships. The study objectives were to: 1) Gain understanding of the advantages and disadvantages of PBF at the HCW level; 2) Gain understanding of the advantages and disadvantages of PBF at the site level; and 3) Inform scale up, modification, or discontinuation of PBF for the national VMMC program. Sixteen focus groups were conducted: eight with HCWs who received PBF for VMMC and eight with HCWs in the same clinics who did not work in VMMC and, therefore, did not receive PBF. Fourteen key informant interviews ascertained administrator opinion. Findings suggest that PBF appreciably increased motivation among VMMC teams and helped improve facilities where VMMC services are provided. However, PBF appears to contribute to antagonism at the workplace, creating divisiveness that may reach beyond VMMC. PBF may also cause distortion in the healthcare system: HCWs prioritized incentivized VMMC services over other routine duties. To reduce workplace tension and improve the VMMC program, participants suggested increasing HCW training in VMMC to expand PBF beneficiaries and strengthening integration of VMMC services into routine care. In the low-resource, short-staffed context of Zimbabwe, PBF enabled rapid VMMC scale up and achievement of ambitious targets; however, side effects make PBF less advantageous and sustainable than envisioned. Careful consideration is warranted in choosing

  13. Medicare program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system and fiscal year 2013 rates; hospitals' resident caps for graduate medical education payment purposes; quality reporting requirements for specific providers and for ambulatory surgical centers. final rule.

    Science.gov (United States)

    2012-08-31

    We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems. Some of the changes implement certain statutory provisions contained in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act) and other legislation. These changes will be applicable to discharges occurring on or after October 1, 2012, unless otherwise specified in this final rule. We also are updating the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. The updated rate-of-increase limits will be effective for cost reporting periods beginning on or after October 1, 2012. We are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) and implementing certain statutory changes made by the Affordable Care Act. Generally, these changes will be applicable to discharges occurring on or after October 1, 2012, unless otherwise specified in this final rule. In addition, we are implementing changes relating to determining a hospital's full-time equivalent (FTE) resident cap for the purpose of graduate medical education (GME) and indirect medical education (IME) payments. We are establishing new requirements or revised requirements for quality reporting by specific providers (acute care hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric facilities (IPFs)) that are participating in Medicare. We also are establishing new administrative, data completeness, and extraordinary circumstance waivers or extension requests requirements, as well as a reconsideration process, for quality reporting by ambulatory surgical centers

  14. Aligning Ambition and Incentives

    DEFF Research Database (Denmark)

    Koch, Alexander; Peyrache, Eloïc

    Labor turnover creates longer term career concerns incentives that motivate employees in addition to the short term monetary incentives provided by the current employer. We analyze how these incentives interact and derive implications for the design of incentive contracts and organizational choice....... The main insights stem from a trade-off between ‘good monetary incentives' and ‘good reputational incentives'. We show that the principal optimally designs contracts to create ambiguity about agents' abilities. This may make it optimal to contract on relative performance measures, even though the extant...... rationales for such schemes are absent. Linking the structure of contracts to organizational design, we show that it can be optimal for the principal to adopt an opaque organization where performance is not verifiable, despite the constraints that this imposes on contracts....

  15. Canadian incentives for oil and gas exploration. [Applicability to USA

    Energy Technology Data Exchange (ETDEWEB)

    1980-04-01

    During the 1970s a number of different exploration and production incentive programs were put in place in Canada, in particular in the Province of Alberta, Canada's principal oil- and gas-producing province. The DOE/RA is evaluating Canadian incentives for oil and gas exploration, and this study is intended to provide information that will help guide DOE/RA in determining the applicability of Canadian incentive programs in US energy policy. The study describes and documents the fiscal structure in which the Canadian oil industry operates. The incentive features of pricing policy, taxation policy, and provincial royalty systems are discussed. A principal focus of the study is on one of the most important of Canada's specific incentive programs, the Alberta Exploratory Drilling Incentive Credit Program (EDICP). The study describes and evaluates the effect of the EDICP on increased oil and gas exploration activity. Similarly, the study also reviews and evaluates other specific incentive programs such as the Alberta Geophysical Incentive Program, Frontier Exploration Allowances, and various tar sand and heavy oil development incentives. Finally the study evaluates the applicability of Canadian incentives to US energy policy.

  16. Innovation in Workforce Incentives

    Science.gov (United States)

    2015-05-13

    against incentives • Gerald Ledford and Barry Gerhart in “Negative Effects of Extrinsic Rewards and Intrinsic Motivation : More Smoke Than Fire” argue...undermine intrinsic motivation making the incentive effect much more powerful than if it relies on extrinsic motivation alone Proposed Approach...with opportunities to innovate that can enhance intrinsic motivation • A notional approach for incentives that are tied to the achievement of cost

  17. Delegation and incentives

    OpenAIRE

    Bester, Helmut; Krähmer, Daniel

    2006-01-01

    This paper analyses the relation between authority and incentives. It extends the standard principal--agent model by a project selection stage in which the principal can either delegate the choice of project to the agent or keep the authority. The agent's subsequent choice of effort depends both on monetary incentives and the selected project. We find that the consideration of effort incentives makes the principal less likely to delegate the authority over projects to the agent. In fact, if t...

  18. Using the lessons of behavioral economics to design more effective pay-for-performance programs.

    Science.gov (United States)

    Mehrotra, Ateev; Sorbero, Melony E S; Damberg, Cheryl L

    2010-07-01

    To describe improvements in the design of pay-for-performance (P4P) programs that reflect the psychology of how people respond to incentives. Investigation of the behavioral economics literature. We describe 7 ways to improve P4P program design in terms of frequency and types of incentive payments. After discussing why P4P incentives can have unintended adverse consequences, we outline potential ways to mitigate these. Although P4P incentives are increasingly popular, the healthcare literature shows that these have had minimal effect. Design improvements in P4P programs can enhance their effectiveness. Lessons from behavioral economics may greatly enhance the design and effectiveness of P4P programs in healthcare, but future work is needed to demonstrate this empirically.

  19. U.S. Department of Agriculture: Resolution of Discrimination Complaints Involving Farm Credit and Payment Programs

    National Research Council Canada - National Science Library

    2001-01-01

    .... These issues came to a head in 1997 when a group of African-American farmers consolidated their claims of racial discrimination in farm lending and benefit programs into one class action suit against USDA Pigford v. Glickman...

  20. Getting the Incentives Right: Improving Oral Health Equity With Universal School-Based Caries Prevention.

    Science.gov (United States)

    Niederman, Richard; Huang, Shulamite S; Trescher, Anna-Lena; Listl, Stefan

    2017-05-01

    Despite significant financial, training, and program investments, US children's caries experience and inequities continued to increase over the last 20 years. We posit that (1) dental insurance payment systems are not aligned with the current best evidence, exacerbating inequities, and (2) system redesign could meet health care's triple aim and reduce children's caries by 80%. On the basis of 2013 to 2016 Medicaid and private payment rates and the caries prevention literature, we find that effective preventive interventions are either (1) consistently compensated less than ineffective interventions or (2) not compensated at all. This economic and clinical misalignment may account for underuse of effective caries prevention and subsequent overuse of restorative care. We propose universal school-based comprehensive caries prevention to address this misalignment. Preliminary modeling suggests that universal caries prevention could eliminate 80% of children's caries and cost less than one fifth of current Medicaid children's oral health spending. If implemented with bundled payments based on cycle of care and measurable outcomes, there would be an alignment of incentives, best evidence, care, and outcomes. Such a program would meet the Healthy People Oral Health goals for children, as well as health care's triple aim.

  1. The Relationship Between Magnet Designation, Electronic Health Record Adoption, and Medicare Meaningful Use Payments.

    Science.gov (United States)

    Lippincott, Christine; Foronda, Cynthia; Zdanowicz, Martin; McCabe, Brian E; Ambrosia, Todd

    2017-08-01

    The objective of this study was to examine the relationship between nursing excellence and electronic health record adoption. Of 6582 US hospitals, 4939 were eligible for the Medicare Electronic Health Record Incentive Program, and 6419 were eligible for evaluation on the HIMSS Analytics Electronic Medical Record Adoption Model. Of 399 Magnet hospitals, 330 were eligible for the Medicare Electronic Health Record Incentive Program, and 393 were eligible for evaluation in the HIMSS Analytics Electronic Medical Record Adoption Model. Meaningful use attestation was defined as receipt of a Medicare Electronic Health Record Incentive Program payment. The adoption electronic health record was defined as Level 6 and/or 7 on the HIMSS Analytics Electronic Medical Record Adoption Model. Logistic regression showed that Magnet-designated hospitals were more likely attest to Meaningful Use than non-Magnet hospitals (odds ratio = 3.58, P electronic health records than non-Magnet hospitals (Level 6 only: odds ratio = 3.68, P electronic health record use, which involves earning financial incentives for successful adoption. Continued investigation is needed to examine the relationships between the quality of nursing care, electronic health record usage, financial implications, and patient outcomes.

  2. Payment Platform

    DEFF Research Database (Denmark)

    Hjelholt, Morten; Damsgaard, Jan

    2012-01-01

    Payment transactions through the use of physical coins, bank notes or credit cards have for centuries been the standard formats of exchanging money. Recently online and mobile digital payment platforms has entered the stage as contenders to this position and possibly could penetrate societies...

  3. Medicaid program; reductions in payments to the states--Health Care Financing Administration. Interim final rule with comment period.

    Science.gov (United States)

    1981-09-30

    This rule amends current Medicaid regulations to implement section 2161 of the Omnibus Budget Reconciliation Act of 1981 (Pub. L 97-35) which imposes reductions in Federal matching payments for fiscal years 1982 through 1984. In the regulations, we describe the conditions and specify minimum criteria under which States may lower the reduction. The conditions are the existence of the qualified hospital cost review program, a specific level of unemployment in a State, and a specific amount of fraud and abuse recoveries by a State or, for fiscal year 1982 only, a combination of fraud and abuse and third party liability recoveries. We intend these regulations to provide guidance as to when the reductions, and offsets against the reductions, will be made and how States can qualify for the offsets. In addition, we have issued a notice of proposed rulemaking elsewhere in this issue of the Federal Register that contains proposed policies concerning recoveries from liable third parties for purposes of implementing section 2161.

  4. Medicare and Medicaid programs; modifications to the Medicare and Medicaid Electronic Health Record (EHR) Incentive Program for 2014 and other changes to EHR Incentive Program; and health information technology: revision to the certified EHR technology definition and EHR certification changes related to standards. Final rule.

    Science.gov (United States)

    2014-09-04

    This final rule changes the meaningful use stage timeline and the definition of certified electronic health record technology (CEHRT) to allow options in the use of CEHRT for the EHR reporting period in 2014. It also sets the requirements for reporting on meaningful use objectives and measures as well as clinical quality measure (CQM) reporting in 2014 for providers who use one of the CEHRT options finalized in this rule for their EHR reporting period in 2014. In addition, it finalizes revisions to the Medicare and Medicaid EHR Incentive Programs to adopt an alternate measure for the Stage 2 meaningful use objective for hospitals to provide structured electronic laboratory results to ambulatory providers; to correct the regulation text for the measures associated with the objective for hospitals to provide patients the ability to view online, download, and transmit information about a hospital admission; and to set a case number threshold exemption for CQM reporting applicable for eligible hospitals and critical access hospitals (CAHs) beginning with FY 2013. Finally, this rule finalizes the provisionally adopted replacement of the Data Element Catalog (DEC) and the Quality Reporting Document Architecture (QRDA) Category III standards with updated versions of these standards.

  5. Medicare Program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system changes and FY2011 rates; provider agreements and supplier approvals; and hospital conditions of participation for rehabilitation and respiratory care services; Medicaid program: accreditation for providers of inpatient psychiatric services. Final rules and interim final rule with comment period.

    Science.gov (United States)

    2010-08-16

    : We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems and to implement certain provisions of the Affordable Care Act and other legislation. In addition, we describe the changes to the amounts and factors used to determine the rates for Medicare acute care hospital inpatient services for operating costs and capital-related costs. We also are setting forth the update to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. We are updating the payment policy and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) and setting forth the changes to the payment rates, factors, and other payment rate policies under the LTCH PPS. In addition, we are finalizing the provisions of the August 27, 2009 interim final rule that implemented statutory provisions relating to payments to LTCHs and LTCH satellite facilities and increases in beds in existing LTCHs and LTCH satellite facilities under the LTCH PPS. We are making changes affecting the: Medicare conditions of participation for hospitals relating to the types of practitioners who may provide rehabilitation services and respiratory care services; and determination of the effective date of provider agreements and supplier approvals under Medicare. We are also setting forth provisions that offer psychiatric hospitals and hospitals with inpatient psychiatric programs increased flexibility in obtaining accreditation to participate in the Medicaid program. Psychiatric hospitals and hospitals with inpatient psychiatric programs will have the choice of undergoing a State survey or of obtaining accreditation from a national accrediting organization whose hospital accreditation

  6. Medicare program; revisions to payment policies under the physician fee schedule, and other Part B payment policies for CY 2008; revisions to the payment policies of ambulance services under the ambulance fee schedule for CY 2008; and the amendment of the e-prescribing exemption for computer generated facsimile transmissions. Final rule with comment period.

    Science.gov (United States)

    2007-11-27

    This final rule with comment period addresses certain provisions of the Tax Relief and Health Care Act of 2006, as well as making other proposed changes to Medicare Part B payment policy. We are making these changes to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. This final rule with comment period also discusses refinements to resource-based practice expense (PE) relative value units (RVUs); geographic practice cost indices (GPCI) changes; malpractice RVUs; requests for additions to the list of telehealth services; several coding issues including additional codes from the 5-Year Review; payment for covered outpatient drugs and biologicals; the competitive acquisition program (CAP); clinical lab fee schedule issues; payment for renal dialysis services; performance standards for independent diagnostic testing facilities; expiration of the physician scarcity area (PSA) bonus payment; conforming and clarifying changes for comprehensive outpatient rehabilitation facilities (CORFs); a process for updating the drug compendia; physician self referral issues; beneficiary signature for ambulance transport services; durable medical equipment (DME) update; the chiropractic services demonstration; a Medicare economic index (MEI) data change; technical corrections; standards and requirements related to therapy services under Medicare Parts A and B; revisions to the ambulance fee schedule; the ambulance inflation factor for CY 2008; and amending the e-prescribing exemption for computer-generated facsimile transmissions. We are also finalizing the calendar year (CY) 2007 interim RVUs and are issuing interim RVUs for new and revised procedure codes for CY 2008. As required by the statute, we are announcing that the physician fee schedule update for CY 2008 is -10.1 percent, the initial estimate for the sustainable growth rate for CY 2008 is -0.1 percent, and the conversion factor (CF) for CY 2008 is $34.0682.

  7. 78 FR 27485 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2013-05-10

    ... the conditions of participation (CoPs) for hospitals relating to the administration of vaccines by...--Program Administration, Validation, and Reconsideration Issues. Shaheen Halim, (410) 786-0641, Hospital... Federation of American Hospitals FDA Food and Drug Administration FFY Federal fiscal year FPL Federal poverty...

  8. 78 FR 50495 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2013-08-19

    ... are revising the conditions of participation (CoPs) for hospitals relating to the administration of... and Hospital Value-Based Purchasing--Program Administration, Validation, and Reconsideration Issues... Financing Administration HCO High-cost outlier HCRIS Hospital Cost Report Information System HHA Home health...

  9. Payment for Environmental Services: The Sloping Land Conversion Program in Ningxia Autonomous Region of China

    NARCIS (Netherlands)

    Zhang, L.; Tu, Q.; Mol, A.P.J.

    2008-01-01

    China's Sloping Land Conversion Program has been implemented since 2002. It aims to achieve goals of ecological recovery and poverty alleviation, by retiring steeply sloping land from crop production and freeing surplus agricultural labor for off-farm activities. Given the huge investment that has

  10. 77 FR 22340 - Section 8 Housing Assistance Payments Program-Annual Adjustment Factors, Fiscal Year 2012

    Science.gov (United States)

    2012-04-13

    ... of Housing, 202-708-3000, for questions relating to all other Section 8 programs; and Geoffrey Newton... AAFs differently. The specific application of the AAFs is determined by the law, the HAP contract, and... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5620-N-01] Section 8 Housing Assistance...

  11. Incentives from Curriculum Tracking

    Science.gov (United States)

    Koerselman, Kristian

    2013-01-01

    Curriculum tracking creates incentives in the years before its start, and we should therefore expect test scores to be higher during those years. I find robust evidence for incentive effects of tracking in the UK based on the UK comprehensive school reform. Results from the Swedish comprehensive school reform are inconclusive. Internationally, I…

  12. Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities (SNFs) for FY 2016, SNF Value-Based Purchasing Program, SNF Quality Reporting Program, and Staffing Data Collection. Final Rule.

    Science.gov (United States)

    2015-08-04

    This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2016. In addition, it specifies a SNF all-cause all-condition hospital readmission measure, as well as adopts that measure for a new SNF Value-Based Purchasing (VBP) Program, and includes a discussion of SNF VBP Program policies we are considering for future rulemaking to promote higher quality and more efficient health care for Medicare beneficiaries. Additionally, this final rule will implement a new quality reporting program for SNFs as specified in the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act). It also amends the requirements that a long-term care (LTC) facility must meet to qualify to participate as a skilled nursing facility (SNF) in the Medicare program, or a nursing facility (NF) in the Medicaid program, by establishing requirements that implement the provision in the Affordable Care Act regarding the submission of staffing information based on payroll data.

  13. 75 FR 78707 - Medicare Program; First Semi-Annual Meeting of the Advisory Panel on Ambulatory Payment...

    Science.gov (United States)

    2010-12-16

    ... appropriate section of the form. They must also clarify their relationship to the organization that they... limited to, the conversion factor, charge compression, revisions to the cost report, pass-through payments...

  14. 75 FR 38533 - Medicare Program; Second Semi-Annual Meeting of the Advisory Panel on Ambulatory Payment...

    Science.gov (United States)

    2010-07-02

    ... clarify their relationship to the organization that they represent in the presentation. Note: Issues that... of the OPPS conversion factor, charge compression, pass-through payments, or wage adjustments are not...

  15. 78 FR 73547 - Medicare Program; Semi-Annual Meeting of the Advisory Panel on Hospital Outpatient Payment (HOP...

    Science.gov (United States)

    2013-12-06

    ... conversion factor, charge compression, revisions to the cost report, pass-through payments, correct coding... that they are requesting CMS to take in the appropriate section of the form. A presenter's relationship...

  16. 78 FR 31558 - Medicare Program; Second Semi-Annual Meeting of the Advisory Panel on Hospital Outpatient Payment...

    Science.gov (United States)

    2013-05-24

    ..., charge compression, revisions to the cost report, pass-through payments, correct coding, new technology... presenter's relationship to the organization that they represent must also be clearly listed. The form is...

  17. 26 CFR 31.3121(a)(18)-1 - Payments or benefits under a qualified educational assistance program.

    Science.gov (United States)

    2010-04-01

    ... SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) EMPLOYMENT TAXES AND COLLECTION OF INCOME TAX AT SOURCE EMPLOYMENT TAXES AND COLLECTION OF INCOME TAX AT SOURCE Federal Insurance Contributions Act (Chapter 21... such payment or benefit from income under section 127. ...

  18. Fair Market Rents (Fair Market Rents For The Section 8 Housing Assistance Payments Program) - National Geospatial Data Asset (NGDA)

    Data.gov (United States)

    Department of Housing and Urban Development — This dataset and map service provides information on Fair Market Rents (FMRs). FMRs are primarily used to determine payment standard amounts for the Housing Choice...

  19. Medicare program; prospective payment system and consolidated billing for skilled nursing facilities for FY 2008. Final rule.

    Science.gov (United States)

    2007-08-03

    This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2008. In addition, this final rule revises and rebases the SNF market basket, and modifies the threshold for the adjustment to account for market basket forecast error. This final rule also responds to public comments submitted on the proposed rule and makes a technical correction in the regulations text.

  20. Contingent valuation and incentives

    Science.gov (United States)

    Patricia A. Champ; Nicholas E. Flores; Thomas C. Brown; James Chivers

    2002-01-01

    We empirically investigate the effect of the payment mechanism on contingent values by asking a willingness-to-pay question with one of three different payment mechanisms: individual contribution, contribution with provision point, and referendum. We find statistical evidence of more affirmative responses in the referendum treatment relative to the individual...

  1. Payment Cards

    Directory of Open Access Journals (Sweden)

    Kantnerová Liběna

    2016-09-01

    Full Text Available The aim of this paper is to analyze the use of payment cards in retail in the Czech Republic from the side of clients (buyers and the side of sellers. Questionnaires for clients examine satisfaction with cards and the service connected with them. Sellers’ satisfaction with the profit and function of cards is analyzed. The data indicated that 92% of the 352 respondents in South Bohemia had a payment card and more than 35% had more than one card. In retail, 70% of sellers had a payment terminal.

  2. Investment incentives in the Korean electricity market

    International Nuclear Information System (INIS)

    Park, Jung-Yeon; Ahn, Nam-Sung; Yoon, Yong-Beum; Koh, Kyung-Ho; Bunn, Derek W.

    2007-01-01

    This paper develops a model-based analysis of the effects of various capacity incentive systems on new investment in the Korean electricity market. The restructuring process in Korea allocated power generation to six firms, competing within a wholesale market, albeit strictly on a cost basis. Because of this cost-based pool, capacity payments were also introduced to encourage new investment. However, it is an open question whether the current fixed capacity payment scheme is enough to secure resource adequacy, and consideration is being given to alternative mechanisms such as the use of LOLP. Using a detailed market simulation model, based on system dynamics, we compare these approaches in terms of how they may influence the investors' decisions and thereby determine the system reserve margin. The simulation results suggest that there may be serious problems in staying with the current fixed capacity payments in order to achieve resource adequacy. In contrast, an LOLP-based capacity mechanism may, in the longer term, increase the reserve margin compared with a fixed capacity payment. More generally, this paper indicates how crucial the effective modeling of the investment behavior of the independent power producers is for adequate policy support, even if they only constitute a fringe in a substantially centrally influenced market

  3. Medicare program; announcement of the calendar year 2002 conversion factor for the hospital outpatient prospective payment system and a pro rata reduction on transitional pass-through payments. Final rule.

    Science.gov (United States)

    2001-11-02

    This final rule announces the Medicare hospital outpatient prospective payment system conversion factor for calendar year (CY) 2002. In addition, it describes the Secretary's estimate of the total amount of transitional pass-through payments for CY 2002 and the implementation of a uniform reduction in each of the pass-through payments for that year.

  4. Analysis of selection procedures to determine priority areas for payment for water ecosystem services programs

    Directory of Open Access Journals (Sweden)

    Ana Feital Gjorup

    2016-03-01

    Full Text Available The approach of ecosystem services has shown promise for the evaluation of interactions between ecosystems and society, integrating environmental and socioeconomic concepts which require interdisciplinary knowledge. However, its usefulness in decision making is limited due to information gaps. This study was therefore developed in order to contribute to the application of principles of ecosystem services in the decision-making for water resources management. It aims to identify procedures and methodologies used for decision-making in order to select priority areas to be included in projects or compensation programs for environmental services. To do so, we searched technical and scientific literature describing methods and experiences used to select priority areas. Key steps in the process of selecting priority areas were identified; then a survey was conducted of the procedures adopted for each key step considering the literature selected; and, finally, the information collected was analyzed and classified. Considering the study’s sample, we noted that the selection of priority areas was based on the direct use of predetermined criteria. The use of indicators and spatial analyses are practices still scarcely employed. We must highlight, however, that most of the analyzed documents did not aim to describe the process of selecting priority areas in detail, which may have resulted in some omissions. Although these conditions may limit the analysis in this study, the results presented here allow us to identify the main objectives, actions and criteria used to select priority areas for programs or compensation projects for environmental services.

  5. 44 CFR 354.6 - Billing and payment of fees.

    Science.gov (United States)

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Billing and payment of fees... EMERGENCY PREPAREDNESS PROGRAM § 354.6 Billing and payment of fees. (a) Electronic billing and payment. We... statutory authority. Working with the Department of the Treasury we now provide for payment of bills by...

  6. 46 CFR 295.31 - Criteria for payment

    Science.gov (United States)

    2010-10-01

    ... OPERATORS MARITIME SECURITY PROGRAM (MSP) Payment and Billing Procedures § 295.31 Criteria for payment (a... 46 Shipping 8 2010-10-01 2010-10-01 false Criteria for payment 295.31 Section 295.31 Shipping... include a certification that the vessel(s) for which payment is requested were operated in accordance with...

  7. 24 CFR 983.353 - Tenant rent; payment to owner.

    Science.gov (United States)

    2010-04-01

    ... URBAN DEVELOPMENT PROJECT-BASED VOUCHER (PBV) PROGRAM Payment to Owner § 983.353 Tenant rent; payment to... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Tenant rent; payment to owner. 983... owner. (b) Tenant payment to owner. (1) The family is responsible for paying the tenant rent (total...

  8. 42 CFR 418.302 - Payment procedures for hospice care.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Payment procedures for hospice care. 418.302... SERVICES (CONTINUED) MEDICARE PROGRAM HOSPICE CARE Payment for Hospice Care § 418.302 Payment procedures for hospice care. (a) CMS establishes payment amounts for specific categories of covered hospice care...

  9. How effective are biodiversity conservation payments in Mexico?

    Directory of Open Access Journals (Sweden)

    Sébastien Costedoat

    Full Text Available We assess the additional forest cover protected by 13 rural communities located in the southern state of Chiapas, Mexico, as a result of the economic incentives received through the country's national program of payments for biodiversity conservation. We use spatially explicit data at the intra-community level to define a credible counterfactual of conservation outcomes. We use covariate-matching specifications associated with spatially explicit variables and difference-in-difference estimators to determine the treatment effect. We estimate that the additional conservation represents between 12 and 14.7 percent of forest area enrolled in the program in comparison to control areas. Despite this high degree of additionality, we also observe lack of compliance in some plots participating in the PES program. This lack of compliance casts doubt on the ability of payments alone to guarantee long-term additionality in context of high deforestation rates, even with an augmented program budget or extension of participation to communities not yet enrolled.

  10. "Meaningful use" of EHR in dental school clinics: how to benefit from the U.S. HITECH Act's financial and quality improvement incentives.

    Science.gov (United States)

    Kalenderian, Elsbeth; Walji, Muhammad; Ramoni, Rachel B

    2013-04-01

    Through the 2009 HITECH (Health Information Technology for Economic and Clinical Health) Act, the U.S. government committed $27 billion to incentivize the adoption and "meaningful use" of certified electronic health records (EHRs) by providers, including dentists. Given their patient profiles, dental school clinics are in a position to benefit from this time-delimited commitment to support the adoption and use of certified EHR technology under the Medicaid-based incentive. The benefits are not merely financial: rather, the meaningful use objectives and clinical quality measures can drive quality improvement initiatives within dental practices and help develop a community of medical and dental professionals focused on quality. This article describes how dentists can qualify as eligible providers and the set of activities that must be undertaken and attested to in order to obtain this incentive. Two case studies describe the approaches that can be used to meet the Medicaid threshold necessary to be eligible for the incentive. Dentists can and have successfully applied for meaningful use incentive payments. Given the diverse set of patients who are treated at dental schools, these dental practices are among those most likely to benefit from the incentive programs.

  11. Value-based payment in implementing evidence-based care: the Mental Health Integration Program in Washington state.

    Science.gov (United States)

    Bao, Yuhua; McGuire, Thomas G; Chan, Ya-Fen; Eggman, Ashley A; Ryan, Andrew M; Bruce, Martha L; Pincus, Harold Alan; Hafer, Erin; Unützer, Jürgen

    2017-01-01

    To assess the role of value-based payment (VBP) in improving fidelity and patient outcomes in community implementation of an evidence-based mental health intervention, the Collaborative Care Model (CCM). Retrospective study based on a natural experiment. We used the clinical tracking data of 1806 adult patients enrolled in a large implementation of the CCM in community health clinics in Washington state. VBP was initiated in year 2 of the program, creating a natural experiment. We compared implementation fidelity (measured by 3 process-of-care elements of the CCM) between patient-months exposed to VBP and patient-months not exposed to VBP. A series of regressions were estimated to check robustness of findings. We estimated a Cox proportional hazard model to assess the effect of VBP on time to achieving clinically significant improvement in depression (measured based on changes in depression symptom scores over time). Estimated marginal effects of VBP on fidelity ranged from 9% to 30% of the level of fidelity had there been no exposure to VBP (P <.05 for every fidelity measure). Improvement in fidelity in response to VBP was greater among providers with a larger patient panel and among providers with a lower level of fidelity at baseline. Exposure to VBP was associated with an adjusted hazard ratio of 1.45 (95% confidence interval, 1.04-2.03) for achieving clinically significant improvement in depression. VBP improved fidelity to key elements of the CCM, both directly incentivized and not explicitly incentivized by the VBP, and improved patient depression outcomes.

  12. Impact of Biological Feedback and Incentives on Blood Fatty Acid Concentrations, Including Omega-3 Index, in an Employer-Based Wellness Program.

    Science.gov (United States)

    McBurney, Michael I; Bird, Julia K

    2017-08-05

    Eicosapentaenoic acid (EPA, C20:5n-3) and docosahexaenoic acid (DHA, C22:6n-3) are important fatty acids for the retina and brain. More than 95% of Americans have suboptimal EPA + DHA blood concentrations. This cross-sectional employer-based study assessed whole blood fatty acid levels of volunteers participating in an onsite wellness biometric screening program and was designed to determine if an incentive, a $5 coupon for a 90-day supply of fish oil supplement typically costing $18-30, stimulated incremental dietary behavior change relative to nutritional status assessment alone to increase EPA + DHA concentrations. Volunteers completed a dietary survey and finger stick blood samples were collected to be analyzed for fatty acid composition. In addition, 636 individuals participated in the initial onsite biometric screening. Three months later, and without prior knowledge, all employees were invited to a second screening. At the second screening, 198 employees volunteered for the first time and 149 employees had a second test (17.9%). At baseline, the average age ( n = 834) was 45 year and omega-3 index was 5.0% with 41% female. EPA + DHA concentration, i.e., omega-3 index, was significantly lower in men (4.8%) than women (5.2%), as were DHA and linoleic acid (LA) concentrations ( p omega-3 index was positively and linearly associated with omega-3 intake. Only 4% of volunteers had an omega-3 index >8% on initial screening. Among the 149 individuals with two measurements, omega-3 intake from supplements, but not food, increased significantly from 258 to 445 mg/d ( p omega-3 index (+0.21, p omega-3 supplement.

  13. Aligning ambition and incentives

    DEFF Research Database (Denmark)

    Koch, Alexander; Peyrache, Eloïc

    2011-01-01

    Labor turnover creates longer term career concerns incentives that motivate employees in addition to the short term monetary incentives provided by the current employer. We analyze how these incentives interact, and derive implications for the design of incentive contracts and organizational choice....... The main insights stem from a trade-off between ‘good monetary incentives’ and ‘good reputational incentives’. We show that the principal optimally designs contracts to create ambiguity about agents’ abilities. This may make it optimal to contract on relative performance measures, even though the extant...... rationales for such schemes are absent. Linking the structure of contracts to organizational design, we show that it can be optimal for the principal to adopt an opaque organization where performance is not verifiable, despite the constraints that this imposes on contracts....

  14. The effect of explicit financial incentives on physician behavior.

    Science.gov (United States)

    Armour, B S; Pitts, M M; Maclean, R; Cangialose, C; Kishel, M; Imai, H; Etchason, J

    2001-05-28

    Managed care organizations use explicit financial incentives to influence physicians' use of resources. This has contributed to concerns regarding conflicts of interest for physicians and adverse effects on the quality of patient care. In light of recent publicized legislative and legal battles about this issue, we reviewed the literature and analyzed studies that examine the effect of these explicit financial incentives on the behavior of physicians. The method used to undertake the literature review followed the approach set forth in the Cochrane Collaboration handbook. Our literature review revealed a paucity of data on the effect of explicit financial incentives. Based on this limited evidence, explicit incentives that place individual physicians at financial risk appear to be effective in reducing physician resource use. However, the empirical evidence regarding the effectiveness of bonus payments on physician resource use is mixed. Similarly, our review revealed mixed effects of the influence of explicit financial incentives on the quality of patient care. The effect of explicit financial incentives on physician behavior is complicated by a lack of understanding of the incentive structure by the managed care organization and the physician. The lack of a universally acceptable definition of quality renders it important that future researchers identify the term explicitly.

  15. Participatory development of incentives to coexist with jaguars and pumas.

    Science.gov (United States)

    Amit, Ronit; Jacobson, Susan K

    2018-01-22

    Reducing costs and increasing benefits for rural communities coexisting with large carnivores is necessary for conservation of jaguar (Panthera onca) and puma (Puma concolor). To design acceptable incentives, stakeholders must be involved in the process. We conducted an innovative, structured, group communication process based on a Delphi technique as a template for identifying potential incentives. Community workshops with 133 members of 7 communities and surveys with 25 multidisciplinary experts from government, nongovernmental organizations, and academia provided iterative data to design a plan of incentives through 4 rounds of discussion. The final product integrated 862 ideas into 6 types of incentives: organization of communities, mechanisms for improved dialogue, citizen technical assistance, green labeling for community products, payment for the ecosystem service of biodiversity, and an assessment of financial alternatives. We used quantitative and qualitative techniques to indicate support for decisions about the design of incentives, which reduced researcher subjectivity. The diverse incentives developed and the cooperation from multiple stakeholders resulted in an incentive plan that integrated issues of governance, equity, and social norms. © 2018 Society for Conservation Biology.

  16. Medicare program; prospective payment system and consolidated billing for skilled nursing facilities for FY 2006. Final rule.

    Science.gov (United States)

    2005-08-04

    In this final rule we update the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs), for fiscal year (FY) 2006. Annual updates to the PPS rates are required by section 1888(e) of the Social Security Act (the Act), as amended by the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 (BBRA), the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA), and the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), relating to Medicare payments and consolidated billing for SNFs. This final rule also responds to public comments submitted on the proposed rule published on May 19, 2005 (70 FR 29070), and promulgates provisions set forth in that proposed rule, along with several additional technical revisions to the regulations.

  17. Medicare program; prospective payment system and consolidated billing for skilled nursing facilities for FY 2015. Final rule.

    Science.gov (United States)

    2014-08-05

    This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2015. In addition, it adopts the most recent Office of Management and Budget (OMB) statistical area delineations to identify a facility's urban or rural status for the purpose of determining which set of rate tables will apply to the facility, and to determine the SNF PPS wage index including a 1-year transition with a blended wage index for all providers for FY 2015. This final rule also contains a revision to policies related to the Change of Therapy (COT) Other Medicare Required Assessment (OMRA). This final rule includes a discussion of a provision related to the Affordable Care Act involving Civil Money Penalties. Finally, this final rule discusses the SNF therapy payment research currently underway within CMS, observed trends related to therapy utilization among SNF providers, and the agency's commitment to accelerating health information exchange in SNFs.

  18. Medicare program; prospective payment system and consolidated billing for skilled nursing facilities for FY 2014. Final rule.

    Science.gov (United States)

    2013-08-06

    This final rule updates the payment rates used under the prospective payment system for skilled nursing facilities (SNFs) for fiscal year (FY) 2014. In addition, it revises and rebases the SNF market basket, revises and updates the labor related share, and makes certain technical and conforming revisions in the regulations text. This final rule also includes a policy for reporting the SNF market basket forecast error in certain limited circumstances and adds a new item to the Minimum Data Set (MDS), Version 3.0 for reporting the number of distinct therapy days. Finally, this final rule adopts a change to the diagnosis code used to determine which residents will receive the AIDS add-on payment, effective for services provided on or after the October 1, 2014 implementation date for conversion to ICD-10-CM.

  19. Medicare program; prospective payment system and consolidated billing for skilled nursing facilities for FY 2012. Final rule.

    Science.gov (United States)

    2011-08-08

    This final rule updates the payment rates used under the prospective payment system for skilled nursing facilities (SNFs) for fiscal year 2012. In addition, it recalibrates the case-mix indexes so that they more accurately reflect parity in expenditures between RUG-IV and the previous case-mix classification system. It also includes a discussion of a Non-Therapy Ancillary component currently under development within CMS. In addition, this final rule discusses the impact of certain provisions of the Affordable Care Act, and reduces the SNF market basket percentage by the multi-factor productivity adjustment. This rule also implements certain changes relating to the payment of group therapy services and implements new resident assessment policies. Finally, this rule announces that the proposed provisions regarding the ownership disclosure requirements set forth in section 6101 of the Affordable Care Act will be finalized at a later date.

  20. 42 CFR 412.432 - Method of payment under the inpatient psychiatric facility prospective payment system.

    Science.gov (United States)

    2010-10-01

    ... SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR... inpatient psychiatric facility receives payment under this subpart for inpatient operating cost and capital... without undue risk of resulting in an overpayment to the provider. (2) Frequency of payment. For...

  1. Medicare program: hospital outpatient prospective payment system and CY 2011 payment rates; ambulatory surgical center payment system and CY 2011 payment rates; payments to hospitals for graduate medical education costs; physician self-referral rules and related changes to provider agreement regulations; payment for certified registered nurse anesthetist services furnished in rural hospitals and critical access hospitals. Final rule with comment period; final rules; and interim final rule with comment period.

    Science.gov (United States)

    2010-11-24

    The final rule with comment period in this document revises the Medicare hospital outpatient prospective payment system (OPPS) to implement applicable statutory requirements and changes arising from our continuing experience with this system and to implement certain provisions of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (Affordable Care Act). In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare hospital outpatient services paid under the prospective payment system. These changes are applicable to services furnished on or after January 1, 2011. In addition, this final rule with comment period updates the revised Medicare ambulatory surgical center (ASC) payment system to implement applicable statutory requirements and changes arising from our continuing experience with this system and to implement certain provisions of the Affordable Care Act. In this final rule with comment period, we set forth the applicable relative payment weights and amounts for services furnished in ASCs, specific HCPCS codes to which these changes apply, and other pertinent ratesetting information for the CY 2011 ASC payment system. These changes are applicable to services furnished on or after January 1, 2011. In this document, we also are including two final rules that implement provisions of the Affordable Care Act relating to payments to hospitals for direct graduate medical education (GME) and indirect medical education (IME) costs; and new limitations on certain physician referrals to hospitals in which they have an ownership or investment interest. In the interim final rule with comment period that is included in this document, we are changing the effective date for otherwise eligible hospitals and critical access hospitals that have been reclassified from urban to rural under section 1886(d)(8)(E) of the Social Security

  2. An overview of reviews evaluating the effectiveness of financial incentives in changing healthcare professional behaviours and patient outcomes.

    Science.gov (United States)

    Flodgren, Gerd; Eccles, Martin P; Shepperd, Sasha; Scott, Anthony; Parmelli, Elena; Beyer, Fiona R

    2011-07-06

    There is considerable interest in the effectiveness of financial incentives in the delivery of health care. Incentives may be used in an attempt to increase the use of evidence-based treatments among healthcare professionals or to stimulate health professionals to change their clinical behaviour with respect to preventive, diagnostic and treatment decisions, or both. Financial incentives are an extrinsic source of motivation and exist when an individual can expect a monetary transfer which is made conditional on acting in a particular way. Since there are numerous reviews performed within the healthcare area describing the effects of various types of financial incentives, it is important to summarise the effectiveness of these in an overview to discern which are most effective in changing health professionals' behaviour and patient outcomes. To conduct an overview of systematic reviews that evaluates the impact of financial incentives on healthcare professional behaviour and patient outcomes. We searched the Cochrane Database of Systematic Reviews (CDSR) (The Cochrane Library); Database of Abstracts of Reviews of Effectiveness (DARE); TRIP; MEDLINE; EMBASE; Science Citation Index; Social Science Citation Index; NHS EED; HEED; EconLit; and Program in Policy Decision-Making (PPd) (from their inception dates up to January 2010). We searched the reference lists of all included reviews and carried out a citation search of those papers which cited studies included in the review. We included both Cochrane and non-Cochrane reviews of randomised controlled trials (RCTs), controlled clinical trials (CCTs), interrupted time series (ITSs) and controlled before and after studies (CBAs) that evaluated the effects of financial incentives on professional practice and patient outcomes, and that reported numerical results of the included individual studies. Two review authors independently extracted data and assessed the methodological quality of each review according to the AMSTAR

  3. Paying for quality not quantity: a wisconsin health maintenance organization proposes an incentive model for reimbursement of chiropractic services.

    Science.gov (United States)

    Pursel, Kevin J; Jacobson, Martin; Stephenson, Kathy

    2012-07-01

    The purpose of this study is to describe a reimbursement model that was developed by one Health Maintenance Organization (HMO) to transition from fee-for-service to add a combination of pay for performance and reporting model of reimbursement for chiropractic care. The previous incentive program used by the HMO provided best-practice education and additional reimbursement incentives for achieving the National Committee for Quality Assurance Back Pain Recognition Program (NCQA-BPRP) recognition status. However, this model had not leveled costs between doctors of chiropractic (DCs). Therefore, the HMO management aimed to develop a reimbursement model to incentivize providers to embrace existing best-practice models and report existing quality metrics. The development goals included the following: it should (1) be as financially predictable as the previous system, (2) cost no more on a per-member basis, (3) meet the coverage needs of its members, and (4) be able to be operationalized. The model should also reward DCs who embraced best practices with compensation, not simply tied to providing more procedures, the new program needed to (1) cause little or no disruption in current billing, (2) be grounded achievable and defined expectations for improvement in quality, and (3) be voluntary, without being unduly punitive, should the DC choose not to participate in the program. The generated model was named the Comprehensive Chiropractic Quality Reimbursement Methodology (CCQRM; pronounced "Quorum"). In this hybrid model, additional reimbursement, beyond pay-for-procedures will be based on unique payment interpretations reporting selected, existing Physician Quality Reporting System (PQRS) codes, meaningful use of electronic health records, and achieving NCQA-BPRP recognition. This model aims to compensate providers using pay-for-performance, pay-for-quality reporting, pay-for-procedure methods. The CCQRM reimbursement model was developed to address the current needs of one

  4. Tax Incentives and Borrowing

    DEFF Research Database (Denmark)

    Alan, Sule; Leth-Petersen, Søren; Munk-Nielsen, Anders

    2016-01-01

    We estimate the effect of a Danish 1987 tax reform, which reduced the tax rate applied to interest deductions from 73% to 50% for households with high incomes, but less for households with middle or low incomes. Using high quality panel data we find that households responded to the reduced tax...... subsidy by lowering interest payments and we find that the responsiveness to the tax subsidy varies by the initial level of interest payments....

  5. Bundling Post-Acute Care Services into MS-DRG Payments

    Data.gov (United States)

    U.S. Department of Health & Human Services — A bundled hospital payment system that encompasses both acute and post-acute care has been proposed as a means of creating financial incentives in the Medicare...

  6. 77 FR 31366 - Medicare Program; Semi-Annual Meeting of the Advisory Panel on Hospital Outpatient Payment (HOP...

    Science.gov (United States)

    2012-05-25

    ... conversion factor, charge compression, revisions to the cost report, pass-through payments, correct coding... appropriate section of the form. A presenter's relationship to the organization that they represent must also... are not limited to, the conversion factor, charge compression, revisions to the cost report, pass...

  7. 26 CFR 31.3306(b)(13)-1 - Payments or benefits under a qualified educational assistance program.

    Science.gov (United States)

    2010-04-01

    ... SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) EMPLOYMENT TAXES AND COLLECTION OF INCOME TAX AT SOURCE EMPLOYMENT TAXES AND COLLECTION OF INCOME TAX AT SOURCE Federal Unemployment Tax Act (Chapter 23, Internal... 26 Internal Revenue 15 2010-04-01 2010-04-01 false Payments or benefits under a qualified...

  8. 26 CFR 31.3401(a)(18)-1 - Payments or benefits under a qualified educational assistance program.

    Science.gov (United States)

    2010-04-01

    ... SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) EMPLOYMENT TAXES AND COLLECTION OF INCOME TAX AT SOURCE EMPLOYMENT TAXES AND COLLECTION OF INCOME TAX AT SOURCE Collection of Income Tax at Source § 31.3401(a)(18)-1... reasonable to believe that the employee will be able to exclude such payment or benefit from income under...

  9. 76 FR 72708 - Medicare Program; Renaming and Other Changes to the Advisory Panel on Hospital Outpatient Payment...

    Science.gov (United States)

    2011-11-25

    ... . (Note: There is an UNDERSCORE after FACA/05--; there is no space.) News Media: Representatives should... required by section 1833(t)(9)(A) of the Social Security Act (the Act) and section 222 of the Public Health... compression, revisions to the cost report, pass-through payments, correct code usage, new technology...

  10. 75 FR 51465 - Medicare Program; Announcement of Five New Members to the Advisory Panel on Ambulatory Payment...

    Science.gov (United States)

    2010-08-20

    ..., drugs and medical devices in the outpatient setting, as well as other forms of relevant expertise. The... providers and other interested organizations. All members must have technical expertise to enable them to participate fully in the work of the Panel. This expertise encompasses hospital payment systems; hospital...

  11. 75 FR 30041 - Medicare Program; Public Meeting in Calendar Year 2010 for New Clinical Laboratory Tests Payment...

    Science.gov (United States)

    2010-05-28

    ... clinical diagnostic laboratory tests under Part B of title XVIII of the Social Security Act (the Act) that... tests are any clinical diagnostic laboratory tests with respect to which a new or substantially revised... Year 2010 for New Clinical Laboratory Tests Payment Determinations AGENCY: Centers for Medicare...

  12. Incentive Use in Research: Protecting Vulnerable Populations from Exploitation

    Directory of Open Access Journals (Sweden)

    Haruna Muwonge

    2013-06-01

    Full Text Available Global investment in Medical Research and Development has markedly increased in the last few decades. However, due to the decreasing public altruism, researchers have come under increased pressures from the funding bodies to produce results. Out of desperation, some researchers have resorted to using incentives as a means of sourcing for volunteers. Consequently, the research burden has disproportionately been shared among the most vulnerable populations in the society. Incentives especially monetary ones present an ethical dilemma because of the uncertainties’ surrounding the morality, amount and type of payment, vulnerability of volunteers and possible threats to voluntary participation. Several studies done on the use of incentives in medical research have noted that financial motivation was the number one reason for subjects to volunteer in Medical research. Mutual benefit and freedom of choice by participants were given as reasons to support their use. However, scientists who are against the use of incentives believe that they are coercive or undue inducements, and may influence a subjects’ ability to give an informed consent. Guidelines exist that protect vulnerable groups from exploitation, although none sheds light into the use of incentives. Nonetheless, in the face of the waning public altruism, the benefits of using incentives far outweigh the dangers, although researchers should avoid situations where their use may become problematic. As a mode of payment to research subjects, researchers should adopt a combination of the Dickerts’ Wage and re-imbursement models as guides in quantifying the incentive. [Archives Medical Review Journal 2013; 22(3.000: 408-417

  13. Medicare program; revisions to payment policies under the physician fee schedule for calendar year 2004. Final rule with comment period.

    Science.gov (United States)

    2003-11-07

    This final rule will refine the resource-based practice expense relative value units (RVUs) and make other changes to Medicare Part B payment policy. The policy changes concern: Medicare Economic Index, practice expense for professional component services, definition of diabetes for diabetes self-management training, supplemental survey data for practice expense, geographic practice cost indices, and several coding issues. In addition, this rule updates the codes subject to the physician self-referral prohibition. We also make revisions to the sustainable growth rate and the anesthesia conversion factor. These changes will ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. We are also finalizing the calendar year (CY) 2003 interim RVUs and are issuing interim RVUs for new and revised procedure codes for CY 2004. As required by the statute, we are announcing that the physician fee schedule update for CY 2004 is -4.5 percent, the initial estimate of the sustainable growth rate for CY 2004 is 7.4 percent, and the conversion factor for CY 2004 is $35.1339. We published a proposed rule (68 FR 50428) in the Federal Register on Part B drug payment reform on August 20, 2003. This proposed rule would also make changes to Medicare payment for furnishing or administering certain drugs and biologicals. We have not finalized these proposals to take into account that the Congress is considering legislation that would address these issues. We will continue to monitor legislative activity that would reform the Medicare Part B drug payment system. If legislation is not enacted soon on this issue, we remain committed to completing the regulatory process.

  14. Internalizing Externalities through Payments for Environmental Services

    Directory of Open Access Journals (Sweden)

    Sudarsono Soedomo

    2012-08-01

    Full Text Available Forest ecosystems, including plantation forests, provide goods and services that are marketable and non-marketable. Positive externalities produced by forest ecosystems are rarely considered in pricing of marketable products that result in economic inefficiencies. Internalizing externalities is required to improve the economic efficiency. The traditional way to internalize an externality is by providing subsidies or imposing taxes. Recently, payments for environmental services  are receiving more attention as an instrument for internalizing externalities provided by forest ecosystems. This promising alternative to improve our environment needs to be studied more extensively. In this paper, it can be indicated theoretically that the Pigovian tax, as a traditional way of addressing environmental problems, is able to mimic the result derived from the employment of environmental services payment. The difference is that environmental services payment improves the welfare of environmental service producers, whereas the Pigovian tax reduces it. A positive Pigovian tax increases the optimal rotation, which is positively associated with environmental improvement, but certainly reduces forest owner's welfare. This difference should be taken into account in the public policymaking so that perverse incentive may be avoided. Payment for environmental services  as an additional income to forest growers, not as alternative source of income, is a potential tool to address simultaneously issues of environment and poverty that are frequently contested.Keywords: externalities, payments for environmental services, tax, perverse incentive, social welfare

  15. Drilling contracts and incentives

    International Nuclear Information System (INIS)

    Osmundsen, Petter; Sorenes, Terje; Toft, Anders

    2008-01-01

    Shortages of rigs and personnel have encouraged discussion of designing incentive contracts in the drilling sector. However, for the drilling contracts, there are not a large variety of contract types in use. This article describes and analyses incentives for drilling contractors. These are directly represented by the compensation formats utilised in the present and in the consecutive drilling contracts. Indirectly, incentives are also provided by the evaluation criteria that oil companies use for awarding drilling assignments. Changes in contract format pose a number of relevant questions relating to resource management, and the article takes an in-depth look at some of these. Do evaluation criteria for awarding drilling assignments encourage the development of new technology and solutions? How will a stronger focus on drilling efficiency influence reservoir utilisation?

  16. Incentives and Earnings Growth

    DEFF Research Database (Denmark)

    Frederiksen, Anders

    2013-01-01

    The career prospects of newly recruited employees differ substantially within an organization. The stars experience considerable growth in earnings; others can hardly maintain their entry salaries. This article sheds light on the mechanisms generating the observed heterogeneity in earnings growth...... by investigating the effects that explicit short-run incentives and implicit incentives have on earnings growth. The model’s predictions are tested using personnel records from a large bank and are found to be consistent with the observed earnings growth during the first half of the employees’ careers....

  17. Cost incentives for doctors

    DEFF Research Database (Denmark)

    Schottmüller, Christoph

    2013-01-01

    If doctors take the costs of treatment into account when prescribing medication, their objectives differ from their patients' objectives because the patients are insured. This misalignment of interests hampers communication between patient and doctor. Giving cost incentives to doctors increases...... welfare if (i) the doctor's examination technology is sufficiently good or (ii) (marginal) costs of treatment are high enough. If the planner can costlessly choose the extent to which doctors take costs into account, he will opt for less than 100%. Optimal health care systems should implement different...... degrees of cost incentives depending on type of disease and/or doctor....

  18. 7 CFR 220.5 - Method of payment to States.

    Science.gov (United States)

    2010-01-01

    ... reimbursement to School Food Authorities through presentation by designated State officials of a payment Voucher... 7 Agriculture 4 2010-01-01 2010-01-01 false Method of payment to States. 220.5 Section 220.5... AGRICULTURE CHILD NUTRITION PROGRAMS SCHOOL BREAKFAST PROGRAM § 220.5 Method of payment to States. Funds to be...

  19. Payments discourage coordination in ecosystem services provision: evidence from behavioral experiments in Southeast Asia

    Science.gov (United States)

    Bell, Andrew; Zhang, Wei

    2016-11-01

    The contribution of synthetic pesticides to closing yield gaps around the world is undeniable; however, their use is also a classic double-edged sword. Beyond the well-recognized social costs (e.g., pollution to soil and water, and health effects both on consumers and other species) there are also private costs on farmers beyond the direct costs of inputs, associated with elevated risks of both acute and chronic damage to farmers’ health, and with the destruction of populations of beneficial organisms. Managing agricultural land use to enhance natural pest control services (also called mobile agent-based ecosystem services or MABES) holds promise to reduce this growing reliance on pesticides, though it too carries costs. In particular, uncertainty in crop yield due to pest damages, as well as the need to coordinate pesticide use with neighboring farms, can be important obstacles to establishing the longer-term public good of natural pest regulation. Current thinking on promoting ecosystem services suggests that payments or other economic incentives are a good fit for the promotion of public good ecosystem services such as MABES. We undertook a framed field experiment to examine the role of subsidies for non-crop habitat in improving insect-based ecosystem services in two separate samples in Southeast Asia—Cambodia and Vietnam. Our central finding is that these two contexts are not poised equally to benefit from incentives promoting MABES, and in fact may be left worse off by payments schemes. As the study and practice of payments for ecosystem services programs grows, this finding provides an important qualifier on recent theory supporting the use of payments to promote public good ecosystem services—where the nature of the coordination problem is complex and nonlinear, farm systems can be made worse off by being encouraged to attempt it.

  20. Delivery and Payment Redesign to Reduce Disparities in High Risk Postpartum Care.

    Science.gov (United States)

    Howell, Elizabeth A; Padrón, Norma A; Beane, Susan J; Stone, Joanne; Walther, Virginia; Balbierz, Amy; Kumar, Rashi; Pagán, José A

    2017-03-01

    Purpose This paper describes the implementation of an innovative program that aims to improve postpartum care through a set of coordinated delivery and payment system changes designed to use postpartum care as an opportunity to impact the current and future health of vulnerable women and reduce disparities in health outcomes among minority women. Description A large health care system, a Medicaid managed care organization, and a multidisciplinary team of experts in obstetrics, health economics, and health disparities designed an intervention to improve postpartum care for women identified as high-risk. The program includes a social work/care management component and a payment system redesign with a cost-sharing arrangement between the health system and the Medicaid managed care plan to cover the cost of staff, clinician education, performance feedback, and clinic/clinician financial incentives. The goal is to enroll 510 high-risk postpartum mothers. Assessment The primary outcome of interest is a timely postpartum visit in accordance with NCQA healthcare effectiveness data and information set guidelines. Secondary outcomes include care process measures for women with specific high-risk conditions, emergency room visits, postpartum readmissions, depression screens, and health care costs. Conclusion Our evidence-based program focuses on an important area of maternal health, targets racial/ethnic disparities in postpartum care, utilizes an innovative payment reform strategy, and brings together insurers, researchers, clinicians, and policy experts to work together to foster health and wellness for postpartum women and reduce disparities.

  1. Federal tax incentives affecting coal and nuclear power economics

    International Nuclear Information System (INIS)

    Chapman, D.

    1982-01-01

    This paper analyzes the effect of federal corporate income tax incentives on coal and nuclear power developments. It estimates (1) the magnitudes of tax incentives in relationship to utility costs, (2) the relative magnitude of benefits going to coal and nuclear facilities, and (3) the influence which the time paths of tax payments and after-tax net income have upon possible incentives for premature construction and excess capacity. Utility planners currently believe that nuclear power enjoys an after-tax competitive advantage over coal plants. Investigation of investment-related credits, deductions, and exclusions in the Internal Revenue Code shows that nuclear power enjoys a more favorable tax subsidy because of its greater capital intensity. In the absence of tax subsidies, no utility would prefer nuclear power to coal generation. Tax changes now under consideration could increase the tax benefits to both without disturbing the differential advantage held by nuclear power. 43 references, 2 figures, 4 tables

  2. Water Conservation and Economic Incentives

    Science.gov (United States)

    Narayanan, M.

    2016-12-01

    Water has played a vital role in the progress of human civilization throughout history. Both agriculture based economics as well as industry based economics totally rely upon water for survival and prosperity. Water could be a limiting factor in dictating day-to-day human activities and as such one should learn to live within the limits of available natural resources. Most of the water on this earth is either salty or undrinkable. Only one percent of world's water is available for all the needs of human civilization. This includes human personal household needs, community activities, agriculture, industry, plant and animal life sustenance. The supply of usable fresh water is finite and the per capita consumption of fresh water needs to be reduced in particularly in some selected regions of this world. The United States consumes about 450 billion gallons of water every day. The U.S. daily average of water pumped by public water supply systems is 185 gallons per person. The biggest water gobbler in a household is the lawn. Typically, at least 50% of water consumed by households is used outdoors. Even inside a house, bathroom facilities claim nearly 75% of the water used. Here is a short list of economic Incentives that may help water conservation. (1) Providing rebates, refunds or other economic incentives to those consumers that are willing to change to modern technological methods. Examples include, but not limited to energy efficient washing machines, low-flush toilets and improved shower head designs. (2) Communities should provide economic incentives to limit the type and size of landscaping. (3) Need, necessity and nature of outdoor water use could be restricted whenever possible. (4) Sprinkler ban may be deemed appropriate in extreme cases. (5) Set up hotlines that can help penalize those that ignore water conservation guidelines. (6) Incorporating water conservation monitors. References: http://www.nrdc.org/water/http://www.ecy.wa.gov/programs/wr/ws/wtrcnsv.htmlhttp://www.sscwd.org/tips.html

  3. The Wisconsin experience with incentives for demand-side management

    International Nuclear Information System (INIS)

    Landgren, D.A.

    1990-01-01

    It has been noted that, within traditional regulatory frameworks for electric utilities, factors exist which discourage demand side management (DSM) and that there is a lack of positive incentives for DSM. Regulatory agencies should therefore make it possible for DSM measures to benefit from the same treatment as supply-side measures. The Wisconsin Public Service Commission (WPSC) has recognized this need and has adopted various measures accordingly. The need for efficiency incentives is described according to the particular experience of Wisconsin Electric concerning their recourse to a DSM incentive and according to new incentive models being tested in collaboration with other electricity suppliers in Wisconsin. The WPSC has concluded that the fact of considering the costs relating to DSM as expenses or capitalizing them within the rate base does not motivate the utility to promote DSM programs. The WPSC has thus decided to experiment with energy efficiency incentives in order to evaluate their eventual impact. The choice of the type of incentive had an objective of starting the process in an area where the lack of experience has created, from the regulatory point of view, a reticence on the part of utilities to engage in DSM programs. The WPSC has designed a variety of incentive models which have been adapted to each utility's own situation. Specific incentive programs developed for three Wisconsin utilities are reviewed

  4. Incentive regulation of nuclear power plants by state regulators

    International Nuclear Information System (INIS)

    Martin, R.L.; Baker, K.; Olson, J.

    1991-02-01

    The Nuclear Regulatory Commission (NRC) monitors incentive programs established by state regulators in order to obtain current information and to consider the potential safety effects of the incentive programs as applied to nuclear units. The current report is an update of NUREG/CR-5509, Incentive Regulation of Nuclear Power Plants by State Public Utility Commissions, published in December 1989. The information in this report was obtained from interviews conducted with each state regulator and each utility with a minimum entitlement of 10%. The agreements, orders, and settlements from which each incentive program was implemented were reviewed as required. The interviews and supporting documentation form the basis for the individual state reports describing the structure and financial impact of each incentive program. The programs currently in effect represent the adoption of an existing nuclear performance incentive program proposal and one new program. In addition, since 1989 a number of nuclear units have been included in one existing program; while one program was discontinued and another one concluded. 6 refs., 27 tabs

  5. Comparing farmers' market revenue trends before and after the implementation of a monetary incentive for recipients of food assistance.

    Science.gov (United States)

    Freedman, Darcy A; Mattison-Faye, Amy; Alia, Kassandra; Guest, M Aaron; Hébert, James R

    2014-05-22

    We examined the influence of an intervention to increase fruit and vegetable purchases at farmers' markets for recipients of food assistance, Shop N Save (SNS), on revenue trends at a farmers' market located at a federally qualified health center (FQHC) in rural South Carolina. We compared revenue trends for 20 weeks before the intervention (2011) and 20 weeks after (2012). SNS provided one $5 monetary incentive per week to customers spending $5 or more in food assistance at the farmers' market. SNS was available to any farmers' market customer using Supplemental Nutrition Assistance Program (SNAP), Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and/or Senior or WIC Farmers' Market Nutrition Program (FMNP) vouchers. Sales receipts were recorded for each transaction at the farmers' market to document payment type and the cost of the purchase. All SNS participants completed a one-time enrollment survey. A total of 336 customers self-enrolled in SNS from June through October 2012. Most SNS participants were female, African American, and patients at the FQHC. In total, the use of all forms of food assistance (SNAP, WIC, and FMNP) at the farmers' market increased significantly after the intervention (from 10% before, to 25% after, P = .003). Senior FMNP vouchers and SNAP usage increased the most. Interventions that provide incentives to recipients of food assistance programs at farmers' markets are a viable strategy for increasing food assistance usage and revenue.

  6. Comparing Farmers’ Market Revenue Trends Before and After the Implementation of a Monetary Incentive for Recipients of Food Assistance

    Science.gov (United States)

    Mattison-Faye, Amy; Alia, Kassandra; Guest, M. Aaron; Hébert, James R.

    2014-01-01

    Introduction We examined the influence of an intervention to increase fruit and vegetable purchases at farmers’ markets for recipients of food assistance, Shop N Save (SNS), on revenue trends at a farmers’ market located at a federally qualified health center (FQHC) in rural South Carolina. We compared revenue trends for 20 weeks before the intervention (2011) and 20 weeks after (2012). Methods SNS provided one $5 monetary incentive per week to customers spending $5 or more in food assistance at the farmers’ market. SNS was available to any farmers’ market customer using Supplemental Nutrition Assistance Program (SNAP), Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and/or Senior or WIC Farmers’ Market Nutrition Program (FMNP) vouchers. Sales receipts were recorded for each transaction at the farmers’ market to document payment type and the cost of the purchase. All SNS participants completed a one-time enrollment survey. Results A total of 336 customers self-enrolled in SNS from June through October 2012. Most SNS participants were female, African American, and patients at the FQHC. In total, the use of all forms of food assistance (SNAP, WIC, and FMNP) at the farmers’ market increased significantly after the intervention (from 10% before, to 25% after, P = .003). Senior FMNP vouchers and SNAP usage increased the most. Conclusion Interventions that provide incentives to recipients of food assistance programs at farmers’ markets are a viable strategy for increasing food assistance usage and revenue. PMID:24854238

  7. The efficacy of incentives to motivate continued fitness-center attendance in college first-year students: a randomized controlled trial.

    Science.gov (United States)

    Pope, Lizzy; Harvey, Jean

    2014-01-01

    To determine whether fitness-center attendance established with the provision of weekly monetary incentives persisted after the discontinuation, or decreased frequency, of incentives. One hundred seventeen first-year college students participated during the 2011-2012 academic year. A randomized controlled trial with control, discontinued-incentive, and continued-incentive conditions was conducted. During fall semester, students in incentive conditions received weekly monetary payments for meeting fitness-center attendance goals. During spring semester, discontinued-incentive condition participants no longer received incentives, whereas continued-incentive condition participants received payments on a variable-interval schedule. ID-card attendance records tracked fitness-center attendance. Goal completion decreased from 63% in the incentive groups during the fall semester to 3% in the discontinued-incentive condition, and 39% in the continued-incentive condition during the spring semester. There was not a significant interaction between condition and body mass index change, F(6, 332) = 0.67, p = .68. Incentive discontinuation resulted in students no longer meeting fitness-center attendance goals. A variable-interval reward schedule better maintained attendance.

  8. Respect as an Incentive

    DEFF Research Database (Denmark)

    Eriksson, Tor Viking; Villeval, Marie-Claire

    by giving the employee costly symbolic rewards after observing his level of effort. This experiment sheds light on the extent to which symbolic rewards are used, how they affect employees' further effort, the duration of relationships, and the profits of employers. Furthermore, we study whether employers......' decisions to give symbolic rewards are driven by strategic considerations, by manipulating the bargaining power of employers and employees.  We find that employers make use of symbolic rewards and chiefly to express their satisfaction with the employee.  Indeed, symbolic rewards are more frequently used......, the opportunity of expressing respect does not improve efficiency compared with an environment in which it does not exist, possibly due to a crowding-out of extrinsic incentives by the availability of non-monetary incentives....

  9. Incentives and moral hazard

    DEFF Research Database (Denmark)

    Wendimu, Mengistu Assefa; Henningsen, Arne; Czekaj, Tomasz Gerard

    2017-01-01

    We investigate the unique contractual arrangement between a large Ethiopian sugar factory and its adjacent outgrower associations. The only significant difference between the sugarcane production on the factory-operated sugarcane plantation and on the outgrower-operated plots is the remuneration...... system and thus, the incentives to the workers. We compare the productivity of these two production schemes using a cross-sectional plot-level data set. As sugarcane production depends on various exogenous factors that are measured as categorical variables (e.g., soil type, cane variety, etc.), we......-operated plots have-ceteris paribus-a statistically and economically significantly higher productivity than factory-operated plots, which can be explained by outgrowers having stronger incentives to put more effort into their work than the employees of the sugar factory....

  10. Risk management versus incentives

    International Nuclear Information System (INIS)

    Aven, E.; Lovas, K.; Osmundsen, P.

    2006-01-01

    Portfolio theory indicates that risk management should take place at the group level. Hedging at the project level or in the individual business areas may lead to suboptimal results. However, the efficiency of a profit centre depends on its management's being able to influence factors that are crucial to the unit's financial results. Price hedging could be one such factor. In the wider perspective, this constitutes part of the balancing between centralisation and decentralisation. This article covers important elements of risk management and incentive design. It goes on to discuss the balancing of overall risk management at the group level and incentive design in profit centres and corporate units. Throughout the article, the oil industry serves as a case. (author)

  11. After the "Doc Fix": Implications of Medicare Physician Payment Reform for Academic Medicine.

    Science.gov (United States)

    Rich, Eugene C; Reschovsky, James D

    2016-07-01

    The Medicare Access and CHIP Reauthorization Act (MACRA) introduces incentives for clinicians serving Medicare patients to move away from traditional "fee-for-service" and into alternative payment models (APMs) such as accountable care organizations and bundled payment arrangements. Thus, MACRA creates strong reasons for various teaching clinical services to participate in APMs, not only for Medicare patients but for other public and private payers as well. Unfortunately, different APMs may be more or less applicable to the diverse teaching physician roles, academic clinical programs, and patient populations served by medical schools and teaching hospitals. Therefore, this time of transition will complicate the work of academic clinical program leaders endeavoring to sustain the tripartite mission of patient care, health professional education, and research. Nonetheless, payment reforms promoted by MACRA can reward efforts to reinvent medical education to better incorporate value into medical decision making, as well as to give clinical learners the tools and insights needed to recognize their personal financial (and other) conflicts and navigate these to meet their patients' needs. This post-MACRA environment may intensify the need for researchers in academic medicine to stay independent of the short-term financial interests of affiliated clinical institutions. Health sciences scholars must be able to study effectively and speak forcefully regarding the actual benefits, risks, and costs of health care services so that educators and clinicians can identify high-value care and deliver it to their patients.

  12. Industry Related Financial Incentives.

    Science.gov (United States)

    1987-09-29

    insurance is loss "realry" for middle managers. Does not participate in insurance mutual pacts. -CE 53HT Propoerty rnsurance nandied by off- snore captive [ E...incentives. Preparedness activities had the greatest impact on production interruption. Goodyear explained that sound , well rehearsed emergency plans and...response activities followed a pattern similar to preparedness activities. The experts determined that sound response procedures and proper response

  13. Are Financial Incentives for Lifestyle Behavior Change Informed or Inspired by Behavioral Economics? A Mapping Review.

    Science.gov (United States)

    McGill, Bronwyn; O'Hara, Blythe J; Bauman, Adrian; Grunseit, Anne C; Phongsavan, Philayrath

    2018-01-01

    To identify the behavioral economics (BE) conceptual underpinnings of lifestyle financial incentive (FI) interventions. A mapping review of peer-reviewed literature was conducted by searching electronic databases. Inclusion criteria were real-world FI interventions explicitly mentioning BE, targeting individuals, or populations with lifestyle-related behavioral outcomes. Exclusion criteria were hypothetical studies, health professional focus, clinically oriented interventions. Study characteristics were tabulated according to purpose, categorization of BE concepts and FI types, design, outcome measures, study quality, and findings. Data Synthesis and Analysis: Financial incentives were categorized according to type and payment structure. Behavioral economics concepts explicitly used in the intervention design were grouped based on common patterns of thinking. The interplay between FI types, BE concepts, and outcome was assessed. Seventeen studies were identified from 1452 unique records. Analysis showed 76.5% (n = 13) of studies explicitly incorporated BE concepts. Six studies provided clear theoretical justification for the inclusion of BE. No pattern in the type of FI and BE concepts used was apparent. Not all FI interventions claiming BE inclusion did so. For interventions that explicitly included BE, the degree to which this was portrayed and woven into the design varied. This review identified BE concepts common to FI interventions, a first step in providing emergent and pragmatic information to public health and health promotion program planners.

  14. Activity-Based Micro-pricing: Realizing Sustainable Behavior Changes through Economic Incentives

    Science.gov (United States)

    Yamabe, Tetsuo; Lehdonvirta, Vili; Ito, Hitoshi; Soma, Hayuru; Kimura, Hiroaki; Nakajima, Tatsuo

    In this paper, we further develop the idea of combining pervasive computing techniques with electronic payment systems to create activity-based micro-incentives. Economic incentives are an effective way to influence consumer behavior, and are used in e.g. marketing and resource coordination. Our approach allows marketers and regulators to induce consumers to perform particular actions in new application domains by attaching micro-prices to a wider range of behaviors. A key challenge is designing incentive mechanisms that result in desired behavior changes. We examine two basic incentive models. Based on the results of preliminary experiments, we discuss how economic incentives can affect consumer attitudes and lead to sustainable behavior changes.

  15. Neural mechanisms underlying paradoxical performance for monetary incentives are driven by loss aversion.

    Science.gov (United States)

    Chib, Vikram S; De Martino, Benedetto; Shimojo, Shinsuke; O'Doherty, John P

    2012-05-10

    Employers often make payment contingent on performance in order to motivate workers. We used fMRI with a novel incentivized skill task to examine the neural processes underlying behavioral responses to performance-based pay. We found that individuals' performance increased with increasing incentives; however, very high incentive levels led to the paradoxical consequence of worse performance. Between initial incentive presentation and task execution, striatal activity rapidly switched between activation and deactivation in response to increasing incentives. Critically, decrements in performance and striatal deactivations were directly predicted by an independent measure of behavioral loss aversion. These results suggest that incentives associated with successful task performance are initially encoded as a potential gain; however, when actually performing a task, individuals encode the potential loss that would arise from failure. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. 42 CFR 495.310 - Medicaid provider incentive payments.

    Science.gov (United States)

    2010-10-01

    ... proxy for charity care. If the State determines that an eligible provider's data are not available on... provider's average annual rate of growth for the most recent 3 years for which data are available per year... this section, the State may use that provider's data on uncompensated care to determine an appropriate...

  17. The cost of making compensation payments to local forest ...

    African Journals Online (AJOL)

    REDD+ is usually presented as an incentive-based mechanism that can provide payments to compensate for the costs induced by conservation restrictions. Yet in Madagascar REDD+ is implemented through a command-and-control approach with almost no or insufficient compensation. This paper challenges the financial

  18. Incentive contracts for development projects

    Science.gov (United States)

    Finley, David T.; Smith, Byron; DeGroff, B.

    2012-09-01

    Finding a contract vehicle that balances the concerns of the customer and the contractor in a development project can be difficult. The customer wants a low price and an early delivery, with as few surprises as possible as the project progresses. The contractor wants sufficient cost and schedule to cover risk. Both want to clearly define what each party will provide. Many program offices do not want to award cost plus contracts because their funding sources will not allow it, their boards do not want an open ended commitment, and they feel like they lose financial control of the project. A fixed price incentive contract, with a mutually agreed upon target cost, provides the owner with visibility into the project and input into the execution of the project, encourages both parties to save costs, and stimulates a collaborative atmosphere by aligning the respective interests of customers and contractors.

  19. 24 CFR 982.514 - Distribution of housing assistance payment.

    Science.gov (United States)

    2010-04-01

    ... payment. 982.514 Section 982.514 Housing and Urban Development Regulations Relating to Housing and Urban... URBAN DEVELOPMENT SECTION 8 TENANT BASED ASSISTANCE: HOUSING CHOICE VOUCHER PROGRAM Rent and Housing Assistance Payment § 982.514 Distribution of housing assistance payment. The monthly housing assistance...

  20. 24 CFR 982.451 - Housing assistance payments contract.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Housing assistance payments... URBAN DEVELOPMENT SECTION 8 TENANT BASED ASSISTANCE: HOUSING CHOICE VOUCHER PROGRAM Housing Assistance Payments Contract and Owner Responsibility § 982.451 Housing assistance payments contract. (a)(1) The HAP...

  1. 7 CFR 240.7 - Payments to States.

    Science.gov (United States)

    2010-01-01

    ... designated State Officials of a Payment Voucher on Letter of Credit (Treasury Form GFO 7578) in accordance... 7 Agriculture 4 2010-01-01 2010-01-01 false Payments to States. 240.7 Section 240.7 Agriculture... CHILD NUTRITION PROGRAMS CASH IN LIEU OF DONATED FOODS § 240.7 Payments to States. (a) Funds to be paid...

  2. 45 CFR 233.32 - Payment and budget months (AFDC).

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false Payment and budget months (AFDC). 233.32 Section... CONDITIONS OF ELIGIBILITY IN FINANCIAL ASSISTANCE PROGRAMS § 233.32 Payment and budget months (AFDC). A State... period used to determine that payment (budget month) and whether it adopts (a) a one-month or two-month...

  3. 42 CFR 413.64 - Payments to providers: Specific rules.

    Science.gov (United States)

    2010-10-01

    ... SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Payments to... following period. However, since initially there is no previous history of cost under the program, the... cost reporting periods, see § 413.350 regarding periodic interim payments for skilled nursing...

  4. 28 CFR 94.41 - Interim emergency payment.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Interim emergency payment. 94.41 Section 94.41 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) CRIME VICTIM SERVICES International Terrorism Victim Expense Reimbursement Program Payment of Claims § 94.41 Interim emergency payment...

  5. 45 CFR 302.38 - Payments to the family.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false Payments to the family. 302.38 Section 302.38... ENFORCEMENT PROGRAM), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES STATE PLAN REQUIREMENTS § 302.38 Payments to the family. The State plan shall provide that any payment...

  6. 7 CFR 792.4 - Demand for payment of debts.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Demand for payment of debts. 792.4 Section 792.4... AGRICULTURE PROVISIONS COMMON TO MORE THAN ONE PROGRAM DEBT SETTLEMENT POLICIES AND PROCEDURES § 792.4 Demand for payment of debts. (a) When a debt is due FSA, an initial written demand for payment of such amount...

  7. A performance incentive contract that pays off for all parties

    International Nuclear Information System (INIS)

    Krummrich, C.R.; Johnston, R.E.; Crist, T.W.

    1995-01-01

    The Western Business Unit Bakersfield drilling department of Chevron, U.S.A. Production Company developed a drilling performance incentive contract that was implemented during 1994 in the Lost Hills field of California. The performance incentive contract (PIC) financially rewarded all of the drilling contractor's rig employees for outperforming pre-established drilling performance goals. The key elements of the performance incentive program are: (1) Goals that rigger incentives are based on cost categories that are controllable by the drilling team; (2) Goals were established using a database of past years performance; (3) Goals that are not achieved negatively impact the incentive earned in an effort to deter repeated errors; (4) Accidents that occur on the job negatively impact the incentive earned; (5) Administration of the program is not time consuming. The results of using an incentive contract in the Lost Hills drilling program are: (1) Time and cost of operations are reduced; (2) The results are measurable and repeatable; (3) A team environment develops in which ideas are shared and acted upon by crew members and supervisory personnel

  8. 20 CFR 411.575 - How does the EN request payment for milestones or outcome payment months achieved by a...

    Science.gov (United States)

    2010-04-01

    ... Section 411.575 Employees' Benefits SOCIAL SECURITY ADMINISTRATION THE TICKET TO WORK AND SELF-SUFFICIENCY PROGRAM Employment Network Payment Systems § 411.575 How does the EN request payment for milestones or... payment for a month if— (i)(A) Social Security disability benefits and Federal SSI cash benefits are not...

  9. 76 FR 6597 - Agency Information Collection Activities: Proposed Collection; Comment Request-Healthy Incentives...

    Science.gov (United States)

    2011-02-07

    ...) households to encourage their purchase and consumption of fruits and vegetables. SNAP households chosen to... fruits and vegetables. The incentive payment will be added to the HIP participant's SNAP benefit account... DEPARTMENT OF AGRICULTURE Food and Nutrition Service Agency Information Collection Activities...

  10. 38 CFR 36.4319 - Servicer loss-mitigation options and incentives.

    Science.gov (United States)

    2010-07-01

    .... (b) The amount of the incentive payment is as follows: Tier ranking One Two Three Four Repayment Plan... options or alternatives to foreclosure completed: repayment plans, special forbearance agreements, loan... respect to a repayment plan (as defined in § 36.4801), when the loan reinstates; (2) With respect to...

  11. Payment Reform: Unprecedented and Evolving Impact on Gynecologic Oncology

    Directory of Open Access Journals (Sweden)

    Sachin eApte

    2016-04-01

    Full Text Available With the signing of the Medicare Access and CHIP Reauthorization Act (MACRA in April 2015, the Centers for Medicare and Medicaid Services (CMS is now positioned to drive the development and implementation of sweeping changes to how physicians and hospitals are paid for the provision of oncology related services. These changes will have a long-lasting impact on the sub-specialty of gynecologic oncology, regardless of practice structure, physician employment and compensation model, or local insurance market. Recently, commercial payers have piloted various models of payment reform via oncology specific clinical pathways, oncology medical homes, episode payment arrangements, and accountable care organizations. Despite the positive results of some pilot programs, adoption remains limited. The goals are to eliminate unnecessary variation in cancer treatment, provide coordinated patient-centered care, while controlling costs. Yet, meaningful payment reform in oncology remains elusive. As the largest payer for oncology services in the United States, CMS has the leverage to make cancer services more value-based. Thus far, the focus has been around pricing of physician-administered drugs with recent work in the area of the Oncology Medical Home. Gynecologic oncology is a unique sub-specialty which blends surgical and medical oncology, with treatment that often involves radiation therapy. This forward-thinking, multi-disciplinary model works to keep the patient at the center of the care continuum and emphasizes care coordination. Because of the breadth and depth of gynecologic oncology, this sub-specialty has both the potential to be disrupted by payment reform as well as potentially benefit from the aspects of reform which can align incentives appropriately to improve coordination. Although the precise future payment models are unknown at this time, focused engagement of gynecologic oncologists and the full care team is imperative to assure that the

  12. Payment Reform: Unprecedented and Evolving Impact on Gynecologic Oncology.

    Science.gov (United States)

    Apte, Sachin M; Patel, Kavita

    2016-01-01

    With the signing of the Medicare Access and CHIP Reauthorization Act in April 2015, the Centers for Medicare and Medicaid Services (CMS) is now positioned to drive the development and implementation of sweeping changes to how physicians and hospitals are paid for the provision of oncology-related services. These changes will have a long-lasting impact on the sub-specialty of gynecologic oncology, regardless of practice structure, physician employment and compensation model, or local insurance market. Recently, commercial payers have piloted various models of payment reform via oncology-specific clinical pathways, oncology medical homes, episode payment arrangements, and accountable care organizations. Despite the positive results of some pilot programs, adoption remains limited. The goals are to eliminate unnecessary variation in cancer treatment, provide coordinated patient-centered care, while controlling costs. Yet, meaningful payment reform in oncology remains elusive. As the largest payer for oncology services in the United States, CMS has the leverage to make cancer services more value based. Thus far, the focus has been around pricing of physician-administered drugs with recent work in the area of the Oncology Medical Home. Gynecologic oncology is a unique sub-specialty that blends surgical and medical oncology, with treatment that often involves radiation therapy. This forward-thinking, multidisciplinary model works to keep the patient at the center of the care continuum and emphasizes care coordination. Because of the breadth and depth of gynecologic oncology, this sub-specialty has both the potential to be disrupted by payment reform as well as potentially benefit from the aspects of reform that can align incentives appropriately to improve coordination. Although the precise future payment models are unknown at this time, focused engagement of gynecologic oncologists and the full care team is imperative to assure that the practice remains patient centered

  13. Payment Reform: Unprecedented and Evolving Impact on Gynecologic Oncology

    Science.gov (United States)

    Apte, Sachin M.; Patel, Kavita

    2016-01-01

    With the signing of the Medicare Access and CHIP Reauthorization Act in April 2015, the Centers for Medicare and Medicaid Services (CMS) is now positioned to drive the development and implementation of sweeping changes to how physicians and hospitals are paid for the provision of oncology-related services. These changes will have a long-lasting impact on the sub-specialty of gynecologic oncology, regardless of practice structure, physician employment and compensation model, or local insurance market. Recently, commercial payers have piloted various models of payment reform via oncology-specific clinical pathways, oncology medical homes, episode payment arrangements, and accountable care organizations. Despite the positive results of some pilot programs, adoption remains limited. The goals are to eliminate unnecessary variation in cancer treatment, provide coordinated patient-centered care, while controlling costs. Yet, meaningful payment reform in oncology remains elusive. As the largest payer for oncology services in the United States, CMS has the leverage to make cancer services more value based. Thus far, the focus has been around pricing of physician-administered drugs with recent work in the area of the Oncology Medical Home. Gynecologic oncology is a unique sub-specialty that blends surgical and medical oncology, with treatment that often involves radiation therapy. This forward-thinking, multidisciplinary model works to keep the patient at the center of the care continuum and emphasizes care coordination. Because of the breadth and depth of gynecologic oncology, this sub-specialty has both the potential to be disrupted by payment reform as well as potentially benefit from the aspects of reform that can align incentives appropriately to improve coordination. Although the precise future payment models are unknown at this time, focused engagement of gynecologic oncologists and the full care team is imperative to assure that the practice remains patient centered

  14. How Accountable Care Organizations Responded to Pediatric Incentives in the Alternative Quality Contract.

    Science.gov (United States)

    Chien, Alyna T; Schiavoni, Katherine H; Sprecher, Eli; Landon, Bruce E; McNeil, Barbara J; Chernew, Michael E; Schuster, Mark A

    2016-03-01

    From 2009 to 2010, 12 accountable care organizations (ACOs) entered into the alternative quality contract (AQC), BlueCross BlueShield of Massachusetts's global payment arrangement. The AQC included 6 outpatient pediatric quality measures among 64 total measures tied to pay-for-performance bonuses and incorporated pediatric populations in their global budgets. We characterized the pediatric infrastructure of these adult-oriented ACOs and obtained leaders' perspectives on their ACOs' response to pediatric incentives. We used Massachusetts Health Quality Partners and American Hospital Association Survey data to characterize ACOs' pediatric infrastructure as extremely limited, basic, and substantial on the basis of the extent of pediatric primary care, outpatient specialist, and inpatient services. After ACOs had 16 to 43 months of experience with the AQC, we interviewed 22 leaders to gain insight into how organizations made changes to improve pediatric care quality, tried to reduce pediatric spending, and addressed care for children with special health care needs. ACOs' pediatric infrastructure ranged from extremely limited (eg, no general pediatricians in their primary care workforce) to substantial (eg, 42% of workforce was general pediatricians). Most leaders reported intensifying their pediatric quality improvement efforts and witnessing changes in quality metrics; most also investigated pediatric spending patterns but struggled to change patients' utilization patterns. All reported that the AQC did little to incentivize care for children with special health care needs and that future incentive programs should include this population. Although ACOs involved in the AQC were adult-oriented, most augmented their pediatric quality improvement and spending reduction efforts when faced with pediatric incentives. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  15. Effects of compensation methods and physician group structure on physicians' perceived incentives to alter services to patients.

    Science.gov (United States)

    Reschovsky, James D; Hadley, Jack; Landon, Bruce E

    2006-08-01

    To examine how health plan payment, group ownership, compensation methods, and other practice management tools affect physician perceptions of whether their overall financial incentives tilt toward increasing or decreasing services to patients. Nationally representative data on physicians are from the 2000-2001 Community Tracking Study Physician Survey (N=12,406). Ordered and multinomial logistic regression were used to explore how physician, group, and market characteristics are associated with physician reports of whether overall financial incentives are to increase services, decrease services, or neither. Seven percent of physicians report financial incentives are to reduce services to patients, whereas 23 percent report incentives to increase services. Reported incentives to reduce services were associated with reports of lower ability to provide quality care. Group revenue in the form of capitation was associated with incentives to reduce services whereas practice ownership and variable compensation and bonuses for employee physicians were mostly associated with incentives to increase services to patients. Full ownership of groups, productivity incentives, and perceived competitive markets for patients were associated with incentives to both increase and reduce services. Practice ownership and the ways physicians are compensated affect their perceived incentives to increase or decrease services to patients. In the latter case, this adversely affects perceived quality of care and satisfaction, although incentives to increase services may also have adverse implications for quality, cost, and insurance coverage.

  16. Payment Instrument Characteristics

    DEFF Research Database (Denmark)

    Holst, Jacques; Kjeldsen, Martin; Hedman, Jonas

    2015-01-01

    Over the last decade, we have witnessed payment innovations that fundamentally have changed the ways we pay. Payment innovations, such as mobile payments and on-line banking, include characteristics or features that are essential to understand if we want to know how and why payers choose among...... payment innovations. Using the Repertory Grid technique to explore 15 payers’ perception of six payment instruments, including coins, banknotes, debit cards, credit cards, mobile payments, and on-line banking, we identify 16 payment characteristics. The characteristics aggregate seventy-six unique...

  17. Association of Practice-Level Social and Medical Risk With Performance in the Medicare Physician Value-Based Payment Modifier Program.

    Science.gov (United States)

    Chen, Lena M; Epstein, Arnold M; Orav, E John; Filice, Clara E; Samson, Lok Wong; Joynt Maddox, Karen E

    2017-08-01

    Medicare recently launched the Physician Value-Based Payment Modifier (PVBM) Program, a mandatory pay-for-performance program for physician practices. Little is known about performance by practices that serve socially or medically high-risk patients. To compare performance in the PVBM Program by practice characteristics. Cross-sectional observational study using PVBM Program data for payments made in 2015 based on performance of large US physician practices caring for fee-for-service Medicare beneficiaries in 2013. High social risk (defined as practices in the top quartile of proportion of patients dually eligible for Medicare and Medicaid) and high medical risk (defined as practices in the top quartile of mean Hierarchical Condition Category risk score among fee-for-service beneficiaries). Quality and cost z scores based on a composite of individual measures. Higher z scores reflect better performance on quality; lower scores, better performance on costs. Among 899 physician practices with 5 189 880 beneficiaries, 547 practices were categorized as low risk (neither high social nor high medical risk) (mean, 7909 beneficiaries; mean, 320 clinicians), 128 were high medical risk only (mean, 3675 beneficiaries; mean, 370 clinicians), 102 were high social risk only (mean, 1635 beneficiaries; mean, 284 clinicians), and 122 were high medical and social risk (mean, 1858 beneficiaries; mean, 269 clinicians). Practices categorized as low risk performed the best on the composite quality score (z score, 0.18 [95% CI, 0.09 to 0.28]) compared with each of the practices categorized as high risk (high medical risk only: z score, -0.55 [95% CI, -0.77 to -0.32]; high social risk only: z score, -0.86 [95% CI, -1.17 to -0.54]; and high medical and social risk: -0.78 [95% CI, -1.04 to -0.51]) (P risk only performed the best on the composite cost score (z score, -0.52 [95% CI, -0.71 to -0.33]), low risk had the next best cost score (z score, -0.18 [95% CI, -0.25 to -0.10]), then

  18. 78 FR 14689 - Medicare Program; Extension of the Payment Adjustment for Low-volume Hospitals and the Medicare...

    Science.gov (United States)

    2013-03-07

    ...) and FY 2012 IPPS/LTCH PPS final rule (76 FR 51680), respectively.) Program guidance on the systems... contractor detailing its status in light of the MDH program extension. Program guidance on the systems... with the regulatory philosophy and principles identified in Executive Order 12866 and 13563, the RFA...

  19. Allocating Group-Level Payments for Ecosystem Services: Experiences from a REDD+ Pilot in Tanzania

    Directory of Open Access Journals (Sweden)

    Elizabeth J. Z. Robinson

    2016-12-01

    Full Text Available Payments for ecosystem services (PES typically reward landowners for managing their land to provide ecosystem services that would not otherwise be provided. REDD+—Reduced Emissions from Deforestation and Forest Degradation—is a form of PES aimed at decreasing carbon emissions from forest conversion and extraction in lower-income countries. A key challenge for REDD+ occurs when it is implemented at a group, rather than an individual landowner, level. Whilst achieving a group-level reduction relies on individuals changing their interaction with the forest, incentives are not aligned explicitly at the individual level. Rather, payments are made to a defined group as a single entity in exchange for verified reduced forest loss, as per a PES scheme. In this paper, we explore how REDD+ has been implemented in one multiple-village pilot in Tanzania with the village defining the group. Our findings suggest that considerable attention has been paid towards monitoring, reporting, verification (MRV, and equity. No explicit mechanism ensures individual compliance with the village-level PES, and few villages allocate funds for explicit enforcement efforts to protect the forest from illegal activities undertaken by individual group members or by outsiders. However, the development of village-level institutions, “social fencing,” and a shared future through equal REDD+ payments, factor into decisions that influence the level of compliance at the village level that the program will eventually achieve.

  20. 7 CFR 784.6 - Rate of payment and limitations on funding.

    Science.gov (United States)

    2010-01-01

    ..., DEPARTMENT OF AGRICULTURE SPECIAL PROGRAMS 2004 EWE LAMB REPLACEMENT AND RETENTION PAYMENT PROGRAM § 784.6... proration provisions of § 784.7, payments for qualifying operations shall be $18 for each qualifying ewe...

  1. 24 CFR 983.351 - PHA payment to owner for occupied unit.

    Science.gov (United States)

    2010-04-01

    ... URBAN DEVELOPMENT PROJECT-BASED VOUCHER (PBV) PROGRAM Payment to Owner § 983.351 PHA payment to owner for occupied unit. (a) When payments are made. (1) During the term of the HAP contract, the PHA shall... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false PHA payment to owner for occupied...

  2. 76 FR 26583 - Extension of Withholding to Certain Payments Made by Government Entities

    Science.gov (United States)

    2011-05-09

    ... payment made in connection with a government voucher or certificate program which functions as a payment... requested exceptions for these types of payments because withholding would detrimentally affect the cash... administrative complexities. In addition, many commenters requested guidance on whether certain types of payments...

  3. Analysis of the ecological conservation behavior of farmers in payment for ecosystem service programs in eco-environmentally fragile areas using social psychology models.

    Science.gov (United States)

    Deng, Jian; Sun, Pingsheng; Zhao, Fazhu; Han, Xinhui; Yang, Gaihe; Feng, Yongzhong

    2016-04-15

    Studies on the ecological conservation behavior of farmers usually focus on individual and socio-economic characteristics without consideration of the underlying psychological constructs, such as farmers' intention and perceptions. This study uses the theory of planned behavior (TPB), a typical social psychology construct, to analyze the factors affecting the intention and behavior of farmers for conserving the ecological achievements from payment for ecosystem service (PES) programs in eco-environmentally fragile areas. Questionnaires based on TPB were administered to 1004 farmers from the Grain to Green Program area in the Loess Plateau, China, with the resulting dataset used to identify the underlying factors determining farmers' intention and behavior based on the structural equation model. The results show that the farmers' intention and behavior toward conserving ecological achievements were explained well by TPB. The farmers'behavior was significantly positively affected by their intention toward conserving ecological achievements, and their intention was significantly influenced by their attitude (positive or negative value of performance), the subjective norm (social pressure in engaging behavior), and perceived behavioral control (perceptions of their ability). The farmers' degree of support for PES programs and their recognition of environmental effects were the factors that most influenced the farmers' attitude. Pressure from neighbors was the most potent driver of the subjective norm. Meanwhile, perceptions of their ability to perform the behavior were the most potent factors affecting intention and it was mostly driven by the farmers' feelings toward environmental improvement and perceived ability (time and labor) to participate in ecological conservation. The drivers of attitude, subjective norm, and perceived behavioral control can be used by policy makers to direct farmers' intention and behavior toward conserving ecological achievements in fragile

  4. 7 CFR 1599.6 - Payments.

    Science.gov (United States)

    2010-01-01

    ... AGRICULTURE McGOVERN-DOLE INTERNATIONAL FOOD FOR EDUCATION AND CHILD NUTRITION PROGRAM § 1599.6 Payments. (a... by the participant for reimbursement of freight, survey costs other than at load port, and other...

  5. Do Monetary Incentives Increase Fitness Center Utilization? It Depends.

    Science.gov (United States)

    Hooker, Stephanie A; Wooldridge, Jennalee S; Ross, Kaile M; Masters, Kevin S

    2018-03-01

    To examine the effects of an employer-based monetary incentive program on membership termination and usage at a fitness center. Retrospective nested case-control study examining the relationship between participation in an incentive program, visits to the fitness center, and membership termination at 1 year. University-based fitness center. Members (N = 1122) of a university-based fitness center. Members were offered either a US$25 incentive for each month they visited the fitness center at least 10 times or no incentive. Data were extracted from the membership database and included membership termination at 1 year (yes, no), length of membership (days), participation in the incentive program (yes, no), and visits to the fitness center per month. Cox proportional hazards model. Members in the incentive program visited the fitness center on average more times per month (5.3 vs 4.3; P fitness center may be initially associated with a greater fitness center utilization but may not be associated with a reduced risk of membership termination.

  6. Financial incentives for healthy behavior: ethical safeguards for behavioral economics.

    Science.gov (United States)

    Lunze, Karsten; Paasche-Orlow, Michael K

    2013-06-01

    Economic incentives to promote healthy behavior are becoming increasingly common and have been suggested as an approach to decreasing healthcare costs. Ethical concerns about programs with such incentives are that they may contribute to inequities, be coercive, interfere with therapeutic relationships, undermine personal responsibility for health, and decrease social solidarity. Additionally, they may be a source of stigma or discrimination, promote dependence, and be unfair for those already engaged in targeted health behaviors or those who cannot fulfill the incentivized behaviors. Incentive programs need to incorporate appropriate safeguards to monitor these risks and support fairness in offering economic incentives to promote healthy behavior. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  7. Medicare program; prospective payment system and consolidated billing for skilled nursing facilities. Department of Health and Human Services (HHS), Health Care Financing Administration (HCFA). Final rule.

    Science.gov (United States)

    1999-07-30

    This final rule responds to comments submitted by the public on our May 12, 1998 interim final rule, that implemented provisions in section 4432 of the Balanced Budget Act of 1997 regarding Medicare payment for skilled nursing facility services. This legislation established a prospective payment system, a consolidated billing provision, and a number of related changes.

  8. Financial incentives and weight control.

    Science.gov (United States)

    Jeffery, Robert W

    2012-11-01

    This paper reviews research studies evaluating the use of financial incentives to promote weight control conducted between 1972 and 2010. It provides an overview of behavioral theories pertaining to incentives and describes empirical studies evaluating specific aspects of incentives. Research on financial incentives and weight control has a history spanning more than 30 years. Early studies were guided by operant learning concepts from Psychology, while more recent studies have relied on economic theory. Both theoretical orientations argue that providing financial rewards for losing weight should motivate people to engage in behaviors that produce weight loss. Empirical research has strongly supported this idea. However, results vary widely due to differences in incentive size and schedule, as well as contextual factors. Thus, many important questions about the use of incentives have not yet been clearly answered. Weight-maintenance studies using financial incentives are particularly sparse, so that their long-term efficacy and thus, value in addressing the public health problem of obesity is unclear. Major obstacles to sustained applications of incentive in weight control are funding sources and acceptance by those who might benefit. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. 42 CFR 412.632 - Method of payment under the inpatient rehabilitation facility prospective payment system.

    Science.gov (United States)

    2010-10-01

    ... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR... rehabilitation facility receives payment under this subpart for inpatient operating costs and capital-related... under the PIP method without undue risk of its resulting in an overpayment to the provider. (2...

  10. The influence of provider characteristics and market forces on response to financial incentives.

    Science.gov (United States)

    O'Neil, Brock; Tyson, Mark; Graves, Amy J; Barocas, Daniel A; Chang, Sam S; Penson, David F; Resnick, Matthew J

    2017-11-01

    Alternative payment models, such as accountable care organizations, use financial incentives as levers for change to facilitate the transition from volume to value. However, implementation raises concerns about adverse changes in market competition and the resultant physician response. We sought to identify physician characteristics and market-level factors associated with variation in response to financial incentives for cancer care that may ultimately be leveraged in risk-shared payment models. Retrospective cohort study of physicians providing minimally invasive bladder cancer procedures to fee-for-service Medicare beneficiaries. We examined the relationship of between-group differences in market-level factors (competition [Herfindahl-Hirschman Index (HHI)] and provider density) and physician-level factors (use of unique billing codes, number of billing codes per patient, and competing financial interest) to responsiveness to financial incentives. Incentive-responsive providers had increased odds (odds ratio [OR], 1.19; 95% CI, 1.04-1.35) of practicing in markets with the highest quartile of provider density but not HHI (OR, 0.96; 95% CI, 0.87-1.05). Incentive-responsive providers were more likely to bill in the highest quartile for unique codes (OR, 1.49; 95% CI, 1.32-1.69) and codes per patient (OR, 1.18; 95% CI, 1.11-1.25) and less likely to have a competing financial interest (OR, 0.76; 95% CI, 0.72-0.81). Responsiveness to financial incentives in cancer care is associated with high market provider density, profit-maximizing billing behavior, and lack of competing financial ownership interests. Identifying physicians and markets responsive to financial incentives may ultimately promote the successful implementation of alternative payment models in cancer care.

  11. Incentives and moral hazard

    DEFF Research Database (Denmark)

    Wendimu, Mengistu Assefa; Henningsen, Arne; Czekaj, Tomasz Gerard

    . As sugar-cane production depends on various exogenous factors that are measured as categorical variables (e.g. soil type, cane variety, etc.), we estimate the production function by a nonparametric kernel regression method that takes into account both continuous and categorical explanatory variables......We investigate the unique contractual arrangement between a large Ethiopian sugar factory and its adjacent outgrower associations. The only significant difference between the sugarcane production on the factory-operated sugarcane plantation and on the outgrower-operated plots is the remuneration...... system and thus, the incentives to the workers. We compare the productivity of the factory-operated plantation with the outgrower-operated plots based on a new cross-sectional plot-level data set that includes all plots that are operated by the sugar factory and its adjacent outgrower associations...

  12. Network versus Economic Incentives

    DEFF Research Database (Denmark)

    Larsen, Christian Albrekt

    The article supplements the traditional economic line of reasoning with an economic sociological account of the transition from unemployment to employment. The lack of full information is recognised by economic theory while the focus on network within the tradition of economic sociology has...... not been adopted. The article argues that the importance of network actually might be very well understood within recent economic theories that emphasise the lack of full information. The empirical evidence for the importance of network both for employed and unemployed is provided by analysing a best case...... might be an important part of the vicious circles of unemployment. Finally, the article analyse the importance of network versus the importance of economic incentives. The result supports the thesis that economic sociology provides a better account of the transition from unemployment to employment than...

  13. 34 CFR 692.111 - For what purposes may a State use its payment under the GAP Program?

    Science.gov (United States)

    2010-07-01

    ... annually notify potentially eligible students in grades 7 through 12 in the State, and their families, of... ASSISTANCE PARTNERSHIP PROGRAM Grants for Access and Persistence Program What Is the Amount of Assistance and... establish a partnership to award grants to eligible students in order to increase the amount of financial...

  14. The law, policy, and ethics of employers' use of financial incentives to improve health.

    Science.gov (United States)

    Madison, Kristin M; Volpp, Kevin G; Halpern, Scott D

    2011-01-01

    The Patient Protection and Affordable Care Act (ACA) turns to a nontraditional mechanism to improve public health: employer-provided financial incentives for healthy behaviors. Critics raise questions about incentive programs' effectiveness, employer involvement, and potential discrimination. We support incentive program development despite these concerns. The ACA sets the stage for a broad-based research and implementation agenda through which we can learn to structure incentive programs to not only promote public health but also address prevalent concerns. © 2011 American Society of Law, Medicine & Ethics, Inc.

  15. Hospital responses to pay-for-performance incentives.

    Science.gov (United States)

    Reiter, Kristin L; Nahra, Tammie A; Alexander, Jeffrey A; Wheeler, John R C

    2006-05-01

    Not-for-profit hospitals are complex organizations and, therefore, may face unique challenges in responding to financial incentives for quality. In this research, we explore the types of behavioural changes made by not-for-profit Michigan hospitals in response to a pay-for-performance system for quality. We also identify factors that motivate or facilitate changes in effort. We apply a conceptual framework based on agency theory to motivate our research questions. Using data derived from structured interviews and surveys administered to 86 hospitals participating in a pay-for-performance system, we compare hospitals reporting and not reporting behavioural changes. Separate analyses are performed for hospitals reporting structure-related changes and hospitals reporting process-related changes. Our findings confirm that hospitals respond to incentive payments; however, our findings also reveal that hospital responses are not universal. Rather, involvement by boards of trustees, willingness to exert leverage with physicians, and financial and competitive motivations are all associated with hospitals' behavioural responses to incentives. Results of this research will help inform payers and hospital managers considering the use of incentives about the nature of hospitals' responses.

  16. Feedback and Incentives:

    DEFF Research Database (Denmark)

    Eriksson, Tor Viking; Poulsen, Anders; Villeval, Marie-Claire

    This paper experimentally investigates the impact of different pay and relative performance information policies on employee effort. We explore three information policies: No feedback about relative performance, feedback given halfway through the production period, and continuously updated feedback....... The pay schemes are a piece rate payment scheme and a winner-takes-all tournament. We find that, regardless of the pay scheme used, feedback does not improve performance. There are no significant peer effects in the piece-rate pay scheme. In contrast, in the tournament scheme we find some evidence...... of positive peer effects since the underdogs almost never quit the competition even when lagging significantly behind, and frontrunners do not slack off. Moreover, in both pay schemes information feedback reduces the quality of the low performers' work....

  17. Strategic use of incentive mechanisms as a regulatory policy tool

    Energy Technology Data Exchange (ETDEWEB)

    McDermott, K.A. (Illinois Commerce Commission, Springfield (United States)); South, D.W.; Bailey, K.A. (Argonne National Lab., IL (United States))

    1992-12-01

    In many quarters, traditional cost-plus regulation has come to be perceived as a failure. This perception is, in part, the result of a conjunction of events, changing philosophy, and measurable performance problems in the electric utility industry. Risk, competition and prudence issues will dominate the regulatory agenda in the 1990s. The experience being gained through application of alternative regulation in the telecommunications industry will have a significant impact on the willingness of regulators to experiment with new incentive approaches in the electric and natural gas industries. If the goals of a program are well specified, and if the incentive mechanism is designed in the appropriate fashion, incentives can play a major role in least-cost planning programs and in more accommodating regulatory environments. Significant attention has been given to alternative incentive programs in the electric power industry. The purpose of this paper is not to review the extensive literature on incentives, but rather to provide a nuts and bolts, common-sense analysis of the strategic value of incentive mechanisms as a regulatory policy. 14 refs., 1 fig., 2 tabs.

  18. Taxonomy of Payments

    DEFF Research Database (Denmark)

    Hedman, Jonas; Tan, Felix B.; Holst, Jacques

    2017-01-01

    . The approach draws heavily on organizational systematics to better understand payers’ choice of payment instruments. Findings: A four-category taxonomy of payments was developed. The authors refer to the taxonomy as the 4Ps: the purchase, the payer, the payment instrument, and the physical technology......) there are over 12,000 startups in the payment arena. For them, the taxonomy can function as a template for the design of payment instruments, as well as understanding the various factors that influence payer choice of payment instruments. Originality/value: The main contribution of this paper is the 4Ps taxonomy...

  19. Costs and results of federal incentives for commercial nuclear energy

    International Nuclear Information System (INIS)

    Bezdek, R.H.; Wendling, R.M.

    1991-01-01

    This paper (1) estimates the total costs of federal expenditures in support of incentives for the development of commercial nuclear energy through 1988, and (2) analyzes the results and benefits to the nation of this federal investment. The federal incentives analyzed include research and development, regulation of commercial nuclear energy, tax incentives, waste management and disposal, enrichment plants, liability insurance, the uranium mining industry, and all other federal support activities. The authors estimate that net federal incentives totaled about $45-50 billion (1988 dollars). They estimate the results of the federal incentives, focusing on six categories, namely, electric energy produced, the total (direct plus indirect) economic benefits of the industry created, R and D program benefits, value of energy imports displaced, environmental effects, and health, safety, and risk effects. The results total $1.9 trillion, with approximately $250-300 billion identified as net benefits. The authors conclude that the high return on the investment justified federal incentives for nuclear energy development over the past four decades and that the federal government and the nation have received a significant return on the incentives investment

  20. Incentive Pass-through for Residential Solar Systems in California

    Energy Technology Data Exchange (ETDEWEB)

    Dong, C. G. [Univ. of Texas, Austin, TX (United States); Wiser, Ryan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Rai, Varun [Univ. of Texas, Austin, TX (United States)

    2014-10-01

    The deployment of solar photovoltaic (PV) systems has grown rapidly over the last decade, partly because of various government incentives. In the United States, among the largest and longest-running incentives have been those established in California. Building on past research, this report addresses the still-unanswered question: to what degree have the direct PV incentives in California been passed through from installers to consumers? This report helps address this question by carefully examining the residential PV market in California (excluding a certain class of third-party-owned PV systems) and applying both a structural-modeling approach and a reduced-form regression analysis to estimate the incentive pass-through rate. The results suggest an average pass-through rate of direct incentives of nearly 100%, though with regional differences among California counties. While these results could have multiple explanations, they suggest a relatively competitive market and well-functioning subsidy program. Further analysis is required to determine whether similar results broadly apply to other states, to other customer segments, to all third-party-owned PV systems, or to all forms of financial incentives for solar (considering not only direct state subsidies, but also utility electric bill savings and federal tax incentives).

  1. Medicare and Medicaid Programs; CY 2018 Home Health Prospective Payment System Rate Update and CY 2019 Case-Mix Adjustment Methodology Refinements; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.

    Science.gov (United States)

    2017-11-07

    This final rule updates the home health prospective payment system (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor, effective for home health episodes of care ending on or after January 1, 2018. This rule also: Updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the third year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between calendar year (CY) 2012 and CY 2014; and discusses our efforts to monitor the potential impacts of the rebasing adjustments that were implemented in CY 2014 through CY 2017. In addition, this rule finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model and to the Home Health Quality Reporting Program (HH QRP). We are not finalizing the implementation of the Home Health Groupings Model (HHGM) in this final rule.

  2. Reporting of quality measures in gynecologic oncology programs at Prospective Payment System (PPS)-Exempt Cancer Hospitals: an early glimpse into a challenging initiative.

    Science.gov (United States)

    Cohn, David E; Leitao, Mario; Levenback, Charles; Berkowitz, Ross; Roman, Lynda; Lucci, Joseph; Kim, Sarah; Lancaster, Johnathon; Odunsi, Kunle; Wakabayashi, Mark; Goff, Barbara A

    2013-09-01

    The Affordable Care Act mandates the Prospective Payment System (PPS)-Exempt Cancer Hospitals Quality Reporting program. These 11 hospitals (which are paid fee-for-service rather than on a DRG system) began reporting measures (2 general safety, 2 breast, 1 colon) in 2013. Given this reporting mandate, we set out to determine whether the PPS-exempt gynecologic oncology programs could identify quality measures specific to the care of our patients. A list of 12 quality measures specific to gynecologic oncology was created (from sources including the National Quality Forum and the SGO). Measures already in use were not included. The list was ranked by the gynecologic oncology program directors at the PPS-exempt hospitals. Descriptive statistics (including mean and SD for rankings) were utilized. Despite mandatory reporting of quality measures for PPS-exempt cancer hospitals, little consensus exists regarding specific gynecologic cancer measures. Documentation of debulking status, cancer survival, and offering minimally invasive surgery (for endometrial cancer) and intraperitoneal chemotherapy (for ovarian cancer) are important, but with widely variable responses (when ranked 1-12, standard deviations are 2-3). General issues regarding adherence to guidelines for the use of GCSF, documentation of functional status, and tracking of patient satisfaction scores were ranked the lowest. Three of the directors reported that their compensation is partially linked to quality outcomes. There is wide variability in ranking of quality measures, and may relate to provider or institutional factors. Despite the mandatory reporting in PPS-exempt cancer hospitals, work remains to define gynecologic cancer quality measures. Copyright © 2013 The Authors. Published by Elsevier Inc. All rights reserved.

  3. Heart Attack Payment - State

    Data.gov (United States)

    U.S. Department of Health & Human Services — Payment for heart attack patients measure – state data. This data set includes state-level data for payments associated with a 30-day episode of care for heart...

  4. Heart Attack Payment - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — Payment for heart attack patients measure – provider data. This data set includes provider data for payments associated with a 30-day episode of care for heart...

  5. Heart Attack Payment - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — Payment for heart attack patients measure – national data. This data set includes national-level data for payments associated with a 30-day episode of care for heart...

  6. Legal and institutional implications of providing financial incentives to encourage the development of solar technologies

    Energy Technology Data Exchange (ETDEWEB)

    Hyatt, R. J.

    1979-07-01

    The legal basis to provide financial incentives is found in the enumerated powers of the Constitution for the exercise of federal authority, the police and tax powers for the exercise of state authority, and state delegated powers for the exercise of local authority. These powers are limited by the federal and state constitutions, and the scope of delegated authority. The major types of financial incentives are tax incentives, including income tax deductions and credits, accelerated depreciation allowances, tax-exempt bonds, and reduction in property and sales taxes; loan incentives, including low interest loans, government guaranteed and insured loans, and elimination of statutory and secondary market constraints; and government transfer incentives, including grants in aid from all levels of government. Other incentives that will indirectly affect the financing and availability of solar energy technologies include eliminating or reducing financial incentives benefiting competitive energy sources, government action to insure the operation of solar energy equipment, government-sponsored education, research, and development programs, government demonstration and procurement programs, and placing priority on rapid passage of solar energy legislation dealing with financial incentives. In most cases, a financial incentives program constituting one or more of these incentives will probably not confront any major, unique, legal or institutional impediments. The minor impediments that do exist can usually be eliminated by preventive legislation.

  7. Auctioning payment entitlements

    DEFF Research Database (Denmark)

    Nielsen, Kurt

    2005-01-01

    Payment entitlements is a new commodity that arises from the new European common agricultural policy. The agricultural subsidies are decoupled from the actual production and replaced by the so-called payment entitlements. A payment entitlement has a farm specific value and may be freely traded. T...... types of payment entitlements for sale. The auction enhances the competition and efficiency of the market, which is essential for the individual members of the European Union in order for them to receive their entitled subsidies....

  8. Existing and Potential Incentives for Practicing Sustainable Forestry on Non-industrial Private Forest Lands

    Science.gov (United States)

    John L. Greene; Michael A. Kilgore; Michael G. Jacobson; Steven E. Daniels; Thomas J. Straka

    2007-01-01

    This study examined the compatibility between sustainable forestry practices and the framework of public and private financial incentive programs directed toward nonindustrial private forest (NIPF) owners. The incentives include tax, cost-share, and other types of programs. The study consisted of four components: a literature review, a mail survey of selected...

  9. Payment and economic evaluation of integrated care

    Directory of Open Access Journals (Sweden)

    Apostolos Tsiachristas

    2015-04-01

    Full Text Available Chronic diseases have an increasingly negative impact on (1 population health by increasing morbidity and mortality, (2 society by increasing health inequalities and burden to informal caregivers, and (3 economy by requiring enormous financial resources and jeopardising macro-economic development (e.g. consumption, capital accumulation, labour productivity and labour supply. Integrated care is the most promising concept in redesigning care to tackle the increasing threat of chronic diseases. Several European countries have experimented with models for integrating care, most frequently in the form of disease management programmes. These models were often supported by payment schemes to provide financial incentives to health care providers for implementing integrated care. This thesis aimed to investigate these payment schemes and assess their impact, explore the variability in costs of disease management programmes, and determine the costs and effects of disease management programmes.

  10. 76 FR 42771 - Medicare Program; Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B...

    Science.gov (United States)

    2011-07-19

    ...--Balanced Budget Act of 1997 (Pub. L. 105-33) BBRA--[Medicare, Medicaid and State Child Health Insurance Program] Balanced Budget Refinement Act of 1999 (Pub. L. 106-113) BIPA--Medicare, Medicaid, and SCHIP...--Modification of Diet in Renal Disease MedCAC--Medicare Evidence Development and Coverage Advisory Committee...

  11. 75 FR 40039 - Medicare Program; Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B...

    Science.gov (United States)

    2010-07-13

    ... American Telemedicine Association AWP Average wholesale price BBA Balanced Budget Act of 1997 (Pub. L. 105-33) BBRA [Medicare, Medicaid and State Child Health Insurance Program] Balanced Budget Refinement Act... of Diet in Renal Disease MedCAC Medicare Evidence Development and Coverage Advisory Committee...

  12. Premier Hospital Quality Incentive Demonstration

    Data.gov (United States)

    U.S. Department of Health & Human Services — CMS is pursuing a vision to improve the quality of health care by expanding the information available about quality of care and through direct incentives to reward...

  13. Medicare program; prospective payment system and consolidated billing for skilled nursing facilities; extension of comment period--HCFA. Notice of extension of comment period for interim final rule.

    Science.gov (United States)

    1998-07-13

    This document extends the comment period for an interim final rule with comment period that was published in the Federal Register on May 12, 1998 (63 FR 26252). That interim final rule implements provisions in section 4432 of the Balanced Budget Act of 1997 related to Medicare payment for skilled nursing facility services. Those include the implementation of a Medicare prospective payment system for skilled nursing facilities, consolidated billing, and a number of related changes. The comment period is extended for 60 days.

  14. Analysis of the results of Federal incentives used to stimulate energy production

    Energy Technology Data Exchange (ETDEWEB)

    Cone, B.W.; Emery, J.C.; Fassbender, A.G.

    1980-06-01

    The research program analyzed the Federal incentives used to stimulate nuclear, hydro, coal, gas, oil, and electricity production in order to supply what was learned to the selection of an incentives strategy to induce new energy production from renewable resources. Following the introductory chapter, Chapter 2 examines the problem of estimating effects from a theoretical perspective. Methods of quantifying and identifying the many interactive effects of government actions are discussed. Chapter 3 presents a generic analysis of the result of Federal incentives. Chapters 4 through 9 deal with incentives to energy forms - nuclear, hydro, coal, oil, gas, and electricity. Chapter 10 summarizes the estimated results of the incentives, which are presented in terms of their quantity and price impacts. The incentive costs per million Btu of induced energy production is also discussed. Chapter 11 discusses the parity issue, that is an equivalence between Federal incentives to renewable resources and to traditional energy resources. Any analysis of incentives for solar needs will profit from an analysis of the costs of solar incentives per million Btu compared with those for traditional energy forms. Chapter 12 concludes the analysis, discussing the history of traditional energy incentives as a guide to solar-energy incentives. 216 references, 38 figures, 91 tables.

  15. Tax incentives to promote green electricity. An overview of EU-27 countries

    International Nuclear Information System (INIS)

    Cansino, Jose M.; Pablo-Romero, Maria del P.; Roman, Rocio; Yniguez, Rocio

    2010-01-01

    This paper provides a comprehensive overview of the main tax incentives used in the EU-27 member states (MSs) to promote green electricity. Sixteen MSs use tax incentives to promote green electricity simultaneously with other promotion measures, especially quota obligations and price regulation. However, not all available technologies are promoted. For example, six MSs (Germany, Romania, Slovak Republic, Denmark, Sweden and Poland) have included an exemption on the payments of excise duties for electricity when the electricity is generated from renewable energy sources (RES). This tax incentive is the most widely used. Limited tax incentives in personal income tax are available in Belgium, France, Czech Republic and Luxembourg. In corporate tax, tax incentives consist mainly of a deduction in the taxable profit (Belgium, Greece, Czech Republic and Spain). Lower tax rates in VAT are applied in three MSs, France, Italy and Portugal. Only Spain and Italy use effective tax incentives in property tax. As a great diversity of tax incentives has been used to promote green electricity, this adds another difficulty to the EU objective of providing a renewable energy policy framework, but also it offers a useful set of case studies which can be used to inform EU policy development. (author)

  16. Tax incentives to promote green electricity: An overview of EU-27 countries

    Energy Technology Data Exchange (ETDEWEB)

    Cansino, Jose M., E-mail: jmcansino@us.e [Department of Economic Analysis and Political Economy, Seville University, Avda. Ramon y Cajal, no 1, 41018 Seville (Spain); Pablo-Romero, Maria del P.; Roman, Rocio; Yniguez, Rocio [Department of Economic Analysis and Political Economy, Seville University, Avda. Ramon y Cajal, no 1, 41018 Seville (Spain)

    2010-10-15

    This paper provides a comprehensive overview of the main tax incentives used in the EU-27 member states (MSs) to promote green electricity. Sixteen MSs use tax incentives to promote green electricity simultaneously with other promotion measures, especially quota obligations and price regulation. However, not all available technologies are promoted. For example, six MSs (Germany, Romania, Slovak Republic, Denmark, Sweden and Poland) have included an exemption on the payments of excise duties for electricity when the electricity is generated from renewable energy sources (RES). This tax incentive is the most widely used. Limited tax incentives in personal income tax are available in Belgium, France, Czech Republic and Luxembourg. In corporate tax, tax incentives consist mainly of a deduction in the taxable profit (Belgium, Greece, Czech Republic and Spain). Lower tax rates in VAT are applied in three MSs, France, Italy and Portugal. Only Spain and Italy use effective tax incentives in property tax. As a great diversity of tax incentives has been used to promote green electricity, this adds another difficulty to the EU objective of providing a renewable energy policy framework, but also it offers a useful set of case studies which can be used to inform EU policy development.

  17. Tax incentives to promote green electricity. An overview of EU-27 countries

    Energy Technology Data Exchange (ETDEWEB)

    Cansino, Jose M.; Pablo-Romero, Maria del P.; Roman, Rocio; Yniguez, Rocio [Department of Economic Analysis and Political Economy, Seville University, Avda. Ramon y Cajal, no 1, 41018 Seville (Spain)

    2010-10-15

    This paper provides a comprehensive overview of the main tax incentives used in the EU-27 member states (MSs) to promote green electricity. Sixteen MSs use tax incentives to promote green electricity simultaneously with other promotion measures, especially quota obligations and price regulation. However, not all available technologies are promoted. For example, six MSs (Germany, Romania, Slovak Republic, Denmark, Sweden and Poland) have included an exemption on the payments of excise duties for electricity when the electricity is generated from renewable energy sources (RES). This tax incentive is the most widely used. Limited tax incentives in personal income tax are available in Belgium, France, Czech Republic and Luxembourg. In corporate tax, tax incentives consist mainly of a deduction in the taxable profit (Belgium, Greece, Czech Republic and Spain). Lower tax rates in VAT are applied in three MSs, France, Italy and Portugal. Only Spain and Italy use effective tax incentives in property tax. As a great diversity of tax incentives has been used to promote green electricity, this adds another difficulty to the EU objective of providing a renewable energy policy framework, but also it offers a useful set of case studies which can be used to inform EU policy development. (author)

  18. Achieving health care cost containment through provider payment reform that engages patients and providers.

    Science.gov (United States)

    Ginsburg, Paul B

    2013-05-01

    The best opportunity to pursue cost containment in the next five to ten years is through reforming provider payment to gradually diminish the role of fee-for-service reimbursement. Public and private payers have launched many promising payment reform pilots aimed at blending fee-for-service with payment approaches based on broader units of care, such as an episode or patients' total needs over a period of time, a crucial first step. But meaningful cost containment from payment reform will not be achieved until Medicare and Medicaid establish stronger incentives for providers to contract in this way, with discouragement of nonparticipation increasing over time. In addition, the models need to evolve to engage beneficiaries, perhaps through incentives for patients to enroll in an accountable care organization and to seek care within that organization's network of providers.

  19. Improving response rates using a monetary incentive for patient completion of questionnaires: an observational study

    Directory of Open Access Journals (Sweden)

    Orchard Jo

    2007-02-01

    Full Text Available Abstract Background Poor response rates to postal questionnaires can introduce bias and reduce the statistical power of a study. To improve response rates in our trial in primary care we tested the effect of introducing an unconditional direct payment of £5 for the completion of postal questionnaires. Methods We recruited patients in general practice with knee problems from sites across the United Kingdom. An evidence-based strategy was used to follow-up patients at twelve months with postal questionnaires. This included an unconditional direct payment of £5 to patients for the completion and return of questionnaires. The first 105 patients did not receive the £5 incentive, but the subsequent 442 patients did. We used logistic regression to analyse the effect of introducing a monetary incentive to increase the response to postal questionnaires. Results The response rate following reminders for the historical controls was 78.1% (82 of 105 compared with 88.0% (389 of 442 for those patients who received the £5 payment (diff = 9.9%, 95% CI 2.3% to 19.1%. Direct payments significantly increased the odds of response (adjusted odds ratio = 2.2, 95% CI 1.2 to 4.0, P = 0.009 with only 12 of 442 patients declining the payment. The incentive did not save costs to the trial – the extra cost per additional respondent was almost £50. Conclusion The direct payment of £5 significantly increased the completion of postal questionnaires at negligible increase in cost for an adequately powered study.

  20. 7 CFR 1463.113 - Issuance of payments in event of death.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Issuance of payments in event of death. 1463.113 Section 1463.113 Agriculture Regulations of the Department of Agriculture (Continued) COMMODITY CREDIT... PROGRAM Tobacco Transition Payment Program § 1463.113 Issuance of payments in event of death. If a quota...

  1. Use of Payment Technology

    DEFF Research Database (Denmark)

    Xiao, Xiao; Hedman, Jonas; Runnemark, Emma

    2015-01-01

    Drawing on the theory of consumption value, this research-in-progress strives to provide a theoretical explanation of payment technology use by investigating the relationship between consumers’ perceptions of different consumption values associated with a certain payment technology and their choice...... to use the technology. We conducted the study in the context of Denmark, a Northern European country, with three well established payment technologies: cash, payment cards, and Internet banking. Following a focus group of identifying and defining four types of consumption values associated with each...... payment technology, a survey was then conducted by a national statistics agency in the country. Preliminary results have shown that different consumption values matter for the use of different payment technologies. The findings will potentially contribute to a better understanding of consumer payment...

  2. Economic incentives and foster child adoption.

    Science.gov (United States)

    Argys, Laura; Duncan, Brian

    2013-06-01

    Every year, a large number of children in the United States enter the foster care system. Many of them are eventually reunited with their biological parents or quickly adopted. A significant number, however, face long-term foster care, and some of these children are eventually adopted by their foster parents. The decision by foster parents to adopt their foster child carries significant economic consequences, including for feiting foster care payments while also assuming responsibility for medical, legal, and educational expenses, to name a few. Since 1980, U.S. states have begun to offer adoption subsidies to offset some of these expenses, significantly lowering the cost of adopting a child who is in the foster care system. This article presents empirical evidence of the role that these economic incentives play in foster parents' decision of when, or if, to adopt their foster child. We find that adoption subsidies increase adoptions through two distinct price mechanisms: by lowering the absolute cost of adoption, and by lowering the relative cost of adoption versus long-term foster care.

  3. Hybrid carbon incentive mechanisms and political acceptability

    International Nuclear Information System (INIS)

    Vollebergh, H.R.J.; De Vries, J.L.; Koutstaal, P.R.

    1997-01-01

    In this paper it is analyzed how hybrid systems of carbon taxes and tradeable permits optimize some conflicting dimensions of political acceptability related to the design of these instruments. Pure systems like taxes without exemptions or auctioned tradeable permits cause problems for political acceptability in open economies due to high overall costs (abatement cost plus payments on the tax or auctions) for current polluters. Unfortunately, pure systems based on grandfathering of emission rights across the board do not provide a feasible alternative because of monitoring and enforcement problems. In contrast, consciously designed hybrid systems employ grandfathering of emission rights together with either carbon taxes or auctioned carbon permits in order to overcome acceptability problems of pure systems, while leaving incentives to reduce emissions at the margin untouched. Moreover, monitoring and enforcement costs of the hybrid systems are less due to the lower number of participating agents compared with the pure systems, while opportunities for cost- or burden-sharing exist as well. 3 figs., 4 tabs., 23 refs

  4. Using reporting requirements to improve employer wellness incentives and their regulation.

    Science.gov (United States)

    Madison, Kristin; Schmidt, Harald; Volpp, Kevin G

    2014-10-01

    Employer interest in offering financial incentives for healthy behaviors has been increasing. Some employers have begun to tie health plan-based rewards or penalties to standards involving tobacco use or biometric measures such as body mass index. The Patient Protection and Affordable Care Act attempts to strike a balance between the potential benefits and risks of wellness incentive programs by permitting these incentives but simultaneously limiting their use. Evidence about the implications of the newest generation of incentive programs for health, health costs, and burdens on individual employees will be critical for informing both private and public decision makers. After describing the many pieces of information that would be valuable for assessing these programs, this article proposes more narrowly targeted reporting requirements that could facilitate incentive program development, evaluation, and oversight. Copyright © 2014 by Duke University Press.

  5. Case Studies on the Effectiveness of State Financial Incentives for Renewable Energy

    Energy Technology Data Exchange (ETDEWEB)

    Gouchoe, S.; Everette, V.; Haynes, R.

    2002-09-01

    The North Carolina Solar Center at NC State University, in collaboration with the National Renewable Energy Laboratory, examined 10 state financial-incentive programs in six states using a case-study approach in order to clarify the key factors-both internal and external to the program-that influence their effectiveness at stimulating deployment of renewable energy technologies. While existing information resources such as the National Database of State Incentives for Renewable Energy (DSIRE, www.dsireusa.org) have documented what incentive programs are available, the effectiveness of such programs is not well understood. Understanding the impact of current financial incentives on the deployment of renewables and the factors that influence their effectiveness is critical to a variety of stakeholders, particularly in states considering new incentives or interested in improving or discarding existing ones.

  6. Existing and Emerging Payment and Delivery Reforms in Cardiology

    Science.gov (United States)

    Farmer, Steven A.; Darling, Margaret L.; George, Meaghan; Casale, Paul N.; Hagan, Eileen; McClellan, Mark B.

    2017-01-01

    IMPORTANCE Recent health care reforms aim to increase patient access, reduce costs, and improve health care quality as payers turn to payment reform for greater value. Cardiologists need to understand emerging payment models to succeed in the evolving payment landscape. We review existing payment and delivery reforms that affect cardiologists, present 4 emerging examples, and consider their implications for clinical practice. OBSERVATIONS Public and commercial payers have recently implemented payment reforms and new models are evolving. Most cardiology models are modified fee-for-service or address procedural or episodic care, but population models are also emerging. Although there is widespread agreement that payment reform is needed, existing programs have significant limitations and the adoption ofnew programs has been slow. New payment reforms address some of these problems, but many details remain undefined. CONCLUSIONS AND RELEVANCE Early payment reforms were voluntary and cardiologists’ participation is variable. However, conventional fee-for-service will become less viable, and enrollment in new payment models will be unavoidable. Early participation in new payment models will allow clinicians to develop expertise in new care pathways during a period of relatively lower risk. PMID:27851858

  7. Public attitudes to financial incentive models for organs

    DEFF Research Database (Denmark)

    Hoeyer, Klaus; Schicktanz, Silke; Deleuran, Ida

    2013-01-01

    Waiting lists for organs have stimulated interest in the use of financial incentives for organ donation (FIs), but the literature does not contain an adequate overview of studies of public attitudes toward this mode of procurement. We conducted a literature review of international peer-reviewed r......Waiting lists for organs have stimulated interest in the use of financial incentives for organ donation (FIs), but the literature does not contain an adequate overview of studies of public attitudes toward this mode of procurement. We conducted a literature review of international peer......-reviewed research published between 2002 and 2012 on how members of the public position themselves toward FIs. We identified and analyzed 23 studies using MEDLINE, PsycINFO, Sociological Abstracts and cross-reference search. The search included whole organs, donation, quantitative and empirical qualitative social...... scientific studies on, public attitudes (excluding professionals and medical students). The review reveals a broad divergence of public opinions on financial incentives. However, quantitative studies showed a low overall level of acceptance of payment for organs in living donation (LD); only a slightly...

  8. Incentives to promote family planning.

    Science.gov (United States)

    Heil, Sarah H; Gaalema, Diann E; Herrmann, Evan S

    2012-11-01

    Over the past 60 years, population control has become an increasingly urgent issue worldwide as a growing population strains already limited resources. The use of financial incentives to promote family planning is an innovative approach that has potential to make a contribution to efforts to better manage population growth. This report reviews eight studies that examined the effect of incentives on family planning. Published studies that tested the impact of incentives to promote some aspect of family planning and included an appropriate control or comparison condition were reviewed. Incentives have been used to promote attendance at contraceptive education sessions, adoption and continuation of contraceptive methods, sterilization, and to limit family size. All but one of the eight studies reviewed reported positive outcomes, but weaknesses in study design and execution limit the strength of the conclusions that can be drawn. Review of this literature suggests that family planning behaviors, like other behaviors, are sensitive to incentives. Given the tremendous need for efficacious interventions in global efforts to manage population growth, further research on this topic using more rigorous experimental methods is warranted. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. Detecting gradual and abrupt changes in water quality time series in response to regional payment programs for watershed services in an agricultural area

    Science.gov (United States)

    He, Tian; Lu, Yan; Cui, Yanping; Luo, Yabo; Wang, Min; Meng, Wei; Zhang, Kaijie; Zhao, Feifei

    2015-06-01

    Market-based watershed protection instruments can effectively improve water quality at various catchment scales. Two payments for watershed services (PWS) programs for water quality improvement have been successively implemented in the Huai River catchment and its sub-watershed, the Shaying River catchment, in Henan Province since 2009. To detect changes in water quality in response to PWS schemes, nonparametric statistical approaches were used to analyze gradual and abrupt trends in water quality, focusing on chemical oxygen demand (COD) and ammonia-nitrogen (NH3-N) at 26 monitoring stations in the Huai River watershed during 2006-2013. The nonparametric Mann-Kendall test and the Theil-Sen estimator were used to identify trends and their magnitudes in weekly water quality observations and the Pettitt test was applied to change-point analysis of water quality time series. We found decreasing concentration trends in the weekly water quality data set in this catchment, with water quality at most stations affected by the PWS schemes. The COD and NH3-N concentrations decreased at 26 stations by an average of 0.05 mg/L wk and 0.01 mg/L wk, respectively, from 2006 to 2013. Meanwhile, the mean concentrations of COD and NH3-N decreased at the 26 stations by an average of 18.03 mg/L and 4.82 mg/L, respectively, after the abrupt change points of the time-series trends of these two pollutants. We also estimated annual reductions in COD and NH3-N for each station based on average flow observations using the Theil-Sen approach along with the resulting economic benefits from 2009 to 2010. The COD and NH3-N reductions were 14604.50 and 6213.25 t/y, respectively, in the Huai River catchment in Henan Province. The total economic benefits of reductions in these two pollutants were 769.71 million ¥ in 2009 and 2010, accounting for 0.08% and 0.06%, respectively, of the GDP in the entire Huai River watershed of Henan Province. These results provide new insights into the linkages

  10. Modeling regulated water utility investment incentives

    Science.gov (United States)

    Padula, S.; Harou, J. J.

    2014-12-01

    This work attempts to model the infrastructure investment choices of privatized water utilities subject to rate of return and price cap regulation. The goal is to understand how regulation influences water companies' investment decisions such as their desire to engage in transfers with neighbouring companies. We formulate a profit maximization capacity expansion model that finds the schedule of new supply, demand management and transfer schemes that maintain the annual supply-demand balance and maximize a companies' profit under the 2010-15 price control process in England. Regulatory incentives for costs savings are also represented in the model. These include: the CIS scheme for the capital expenditure (capex) and incentive allowance schemes for the operating expenditure (opex) . The profit-maximizing investment program (what to build, when and what size) is compared with the least cost program (social optimum). We apply this formulation to several water companies in South East England to model performance and sensitivity to water network particulars. Results show that if companies' are able to outperform the regulatory assumption on the cost of capital, a capital bias can be generated, due to the fact that the capital expenditure, contrarily to opex, can be remunerated through the companies' regulatory capital value (RCV). The occurrence of the 'capital bias' or its entity depends on the extent to which a company can finance its investments at a rate below the allowed cost of capital. The bias can be reduced by the regulatory penalties for underperformances on the capital expenditure (CIS scheme); Sensitivity analysis can be applied by varying the CIS penalty to see how and to which extent this impacts the capital bias effect. We show how regulatory changes could potentially be devised to partially remove the 'capital bias' effect. Solutions potentially include allowing for incentives on total expenditure rather than separately for capex and opex and allowing

  11. Paying for Forest Ecosystem Services: Voluntary Versus Mandatory Payments.

    Science.gov (United States)

    Roesch-McNally, Gabrielle E; Rabotyagov, Sergey S

    2016-03-01

    The emergence of new markets for forest ecosystem services can be a compelling opportunity for market diversification for private forest landowners, while increasing the provision of public goods from private lands. However, there is limited information available on the willingness-to-pay (WTP) for specific forest ecosystem services, particularly across different ecosystem market mechanisms. We utilize survey data from Oregon and Washington households to compare marginal WTP for forest ecosystem services and the total WTP for cost-effective bundles of forest ecosystem services obtained from a typical Pacific Northwest forest across two value elicitation formats representing two different ecosystem market mechanisms: an incentive-compatible choice experiment involving mandatory tax payments and a hypothetical private provision scenario modeled as eliciting contributions to the preferred forest management alternative via a provision point mechanism with a refund. A representative household's total WTP for the average forest management program was estimated at $217.59 per household/year under a mandatory tax mechanism and $160.44 per household/per year under a voluntary, crowdfunding-style, contribution mechanism; however, these estimates are not statistically different. Marginal WTP estimates were assessed for particular forest ecosystem service attributes including water quality, carbon storage, mature forest habitat, and public recreational access. This study finds that survey respondents place significant economic value on forest ecosystem services in both elicitation formats and that the distributions of the marginal WTP are not statistically significantly different.

  12. Paying for Forest Ecosystem Services: Voluntary Versus Mandatory Payments

    Science.gov (United States)

    Roesch-McNally, Gabrielle E.; Rabotyagov, Sergey S.

    2016-03-01

    The emergence of new markets for forest ecosystem services can be a compelling opportunity for market diversification for private forest landowners, while increasing the provision of public goods from private lands. However, there is limited information available on the willingness-to-pay (WTP) for specific forest ecosystem services, particularly across different ecosystem market mechanisms. We utilize survey data from Oregon and Washington households to compare marginal WTP for forest ecosystem services and the total WTP for cost-effective bundles of forest ecosystem services obtained from a typical Pacific Northwest forest across two value elicitation formats representing two different ecosystem market mechanisms: an incentive-compatible choice experiment involving mandatory tax payments and a hypothetical private provision scenario modeled as eliciting contributions to the preferred forest management alternative via a provision point mechanism with a refund. A representative household's total WTP for the average forest management program was estimated at 217.59 per household/year under a mandatory tax mechanism and 160.44 per household/per year under a voluntary, crowdfunding-style, contribution mechanism; however, these estimates are not statistically different. Marginal WTP estimates were assessed for particular forest ecosystem service attributes including water quality, carbon storage, mature forest habitat, and public recreational access. This study finds that survey respondents place significant economic value on forest ecosystem services in both elicitation formats and that the distributions of the marginal WTP are not statistically significantly different.

  13. Industry Relationships With Pediatricians: Findings From the Open Payments Sunshine Act.

    Science.gov (United States)

    Parikh, Kavita; Fleischman, William; Agrawal, Shantanu

    2016-06-01

    Ties between physicians and pharmaceutical/medical device manufactures have received considerable attention. The Open Payments program, part of the Affordable Care Act, requires public reporting of payments to physicians from industry. We sought to describe payments from industry to physicians caring for children by (1) comparing payments to pediatricians to other medical specialties, (2) determining variation in payments among pediatric subspecialties, and (3) identifying the types of payment and the products associated with payments to pediatricians. We conducted a descriptive, cross-sectional analysis of Open Payments data from January 1 to December 31, 2014. The primary outcomes included percent of physicians receiving payments, median total pay per physician, the types of payments received, and the drugs and devices associated with payments. There were 9 638 825 payments to physicians, totaling $1 186 217 157. There were 244 915 payments to general pediatricians and pediatric subspecialists, totaling >$32 million. The median individual payment to general pediatricians was $14.63 (interquartile range 12-20), and median total pay per general pediatrician was $89 (interquartile range 32-186). General pediatricians accounted for 1.7% of total payments, and 0.9% of the sum of payments. Developmental pediatricians had the highest percentage of pediatric physicians receiving payment, and pediatric endocrinologists received the highest median payment. Top marketed medications were for attention-deficient/hyperactivity disorder and vaccinations. More than 40% of pediatricians received payments from industry in 2014, a lower percentage than family physicians or internists. There was considerable variation in physician-industry ties among the pediatric subspecialties. Most payments were associated with medications that treat attention-deficient/hyperactivity disorder and vaccinations. Copyright © 2016 by the American Academy of Pediatrics.

  14. Industry ties in otolaryngology: initial insights from the physician payment sunshine act.

    Science.gov (United States)

    Rathi, Vinay K; Samuel, Andre M; Mehra, Saral

    2015-06-01

    To characterize nonresearch payments made by industry to otolaryngologists in order to explore how the potential for conflicts of interests varies among otolaryngologists and compares between otolaryngologists and other surgical specialists. Retrospective cross-sectional database analysis. Open Payments program database recently released by Centers for Medicare and Medicaid Services. Surgeons nationwide who were identified as receiving nonresearch payment from industry in accordance with the Physician Payment Sunshine Act. The proportion of otolaryngologists receiving payment, the mean payment per otolaryngologist, and the standard deviation thereof were determined using the Open Payments database and compared to other surgical specialties. Otolaryngologists were further compared by specialization, census region, sponsor, and payment amount. Less than half of otolaryngologists (48.1%) were reported as receiving payments over the study period, the second smallest proportion among surgical specialties. Otolaryngologists received the lowest mean payment per compensated individual ($573) compared to other surgical specialties. Although otolaryngology had the smallest variance in payment among surgical specialties (SD, $2806), the distribution was skewed by top earners; the top 10% of earners accounted for 87% ($2,199,254) of all payment to otolaryngologists. Otolaryngologists in the West census region were less likely to receive payments (38.6%, P industry compared to other surgeons, though variation exists within otolaryngology. Further refinement of the Open Payments database is needed to explore differences between otolaryngologists and leverage payment information as a tool for self-regulation. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  15. The adoption of residential solar photovoltaic systems in the presence of a financial incentive: A case study of consumer experiences with the Renewable Energy Standard Offer Program in Ontario (Canada)

    Science.gov (United States)

    Adachi, Christopher William Junji

    2009-12-01

    Traditionally, high initial capital costs and lengthy payback periods have been identified as the most significant barriers that limit the diffusion of solar photovoltaic (PV) systems. In response, the Ontario Government, through the Ontario Power Authority (OPA), introduced the Renewable Energy Standard Offer Program (RESOP) in November, 2006. The RESOP offers owners of solar PV systems with a generation capacity under 10MW a 20 year contract to sell electricity back to the grid at a guaranteed rate of $0.42/kWh. While it is the intent of incentive programs such as the RESOP to begin to lower financial barriers in order to increase the uptake of solar PV systems, there is no guarantee that the level of participation will in fact rise. The "on-the-ground" manner in which consumers interact with such an incentive program ultimately determines its effectiveness. The purpose of this thesis is to analyze the relationship between the RESOP and solar PV system consumers. To act on this purpose, the experiences of current RESOP participants are presented, wherein the factors that are either hindering or promoting utilization of the RESOP and the adoption of solar PV systems are identified. This thesis was conducted in three phases--a literature review, preliminary key informant interviews, and primary RESOP participant interviews--with each phase informing the scope and design of the subsequent stage. First, a literature survey was completed to identify and to understand the potential drivers and barriers to the adoption of a solar PV system from the perspective of a consumer. Second, nine key informant interviews were completed to gain further understanding regarding the specific intricacies of the drivers and barriers in the case of Ontario, as well as the overall adoption system in the province. These interviews were conducted between July and September, 2008. Third, interviews with 24 RESOP participants were conducted; they constitute the primary data set. These

  16. The Original Management Incentive Schemes

    OpenAIRE

    Richard T. Holden

    2005-01-01

    During the 1990s, the structure of pay for top corporate executives shifted markedly as the use of stock options greatly expanded. By the early 2000s, as the dot-com boom ended and the Nasdaq stock index melted down, these modern executive incentive schemes were being sharply questioned on many grounds—for encouraging excessive risk-taking and a short-run orientation, for being an overly costly and inefficient method of providing incentives, and even for tempting managers of firms like Enron,...

  17. Do not trash the incentive! Monetary incentives and waste sorting

    NARCIS (Netherlands)

    Bucciol, A.; Montinari, N.; Piovesan, M.

    2011-01-01

    This paper examines whether monetary incentives are an effective tool for increasing domestic waste sorting. We exploit the exogenous variation in the pricing systems experienced during the 1999-2008 decade by the 95 municipalities in the district of Treviso (Italy). We estimate with a panel

  18. Financial incentive increases CPAP acceptance in patients from low socioeconomic background.

    Directory of Open Access Journals (Sweden)

    Ariel Tarasiuk

    Full Text Available OBJECTIVE: We explored whether financial incentives have a role in patients' decisions to accept (purchase a continuous positive airway pressure (CPAP device in a healthcare system that requires cost sharing. DESIGN: Longitudinal interventional study. PATIENTS: The group receiving financial incentive (n = 137, 50.8±10.6 years, apnea/hypopnea index (AHI 38.7±19.9 events/hr and the control group (n = 121, 50.9±10.3 years, AHI 39.9±22 underwent attendant titration and a two-week adaptation to CPAP. Patients in the control group had a co-payment of $330-660; the financial incentive group paid a subsidized price of $55. RESULTS: CPAP acceptance was 43% greater (p = 0.02 in the financial incentive group. CPAP acceptance among the low socioeconomic strata (n = 113 (adjusting for age, gender, BMI, tobacco smoking was enhanced by financial incentive (OR, 95% CI (3.43, 1.09-10.85, age (1.1, 1.03-1.17, AHI (>30 vs. 30 vs. 30 vs. <30 (5.25, 1.34-18.5. CONCLUSIONS: Minimizing cost sharing reduces a barrier for CPAP acceptance among low socioeconomic status patients. Thus, financial incentive should be applied as a policy to encourage CPAP treatment, especially among low socioeconomic strata patients.

  19. Financial incentive increases CPAP acceptance in patients from low socioeconomic background.

    Science.gov (United States)

    Tarasiuk, Ariel; Reznor, Gally; Greenberg-Dotan, Sari; Reuveni, Haim

    2012-01-01

    We explored whether financial incentives have a role in patients' decisions to accept (purchase) a continuous positive airway pressure (CPAP) device in a healthcare system that requires cost sharing. Longitudinal interventional study. The group receiving financial incentive (n = 137, 50.8±10.6 years, apnea/hypopnea index (AHI) 38.7±19.9 events/hr) and the control group (n = 121, 50.9±10.3 years, AHI 39.9±22) underwent attendant titration and a two-week adaptation to CPAP. Patients in the control group had a co-payment of $330-660; the financial incentive group paid a subsidized price of $55. CPAP acceptance was 43% greater (p = 0.02) in the financial incentive group. CPAP acceptance among the low socioeconomic strata (n = 113) (adjusting for age, gender, BMI, tobacco smoking) was enhanced by financial incentive (OR, 95% CI) (3.43, 1.09-10.85), age (1.1, 1.03-1.17), AHI (>30 vs. acceptance was affected by AHI (>30 vs. 30 vs. acceptance among low socioeconomic status patients. Thus, financial incentive should be applied as a policy to encourage CPAP treatment, especially among low socioeconomic strata patients.

  20. A systematic review finds underreporting of ethics approval, informed consent, and incentives in clinical trials.

    Science.gov (United States)

    Trung, Ly Quoc; Morra, Mostafa Ebraheem; Truong, Nguyen Duc; Turk, Tarek; Elshafie, Ahmed; Foly, Amr; Hien Tam, Dao Ngoc; Iraqi, Ahmed; Hong Van, Trinh Thi; Elgebaly, Ahmed; Ngoc, Tran Nhu; Vu, Tran Le Huy; Chu, Ngan Thy; Hirayama, Kenji; Karbwang, Juntra; Huy, Nguyen Tien

    2017-11-01

    In this study, we aim to review researchers' reporting practices of the ethics statement, financial incentives, and local ethical committees' profile in their clinical trials. A systematic search was done through top-ranked 50 medical journals (Scimago Ranking) to retrieve 2,000 latest publications. Only primary clinical trials were included with no restriction to language or participants. Among the 927 included trials, 14 trials (1.5%) did not report an ethical statement and two-third (63%) did not completely report the investigated components (Institutional Review eBoard approval, Helsinki Declaration, and informed consent). Moreover, 21 trials (2.26%) reported motivational incentives with the method and amount of payment for participants. Of them, 15 trials offered monetary incentives to participants in different forms. In the remaining six trials, the incentives were mainly medical benefits. Only one trial reported the profile or quality of local Institutional Review Board. A potential gap in the reporting practices of ethics statement and financial incentives was addressed in this review. Authors are urged to fully report all ethical components related to their study, including incentives and compensations plan. Medical journals are also recommended to implement further publication requirements concerning ethics reporting. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Payment for performance in the Family Health Programme: lessons from the UK Quality and Outcomes Framework

    Directory of Open Access Journals (Sweden)

    Matthew Harris

    2012-06-01

    Full Text Available OBJECTIVE: Payment for performance financial incentive schemes reward doctors based on the quality and the outcomes of their treatment. In Brazil, the Ministry of Health is looking to scale up its use in public hospitals and some municipalities are developing payment for performance schemes even for the Family Health Programme. In this article the Quality and Outcomes Framework used in the UK since 2004 is discussed, as well as its experience to elaborate some important lessons that Brazilian municipalities should consider before embarking on payment for performance scheme in primary care settings.

  2. Unintended consequences of steps to cut readmissions and reform payment may threaten care of vulnerable older adults.

    Science.gov (United States)

    Naylor, Mary D; Kurtzman, Ellen T; Grabowski, David C; Harrington, Charlene; McClellan, Mark; Reinhard, Susan C

    2012-07-01

    The US health care system is characterized by fragmentation and misaligned incentives, which creates challenges for both providers and recipients. These challenges are magnified for older adults who receive long-term services and supports. The Affordable Care Act attempts to address some of these challenges. We analyzed three provisions of the act: the Hospital Readmissions Reduction Program; the National Pilot Program on Payment Bundling; and the Community-Based Care Transitions Program. These three provisions were designed to enhance care transitions for the broader population of adults coping with chronic illness. We found that these provisions inadequately address the unique needs of vulnerable subgroup members who require long-term services and supports and, in some instances, could produce unintended consequences that would contribute to avoidable poor outcomes. We recommend that policy makers anticipate such unintended consequences and advance payment policies that integrate care. They should also prepare the delivery system to keep up with new requirements under the Affordable Care Act, by supporting providers in implementing evidence-based transitional care practices, recrafting strategic and operational plans, developing educational and other resources for frail older adults and their family caregivers, and integrating measurement and reporting requirements into performance systems.

  3. Medicare program; prospective payment system and consolidated billing for skilled nursing facilities--update. Health Care Financing Administration (HCFA), HHS. Notice.

    Science.gov (United States)

    1999-07-30

    This notice sets forth the updates required in section 1888(e) of the Social Security Act (the Act), as added by section 4432 of the Balanced Budget Act of 1997, related to Medicare payments and consolidated billing for skilled nursing facilities.

  4. Energy Education Incentives: Evaluating the Impact of Consumer Energy Kits

    Science.gov (United States)

    Kirby, Sarah D.; Guin, Autumn; Langham, Laura

    2015-01-01

    Measuring the energy and environmental impact of residential energy education efforts is difficult. The E-Conservation residential energy management program uses consumer energy kits to document the impact of energy-efficient improvements. The consumer energy kit provides an incentive for individuals attending energy education workshop, helps…

  5. The Impacts of Seed Grants as Incentives for Engagement

    Science.gov (United States)

    Zuiches, James J.

    2013-01-01

    This article reports on an assessment of North Carolina State University's Extension, Engagement, and Economic Development Seed Grant Program (2004-2009). The research questions addressed the extent to which the grants (1) stimulated faculty interest in the engagement and outreach mission of the university; (2) served as incentives for faculty…

  6. Renewable Energy Cost Modeling. A Toolkit for Establishing Cost-Based Incentives in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Gifford, Jason S. [Sustainable Energy Advantage, LLC, Framington, MA (United States); Grace, Robert C. [Sustainable Energy Advantage, LLC, Framington, MA (United States); Rickerson, Wilson H. [Meister Consultants Group, Inc., Boston, MA (United States)

    2011-05-01

    This report serves as a resource for policymakers who wish to learn more about levelized cost of energy (LCOE) calculations, including cost-based incentives. The report identifies key renewable energy cost modeling options, highlights the policy implications of choosing one approach over the other, and presents recommendations on the optimal characteristics of a model to calculate rates for cost-based incentives, FITs, or similar policies. These recommendations shaped the design of NREL's Cost of Renewable Energy Spreadsheet Tool (CREST), which is used by state policymakers, regulators, utilities, developers, and other stakeholders to assist with analyses of policy and renewable energy incentive payment structures. Authored by Jason S. Gifford and Robert C. Grace of Sustainable Energy Advantage LLC and Wilson H. Rickerson of Meister Consultants Group, Inc.

  7. Incentives in Supply Function Equilibrium

    DEFF Research Database (Denmark)

    Vetter, Henrik

    2014-01-01

    The author analyses delegation in homogenous duopoly under the assumption that the firm-managers compete in supply functions. In supply function equilibrium, managers’ decisions are strategic complements. This reverses earlier findings in that the author finds that owners give managers incentives...

  8. Offering Incentives from the Outside

    DEFF Research Database (Denmark)

    Emmanuel, Nikolas G.

    2017-01-01

    Incentives offer a good deal of underexplored opportunities to help manage conflict by encouraging political bargaining. This study has two primary objectives. First, it furthers the discussion of how external third parties can help manage conflicts. Second, it offers a typology of the available ...

  9. Legal incentives for minimizing waste

    International Nuclear Information System (INIS)

    Clearwater, S.W.; Scanlon, J.M.

    1991-01-01

    Waste minimization, or pollution prevention, has become an integral component of federal and state environmental regulation. Minimizing waste offers many economic and public relations benefits. In addition, waste minimization efforts can also dramatically reduce potential criminal requirements. This paper addresses the legal incentives for minimizing waste under current and proposed environmental laws and regulations

  10. Incentives and regulation in banking

    NARCIS (Netherlands)

    Martynova, N.

    2015-01-01

    The financial crisis of 2007-2008 has unveiled the hidden flaws in the regulatory framework of the financial sector. The rules of the game established by regulators were not stringent enough and provided bankers with wrong incentives to gamble with depositors’ money. There are two major challenges

  11. 9 CFR 54.3 - Animals eligible for indemnity payments.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Animals eligible for indemnity payments. 54.3 Section 54.3 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE... SCRAPIE Scrapie Indemnification Program § 54.3 Animals eligible for indemnity payments. (a) Indemnity may...

  12. 39 CFR 501.16 - PC postage payment methodology.

    Science.gov (United States)

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false PC postage payment methodology. 501.16 Section 501.16 Postal Service UNITED STATES POSTAL SERVICE POSTAGE PROGRAMS AUTHORIZATION TO MANUFACTURE AND DISTRIBUTE POSTAGE EVIDENCING SYSTEMS § 501.16 PC postage payment methodology. (a) The PC Postage customer is...

  13. 42 CFR 60.54 - Payment of refunds by schools.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Payment of refunds by schools. 60.54 Section 60.54... ASSISTANCE LOAN PROGRAM The School § 60.54 Payment of refunds by schools. A participating school must pay... subsequent holder of the loan note, if the school has knowledge of the holder's identity). At the same time...

  14. Payment methods for outpatient care facilities

    Science.gov (United States)

    Yuan, Beibei; He, Li; Meng, Qingyue; Jia, Liying

    2017-01-01

    Background Outpatient care facilities provide a variety of basic healthcare services to individuals who do not require hospitalisation or institutionalisation, and are usually the patient's first contact. The provision of outpatient care contributes to immediate and large gains in health status, and a large portion of total health expenditure goes to outpatient healthcare services. Payment method is one of the most important incentive methods applied by purchasers to guide the performance of outpatient care providers. Objectives To assess the impact of different payment methods on the performance of outpatient care facilities and to analyse the differences in impact of payment methods in different settings. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL), 2016, Issue 3, part of the Cochrane Library (searched 8 March 2016); MEDLINE, OvidSP (searched 8 March 2016); Embase, OvidSP (searched 24 April 2014); PubMed (NCBI) (searched 8 March 2016); Dissertations and Theses Database, ProQuest (searched 8 March 2016); Conference Proceedings Citation Index (ISI Web of Science) (searched 8 March 2016); IDEAS (searched 8 March 2016); EconLit, ProQuest (searched 8 March 2016); POPLINE, K4Health (searched 8 March 2016); China National Knowledge Infrastructure (searched 8 March 2016); Chinese Medicine Premier (searched 8 March 2016); OpenGrey (searched 8 March 2016); ClinicalTrials.gov, US National Institutes of Health (NIH) (searched 8 March 2016); World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (searched 8 March 2016); and the website of the World Bank (searched 8 March 2016). In addition, we searched the reference lists of included studies and carried out a citation search for the included studies via ISI Web of Science to find other potentially relevant studies. We also contacted authors of the main included studies regarding any further published or unpublished work. Selection criteria Randomised

  15. Adaptive Incentive Controls for Stackelberg Games with Unknown Cost Functionals.

    Science.gov (United States)

    1984-01-01

    APR EZT:: F I AN 73S e OsL:-: UNCLASSI?:-- Q4~.’~- .A.., 6, *~*i i~~*~~*.- U ADAPTIVE INCENTIVE CONTROLS FOR STACKELBERG GAMES WITH UNKNOWN COST...AD-A161 885 ADAPTIVE INCENTIVE CONTROLS FOR STACKELBERG GAMES WITH i/1 UNKNOWN COST FUNCTIONALSCU) ILLINOIS UNIV AT URBANA DECISION AND CONTROL LAB T...ORGANIZATION 6b. OFFICE SYMBOL 7.. NAME OF MONITORING ORGANIZATION CoriaeLcenef~pda~ Joint Services Electronics Program Laboratory, Univ. of Illinois N/A

  16. Variation in Incentive Effects across Neighbourhoods

    Directory of Open Access Journals (Sweden)

    Mark J Hanly

    2014-03-01

    Full Text Available Small monetary incentives increase survey cooperation rates, however evidence suggests that the appeal of incentives may vary across sample subgroups. Fieldwork budgets can be most effectively distributed by targeting those subgroups where incentives will have the strongest appeal. We examine data from a randomised experiment implemented in the pilot phase of the Irish Longitudinal Study of Ageing, which randomly assigned households to receive a higher (€25 or lower (€10 incentive amount. Using a random effects logistic regression model, we observe a variable effect of the higher incentive across geographic neighbourhoods. The higher incentive has the largest impact in neighbourhoods where baseline cooperation is low, as predicted by Leverage-Saliency theory. Auxiliary neighbourhood-level variables are linked to the sample frame to explore this variation further, however none of these moderate the incentive effect, suggesting that richer information is needed to identify sample subgroups where incentive budgets should be directed.

  17. On the Effectiveness of Incentive Pay

    DEFF Research Database (Denmark)

    Friis, Ivar; Hansen, Allan; Vámosi, Tamás S.

    2015-01-01

    Extant research already emphasises that complementarities and substitution involving incentive pay and other elements of an organisation's management control system play an important role in terms of explaining the effectiveness of incentive systems. Despite this awareness calls continue for more...

  18. The Effect of Incentives on Sustainable Behavior

    DEFF Research Database (Denmark)

    Huber, Laura Rosendahl; Sloof, Randolph; Van Praag, Mirjam

    2017-01-01

    This study investigates how children respond to different treatments aimed to fostersustainable behavior in a productive (firm like) setting. We conduct a field experiment using teams of children (aged 11 or 12) that are participating in an entrepreneurship education program in the last grade...... of primary school in the Netherlands. Schools participating in this program are randomly assigned to one of three treatments: the first is purely financially oriented, the second promotes sustainable behavior and the third also induces sustainability by (monetary) incentives. Comparing the first twogroups we...... find that solely promoting sustainability does not lead to a change in sustainable behavior. However, once the monetary reward is linked to sustainable outcome measures, we find a significant positive effect on sustainable behavior. Inour specificsetting, the choice to behave more sustainable comes...

  19. Public Awareness of and Contact With Physicians Who Receive Industry Payments: A National Survey.

    Science.gov (United States)

    Pham-Kanter, Genevieve; Mello, Michelle M; Lehmann, Lisa Soleymani; Campbell, Eric G; Carpenter, Daniel

    2017-07-01

    The Physician Payments Sunshine Act, part of the Affordable Care Act, requires pharmaceutical and medical device firms to report payments they make to physicians and, through its Open Payments program, makes this information publicly available. To establish estimates of the exposure of the American patient population to physicians who accept industry payments, to compare these population-based estimates to physician-based estimates of industry contact, and to investigate Americans' awareness of industry payments. Cross-sectional survey conducted in late September and early October 2014, with data linkage of respondents' physicians to Open Payments data. A total of 3542 adults drawn from a large, nationally representative household panel. Respondents' contact with physicians reported in Open Payments to have received industry payments; respondents' awareness that physicians receive payments from industry and that payment information is publicly available; respondents' knowledge of whether their own physician received industry payments. Among the 1987 respondents who could be matched to a specific physician, 65% saw a physician who had received an industry payment during the previous 12 months. This population-based estimate of exposure to industry contact is much higher than physician-based estimates from the same period, which indicate that 41% of physicians received an industry payment. Across the six most frequently visited specialties, patient contact with physicians who had received an industry payment ranged from 60 to 85%; the percentage of physicians with industry contact in these specialties was much lower (35-56%). Only 12% of survey respondents knew that payment information was publicly available, and only 5% knew whether their own doctor had received payments. Patients' contact with physicians who receive industry payments is more prevalent than physician-based measures of industry contact would suggest. Very few Americans know whether their own doctor

  20. Solar workshops financial incentives

    Energy Technology Data Exchange (ETDEWEB)

    None

    1979-01-01

    Ten one-day workshops were held across the United States. Information in this workbook is compiled in conjunction with those workshops. The following discussions are included: solar as a fuel (history); why alternative fuels are being sought today; the need for conservation; advantages of solar energy; the potential of solar energy; why solar energy is not more widely used; a definition of solar; how solar can help meet energy demands; Federal policies and programs; what solar technologies exist today that can be effectively utilized (thermal applications, fuels from biomass, solar electric). Additional information is presented in three attachments: Energy-Conserving Methods; Domestic Policy Review of Solar Energy; and DOE Secretary's Annual Report to Congress-Solar Section. (MCW)