78 FR 25013 - Medicare Program; Requirements for the Medicare Incentive Reward Program and Provider Enrollment

Science.gov (United States)

2013-04-29

.... ACTION: Proposed rule. SUMMARY: This proposed rule would revise the Incentive Reward Program provisions... significant of these revisions include: changing the Incentive Reward Program potential reward amount for... related to the Incentive Reward Program. Frank Whelan, (410) 786-1302, for issues related to provider...

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.

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

A RANGELAND GRASSHOPPER INSURANCE PROGRAM

OpenAIRE

Skold, Melvin D.; Davis, Robert M.

1995-01-01

The incidence of benefits and costs from controlling rangeland grasshoppers on public grazing lands poses problems of economic efficiency and distributional equity. Public grasshopper control programs operate like public disaster assistance. However, grasshopper infestations are an insurable risk. This article proposes a rangeland grasshopper insurance program which reduces the economic inefficiencies and distributional inequities of the existing program.

3 CFR - State Children's Health Insurance Program

Science.gov (United States)

2010-01-01

... 3 The President 1 2010-01-01 2010-01-01 false State Children's Health Insurance Program... Insurance Program Memorandum for the Secretary of Health and Human Services The State Children's Health Insurance Program (SCHIP) encourages States to provide health coverage for uninsured children in families...

Wellness Programs With Financial Incentives Through Disparities Lens.

Science.gov (United States)

Cuellar, Alison; LoSasso, Anthony T; Shah, Mona; Atwood, Alicia; Lewis-Walls, Tanya R

2018-02-01

To examine wellness programs with financial incentives and their effect on disparities in preventive care. Financial incentives were introduced by 15 large employers, from 2010 to 2013. Fifteen private employers. A total of 299 436 employees and adult dependents. Preventive services and participation in financial incentives. Multivariate linear regression. Disparities in preventive services widened after introduction of financial incentives. Asians were 3% more likely and African Americans were 3% less likely to receive wellness rewards than whites and non-Hispanics, controlling for other factors. Federal law limits targeting of wellness financial incentives by subgroups; thus, employers should consider outreach and culturally appropriate messaging.

75 FR 30106 - Terrorism Risk Insurance Program; Recordkeeping Requirements for Insurers Compensated Under the...

Science.gov (United States)

2010-05-28

... DEPARTMENT OF THE TREASURY Terrorism Risk Insurance Program; Recordkeeping Requirements for... Budget. The Terrorism Risk Insurance Program Office within the Department of the Treasury is soliciting... original and two copies) to: Terrorism Risk Insurance Program, Public Comment Record, Suite 2100...

Value-based insurance design: aligning incentives and evidence in pulmonary medicine.

Science.gov (United States)

Fendrick, A Mark; Zank, Daniel C

2013-11-01

When consumers are required to pay the same out-of-pocket amount for pulmonary services for which clinical benefits depend on patient characteristics, clinical indication, and provider choice, there is an enormous potential for both underutilization and overutilization. Unlike most current one-size-fits-all health plan designs, value-based insurance design (V-BID) explicitly acknowledges clinical heterogeneity across the continuum of care. By adding clinical nuance to benefit design, V-BID seeks to align consumer and provider incentives with value, encouraging the use of high-value services and discouraging the use of low-value interventions. This article describes the concept of V-BID; creates a framework for its development in pulmonary medicine; and outlines how this concept aligns with research, care delivery, and payment reform initiatives.

Behavioral economics holds potential to deliver better results for patients, insurers, and employers.

Science.gov (United States)

Loewenstein, George; Asch, David A; Volpp, Kevin G

2013-07-01

Many programs being implemented by US employers, insurers, and health care providers use incentives to encourage patients to take better care of themselves. We critically review a range of these efforts and show that many programs, although well-meaning, are unlikely to have much impact because they require information, expertise, and self-control that few patients possess. As a result, benefits are likely to accrue disproportionately to patients who already are taking adequate care of their health. We show how these programs could be made more effective through the use of insights from behavioral economics. For example, incentive programs that offer patients small and frequent payments for behavior that would benefit the patients, such as medication adherence, can be more effective than programs with incentives that are far less visible because they are folded into a paycheck or used to reduce a monthly premium. Deploying more-nuanced insights from behavioral economics can lead to policies with the potential to increase patient engagement and deliver dividends for patients and favorable cost-effectiveness ratios for insurers, employers, and other relevant commercial entities.

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.

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.

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.

Employer contribution and premium growth in health insurance.

Science.gov (United States)

Liu, Yiyan; Jin, Ginger Zhe

2015-01-01

We study whether employer premium contribution schemes could impact the pricing behavior of health plans and contribute to rising premiums. Using 1991-2011 data before and after a 1999 premium subsidy policy change in the Federal Employees Health Benefits Program (FEHBP), we find that the employer premium contribution scheme has a differential impact on health plan pricing based on two market incentives: 1) consumers are less price sensitive when they only need to pay part of the premium increase, and 2) each health plan has an incentive to increase the employer's premium contribution to that plan. Both incentives are found to contribute to premium growth. Counterfactual simulation shows that average premium would have been 10% less than observed and the federal government would have saved 15% per year on its premium contribution had the subsidy policy change not occurred in the FEHBP. We discuss the potential of similar incentives in other government-subsidized insurance systems such as the Medicare Part D and the Health Insurance Marketplace under the Affordable Care Act. Copyright © 2014 Elsevier B.V. All rights reserved.

[Remunerations, benefits and labor incentives perceived by health care workers in Peru: an analysis comparing the Ministry of Health and the Social Insurance, 2009].

Science.gov (United States)

Pardo, Karim; Andia, Marcelino; Rodriguez, Amado; Pérez, Walter; Moscoso, Betsy

2011-06-01

To describe the main characteristics of the general salaries situation and the incentive policies of health care workers of Peru, comparing them by their origin institution and type of contract. A mixed design study was done including both quantitative and qualitative components during 2008 and 2009 with both professional and technical personnel of the Ministry of Health (MINSA) and the Social Insurance (EsSalud) in Peru. The salary structure was primarily evaluated considering incentives, bonuses and other remunerations according to position, type of contract and work place. Remuneration and bonus policies at the national level are determined by the responsibilities and amount of time served. The type of contract is determined by the programs of the public system (DL 276) and the private system (DL 728), also by the Special Program of Contract Services Administration (CAS) and exclusively in MINSA contracting is determined by local health administration Committees (CLAS). The salary structure differs between both types of institutions, especially with respect to incentives and benefits. An special economic incentive for assistance (AETA) is unique to MINSA, but the proportion of assistance varies by region. The professionals of MINSA have lower salaries than those of EsSalud, in all types of contracts. A professional contracted through CAS generally has a lower salary than staff peers in MINSA, though this situation is reversed in EsSalud. The lowest salaries are found in contracts made through CLAS. The structure and salary amounts differ between MINSA and EsSalud, just as they differ by existing contracting types.

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.

78 FR 40084 - Proposed Requirement-Migrant Education Program Consortium Incentive Grant Program

Science.gov (United States)

2013-07-03

... DEPARTMENT OF EDUCATION 34 CFR Chapter II Proposed Requirement--Migrant Education Program... educational agencies (SEAs) under the Migrant Education Program (MEP) Consortium Incentive Grant (CIG) Program... the interstate or intrastate coordination of migrant education programs by addressing key needs of...

Managing risk selection incentives in health sector reforms.

Science.gov (United States)

Puig-Junoy, J

1999-01-01

The object of the paper is to review theoretical and empirical contributions to the optimal management of risk selection incentives ('cream skimming') in health sector reforms. The trade-off between efficiency and risk selection is fostered in health sector reforms by the introduction of competitive mechanisms such as price competition or prospective payment systems. The effects of two main forms of competition in health sector reforms are observed when health insurance is mandatory: competition in the market for health insurance, and in the market for health services. Market and government failures contribute to the assessment of the different forms of risk selection employed by insurers and providers, as the effects of selection incentives on efficiency and their proposed remedies to reduce the impact of these perverse incentives. Two European (Netherlands and Spain) and two Latin American (Chile and Colombia) case studies of health sector reforms are examined in order to observe selection incentives, their effects on efficiency and costs in the health system, and regulation policies implemented in each country to mitigate incentives to 'cream skim' good risks.

Participant Satisfaction with a Food Benefit Program with Restrictions and Incentives.

Science.gov (United States)

Rydell, Sarah A; Turner, Rachael M; Lasswell, Tessa A; French, Simone A; Oakes, J Michael; Elbel, Brian; Harnack, Lisa J

2018-02-01

Policy makers are considering changes to the Supplemental Nutrition Assistance Program (SNAP). Proposed changes include financially incentivizing the purchase of healthier foods and prohibiting the use of funds for purchasing foods high in added sugars. SNAP participant perspectives may be useful in understanding the consequences of these proposed changes. To determine whether food restrictions and/or incentives are acceptable to food benefit program participants. Data were collected as part of an experimental trial in which lower-income adults were randomly assigned to one of four financial food benefit conditions: (1) Incentive: 30% financial incentive on eligible fruits and vegetables purchased using food benefits; (2) Restriction: not allowed to buy sugar-sweetened beverages, sweet baked goods, or candies with food benefits; (3) Incentive plus Restriction; or (4) Control: no incentive/restriction. Participants completed closed- and open-ended questions about their perceptions on completion of the 12-week program. Adults eligible or nearly eligible for SNAP were recruited between 2013 and 2015 by means of events or flyers in the Minneapolis/St Paul, MN, metropolitan area. Of the 279 individuals who completed baseline measures, 265 completed follow-up measures and are included in these analyses. χ 2 analyses were conducted to assess differences in program satisfaction. Responses to open-ended questions were qualitatively analyzed using principles of content analysis. There were no statistically significant or meaningful differences between experimental groups in satisfaction with the program elements evaluated in the study. Most participants in all conditions found the food program helpful in buying nutritious foods (94.1% to 98.5%) and in buying the kinds of foods they wanted (85.9% to 95.6%). Qualitative data suggested that most were supportive of restrictions, although a few were dissatisfied. Participants were uniformly supportive of incentives. Findings

78 FR 52780 - National Flood Insurance Program (NFIP); Assistance to Private Sector Property Insurers...

Science.gov (United States)

2013-08-26

...] National Flood Insurance Program (NFIP); Assistance to Private Sector Property Insurers, Availability of FY... Assistance/Subsidy Arrangement (Arrangement), 85 (as of June 2013) private sector property insurers sell... Financial Assistance/ Subsidy Arrangement (Arrangement) to notify private insurance companies (Companies...

77 FR 36566 - National Flood Insurance Program (NFIP); Assistance to Private Sector Property Insurers...

Science.gov (United States)

2012-06-19

...] National Flood Insurance Program (NFIP); Assistance to Private Sector Property Insurers, Availability of FY... Assistance/Subsidy Arrangement (Arrangement), 82 (as of April, 2012) private sector property insurers sell... Financial Assistance/ Subsidy Arrangement (Arrangement) to notify private insurance companies (Companies...

78 FR 32126 - VA Dental Insurance Program

Science.gov (United States)

2013-05-29

... secure reasonable premium and copayment pricing through multiple tier options to allow enrollees to... program that offers premium-based dental insurance to enrolled veterans and certain survivors and... regulations to establish VADIP, a pilot program that would offer premium-based dental insurance to enrolled...

75 FR 45563 - Terrorism Risk Insurance Program; Final Netting

Science.gov (United States)

2010-08-03

... DEPARTMENT OF THE TREASURY 31 CFR Part 50 RIN 1505-AC24 Terrorism Risk Insurance Program; Final... Title I of the Terrorism Risk Insurance Act of 2002 (``TRIA'' or ``the Act''), as amended by the Terrorism Risk Insurance Extension Act of 2005 (``Extension Act'') and the Terrorism Risk Insurance Program...

Program evaluation and incentives for administrators of energy-efficiency programs: Can evaluation solve the principal/agent problem?

Energy Technology Data Exchange (ETDEWEB)

Blumstein, Carl, E-mail: blumstei@berkeley.ed [University of California Energy Institute, 2547 Channing Way, Berkeley, CA 94720 (United States)

2010-10-15

This paper addresses the nexus between evaluation of energy-efficiency programs and incentive payments based on performance for program administrators in California. The paper describes the problems that arise when evaluators are asked to measure program performance by answering the counterfactual question-what would have happened in the absence of the program? Then the paper examines some ways of addressing these problems. Key conclusions are (1) program evaluation cannot precisely and accurately determine the counterfactual, there will always be substantial uncertainty, (2) given the current state of knowledge, the decision to tie all incentives to program outcomes is misguided, and (3) incentive programs should be regularly reviewed and revised so that they can be adapted to new conditions.

Program evaluation and incentives for administrators of energy-efficiency programs. Can evaluation solve the principal/agent problem?

Energy Technology Data Exchange (ETDEWEB)

Blumstein, Carl [University of California Energy Institute, 2547 Channing Way, Berkeley, CA 94720 (United States)

2010-10-15

This paper addresses the nexus between evaluation of energy-efficiency programs and incentive payments based on performance for program administrators in California. The paper describes the problems that arise when evaluators are asked to measure program performance by answering the counterfactual question - what would have happened in the absence of the program? Then the paper examines some ways of addressing these problems. Key conclusions are (1) program evaluation cannot precisely and accurately determine the counterfactual, there will always be substantial uncertainty, (2) given the current state of knowledge, the decision to tie all incentives to program outcomes is misguided, and (3) incentive programs should be regularly reviewed and revised so that they can be adapted to new conditions. (author)

Program evaluation and incentives for administrators of energy-efficiency programs: Can evaluation solve the principal/agent problem?

International Nuclear Information System (INIS)

Blumstein, Carl

2010-01-01

This paper addresses the nexus between evaluation of energy-efficiency programs and incentive payments based on performance for program administrators in California. The paper describes the problems that arise when evaluators are asked to measure program performance by answering the counterfactual question-what would have happened in the absence of the program? Then the paper examines some ways of addressing these problems. Key conclusions are (1) program evaluation cannot precisely and accurately determine the counterfactual, there will always be substantial uncertainty, (2) given the current state of knowledge, the decision to tie all incentives to program outcomes is misguided, and (3) incentive programs should be regularly reviewed and revised so that they can be adapted to new conditions.

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

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

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.

Program evaluation and incentives for administrators of energy efficiency programs: can evaluation solve the principal/agent problem?

Energy Technology Data Exchange (ETDEWEB)

Blumstein, Carl (Univ. of California, Energy Institute (United States))

2009-07-01

This paper addresses the nexus between the evaluation of energy-efficiency programs and incentive payments based on performance for program administrators in California. The paper describes problems that arise when evaluators are asked to measure program performance by answering the counterfactual question, what would have happened in the absence of the program? Then some ways of addressing these problems are examined. Key conclusions are that 1) program evaluation cannot precisely and accurately determine the counterfactual, there will always be substantial uncertainty, 2) given the current state of knowledge, the decision to tie all of the incentive to program outcomes is misguided, and 3) incentive programs should be regularly reviewed and revised so that they can be adapted to new conditions.

Marketing to Nurses through an Incentive Program.

Science.gov (United States)

Campbell, Jeanne Phillips; Williams, Trudy

1983-01-01

Describes the Incentive Career Mobility Plan, a program for improving employee morale and retention by rewarding self-improvement. Discusses its use by nurse administrators for marketing their institutions to current and potential employees. (JOW)

75 FR 48815 - Medicaid Program and Children's Health Insurance Program (CHIP); Revisions to the Medicaid...

Science.gov (United States)

2010-08-11

... Parts 431, 447, and 457 Medicaid Program and Children's Health Insurance Program (CHIP); Revisions to... 431, 447, and 457 [CMS-6150-F] RIN 0938-AP69 Medicaid Program and Children's Health Insurance Program... final rule implements provisions from the Children's Health Insurance Program Reauthorization Act of...

Availability of Insurance Linkage Programs in U.S. Emergency Departments

Directory of Open Access Journals (Sweden)

Mia Kanak

2014-07-01

Full Text Available Introduction: As millions of uninsured citizens who use emergency department (ED services are now eligible for health insurance under the Affordable Care Act, the ED is ideally situated to facilitate linkage to insurance. Forty percent of U.S. EDs report having an insurance linkage program. This is the first national study to examine the characteristics of EDs that offer or do not offer these programs. Methods: This was a secondary analysis of data from the National Survey for Preventive Health Services in U.S. EDs conducted in 2008-09. We compared EDs with and without insurance programs across demographic and operational factors using univariate analysis. We then tested our hypotheses using multivariable logistic regression. We also further examined program capacity and priority among the sub-group of EDs with no insurance linkage program. Results: After adjustment, ED-insurance linkage programs were more likely to be located in the West (RR= 2.06, 95% CI = 1.33 – 2.72. The proportion of uninsured patients in an ED, teaching hospital status, and public ownership status were not associated with insurance linkage availability. EDs with linkage programs also offer more preventive services (RR = 1.87, 95% CI = 1.37–2.35 and have greater social worker availability (RR = 1.71, 95% CI = 1.12–2.33 than those who do not. Four of five EDs with a patient mix of ≥25% uninsured and no insurance linkage program reported that they could not offer a program with existing staff and funding. Conclusion: Availability of insurance linkage programs in the ED is not associated with the proportion of uninsured patients served by an ED. Policy or hospital-based interventions to increase insurance linkage should first target the 27% of EDs with high rates of uninsured patients that lack adequate program capacity. Further research on barriers to implementation and cost effectiveness may help to facilitate increased adoption of insurance linkage programs. [West J

75 FR 42766 - National Flood Insurance Program (NFIP); Assistance to Private Sector Property Insurers...

Science.gov (United States)

2010-07-22

...] National Flood Insurance Program (NFIP); Assistance to Private Sector Property Insurers, Availability of... Financial Assistance/Subsidy Arrangement (Arrangement), (90 as of June 1, 2010) private sector property... Financial Assistance/ Subsidy Arrangement (Arrangement) to notify private insurance companies (Companies...

76 FR 45281 - National Flood Insurance Program (NFIP); Assistance to Private Sector Property Insurers...

Science.gov (United States)

2011-07-28

...] National Flood Insurance Program (NFIP); Assistance to Private Sector Property Insurers, Availability of... Financial Assistance/Subsidy Arrangement (Arrangement), 87 (as of July 1, 2011) private sector property... Financial Assistance/ Subsidy Arrangement (Arrangement) to notify private insurance companies (Companies...

On Supplementing “Foot in the Door” Incentives for eHealth Program Engagement

Science.gov (United States)

2014-01-01

Financial health incentives, such as paying people to lose weight, are being widely implemented by Western nations and large corporations. A growing number of studies have tested the impact of incentives on health behaviors, though few have evaluated the approach on a population-scale. In this issue of the Journal of Medical Internet Research, Liu et al add to the evidence-base by examining whether a single incentive can motivate enrollment and engagement in a preventive eHealth program in a sample of 142,726 Canadian adults. While the incentives increased enrollment significantly (by a factor of about 28), a very high level of program attrition was noted (90%). The “foot in the door” incentive technique employed was insufficient; enrollees received incentives for signing-up for, but not for engaging with, the eHealth program. To supplement this technique and drive sustained behavior change, several theoretically- and empirically-based strategies are proposed. Specifically, incentives indexed to behavioral achievements over time are highlighted as one approach to boost engagement in this population in the future. PMID:25092221

Effects of Monetary Incentives on Engagement in the PACE Parenting Program

Science.gov (United States)

Dumas, Jean E.; Begle, Angela Moreland; French, Brian; Pearl, Amanda

2010-01-01

This study evaluated parental engagement in an 8-week parenting program offered through daycare centers that were randomly assigned to a monetary incentive or nonincentive condition. Of an initial sample of 1,050 parents who rated their intent to enroll in the program, 610 went on to enroll--319 in the incentive and 291 in the nonincentive…

Determining Safety Inspection Thresholds for Employee Incentives Programs on Construction Sites.

Science.gov (United States)

Sparer, Emily; Dennerlein, Jack

2013-01-01

The goal of this project was to evaluate approaches of determining the numerical value of a safety inspection score that would activate a reward in an employee safety incentive program. Safety inspections are a reflection of the physical working conditions at a construction site and provide a safety score that can be used in incentive programs to reward workers. Yet it is unclear what level of safety should be used when implementing this kind of program. This study explored five ways of grouping safety inspection data collected during 19 months at Harvard University-owned construction projects. Each approach grouped the data by one of the following: owner, general contractor, project, trade, or subcontractor. The median value for each grouping provided the threshold score. These five approaches were then applied to data from a completed project in order to calculate the frequency and distribution of rewards in a monthly safety incentive program. The application of each approach was evaluated qualitatively for consistency, competitiveness, attainability, and fairness. The owner-specific approach resulted in a threshold score of 96.3% and met all of the qualitative evaluation goals. It had the most competitive reward distribution (only 1/3 of the project duration) yet it was also attainable. By treating all workers equally and maintaining the same value throughout the project duration, this approach was fair and consistent. The owner-based approach for threshold determination can be used by owners or general contractors when creating leading indicator incentives programs and by researchers in future studies on incentive program effectiveness.

75 FR 63480 - Medicaid Program: Implementation of Section 614 of the Children's Health Insurance Program...

Science.gov (United States)

2010-10-15

... Children's Health Insurance Program Reauthorization Act of 2009 for Adjustments to the Federal Medical... section 614 of the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA), Public Law... Medicaid program and required by Section 614 of the Children's Health Insurance Program Reauthorization Act...

75 FR 30106 - Terrorism Risk Insurance Program; Litigation Management Submissions

Science.gov (United States)

2010-05-28

... DEPARTMENT OF THE TREASURY Terrorism Risk Insurance Program; Litigation Management Submissions... U.S.C. 3506(c)(2)(A)). Currently, the Terrorism Risk Insurance Program Office is seeking comments... or by mail (if hard copy, preferably an original and two copies) to: Terrorism Risk Insurance Program...

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.

The need for an organized approach for Government Medical Insurance Programs in the Commonwealth of Virginia.

Science.gov (United States)

Edlich, Richard F

2005-01-01

The Commonwealth of Virginia has a disorganized approach to enrolling their retired faculty in Medicare Supplement Insurance Programs. An organized approach to establishing Medicare Supplemental Insurance for retired University faculty should include the following administrative changes to correct this potential health-care crisis for retired state faculty members. First, the ombudsman for human resources for the state universities must receive educational programs that prepare the retired faculty members over the age of 65 to select the corporate insurance policy from Anthem Blue Cross/Blue Shield Insurance Company. Included in this educational program should be a review of the Advantage 65 Member Handbook. Second, they must point out to the faculty member that they are receiving a CORPORATE insurance policy rather than an individual insurance policy from Anthem Blue Cross/Blue Shield Insurance Company. They must provide the telephone numbers of the Anthem Blue Cross/Blue Shield offices in Roanoke, Virginia. Concomitantly, they must send the name and address of the faculty member to the Commonwealth of Virginia Department of Human Resource Management. They should inform the faculty member that the Commonwealth of Virginia Department of Human Resource Management will be sending them newsletters that outline any changes in the corporate insurance policy that they coordinate with the Anthem Blue Cross/Blue Shield Insurance Company. The Commonwealth of Virginia Department of Human Resource Management must take on some new responsibilities in their efforts to coordinate health-care coverage of the retired faculty over the age of 65. First, they must have a computer registry of all corporate health-care policies of the individual faculty members to ensure that newsletters are being sent to them. Ideally, this agency should have a computerized system that allows it to send out its newsletter update by email to those retired faculty members who have computers. They should

Re-insurance in the Swiss health insurance market: Fit, power, and balance.

Science.gov (United States)

Schmid, Christian P R; Beck, Konstantin

2016-07-01

Risk equalization mechanisms mitigate insurers' incentives to practice risk selection. On the other hand, incentives to limit healthcare spending can be distorted by risk equalization, particularly when risk equalization payments depend on realized costs instead of expected costs. In addition, cost based risk equalization mechanisms may incentivize health insurers to distort the allocation of resources among different services. The incentives to practice risk selection, to limit healthcare spending, and to distort the allocation of resources can be measured by fit, power, and balance, respectively. We apply these three measures to evaluate the risk adjustment mechanism in Switzerland. Our results suggest that it performs very well in terms of power but rather poorly in terms of fit. The latter indicates that risk selection might be a severe problem. We show that re-insurance can reduce this problem while power remains on a high level. In addition, we provide evidence that the Swiss risk equalization mechanism does not lead to imbalances across different services. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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

2007-01-01

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...

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.

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.

Entrepreneurial Moral Hazard in Income Insurance

NARCIS (Netherlands)

Ejrnaes, Mette; Hochguertel, Stefan

2008-01-01

We study risk behavior of Danish self-employed entrepreneurs, whose income risk may be driven by both exogenous factors and effort choice (moral hazard). Partial insurance is available through voluntary unemployment insurance (UI). Additional incentives to sign insurance contracts stem from a

Effects of Charitable Versus Monetary Incentives on the Acceptance of and Adherence to a Pedometer-Based Health Intervention: Study Protocol and Baseline Characteristics of a Cluster-Randomized Controlled Trial.

Science.gov (United States)

Kowatsch, Tobias; Kramer, Jan-Niklas; Kehr, Flavius; Wahle, Fabian; Elser, Niklas; Fleisch, Elgar

2016-09-13

Research has so far benefited from the use of pedometers in physical activity interventions. However, when public health institutions (eg, insurance companies) implement pedometer-based interventions in practice, people may refrain from participating due to privacy concerns. This might greatly limit the applicability of such interventions. Financial incentives have been successfully used to influence both health behavior and privacy concerns, and may thus have a beneficial effect on the acceptance of pedometer-based interventions. This paper presents the design and baseline characteristics of a cluster-randomized controlled trial that seeks to examine the effect of financial incentives on the acceptance of and adherence to a pedometer-based physical activity intervention offered by a health insurance company. More than 18,000 customers of a large Swiss health insurance company were allocated to a financial incentive, a charitable incentive, or a control group and invited to participate in a health prevention program. Participants used a pedometer to track their daily physical activity over the course of 6 months. A Web-based questionnaire was administered at the beginning and at the end of the intervention and additional data was provided by the insurance company. The primary outcome of the study will be the participation rate, secondary outcomes will be adherence to the prevention program, physical activity, and health status of the participants among others. Baseline characteristics indicate that residence of participants, baseline physical activity, and subjective health should be used as covariates in the statistical analysis of the secondary outcomes of the study. This is the first study in western cultures testing the effectiveness of financial incentives with regard to a pedometer-based health intervention offered by a large health insurer to their customers. Given that the incentives prove to be effective, this study provides the basis for powerful health

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.

Safety, economic incentives and insurance in the Norwegian petroleum industry

International Nuclear Information System (INIS)

Osmundsen, Petter; Aven, Terje; Erik Vinnem, Jan

2008-01-01

There is an increased use of key performance indicators and incentive schemes in the petroleum industry. Applying modern incentive theory, we explore what implications this management trend has for injury and major accident prevention efforts and safety. Can economic incentives be designed for accident prevention activities? In cases where this is not possible, what are the challenges for the safety efforts? In particular, how are safety efforts affected by enhanced economic incentives for other performance dimensions like production and rate of return? Can safety be neglected? What remedies are available?

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.

A perverse 'net' effect? Health insurance and ex-ante moral hazard in Ghana

NARCIS (Netherlands)

Debebe, Z.Y.; Kempen, L.A.C.M. van; Hoop, T.J. de

2012-01-01

Incentive problems in insurance markets are well-established in economic theory. One of these incentive problems is related to reduced prevention efforts following insurance coverage (ex-ante moral hazard). This prediction is yet to be tested empirically with regard to health insurance, as the

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.

Exploring parent attitudes around using incentives to promote engagement in family-based weight management programs

Directory of Open Access Journals (Sweden)

Elizabeth Jacob-Files

2018-06-01

Full Text Available Incentives can promote adult wellness. We sought to examine whether incentives might help overcome barriers to engagement in child weight management programs and the ideal value, type and recipient of incentives. In 2017, we conducted semi-structured phone interviews with parents of children ≤17 years old, formerly or currently affected by obesity, who had (n = 11 or had never (n = 12 participated in family-based behavioral treatment (FBT for obesity. Interviews explored the range and type of incentives families would be willing to accept. Interview transcripts were coded and data were analyzed using a thematic analysis. We found that some parents were skeptical about receiving cash incentives. However, once treatment-related costs were identified, some became more interested in reimbursement for out of pocket expenditures. Most parents felt up to $100/month would be adequate and that incentives should be tied to changing behaviors, not BMI. Some interviewees expressed preferences for non-cash incentives (e.g. a gift card over cash incentives. Parents were willing to share incentives with adolescents, up to $50/month, but there was concern about incentives affecting a child's intrinsic motivation for behavior change. All parents acknowledged that moderate incentives alone couldn't overcome the realities of structural and familial barriers to engaging in weight management programs. In summary, we identified aspects of an incentive program to promote engagement in FBT that would be desirable and feasible to implement. Future quantitative work can reveal the value and structure of incentives that are effective for improving obesogenic health behaviors and outcomes. Keywords: Behavioral economics, Family-based treatment, Financial incentives, Health incentives, Childhood obesity

National Flood Insurance Program (NFIP) Residential Historical Claims

Data.gov (United States)

Department of Homeland Security — The National Flood Insurance Program (NFIP) aims to reduce the impact of flooding—a burden not covered by homeowner’s insurance—by providing insurance to homeowners,...

Health, Disability Insurance and Retirement in Denmark

DEFF Research Database (Denmark)

Bingley, Paul; Datta Gupta, Nabanita; Jørgensen, Michael

2014-01-01

There are large differences in labor force participation rates by health status. We examine to what extent these differences are determined by the provisions of Disability Insurance and other pension programs. Using administrative data for Denmark we find that those in worse health and with less...... schooling are more likely to receive DI. The gradient of DI participation across health quintiles is almost twice as steep as for schooling - moving from having no high school diploma to college completion. Using an option value model that accounts for different pathways to retirement, applied to a period...... spanning a major pension reform, we find that pension program incentives in general are important determinants of retirement age. Individuals in poor health and with low schooling are significantly more responsive to economic incentives than those who are in better health and with more schooling. Similar...

VA Dental Insurance Program--federalism. Direct final rule.

Science.gov (United States)

2013-10-22

The Department of Veterans Affairs (VA) is taking direct final action to amend its regulations related to the VA Dental Insurance Program (VADIP), a pilot program to offer premium-based dental insurance to enrolled veterans and certain survivors and dependents of veterans. Specifically, this rule will add language to clarify the limited preemptive effect of certain criteria in the VADIP regulations.

77 FR 23193 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program-Stage 2; Corrections

Science.gov (United States)

2012-04-18

..., 413, and 495 [CMS-0044-CN] RIN 0938-AQ84 Medicare and Medicaid Programs; Electronic Health Record... proposed rule entitled ``Medicare and Medicaid Programs; Electronic Health Record Incentive Program--Stage... (77 FR 13698), the proposed rule entitled ``Medicare and Medicaid Programs; Electronic Health Record...

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.

Study of the Incentive Program for Washington's National Board Certified Teachers

Science.gov (United States)

Plecki, Margaret L.; Elfers, Ana M.; St. John, Elise; Finster, Matthew; Emry, Terese; Nishida, Nasue; Harmon, Jeanne

2010-01-01

This study examines the impact of Washington state's incentives for teachers to attain National Board Certification and to work in challenging schools. Using surveys and secondary analyses of state databases, we examine the workforce both prior to and following recent changes in the incentive program. The study considers the nature of National…

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

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.

Infusing Adult Education Principles Into a Health Insurance Literacy Program.

Science.gov (United States)

Brown, Virginia

2018-03-01

Health insurance literacy is an emerging concept in the health education and health promotion field. The passage of the Affordable Care Act highlighted the link between health insurance and health outcomes. However, the law does not specifically address how the public should be educated on choosing an appropriate health insurance plan. Research shows adults, regardless of previous health insurance status, are likely confused and uncertain about their selection. The University of Maryland Extension developed and created health insurance Smart Choice Health Insurance™ to reduce confusion and increase confidence and capability to make this decision. Andragogy, an adult learning theory, was used to guide the development of the program and help ensure best practices are used to achieve desired outcomes. Using the six principles of andragogy, the team incorporated reality-based case studies, allowed adults time to practice, and emphasized choice making and many other elements to create an atmosphere conducive to adult learning. Results from Smart Choice indicate the program is successful in reducing confusion and increasing confidence. Furthermore, feedback from participants and trained educators indicates that adults were engaged in the program and found the materials useful. Based on program success, creation of new health insurance literacy programs grounded in adult education principles is under way.

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.

76 FR 7508 - National Flood Insurance Program, Policy Wording Correction

Science.gov (United States)

2011-02-10

... the insurance industry's homeowners policy. FEMA also proposed changes in the coverage. On October 12...: FEMA-2010-0021] RIN 1660-AA70 National Flood Insurance Program, Policy Wording Correction AGENCY... Insurance and Mitigation Administration, Standard Flood Insurance Policy regulations. In order to increase...

Self-insurance and worksite alcohol programs: an econometric analysis.

Science.gov (United States)

Kenkel, D S

1997-03-01

The worksite is an important point of access for alcohol treatment and prevention, but not all firms are likely to find offering alcohol programs profitable. This study attempts to identify at a conceptual and empirical level factors that are important determinants of the profitability of worksite alcohol programs. A central question considered in the empirical analysis is whether firms' decisions about worksite alcohol programs are related to how employee group health insurance is provided. The data used are from the 1992 National Survey of Worksite Health Promotion Activities (N = 1,389-1,412). The econometric analysis focuses on measures of whether the surveyed firms offer Employee Assistance Programs (EAPs), individual counseling, group classes and resource materials regarding alcohol and other substance abuse. Holding other factors constant, the probability that a self-insured firm offers an EAP is estimated to be 59%, compared to 51% for a firm that purchases market group health insurance for its employees. Unionized worksites and larger worksites are also found to be more likely to offer worksite alcohol programs, compared to nonunionized smaller worksites. Worksites with younger work-forces are less likely than those with older employees to offer alcohol programs. The empirical results are consistent with the conceptual framework from labor economics, since self-insurance is expected to increase firms' demand for worksite alcohol programs while large worksite is expected to reduce the average program cost. The role of union status and workforce age suggests it is important to consider workers' preferences for the programs as fringe benefits. The results also suggest that the national trend towards self-insurance may be leading to more prevention and treatment of worker alcohol-related problems.

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

Some stakeholders continue to voice concerns about the performance of customer-sited photovoltaic (PV) systems, particularly because these systems typically receive financial support through ratepayer- or publicly-funded programs. Although much remains to be understood about the extent and specific causes of poor PV system performance, several studies of the larger programs and markets have shed some light on the issue. An evaluation of the California Energy Commission (CEC)'s Emerging Renewables Program, for example, found that 7% of systems, in a sample of 95, had lower-than-expected power output due to shading or soiling (KEMA 2005). About 3% of a larger sample of 140 systems were not operating at all or were operating well below expected output, due to failed equipment, faulty installation workmanship, and/or a lack of basic maintenance. In a recent evaluation of the other statewide PV incentive program in California, the Self-Generation Incentive Program, 9 of 52 projects sampled were found to have annual capacity factors less than 14.5%, although reasons for these low capacity factors generally were not identified (Itron 2005). Studies of PV systems in Germany and Japan, the two largest PV markets worldwide, have also revealed some performance problems associated with issues such as shading, equipment and installation defects, inverter failure, and deviations from module manufacturers' specifications (Otani et al. 2004, Jahn & Nasse 2004). Although owners of PV systems have an inherent incentive to ensure that their systems perform well, many homeowners and building operators may lack the necessary information and expertise to carry out this task effectively. Given this barrier, and the responsibility of PV incentive programs to ensure that public funds are prudently spent, these programs should (and often do) play a critical role in promoting PV system performance. Performance-based incentives (PBIs), which are based on actual energy production

Can an incentive-based intervention increase physical activity and reduce sitting among adults? the ACHIEVE (Active Choices IncEntiVE) feasibility study.

Science.gov (United States)

Ball, Kylie; Hunter, Ruth F; Maple, Jaimie-Lee; Moodie, Marj; Salmon, Jo; Ong, Kok-Leong; Stephens, Lena D; Jackson, Michelle; Crawford, David

2017-03-21

Despite recent interest in the potential of incentivisation as a strategy for motivating healthier behaviors, little remains known about the effectiveness of incentives in promoting physical activity and reducing sedentary behavior, and improving associated health outcomes. This pre-post-test design study investigated the feasibility, appeal and effects of providing non-financial incentives for promoting increased physical activity, reduced sedentary time, and reduced body mass index (BMI) and blood pressure among inactive middle-aged adults. Inactive men (n = 36) and women (n = 46) aged 40-65 years were recruited via a not-for-profit insurance fund and participated in a 4 month pre-post design intervention. Baseline and post-intervention data were collected on self-reported physical activity and sitting time (IPAQ-Long), BMI and blood pressure. Participants were encouraged to increase physical activity to 150 mins/week and reduce sedentary behavior by 150 mins/week in progressive increments. Incentives included clothing, recipe books, store gift vouchers, and a chance to win one of four Apple iPad Mini devices. The incentive component of the intervention was supported by an initial motivational interview and text messaging to encourage participants and provide strategies to increase physical activity and reduce sedentary behaviors. Only two participants withdrew during the program, demonstrating the feasibility of recruiting and retaining inactive middle-aged participants. While two-thirds of the sample qualified for the easiest physical activity incentive (by demonstrating 100 mins physical activity/week or 100 mins reduced sitting time/week), only one third qualified for the most challenging incentive. Goals to reduce sitting appeared more challenging, with 43% of participants qualifying for the first incentive, but only 20% for the last incentive. More men than women qualified for most incentives. Mean leisure-time physical activity increased by 252

75 FR 54076 - National Flood Insurance Program, Policy Wording Correction

Science.gov (United States)

2010-09-03

... line with the format of the insurance industry's homeowners policy. FEMA also proposed changes in the...: FEMA-2010-0021] RIN 1660-AA70 National Flood Insurance Program, Policy Wording Correction AGENCY... correction to the FEMA, Federal Insurance and Mitigation Administration, Standard Flood Insurance Policy...

Business Cycle Dependent Unemployment Insurance

DEFF Research Database (Denmark)

Andersen, Torben M.; Svarer, Michael

The consequences of business cycle contingencies in unemployment insurance systems are considered in a search-matching model allowing for shifts between "good" and "bad" states of nature. We show that not only is there an insurance argument for such contingencies, but there may also be an incentive...

Supplementary insurance as a switching cost for basic health insurance: Empirical results from the Netherlands.

Science.gov (United States)

Willemse-Duijmelinck, Daniëlle M I D; van de Ven, Wynand P M M; Mosca, Ilaria

2017-10-01

Nearly everyone with a supplementary insurance (SI) in the Netherlands takes out the voluntary SI and the mandatory basic insurance (BI) from the same health insurer. Previous studies show that many high-risks perceive SI as a switching cost for BI. Because consumers' current insurer provides them with a guaranteed renewability, SI is a switching cost if insurers apply selective underwriting to new applicants. Several changes in the Dutch health insurance market increased insurers' incentives to counteract adverse selection for SI. Tools to do so are not only selective underwriting, but also risk rating and product differentiation. If all insurers use the latter tools without selective underwriting, SI is not a switching cost for BI. We investigated to what extent insurers used these tools in the periods 2006-2009 and 2014-2015. Only a few insurers applied selective underwriting: in 2015, 86% of insurers used open enrolment for all their SI products, and the other 14% did use open enrolment for their most common SI products. As measured by our indicators, the proportion of insurers applying risk rating or product differentiation did not increase in the periods considered. Due to the fear of reputation loss insurers may have used 'less visible' tools to counteract adverse selection that are indirect forms of risk rating and product differentiation and do not result in switching costs. So, although many high-risks perceive SI as a switching cost, most insurers apply open enrolment for SI. By providing information to high-risks about their switching opportunities, the government could increase consumer choice and thereby insurers' incentives to invest in high-quality care for high-risks. Copyright © 2017 Elsevier B.V. All rights reserved.

A work-site weight control program using financial incentives collected through payroll deduction.

Science.gov (United States)

Forster, J L; Jeffery, R W; Sullivan, S; Snell, M K

1985-11-01

In a work-site weight control program using a self-motivational program of financial incentives implemented through payroll deduction, 131 university employees chose weight loss goals (0 to 60 lb) and incentives (+5 to +30) to be deducted from each paycheck for six months. Return of incentive money was contingent on progress toward weight goals. Participants were assigned randomly to one of four protocols, involving group educational sessions v self-instruction only and required v optional attendance at weigh-ins and sessions. Overall, dropout rates (21.4%) and mean weight loss (12.2 lb) were encouraging, especially compared with those of other work-site programs. Weight loss was positively associated with attendance at weigh-ins and educational sessions. However, requiring attendance did not increase program effectiveness and seemed also to discourage enrollment among men. The weight control program was equally effective when offered with professionally led educational sessions or when accompanied by self-instructional materials only.

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.

33 CFR 402.5 - New Business Incentive Program

Science.gov (United States)

2010-07-01

... Business. (c) A commodity/origin/destination combination that qualifies as New Business after the 30th day... navigation seasons; and (d) A commodity/origin/destination combination that qualifies as New Business after... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false New Business Incentive Program...

U.S. physicians' views on financing options to expand health insurance coverage: a national survey.

Science.gov (United States)

McCormick, Danny; Woolhandler, Steffie; Bose-Kolanu, Anjali; Germann, Antonio; Bor, David H; Himmelstein, David U

2009-04-01

Physician opinion can influence the prospects for health care reform, yet there are few recent data on physician views on reform proposals or access to medical care in the United States. To assess physician views on financing options for expanding health care coverage and on access to health care. Nationally representative mail survey conducted between March 2007 and October 2007 of U.S. physicians engaged in direct patient care. Rated support for reform options including financial incentives to induce individuals to purchase health insurance and single-payer national health insurance; rated views of several dimensions of access to care. 1,675 of 3,300 physicians responded (50.8%). Only 9% of physicians preferred the current employer-based financing system. Forty-nine percent favored either tax incentives or penalties to encourage the purchase of medical insurance, and 42% preferred a government-run, taxpayer-financed single-payer national health insurance program. The majority of respondents believed that all Americans should receive needed medical care regardless of ability to pay (89%); 33% believed that the uninsured currently have access to needed care. Nearly one fifth of respondents (19.3%) believed that even the insured lack access to needed care. Views about access were independently associated with support for single-payer national health insurance. The vast majority of physicians surveyed supported a change in the health care financing system. While a plurality support the use of financial incentives, a substantial proportion support single payer national health insurance. These findings challenge the perception that fundamental restructuring of the U.S. health care financing system receives little acceptance by physicians.

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.

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)

Residential dual energy programs: Tariffs and incentives

International Nuclear Information System (INIS)

Doucet, J.A.

1992-01-01

The problem of efficiently pricing electricity has been of concern to economists and policy makers for some time. A natural solution to variable demand is tariffs to smooth demand and reduce the need for excessive reserve margins. An alternative approach is dual energy programs whereby electric space heating systems are equipped with a secondary system (usually oil) which is used during periods of peak demand. Comments are presented on two previous papers (Bergeron and Bernard, 1991; Sollows et al., 1991) published in Energy Studies Review, applying them to Hydro Quebec tariff structure and dual energy programs. The role of tariffs in demand-side management needs to be considered more fully. Hydro-Quebec's bi-energy tariff structure could be modified by using positive incentives to make use of bi-energy attractive below -12 C to give the following benefits. The modified tariff would be easier for consumers to understand, corrects the misallocation problem due to differential pricing in the current tariff, transfers the risk related to price fluctuations of the alternative energy source from the consumer to the utility, and corrects the potential avoidance problem due to the negative incentive of the current tariff. 21 refs

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

77 FR 12041 - Applications for New Awards; Migrant Education Program (MEP) Consortium Incentive Grants Program

Science.gov (United States)

2012-02-28

... involvement of migratory parents in the education of migratory students whose education is interrupted... DEPARTMENT OF EDUCATION Applications for New Awards; Migrant Education Program (MEP) Consortium Incentive Grants Program AGENCY: Office of Elementary and Secondary Education, Department of Education...

Paying people to lose weight: the effectiveness of financial incentives provided by health insurers for the prevention and management of overweight and obesity - a systematic review.

Science.gov (United States)

Ananthapavan, J; Peterson, A; Sacks, G

2018-05-01

Curbing the obesity epidemic is likely to require a suite of interventions targeting the obesogenic environment as well as individual behaviour. Evidence suggests that the effectiveness of behaviour modification programmes can be enhanced by financial incentives that immediately reward weight loss behaviour. This systematic review investigated the effectiveness of incentives with a focus on assessing the relative effectiveness of incentives that target different behaviours as well as factors of importance when implementing these programmes in real-world settings (health insurer settings). A narrative review of the academic and grey literature including a variety of study designs was undertaken. Twenty studies met inclusion criteria and were assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Results suggest that incentivizing weight loss is effective in the short term while the incentives are in place. There are various incentive designs, and although the relative effectiveness of each of these on weight loss is not clear, it appears that positive incentives increase the uptake into programmes and may reduce dropouts. As with other weight loss initiatives, there is a need to explore ways to maintain weight loss in the longer term - incentives for weight maintenance could play a role. © 2017 World Obesity Federation.

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

Science.gov (United States)

2010-01-13

... Payment Calculation for Eligible Hospitals c. Medicare Share d. Charity Care e. Transition Factor f...) and eligible hospitals participating in Medicare and Medicaid programs that adopt and meaningfully use... an EP and eligible hospital must meet in order to qualify for the incentive payment; calculation of...

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....

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.

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

Science.gov (United States)

2010-07-01

... reduce your overall relocation costs. You must not make a home marketing incentive payment that exceeds... our home marketing incentive payment program? 302-14.100 Section 302-14.100 Public Contracts and... 14-HOME MARKETING INCENTIVE PAYMENTS Agency Responsibilities § 302-14.100 How should we administer...

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.

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

The Progressive Insurance Automotive X PRIZE Education Program

Energy Technology Data Exchange (ETDEWEB)

Robyn Ready

2011-12-31

The Progressive Insurance Automotive X PRIZE Education Program conducted education and outreach activities and used the competition's technical goals and vehicle demonstrations as a means of attracting students and the public to learn more about advanced vehicle technologies, energy efficiency, climate change, alternative fuels, and the science and math behind efficient vehicle development. The Progressive Insurance Automotive X PRIZE Education Program comprised three integrated components that were designed to educate the general public and create a multi-tiered initiative to engage students and showcase the 21st century skills students will need to compete in our global economy: teamwork, creativity, strong literacy, math and science skills, and innovative thinking. The elements included an Online Experience, a National Student Contest, and in person education events and activites. The project leveraged online connections, strategic partnerships, in-classroom, and beyond-the-classroom initiatives, as well as mainstream media. This education program supported by the U.S. Department of Energy (DOE) also funded the specification of vehicle telemetry and the full development and operation of an interactive online experience that allowed internet users to follow the Progressive Insurance Automotive X PRIZE vehicles as they performed in real-time during the Progressive Insurance Automotive X PRIZE competition events.

Mandatory high-risk pooling: an approach to reducing incentives for cream skimming.

Science.gov (United States)

van Barneveld, E M; van Vliet, R C; van de Ven, W P

1996-01-01

Risk-adjusted capitation payments (RACPs) to competing health insurers are an essential element of market-oriented health care reforms in The Netherlands. Crude RACPs are inadequate, especially because they encourage insurers to select against people expected to be unprofitable--a practice called cream skimming. However, implementing improved RACPs does not appear to be straightforward. This paper analyzes an approach that, given a system of crude RACPs, reduces insurers' incentives for cream skimming in the market for individual health insurance, while preserving incentives for efficiency and cost containment. Under the proposed system of Mandatory High-Risk Pooling (MHRP), each insurer would be allowed to periodically predetermine a small fraction of its members whose costs would be (partially) pooled. The pool would be financed with mandatory, flat-rate contributions. The results suggest that MHRP is a promising supplement to RACPs.

42 CFR 431.636 - Coordination of Medicaid with the Children's Health Insurance Program (CHIP).

Science.gov (United States)

2010-10-01

... Insurance Program (CHIP). 431.636 Section 431.636 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES...'s Health Insurance Program (CHIP). (a) Statutory basis. This section implements— (1) Section 2102(b... coordination between a State child health program and other public health insurance programs. (b) Obligations...

12 CFR 2.4 - Bonus and incentive plans.

Science.gov (United States)

2010-01-01

... plan based on the sale of credit life insurance if payments to the employee or officer in any one year... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Bonus and incentive plans. 2.4 Section 2.4 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY SALES OF CREDIT LIFE INSURANCE...

78 FR 46339 - Medicare, Medicaid, and Children's Health Insurance Programs: Announcement of Temporary Moratoria...

Science.gov (United States)

2013-07-31

...] Medicare, Medicaid, and Children's Health Insurance Programs: Announcement of Temporary Moratoria on... combat fraud, waste, and abuse in Medicare, Medicaid, and the Children's Health Insurance Program (CHIP... Health Insurance Programs; Additional Screening Requirements, Application Fees, Temporary Enrollment...

Regulating a health insurance exchange: implications for individuals with mental illness.

Science.gov (United States)

McGuire, Thomas G; Sinaiko, Anna D

2010-11-01

Under the newly enacted health reform law, millions of lower- and middle-income Americans will purchase individual or family health insurance through state-based markets for private health insurance called insurance "exchanges," which consolidate and regulate the market for individual and small-group health insurance. The authors consider options for structuring choice and pricing of health insurance in an exchange from the perspective of efficiently and fairly serving persons with mental illness. Exchanges are intended to foster choice and competition. However, certain features-open enrollment, individual choice, and imperfect risk adjusters-create incentives for "adverse selection," especially in providing coverage for persons with mental illness, who have higher overall health care costs. The authors review the experience of persons with mental illness in insurance markets similar to the exchanges, such as the Massachusetts Connector and the Federal Employees Health Benefit Program, and note that competition among health plans for enrollees who are "good risks" can undermine coverage and efficiency. They review the possible approaches for contending with selection-related incentives, such as carving out all or part of mental health benefits, providing reinsurance for some mental health care costs, or their preferred option, running the exchange in the same way that an employer runs its employee benefits and addressing selection and cost control issues by choice of contractor. The authors also consider approaches an exchange could use to promote effective consumer choice, such as passive and active roles for the exchange authority. Regulation will be necessary to establish a foundation for success of the exchanges.

42 CFR 457.618 - Ten percent limit on certain Children's Health Insurance Program expenditures.

Science.gov (United States)

2010-10-01

... Insurance Program expenditures. 457.618 Section 457.618 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS... Children's Health Insurance Program expenditures. (a) Expenditures. (1) Primary expenditures are...

Strange Bedfellows: A Local Insurer/Physician Practice Partnership to Fund Innovation.

Science.gov (United States)

Kraft, Sally; Strutz, Elizabeth; Kay, Lawrence; Welnick, Richard; Pandhi, Nancy

2015-01-01

Despite an unprecedented urgency to control healthcare costs while simultaneously improving quality, there are many barriers to investing in quality improvement. Traditional fee-for-service reimbursement models fail to reward providers whose improved processes lead to decreases in billable clinical activity. In addition, providers may lack the necessary skills for improvement, or the organizational infrastructure to conduct these activities. Insurance firms lack incentives to invest in healthcare delivery system improvements that lead to benefits for all patients, even those covered by competitors. In this article, we describe a novel program in its sixth year of existence that funds ambulatory care improvements through a collaborative partnership between a local academic healthcare delivery system and an insurance firm. The program is designed as a competitive grant program and the payer and healthcare organization jointly benefit from completed improvement projects. Factors contributing to the ongoing success of the program and lessons learned are discussed in order to inform the potential development of similar programs in other markets.

78 FR 4593 - Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in...

Science.gov (United States)

2013-01-22

...'s Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans...-2334-P] RIN 0938-AR04 Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health... 2010 (collectively referred to as the Affordable Care Act), and the Children's Health Insurance Program...

75 FR 6673 - Expert Meeting on Measurement Criteria for Children's Health Insurance Program; Reauthorization...

Science.gov (United States)

2010-02-10

... on Measurement Criteria for Children's Health Insurance Program; Reauthorization Act Pediatric... enacted in the Children's Health Insurance Program Reauthorization Act (CHIPRA). DATES: The meeting will...) reauthorized the Child Health Insurance Program (CHIP) originally established in 1997, and in Title IV of the...

Impact of standards and certification on environmental impairment liability insurance programs

International Nuclear Information System (INIS)

Gulledge, W.P.

1993-01-01

Environmental impairment liability (EIL) insurance is available for petroleum storage tank and other environmental exposures. Recent standards and performance criteria for leak detection for underground storage tanks (USTs) and other technical standards for USTs have been both a benefit and an interference to risk-based underwriting of storage tank EIL insurance programs. Insurance underwriters and state financial responsibility program administrators are confronted with confusing information to manage these environmental risks. Standards and certification are also key issues for site assessment programs. Recent activities from ASTM and the Institute for Environmental Auditing (IEA) have addressed the need to increase the professional stature of site assessments and environmental management. Reaction and acceptance of these efforts by the users have been mixed. Ultimately, these efforts will greatly impact insurance coverage for environmental risks

Photovoltaic Incentive Design Handbook

Energy Technology Data Exchange (ETDEWEB)

Hoff, T. E.

2006-12-01

Investments in customer-owned grid-connected photovoltaic (PV) energy systems are growing at a steady pace. This is due, in part, to the availability of attractive economic incentives offered by public state agencies and utilities. In the United States, these incentives have largely been upfront lump payments tied to the system capacity rating. While capacity-based ''buydowns'' have stimulated the domestic PV market, they have been criticized for subsidizing systems with potentially poor energy performance. As a result, the industry has been forced to consider alternative incentive structures, particularly ones that pay based on long-term measured performance. The industry, however, lacks consensus in the debate over the tradeoffs between upfront incentive payments versus longer-term payments for energy delivery. This handbook is designed for agencies and utilities that offer or intend to offer incentive programs for customer-owned PV systems. Its purpose is to help select, design, and implement incentive programs that best meet programmatic goals. The handbook begins with a discussion of the various available incentive structures and then provides qualitative and quantitative tools necessary to design the most appropriate incentive structure. It concludes with program administration considerations.

Leaving "Hotel California" : How Incentives Affect Flows of Benefit Recipients in the Netherlands

NARCIS (Netherlands)

van Ours, J.C.

2006-01-01

This paper discusses developments in the Netherlands concerning unemployment insurance, unemployment assistance and disability insurance.The emphasis is on how incentives for individual workers and firms affect flows of benefit recipients.

How effective are energy-efficiency incentive programs? Evidence from Italian homeowners

International Nuclear Information System (INIS)

Alberini, Anna; Bigano, Andrea

2015-01-01

We evaluate incentives for residential energy upgrades in Italy using data from an original survey of Italian homeowners. In this paper, attention is restricted to heating system replacements, and to the effect of monetary and non-monetary incentives on the propensity to replace the heating equipment with a more efficient one. To get around adverse selection and free riding issues, we ask stated preference questions to those who weren't planning energy efficiency upgrades any time soon. We argue that these persons are not affected by these behaviors. We use their responses to fit an energy-efficiency renovations curve that predicts the share of the population that will undertake these improvements for any given incentive level. This curve is used to estimate the CO_2 emissions saved and their cost-effectiveness. Respondents are more likely to agree to a replacement when the savings on the energy bills are larger and experienced over a longer horizon, and when rebates are offered to them. Reminding the respondents about possible CO_2 emissions reductions (our non-monetary incentive) had little effect. Even under optimistic assumptions, monetary incentives similar to those in the Italian tax credit program are generally not cost-effective.

76 FR 78741 - Medicare, Medicaid, Children's Health Insurance Programs; Transparency Reports and Reporting of...

Science.gov (United States)

2011-12-19

... Parts 402 and 403 [CMS-5060-P] RIN 0938-AR33 Medicare, Medicaid, Children's Health Insurance Programs...'s Health Insurance Program (CHIP) to report annually to the Secretary certain payments or transfers... State plan under title XIX (Medicaid) or XXI of the Act (the Children's Health Insurance Program, or...

Agricultural Incentives: Implications for Small-Scale and Subsistence Farming in the US Caribbean Islands

Science.gov (United States)

Alvarez-Berrios, N.; Parés-Ramos, I.; Gould, W. A.

2017-12-01

The effects of climate change threaten the world's most sensitive agroecosystems and our potential to reach agricultural productivity levels needed to feed a projected global population of 9.7 billion people by 2050. The US Caribbean agriculture is especially vulnerable to the effects of climate change, due to the region's frequent exposure to extreme weather events, its geographic and economic scale, shortage of labor force, and rapid urban expansion. Currently, agriculture contributes less than 1% of the island's GDP, and over 80% of the food consumed in the region is imported. Despite low production levels, there is widespread interest in reinvigorating the agricultural sector's contribution to the economy. Local and federal institutions play a major role strengthening the agricultural sector by providing access to incentives, loans, and education for best management practices. However, many of these efforts conform to agricultural systems of larger scale of production and temperate environments. In this study, we explore agricultural incentives programs and their implication for highly diverse, small-scale, and subsistence operations that characterize agricultural systems in Puerto Rico and the US Virgin Islands. We analyze records and maps from the USDA Farm Service Agency, to typify participating farms, and to track changes in land cover, farm size, crop diversity, practices, and production levels resulting from their enrollment in such programs. Preliminary results indicate that many incentives programs are not tailored to agricultural tropical systems and prescribe alternatives that exclude traditional farming methods employed in small-scale and subsistence farms (e.g. crop insurance that benefit monoculture over intercropped systems). Moreover, many of the incentives are contradictory in their recommendations (e.g., crop insurance benefit sun-grown coffee production, while best agricultural practices recommend agroforestry with shade-grown coffee

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

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.

24 CFR 4001.203 - Calculation of upfront and annual mortgage insurance premiums for Program mortgages.

Science.gov (United States)

2010-04-01

... mortgage insurance premiums for Program mortgages. 4001.203 Section 4001.203 Housing and Urban Development... HOMEOWNERS PROGRAM HOPE FOR HOMEOWNERS PROGRAM Rights and Obligations Under the Contract of Insurance § 4001.203 Calculation of upfront and annual mortgage insurance premiums for Program mortgages. (a...

Effectiveness of the toll-free line for public insurance programs.

Science.gov (United States)

Saunders, Cynthia M

2005-03-01

Toll-free lines for public insurance programs are a major point of entry to inquire about information. More than 1 million Californians are eligible for public insurance programs based on income but not yet enrolled. In 2000 and 2002, a "mystery-shopper" survey was conducted to ascertain overall effectiveness and interlanguage variation for information provided in Armenian, Cantonese, English, Farsi, Hmong, Khmer, Korean, Russian, Spanish, and Vietnamese. Although the 2002 study showed statistically significant improvements from 2000, many constructs remained problematic. In 2002, for example, statistically significant interlanguage variation was identified in discussing and checking eligibility for the program. Specifically, Spanish and Armenian callers were less likely than other language callers to have eligibility checked or deemed eligible. Removing barriers to enrollment in public insurance programs often requires political solutions, but improving customer service for the toll-free line necessitates efficiency and a focus on continuous quality improvement.

Financial Incentives, Workplace Wellness Program Participation, and Utilization of Health Care Services and Spending.

Science.gov (United States)

Fronstin, Paul; Roebuck, M Christopher

2015-08-01

This paper analyzes data from a large employer that enhanced financial incentives to encourage participation in its workplace wellness programs. It examines, first, the effect of financial incentives on wellness program participation, and second, it estimates the impact of wellness program participation on utilization of health care services and spending. The Patient Protection and Affordable Care Act of 2010 (PPACA) allows employers to provide financial incentives of as much as 30 percent of the total cost of coverage when tied to participation in a wellness program. Participation in health risk assessments (HRAs) increased by 50 percentage points among members of unions that bargained in the incentive, and increased 22 percentage points among non-union employees. Participation in the biometric screening program increased 55 percentage points when financial incentives were provided. Biometric screenings led to an average increase of 0.31 annual prescription drug fills, with related spending higher by $56 per member per year. Otherwise, no significant effects of participation in HRAs or biometric screenings on utilization of health care services and spending were found. The largest increase in medication utilization as a result of biometric screening was for statins, which are widely used to treat high cholesterol. This therapeutic class accounted for one-sixth of the overall increase in prescription drug utilization. Second were antidepressants, followed by ACE inhibitors (for hypertension), and thyroid hormones (for hypothyroidism). Biometric screening also led to significantly higher utilization of biologic response modifiers and immunosuppressants. These specialty medications are used to treat autoimmune diseases, such as rheumatoid arthritis and multiple sclerosis, and are relatively expensive compared with non-specialty medications. The added spending associated with the combined increase in fills of 0.02 was $27 per member per year--about one-half of the

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.

Economic incentives as a policy tool to promote safety and health at work.

Science.gov (United States)

Kankaanpää, Eila

2010-06-01

Incentives are regarded as a promising policy tool for promoting occupational safety and health (OSH). This article discusses the potential of different kinds of incentives in light of economic theory and evidence from research. When incentives are used as a policy tool, it implies the existance of an institution that has both the interest and the power to apply incentives to stakeholders, usually to employers. Governments can subsidize employers' investments in OSH with subsidies and tax structures. These incentives are successful only if the demand for OSH responds to the change in the price of OSH investments and if the suppliers of OSH are able to increase their production smoothly. Otherwise, the subsidy will only lead to higher prices for OSH goods. Both public and private insurance companies can differentiate insurance premiums according to claim behavior in the past (experience rating). There is evidence that this can effectively lower the frequency of claims, but not the severity of cases. This papers concludes that incentives do not directly lead to improvement. When incentives are introduced, their objective(s) should be clear and the end result (ie what the incentive aims to promote) should be known to be effective in achieving healthy and safe workplaces.

76 FR 11782 - Medicare, Medicaid, and Children's Health Insurance Programs; Renewal, Expansion, and Renaming of...

Science.gov (United States)

2011-03-03

...] Medicare, Medicaid, and Children's Health Insurance Programs; Renewal, Expansion, and Renaming of the...'s Health Insurance Program (CHIP) about options for selecting health care coverage under these and... needs are for experts in health disparities, State Health Insurance Assistance Programs (SHIPs), health...

A Peer-to-Peer Mentoring Program for In-Center Hemodialysis: A Patient-Centered Quality Improvement Program.

Science.gov (United States)

St Clair Russell, Jennifer; Southerland, Shiree; Huff, Edwin D; Thomson, Maria; Meyer, Klemens B; Lynch, Janet R

2017-01-01

A patient-centered quality improvement program implemented in one Virginia hemodialysis facility sought to determine if peer-to-peer (P2P) programs can assist patients on in-center hemodialysis with self-management and improve outcomes. Using a single-arm, repeatedmeasurement, quasi-experimental design, 46 patients participated in a four-month P2P intervention. Outcomes include knowledge, self-management behaviors, and psychosocial health indicators: self-efficacy, perceived social support, hemodialysis social support, and healthrelated quality of life (HRQoL). Physiological health indicators included missed and shortened treatments, arteriovenous fistula placement, interdialytic weight gain, serum phosphorus, and hospitalizations. Mentees demonstrated increased knowledge, self-efficacy, perceived social support, hemodialysis social support, and HRQoL. Missed treatments decreased. Mentors experienced increases in knowledge, self-management, and social support. A P2P mentoring program for in-center hemodialysis can benefit both mentees and mentors. Copyright© by the American Nephrology Nurses Association.

75 FR 32182 - Medicaid Program: Proposed Implementation of Section 614 of the Children's Health Insurance...

Science.gov (United States)

2010-06-07

... of the Children's Health Insurance Program Reauthorization Act of 2009 for Adjustments to the Federal... subject to adjustment pursuant to section 614 of the Children's Health Insurance Program Reauthorization... assistance expenditures under the Children's Health Insurance Program under title XXI of the Social Security...

Financial incentives for disease management programmes and integrated care in German social health insurance.

Science.gov (United States)

Greb, Stefan; Focke, Axel; Hessel, Franz; Wasem, Jürgen

2006-10-01

As a result of recent health care reforms sickness funds and health care providers in German social health insurance face increased financial incentives for implementing disease management and integrated care. Sickness funds receive higher payments form the risk adjustment system if they set up certified disease management programmes and induce patients to enrol. If health care providers establish integrated care projects they are able to receive extra-budgetary funding. As a consequence, the number of certified disease management programmes and the number of integrated care contracts is increasing rapidly. However, contracts about disease management programmes between sickness funds and health care providers are highly standardized. The overall share of health care expenses spent on integrated care still is very low. Existing integrated care is mostly initiated by hospitals, is based on only one indication and is not fully integrated. However, opportunity to invest in integrated care may open up innovative processes, which generate considerable productivity gains. What is more, integrated care may serve as gateway for the introduction of more widespread selective contracting.

Changes in the demand for private medical insurance following a shift in tax incentives.

Science.gov (United States)

Rodríguez, Marisol; Stoyanova, Alexandrina

2008-02-01

The 1998 Spanish reform of the Personal Income Tax eliminated the 15% deduction for private medical expenditures including payments on private health insurance (PHI) policies. To avoid an undesired increase in the demand for publicly funded health care, tax incentives to buy PHI were not completely removed but basically shifted from individual to group employer-paid policies. In a unique fiscal experiment, at the same time that the tax relief for individually purchased policies was abolished, the government provided for tax allowances on policies taken out through employment. Using a bivariate probit model on data from National Health Surveys, we estimate the impact of said reform on the demand for PHI and the changes occurred within it. Our findings indicate that the total probability of buying PHI was not significantly affected by the reform. Indeed, the fall in the demand for individual policies (by 10% between 1997 and 2001) was offset by an increase in the demand for group employer-paid ones. We also briefly discuss the welfare effects on the state budget, the industry and society at large.

A Hierarchical Agency Model of Deposit Insurance

OpenAIRE

Jonathan Carroll; Shino Takayama

2010-01-01

This paper develops a hierarchical agency model of deposit insurance. The main purpose is to undertake a game theoretic analysis of the consequences of deposit insurance schemes and their effects on monitoring incentives for banks. Using this simple framework, we analyze both risk- independent and risk-dependent premium schemes along with reserve requirement constraints. The results provide policymakers with not only a better understanding of the effects of deposit insurance on welfare and th...

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…

76 FR 9233 - Children's Health Insurance Program (CHIP); Allotment Methodology and States' Fiscal Years 2009...

Science.gov (United States)

2011-02-17

... [CMS-2291-F] RIN 0938-AP53 Children's Health Insurance Program (CHIP); Allotment Methodology and States... under Title XXI of the Social Security Act (the Act), for the Children's Health Insurance Program (CHIP), as amended by the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA), by the...

78 FR 42159 - Medicaid and Children's Health Insurance Programs: Essential Health Benefits in Alternative...

Science.gov (United States)

2013-07-15

... and 156 Medicaid and Children's Health Insurance Programs: Essential Health Benefits in Alternative... Secretary 45 CFR Parts 155 and 156 [CMS-2334-F] RIN 0938-AR04 Medicaid and Children's Health Insurance... Medicaid and the Children's Health Insurance Program (CHIP) eligibility notices, delegation of appeals, and...

FY11_EOM_August_Number of Life Insurance Policies by Program by State

Data.gov (United States)

Department of Veterans Affairs — Number of life insurance policies for each administered life insurance program listed by state. Data is current as of 08/31/11. All programs are closed to new issues...

HUD PowerSaver Pilot Loan Program

Energy Technology Data Exchange (ETDEWEB)

Zimring, Mark [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hoffman, Ian [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2010-12-10

The U.S. Department of Housing and Urban Development (HUD) recently announced the creation of a pilot loan program for home energy improvements. The PowerSaver loan program is a new, energy-focused variant of the Title I Property Improvement Loan Insurance Program (Title I Program) and is planned for introduction in early 2011. The PowerSaver pilot will provide lender insurance for secured and unsecured loans up to $25,000 to single family homeowners. These loans will specifically target residential energy efficiency and renewable energy improvements. HUD estimates the two-year pilot will fund approximately 24,000 loans worth up to $300 million; the program is not capped. The Federal Housing Administration (FHA), HUD's mortgage insurance unit, will provide up to $25 million in grants as incentives to participating lenders. FHA is seeking lenders in communities with existing programs for promoting residential energy upgrades.

Marine Corps Pay Incentives

Science.gov (United States)

Marines from 2000 to 2017. The thesis includes a literature review on economic theory related to pay incentives in the Department of Defense, a...The purpose of this thesis to provide the Marine Corps with a comprehensive report on pay incentive programs and special pay that were available to...summarization of pay incentive categories, a data analysis on take-up rates and average annual amounts at the end of each fiscal year, and a program review

Is Historical Cost Accounting a Panacea? Market Stress, Incentive Distortions, and Gains Trading

OpenAIRE

Ellul, Andrew; Jotikasthira, Chotibhak; Lundblad, Christian T; Wang, Yihui

2015-01-01

This paper explores the trading incentives of financial institutions induced by the interaction between regulatory accounting rules and capital requirements by investigating insurance companies’ trading behavior during the recent financial crisis. According to insurance regulation, life insurers have a greater degree of flexibility to hold downgraded instruments at historical cost, whereas property and casualty insurers are forced to re-mark many of their downgraded securities to market price...

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.

The relationship between employer health insurance characteristics and the provision of employee assistance programs.

Science.gov (United States)

Zarkin, G A; Garfinkel, S A

1994-01-01

Workplace drug and alcohol abuse imposes substantial costs on employers. In response, employers have implemented a variety of programs to decrease substance abuse in the workplace, including drug testing, health and wellness programs, and employee assistance programs (EAPs). This paper focuses on the relationship between enterprises' organizational and health insurance characteristics and the firms' decisions to provide EAPs. Using data from the 1989 Survey of Health Insurance Plans (SHIP), sponsored by the Health Care Financing Administration (HCFA), we estimated the prevalence of EAPs by selected organizational and health insurance characteristics for those firms that offer health insurance to their workers. In addition, we estimated logistic models of the enterprises' decisions to provide EAPs as functions of the extent of state substance abuse and mental health insurance mandates, state-level demographic variables, and organizational and health insurance characteristics. Our results suggest that state mandates and demographic variables, as well as organizational and health insurance characteristics, are important explanatory variables of enterprises' decisions to provide EAPs.

Spousal labor market effects from government health insurance: Evidence from a veterans affairs expansion.

Science.gov (United States)

Boyle, Melissa A; Lahey, Joanna N

2016-01-01

Measuring the total impact of health insurance receipt on household labor supply is important in an era of increased access to publicly provided and subsidized insurance. Although government expansion of health insurance to older workers leads to direct labor supply reductions for recipients, there may be spillover effects on the labor supply of uncovered spouses. While the most basic model predicts a decrease in overall household work hours, financial incentives such as credit constraints, target income levels, and the need for own health insurance suggest that spousal labor supply might increase. In contrast, complementarities of spousal leisure would predict a decrease in labor supply for both spouses. Utilizing a mid-1990s expansion of health insurance for U.S. veterans, we provide evidence on the effects of public insurance availability on the labor supply of spouses. Using data from the Current Population Survey and Health and Retirement Study, we employ a difference-in-differences strategy to compare the labor market behavior of the wives of older male veterans and non-veterans before and after the VA health benefits expansion. Although husbands' labor supply decreases, wives' labor supply increases, suggesting that financial incentives dominate complementarities of spousal leisure. This effect is strongest for wives with lower education levels and lower levels of household wealth and those who were not previously employed full-time. These findings have implications for government programs such as Medicare and Social Security and the Affordable Care Act. Copyright © 2015 Elsevier B.V. All rights reserved.

Does race matter in landowners' participation in conservation incentive programs?

Science.gov (United States)

Jianbang Gan; Okwuldili O. Onianwa; John Schelhas; Gerald C. Wheelock; Mark R. Dubois

2005-01-01

This study investigated and compared the participation behavior of white and minority small landowners in Alabama in eight conservation incentive programs. Using nonparametric tests and logit modeling, we found both similarities and differences in participation behavior between these two landowner groups. Both white and minority landowners tended not to participate in...

78 FR 45208 - Children's Health Insurance Program (CHIP); Final Allotments to States, the District of Columbia...

Science.gov (United States)

2013-07-26

... 0938-AR79 Children's Health Insurance Program (CHIP); Final Allotments to States, the District of... and expand health insurance coverage to uninsured, low-income children under the Children's Health...). States may implement the Children's Health Insurance Program (CHIP) through a separate state program...

U.S. Army Incentive Program: Incentives That Motivate Recruiters

National Research Council Canada - National Science Library

Starkey, Benjamin

1999-01-01

.... Sixty recruiters and staff personnel at the brigade, battalion and company echelons were randomly selected and interviewed on how the various national and local incentives motivate recruiters to meet...

Reforming insurance to support workers' rights to compensation.

Science.gov (United States)

McCluskey, Martha T

2012-06-01

The structure and regulation of the insurance system for financing workers' compensation affects the costs of workers' benefits. Using the example of Maine's insurance market restructuring in response to a crisis of the early 1990s, this commentary explores how changes in insurance regulation might better support the goals of workers' compensation. The commentary analyzes how insurance and its regulation should go beyond correct pricing of risks to questions of how to structure incentives for loss control to include workers' interests as well as the interests of employers and insurers. Copyright © 2012 Wiley Periodicals, Inc.

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.

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)

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.

26 CFR 301.6511(d)-7 - Overpayment of income tax on account of work incentive program credit carryback.

Science.gov (United States)

2010-04-01

... or refund related to an overpayment of income tax attributable to a work incentive program (WIN... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Overpayment of income tax on account of work incentive program credit carryback. 301.6511(d)-7 Section 301.6511(d)-7 Internal Revenue INTERNAL REVENUE...

FY11_EOM_Oct_Face Amount of Life Insurance Coverage by Program by State

Data.gov (United States)

Department of Veterans Affairs — Face value of insurance for each administered life insurance program listed by state. Data is current as of 10-31-11. All programs are closed to new issues except...

Impact of a Rewards-Based Incentive Program on Promoting Fruit and Vegetable Purchases

Science.gov (United States)

Phipps, Etienne J.; Braitman, Leonard E.; Stites, Shana D.; Singletary, S. Brook; Wallace, Samantha L.; Hunt, Lacy; Axelrod, Saul; Glanz, Karen; Uplinger, Nadine

2015-01-01

Objectives. We assessed the impact of a rewards-based incentive program on fruit and vegetable purchases by low-income families. Methods. We conducted a 4-phase prospective cohort study with randomized intervention and wait-listed control groups in Philadelphia, Pennsylvania, in December 2010 through October 2011. The intervention provided a rebate of 50% of the dollar amount spent on fresh or frozen fruit and vegetables, reduced to 25% during a tapering phase, then eliminated. Primary outcome measures were number of servings of fruit and of vegetables purchased per week. Results. Households assigned to the intervention purchased an average of 8 (95% confidence interval [CI] = 1.5, 16.9) more servings of vegetables and 2.5 (95% CI = 0.3, 9.5) more servings of fruit per week than did control households. In longitudinal price-adjusted analyses, when the incentive was reduced and then discontinued, the amounts purchased were similar to baseline. Conclusions. Investigation of the financial costs and potential benefits of incentive programs to supermarkets, government agencies, and other stakeholders is needed to identify sustainable interventions. PMID:24625144

FY11_EOM_August_Face Amount of Life Insurance Coverage by Program by State

Data.gov (United States)

Department of Veterans Affairs — Face value of insurance for each administered life insurance program listed by state. Data is current as of 8-31-11. All programs are closed to new issues except for...

EOM July FY2011 - Face Amount of Life Insurance Coverage by Program by State

Data.gov (United States)

Department of Veterans Affairs — Face value of insurance for each administered life insurance program listed by state. Data is current as of 7-31-11. All programs are closed to new issues except for...

A Comprehensive Study of the Incentive Award Program at General Leonard Wood Army Community Hospital

National Research Council Canada - National Science Library

Cox, Michael

2001-01-01

.... Therefore, they commissioned this study to evaluate the present incentive award program based on fairness and effectiveness and to explore methods of reshaping the program into one that both rewards...

Risk Management and Nuclear Insurance Program within Societatea Nationala Nuclearelectrica S.A

International Nuclear Information System (INIS)

Havris, Alexandru

2008-01-01

This paper shall present the Risk Management and associated nuclear insurance program developed within Societatea Nationala 'Nuclearelectrica' S.A, owner and operator of Units 1 and 2 Cernavoda NPP, the Nuclear Fuel Plant and in charge with commissioning of Units 3 and 4. From the risk management perspective, the main aspects that energy industry has to face due to global economic changes within a dynamic business environment are highlighted. In order to mitigate the operational and investment associated risks, Societatea Nationala 'Nuclearelectrica' S.A. successfully developed, implemented and maintained a coherent insurance program both on local and international insurance market. (authors)

78 FR 72089 - Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee...

Science.gov (United States)

2013-12-02

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-6051-N] Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee Amount... period entitled ``Medicare, Medicaid, and Children's Health Insurance Programs; Additional Screening...

Extending health insurance coverage to the informal sector: Lessons from a private micro health insurance scheme in Lagos, Nigeria.

Science.gov (United States)

Peterson, Lauren; Comfort, Alison; Hatt, Laurel; van Bastelaer, Thierry

2018-04-15

As a growing number of low- and middle-income countries commit to achieving universal health coverage, one key challenge is how to extend coverage to informal sector workers. Micro health insurance (MHI) provides a potential model to finance health services for this population. This study presents lessons from a pilot study of a mandatory MHI plan offered by a private insurance company and distributed through a microfinance bank to urban, informal sector workers in Lagos, Nigeria. Study methods included a survey of microfinance clients, key informant interviews, and a review of administrative records. Demographic, health care seeking, and willingness-to-pay data suggested that microfinance clients, particularly women, could benefit from a comprehensive MHI plan that improved access to health care and reduced out-of-pocket spending on health services. However, administrative data revealed declining enrollment, and key informant interviews further suggested low use of the health insurance plan. Key implementation challenges, including changes to mandatory enrollment requirements, insufficient client education and marketing, misaligned incentives, and weak back-office systems, undermined enrollment and use of the plan. Mandatory MHI plans, intended to mitigate adverse selection and facilitate private insurers' entry into new markets, present challenges for covering informal sector workers, including when distributed through agents such as a microfinance bank. Properly aligning the incentives of the insurer and the agent are critical to effectively distribute and service insurance. Further, an urban environment presents unique challenges for distributing MHI, addressing client perceptions of health insurance, and meeting their health care needs. Copyright © 2018 John Wiley & Sons, Ltd.

Determinants of Private Long-Term Care Insurance Purchase in Response to the Partnership Program.

Science.gov (United States)

Lin, Haizhen; Prince, Jeffrey T

2016-04-01

To assess three possible determinants of individuals' response in their private insurance purchases to the availability of the Partnership for Long-Term Care (PLTC) insurance program: bequest motives, financial literacy, and program awareness. The health and retirement study (HRS) merged with data on states' implementation of the PLTC program. Individual-level decision on private long-term care insurance is regressed on whether the PLTC program is being implemented for a given state-year, asset dummies, policy determinant variable, two-way and three-way interactions of these variables, and other controls, using fixed effects panel regression. Analysis used a sample between 50 and 69 years of age from 2002 to 2010, resulting in 12,695 unique individuals with a total of 39,151 observations. We find mild evidence that intent to bequest influences individual purchase of insurance. We also find that program awareness is necessary for response, while financial literacy notably increases responsiveness. Increasing response to the PLTC program among the middle class (the stated target group) requires increased efforts to create awareness of the program's existence and increased education about the program's benefits, and more generally, about long-term care risks and needs. © Health Research and Educational Trust.

78 FR 6275 - Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in...

Science.gov (United States)

2013-01-30

... Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative...'s Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 430...

Health Care Analysis for the MCRMC Insurance Cost Model

Science.gov (United States)

2015-06-01

incentive to reduce utilization  Subsidy to leave TRICARE and use other private health insurance  Increases in TRICARE premiums and co-pays  This...analysis develops the estimated cost of providing health care through a premium -based insurance model consistent with an employer-sponsored benefit...State  Income  Plan premium data  Contract cost data 22 May 2015 9 Agenda  Overview  Background  Data  Insurance Cost Estimate Methodology

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 ...

Risk Management and Nuclear Insurance Program within Societatea Nationala Nuclearelectrica S.A

Energy Technology Data Exchange (ETDEWEB)

Havris, Alexandru [Societatea Nationala Nuclearelectrica S.A, 65 Polona Street, code 010494, sector 1, Bucharest (Romania)

2008-07-01

This paper shall present the Risk Management and associated nuclear insurance program developed within Societatea Nationala 'Nuclearelectrica' S.A, owner and operator of Units 1 and 2 Cernavoda NPP, the Nuclear Fuel Plant and in charge with commissioning of Units 3 and 4. From the risk management perspective, the main aspects that energy industry has to face due to global economic changes within a dynamic business environment are highlighted. In order to mitigate the operational and investment associated risks, Societatea Nationala 'Nuclearelectrica' S.A. successfully developed, implemented and maintained a coherent insurance program both on local and international insurance market. (authors)

20 CFR 422.510 - Applications and related forms used in the health insurance for the aged program.

Science.gov (United States)

2010-04-01

... health insurance for the aged program. 422.510 Section 422.510 Employees' Benefits SOCIAL SECURITY... forms used in the health insurance for the aged program. (a) Application forms. The following forms are prescribed for use in applying for entitlement to benefits under the health insurance for the aged program...

[Occupational health services as the insurance product and insurance economic instruments].

Science.gov (United States)

Rydlewska-Liszkowska, Izabela

2014-01-01

One of the most controversial issues in restructuring the Polish health insurance system is the implementation of private voluntary insurance and creation within it a new insurance product known as occupational health services (OHS). In this article some opportunities and dilemmas likely to be faced by providers and employers/employees, when contracting with insurance institutions, are considered as a contribution to the discussion on private insurance in Poland. The basic question is how private insurance institutions could influence the promotion of different preventive activities at the company level by motivating both OHS providers and employers. The descriptive qualitative method has been applied in the analysis of legal acts, scientific publications selected according to keywords (Pubmed), documents and expert evaluations and research project results. Taking into account the experiences of European countries, described in publications, international experts' opinions and results of research projects the solution proposed in Poland could be possible under the following several prerequisites: inclusion of a full scope of occupational health services into the insurance product, constant supervision of occupational medicine professionals, monitoring of the health care quality and the relations between private insurers and OHS provider and implementation of the economic incentives scheme to ensure an adequate position of OHS providers on the market. The proposed reconstruction of the health insurance system, comprising undoubtedly positive elements, may entail some threats in the area of health, organization and economy. Private voluntary health insurance implementation requires precisely defined solutions concerning the scope of insurance product, motivation scheme and information system.

Deposit insurance reform; or, deregulation is the cart, not the horse

OpenAIRE

John H. Kareken

1990-01-01

This paper, originally published in the spring 1983 Quarterly Review, explains why flat-rate deposit insurance gives financial intermediaries an incentive to take on too much risk. It also discusses the purposes of deposit insurance and some ways reforms might serve those purposes. Three possible reforms are discussed: abolishing the insurance and requiring depository institutions to either hold safe assets or mark to market, reducing the deposit ceilings for insurance, and risk-adjusting the...

Evaluation of the League General Insurance Company child safety seat distribution program

Science.gov (United States)

1982-05-01

This report presents an evaluation of the child safety seat distribution initiated by the League General Insurance Company in June 1979. The program provides child safety seats as a benefit under the company's auto insurance policies to policy-holder...

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...

Designing Incentives for Public School Teachers: Evidence from a Texas Incentive Pay Program

Science.gov (United States)

Springer, Matthew G.; Taylor, Lori L.

2016-01-01

Pay-for-performance is a popular public education reform, but there is little evidence about the characteristics of a well-designed incentive pay plan for teachers. Some of the literature suggests that effective incentive plans must offer relatively large awards to induce behavioral changes. On the other hand, the experimental economics literature…

78 FR 62441 - VA Dental Insurance Program-Federalism

Science.gov (United States)

2013-10-22

...--Federalism AGENCY: Department of Veterans Affairs. ACTION: Direct final rule. SUMMARY: The Department of... that they are submitted in response to ``RIN 2900-AO85-VA Dental Insurance Program-- Federalism... add preemption language in accordance with the discussion above. Executive Order 13132, Federalism...

31 CFR 103.137 - Anti-money laundering programs for insurance companies.

Science.gov (United States)

2010-07-01

... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Anti-money laundering programs for... Finance FINANCIAL RECORDKEEPING AND REPORTING OF CURRENCY AND FOREIGN TRANSACTIONS Anti-Money Laundering Programs Anti-Money Laundering Programs § 103.137 Anti-money laundering programs for insurance companies...

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.

Unemployment duration and unemployment insurance

DEFF Research Database (Denmark)

Røed, Knut; Jensen, Peter; Thoursie, Anna

2008-01-01

Based on pooled register data from Norway and Sweden, we find that differences in unemployment duration patterns reflect dissimilarities in unemployment insurance (UI) systems in a way that convincingly establishes the link between economic incentives and job search behaviour. Specifically, UI...... benefits are relatively more generous for low-income workers in Sweden than in Norway, leading to relatively longer unemployment spells for low-income workers in Sweden. Based on the between-countries variation in replacement ratios, we find that the elasticity of the outflow rate from insured unemployment...

Health incentives: the science and art of motivating healthy behaviors.

Science.gov (United States)

Hall, Barry

2008-01-01

Employers seeking to motivate and encourage healthy behaviors among their employees are increasingly turning to incentive rewards. In fact, a recent Buck Consultants survey of 555 employers, titled Working Well: A Global Survey of Health Promotion and Workplace Wellness Strategies, predicts the use of such rewards to more than double over the next two to three years. This article provides an overview of the key considerations for employers seeking to maximize the value of incentive rewards. Discussion includes incentive strategies, types of rewards, reward amounts and regulatory considerations under the Health Insurance Portability and Accountability Act (HIPAA) and the Americans with Disabilities Act (ADA).

Cost-effectiveness of national health insurance programs in high-income countries: A systematic review.

Directory of Open Access Journals (Sweden)

Son Nghiem

Full Text Available National health insurance is now common in most developed countries. This study reviews the evidence and synthesizes the cost-effectiveness information for national health insurance or disability insurance programs across high-income countries.A literature search using health, economics and systematic review electronic databases (PubMed, Embase, Medline, Econlit, RepEc, Cochrane library and Campbell library, was conducted from April to October 2015.Two reviewers independently selected relevant studies by applying screening criteria to the title and keywords fields, followed by a detailed examination of abstracts.Studies were selected for data extraction using a quality assessment form consisting of five questions. Only studies with positive answers to all five screening questions were selected for data extraction. Data were entered into a data extraction form by one reviewer and verified by another.Data on costs and quality of life in control and treatment groups were used to draw distributions for synthesis. We chose the log-normal distribution for both cost and quality-of-life data to reflect non-negative value and high skew. The results were synthesized using a Monte Carlo simulation, with 10,000 repetitions, to estimate the overall cost-effectiveness of national health insurance programs.Four studies from the United States that examined the cost-effectiveness of national health insurance were included in the review. One study examined the effects of medical expenditure, and the remaining studies examined the cost-effectiveness of health insurance reforms. The incremental cost-effectiveness ratio (ICER ranged from US$23,000 to US$64,000 per QALY. The combined results showed that national health insurance is associated with an average incremental cost-effectiveness ratio of US$51,300 per quality-adjusted life year (QALY. Based on the standard threshold for cost-effectiveness, national insurance programs are cost-effective interventions

78 FR 63143 - VA Dental Insurance Program-Federalism

Science.gov (United States)

2013-10-23

...--Federalism AGENCY: Department of Veterans Affairs. ACTION: Proposed rule. SUMMARY: The Department of Veterans... that they are submitted in response to ``RIN 2900-AO86-VA Dental Insurance Program-- Federalism... Order 13132, Federalism Section 6(c) of Executive Order 13132 (entitled ``Federalism'') requires an...

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

76 FR 40741 - Federal Housing Administration (FHA) Mortgage Insurance Premiums for Multifamily Housing Programs...

Science.gov (United States)

2011-07-11

... Administration (FHA) Mortgage Insurance Premiums for Multifamily Housing Programs, Health Care Facilities and... mortgage insurance premiums (MIPs) for FHA Multifamily Housing, Health Care Facilities, and Hospital... mortgage insurance regulation at 24 CFR 207.254 provides as follows: Notice of future premium changes will...

78 FR 9457 - Medicare, Medicaid, Children's Health Insurance Programs; Transparency Reports and Reporting of...

Science.gov (United States)

2013-02-08

... Parts 402 and 403 [CMS-5060-F] RIN 0938-AR33 Medicare, Medicaid, Children's Health Insurance Programs...'s Health Insurance Program (CHIP) to report annually to the Secretary certain payments or transfers... Vol. 78 Friday, No. 27 February 8, 2013 Part II Department of Health and Human Services Centers...

Incentive Design and Quality Improvements: Evidence from State Medicaid Nursing Home Pay-for-Performance Programs.

Science.gov (United States)

Konetzka, R Tamara; Skira, Meghan M; Werner, Rachel M

2018-01-01

Pay-for-performance (P4P) programs have become a popular policy tool aimed at improving health care quality. We analyze how incentive design affects quality improvements in the nursing home setting, where several state Medicaid agencies have implemented P4P programs that vary in incentive structure. Using the Minimum Data Set and the Online Survey, Certification, and Reporting data from 2001 to 2009, we examine how the weights put on various performance measures that are tied to P4P bonuses, such as clinical outcomes, inspection deficiencies, and staffing levels, affect improvements in those measures. We find larger weights on clinical outcomes often lead to larger improvements, but small weights can lead to no improvement or worsening of some clinical outcomes. We find a qualifier for P4P eligibility based on having few or no severe inspection deficiencies is more effective at decreasing inspection deficiencies than using weights, suggesting simple rules for participation may incent larger improvement.

Michigan's fee-for-value physician incentive program reduces spending and improves quality in primary care.

Science.gov (United States)

Lemak, Christy Harris; Nahra, Tammie A; Cohen, Genna R; Erb, Natalie D; Paustian, Michael L; Share, David; Hirth, Richard A

2015-04-01

As policy makers and others seek to reduce health care cost growth while improving health care quality, one approach gaining momentum is fee-for-value reimbursement. This payment strategy maintains the traditional fee-for-service arrangement but includes quality and spending incentives. We examined Blue Cross Blue Shield of Michigan's Physician Group Incentive Program, which uses a fee-for-value approach focused on primary care physicians. We analyzed the program's impact on quality and spending from 2008 to 2011 for over three million beneficiaries in over 11,000 physician practices. Participation in the incentive program was associated with approximately 1.1 percent lower total spending for adults (5.1 percent lower for children) and the same or improved performance on eleven of fourteen quality measures over time. Our findings contribute to the growing body of evidence about the potential effectiveness of models that align payment with cost and quality performance, and they demonstrate that it is possible to transform reimbursement within a fee-for-service framework to encourage and incentivize physicians to provide high-quality care, while also reducing costs. Project HOPE—The People-to-People Health Foundation, Inc.

On the road again: traffic fatalities and auto insurance minimums

Directory of Open Access Journals (Sweden)

Pavel A. Yakovlev

2018-03-01

Full Text Available Prior research on policy-induced moral hazard effects in the auto insurance market has focused on the impact of compulsory insurance, no-fault liability, and tort liability laws on traffic fatalities. In contrast, this paper examines the moral hazard effect of a previously overlooked policy variable: minimum auto insurance coverage. We hypothesize that state-mandated auto insurance minimums may “over-insure” some drivers, lowering their incentives to drive carefully. Using a longitudinal panel of American states from 1982 to 2006, we find that policy-induced increases in auto insurance minimums are associated with higher traffic fatality rates, ceteris paribus.

Insurance premiums and insurance coverage of near-poor children.

Science.gov (United States)

Hadley, Jack; Reschovsky, James D; Cunningham, Peter; Kenney, Genevieve; Dubay, Lisa

States increasingly are using premiums for near-poor children in their public insurance programs (Medicaid/SCHIP) to limit private insurance crowd-out and constrain program costs. Using national data from four rounds of the Community Tracking Study Household Surveys spanning the seven years from 1996 to 2003, this study estimates a multinomial logistic regression model examining how public and private insurance premiums affect insurance coverage outcomes (Medicaid/SCHIP coverage, private coverage, and no coverage). Higher public premiums are significantly associated with a lower probability of public coverage and higher probabilities of private coverage and uninsurance; higher private premiums are significantly related to a lower probability of private coverage and higher probabilities of public coverage and uninsurance. The results imply that uninsurance rates will rise if both public and private premiums increase, and suggest that states that impose or increase public insurance premiums for near-poor children will succeed in discouraging crowd-out of private insurance, but at the expense of higher rates of uninsurance. Sustained increases in private insurance premiums will continue to create enrollment pressures on state insurance programs for children.

Michigan's Physician Group Incentive Program offers a regional model for incremental 'fee for value' payment reform.

Science.gov (United States)

Share, David A; Mason, Margaret H

2012-09-01

Blue Cross Blue Shield of Michigan partnered with providers across the state to create an innovative, "fee for value" physician incentive program that would deliver high-quality, efficient care. The Physician Group Incentive Program rewards physician organizations-formal groups of physicians and practices that can accept incentive payments on behalf of their members-based on the number of quality and utilization measures they adopt, such as generic drug dispensing rates, and on their performance on these measures across their patient populations. Physicians also receive payments for implementing a range of patient-centered medical home capabilities, such as patient registries, and they receive higher fees for office visits for incorporating these capabilities into routine practice while also improving performance. Taken together, the incentive dollars, fee increases, and care management payments amount to a potential increase in reimbursement of 40 percent or more from Blue Cross Blue Shield of Michigan for practices designated as high-performing patient-centered medical homes. At the same time, we estimate that implementing the patient-centered medical home capabilities was associated with $155 million in lower medical costs in program year 2011 for Blue Cross Blue Shield of Michigan members. We intend to devote a higher percentage of reimbursement over time to communities of caregivers that offer high-value, system-based care, and a lower percentage of reimbursement to individual physicians on a service-specific basis.

Benefit Reentitlement Conditions in Unemployment Insurance Schemes

DEFF Research Database (Denmark)

Andersen, Torben M.; Christoffersen, Mark Strøm; Svarer, Michael

and employment requirements are substitute instruments in affecting job search incentives and thus gross unemployment. We analyse the optimal design of the unemployment insurance system (benefit levels, duration and employment requirements) under a utilitarian social welfare function. Simulations show...

Coupons for Success: A Marketing Incentive in Academic Support

Science.gov (United States)

Potacco, Donna R.; Chen, Peter; Desroches, Danielle; Chisholm, Daniel R.; De Young, Sandra

2013-01-01

How does a Coupon Incentive Program motivate students to seek academic support in high-risk courses? Results from this study demonstrated that the Coupon Incentive Program was effective in motivating voluntary student attendance and improving student outcomes. Recommendations related to implementation of the Coupon Incentive Program are discussed.…

42 CFR 495.310 - Medicaid provider incentive payments.

Science.gov (United States)

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Medicaid provider incentive payments. 495.310 Section 495.310 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.310 Medicaid provider incentive...

24 CFR 257.203 - Calculation of up-front and annual mortgage insurance premiums for H4H program mortgages.

Science.gov (United States)

2010-04-01

... mortgage insurance premiums for H4H program mortgages. 257.203 Section 257.203 Housing and Urban... mortgage insurance premiums for H4H program mortgages. (a) Applicable premiums. Any mortgage presented for... LOAN INSURANCE PROGRAMS UNDER NATIONAL HOUSING ACT AND OTHER AUTHORITIES HOPE FOR HOMEOWNERS PROGRAM...

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

... 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 TRANSACTION ALLOWANCES 14-HOME MARKETING INCENTIVE PAYMENTS Agency Responsibilities § 302-14.101 What policies...

Trends in pension insurance

Directory of Open Access Journals (Sweden)

D. Shterev

2017-12-01

Full Text Available This article deals with a topical for our country problem which is related to the State Social Insurance. It provides a review of the factors having an adverse effect onto the financial state of the Bulgarian pension system. Discussed are the basic parameters related to the economic incentives in connection with the optimal functioning of the pension system

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...

76 FR 46684 - Medicaid and Children's Health Insurance Programs; Disallowance of Claims for FFP and Technical...

Science.gov (United States)

2011-08-03

..., 433, 447, and 457 [CMS-2292-P] RIN 0938-AQ32 Medicaid and Children's Health Insurance Programs... Children's Health Insurance Program (CHIP) disallowance process to allow States the option to retain... [[Page 46685

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…

Insurance against climate change and flood risk: Insurability and decision processes of insurers

Science.gov (United States)

Hung, Hung-Chih; Hung, Jia-Yi

2016-04-01

equivalent,' and 'gamble tradeoff' methods were used. We then synthesized a Tobit and an OLS regression analysis to identify and examine the determinants of insurers' decisions on insurability and pricing for flood risk. Furthermore, the data were collected through a questionnaire survey, which was conducted with the assistance from the Non-life Underwriters Society, Taiwan and the Actuarial Institute, Taiwan. After pretesting, questionnaires were mailed to 410 randomly chosen commercial property-and-casualty insurance firms' actuaries and underwriters. The final sample consisted of 179 questionnaires for a 43.8% response rate. 3. Results Results of the questionnaire survey reveal that flood risk tends to be more uninsurable when there is ambiguity regarding the probability of a particular flood event loss. The presence of insurers' risk aversion appears to be robust. Insurers would charge a significantly higher price for a flood insurance policy than normal property insurance. The findings also show that the insurers who perceived higher levels of flood risk, or/and had a company with smaller size or higher financial leverage, would trigger a higher premium for flood insurance. Governmental risk management strategies, such as land-use planning, building codes, flood-hazard zone regulations, also played a prominent role in enhancing insurability and decreasing insurance premium. Therefore, appropriate incentives should be combined with better public risk communication and mitigation strategies to stimulate insurance coverage in reducing flood loss.

78 FR 4478 - Federal Employees Dental and Vision Insurance Program: Application Process for Contract Awards

Science.gov (United States)

2013-01-22

... process is being changed to be in line with the process used for the Federal Employees Health Benefits... OFFICE OF PERSONNEL MANAGEMENT Federal Employees Dental and Vision Insurance Program: Application... Process for Federal Employees Dental and Vision Insurance Program Contract Awards. SUMMARY: The U. S...

78 FR 64873 - Federal Employees Health Benefits Program and Federal Employees Dental and Vision Insurance...

Science.gov (United States)

2013-10-30

... family members under the FEHB and the Federal Employees Dental and Vision Insurance Program (FEDVIP... procedure, Government employees, Health facilities, Health insurance, Health professions, Hostages, Iraq... Administrative practice and procedure, Government employees, Health insurance, Taxes, Wages. 5 CFR Part 894...

Study of the Insurance Premium Charged to Borrowers under the Guaranteed Student Loan Program. Report No. 3.

Science.gov (United States)

Touche Ross and Co., Washington, DC.

Insurance premiums being charged to borrowers under the Guaranteed Student Loan (GSL) program were studied to determine if the rate exceeded the rate necessary to protect the reserves of the insurer. Attention was directed to whether historical changes in the GSL program have affected insurance premiums. Guaranty agency's sources and uses of funds…

The Mental Health Nurse Incentive Program: desirable knowledge, skills and attitudes from the perspective of nurses.

Science.gov (United States)

Happell, Brenda; Palmer, Christine; Tennent, Rebeka

2011-03-01

To enhance the understanding of the skills and attitudes of mental health nurses working in the Australian Mental Health Nurse Incentive Program. The Mental Health Nurse Incentive Program places qualified mental health nurses alongside community-based general practitioners, private psychiatric practices and other appropriate organisations to provide clients with mental health conditions with a more integrated treatment plan. An exploratory, qualitative approach was undertaken, given the paucity of relevant research in this area. Exploratory individual interviews were conducted with ten mental health nurses working in this scheme. Data analysis was organised and managed using QSR NVivo qualitative analysis software. Respondents identified specific skills and attitudes required for practice under the Mental Health Nurse Incentive Program. Eight areas of skill and attitude were identified as essential for mental health nurses working in this field. This study highlights that many of these skills and attitudes are specific to the setting where mental health nurses are working. Mental health nurses working under this programme have a role to play in the dissemination of knowledge about their practice. More needs to be done by governments and other institutions to ensure that general practitioners and other health professionals understand the role played by mental health nurses in the provision of care. The extent to which the Mental Health Nurse Incentive Program becomes a sustainable strategy to promote quality and accessible mental health care will depend to some degree on the capacity to identify the skills and attitudes necessary for practice. The findings presented in this paper provide a significant contribution to articulating the essential characteristics required for this area of practice. © 2011 Blackwell Publishing Ltd.

A Comprehensive Study of the Incentive Award Program at General Leonard Wood Army Community Hospital

National Research Council Canada - National Science Library

Cox, Michael

2001-01-01

... appropriate behavior and motivates employees. The study is broken into three phases. In Phase I, a retrospective study looked at the current incentive award program to determine if awards distribution is equitable...

An Examination of How the Availability of State-backed Terrorism Insurance Programs and Commercial Terrorism Insurance Affects the Operational Decisions of Multinational Companies.

OpenAIRE

GREY, William / WJG

2011-01-01

This dissertation explores the extent to which the operational decisions of multinational companies (MNCs) are affected by the availability of State-backed terrorism insurance programs and commercial terrorism insurance. The initial hypothesis made is that MNCs will be reluctant to invest in zones or countries with high terrorism or political risks, especially when insurance for these risks may be limited or unavailable. This investigation finds that the availability of State-backed terrorism...

Insuring against Health Shocks: Health Insurance and Household Choices

OpenAIRE

Liu, Kai

2015-01-01

This paper provides empirical evidence on the role of public health insurance in mitigating adverse outcomes associated with health shocks. Exploiting the rollout of a universal health insurance program in rural China, I find that total household income and consumption are fully insured against health shocks even without access to health insurance. Household labor supply is an important insurance mechanism against health shocks. Access to health insurance helps households to maintain investme...

77 FR 31499 - Medicaid and Children's Health Insurance Programs; Disallowance of Claims for FFP and Technical...

Science.gov (United States)

2012-05-29

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 430, 433, 447, and 457 [CMS-2292-F] RIN 0938-AQ32 Medicaid and Children's Health Insurance Programs... Children's Health Insurance Program (CHIP) disallowance process to allow States the option to retain...

Mandatory pooling as a supplement to risk-adjusted capitation payments in a competitive health insurance market.

Science.gov (United States)

Van Barneveld, E M; Lamers, L M; van Vliet, R C; van de Ven, W P

1998-07-01

Risk-adjusted capitation payments (RACPs) to competing health insurers are an essential element of market-oriented health care reforms in many countries. RACPs based on demographic variables only are insufficient, because they leave ample room for cream skimming. However, the implementation of improved RACPs does not appear to be straightforward. A solution might be to supplement imperfect RACPs with a form of mandatory pooling that reduces the incentives for cream skimming. In a previous paper it was concluded that high-risk pooling (HRP), is a promising supplement to RACPs. The purpose of this paper is to compare HRP with two other main variants of mandatory pooling. These variants are called excess-of-loss (EOL) and proportional pooling (PP). Each variant includes ex post compensations to insurers for some members which depend to various degrees on actually incurred costs. Therefore, these pooling variants reduce the incentives for cream skimming which are inherent in imperfect RACPs, but they also reduce the incentives for efficiency and cost containment. As a rough measure of the latter incentives we use the percentage of total costs for which an insurer is at risk. This paper analyzes which of the three main pooling variants yields the greatest reduction of incentives for cream skimming given such a percentage. The results show that HRP is the most effective of the three pooling variants.

The unending deposit insurance mess.

Science.gov (United States)

Kane, E J

1989-10-27

The thrift institution deposit insurance mess is rooted in defects in political and bureaucratic accountability. Under existing incentives, covering up evidence of poor regulatory performance and relaxing binding capital requirements are rational governmental responses to widespread industry insolvency. Similarly, aggressive industry risk taking is a rational response by thrift managers to regulatory forbearances. Far from acknowledging these incentive defects, the Bush plan for cleaning up the mess adopts theories that spotlight other causes: specifically, poor thrift management and the deregulation of thrift institution activities and of deposit interest rates. To end the mess, politicians and regulators must jettison these comfortable theories and surrender discretion that permits them to finesse the need to budget for governmental financial commitments.

Analysis of the Servicemembers' Group Life Insurance (SGLI) program: history, current issues and future implications

OpenAIRE

Callan, Patrick M.; Voogd, Michael; Schmid, Christopher M.

2011-01-01

MBA Professional Report The SGLI program is the military life insurance program overseen by the Veterans' Affairs (VA) but managed and administered by The Prudential Insurance Company of America. Recently, a series of news stories by Bloomberg News reported that the program might not be following the law, and that Prudential was profiting from the deaths of servicemen and women. The primary purpose of this paper was to analyze the news articles for factual content and determine whethe...

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.

77 FR 43290 - Children's Health Insurance Program (CHIP); Final Allotments to States, the District of Columbia...

Science.gov (United States)

2012-07-24

... 0938-AR45 Children's Health Insurance Program (CHIP); Final Allotments to States, the District of... and expand health insurance coverage to uninsured, low-income children under the Children's Health... under title XXI of the Social Security Act (the Act). States may implement Children's Health Insurance...

Medicare Program; Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive Under the Physician Fee Schedule, and Criteria for Physician-Focused Payment Models. Final rule with comment period.

Science.gov (United States)

2016-11-04

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repeals the Medicare sustainable growth rate (SGR) methodology for updates to the physician fee schedule (PFS) and replaces it with a new approach to payment called the Quality Payment Program that rewards the delivery of high-quality patient care through two avenues: Advanced Alternative Payment Models (Advanced APMs) and the Merit-based Incentive Payment System (MIPS) for eligible clinicians or groups under the PFS. This final rule with comment period establishes incentives for participation in certain alternative payment models (APMs) and includes the criteria for use by the Physician-Focused Payment Model Technical Advisory Committee (PTAC) in making comments and recommendations on physician-focused payment models (PFPMs). Alternative Payment Models are payment approaches, developed in partnership with the clinician community, that provide added incentives to deliver high-quality and cost-efficient care. APMs can apply to a specific clinical condition, a care episode, or a population. This final rule with comment period also establishes the MIPS, a new program for certain Medicare-enrolled practitioners. MIPS will consolidate components of three existing programs, the Physician Quality Reporting System (PQRS), the Physician Value-based Payment Modifier (VM), and the Medicare Electronic Health Record (EHR) Incentive Program for Eligible Professionals (EPs), and will continue the focus on quality, cost, and use of certified EHR technology (CEHRT) in a cohesive program that avoids redundancies. In this final rule with comment period we have rebranded key terminology based on feedback from stakeholders, with the goal of selecting terms that will be more easily identified and understood by our stakeholders.

Postoperative outcomes in bariatric surgical patients participating in an insurance-mandated preoperative weight management program.

Science.gov (United States)

Schneider, Andrew; Hutcheon, Deborah A; Hale, Allyson; Ewing, Joseph A; Miller, Megan; Scott, John D

2018-02-02

Many insurance companies require patient participation in a medically supervised weight management program (WMP) before offering approval for bariatric surgery. Clinical data surrounding benefits of participation are limited. To evaluate the relationship between preoperative insurance-mandated WMP participation and postoperative outcomes in bariatric surgery patients. Regional referral center and teaching hospital. A retrospective review of patients who underwent vertical sleeve gastrectomy or Roux-en-Y gastric bypass between January 2014 and January 2016 was performed. Patients (N = 354) were divided into 2 cohorts and analyzed according to presence (n = 266) or absence (n = 88) of an insurance-mandated WMP requirement. Primary endpoints included rate of follow-up and percent of excess weight loss (%EWL) at postoperative months 1, 3, 6, and 12. All patients, regardless of the insurance-mandated WMP requirement, followed a program-directed preoperative diet. The majority of patients with an insurance-mandated WMP requirement had private insurance (63.9%). Both patient groups experienced a similar proportion of readmissions and reoperations, rate of follow-up, and %EWL at 1, 3, 6, and 12 months (P = NS). Median operative duration and hospital length of stay were also similar between groups. Linear regression analysis revealed no significant improvement in %EWL at 12 months in the yes-WMP group. These data show that patients who participate in an insurance-mandated WMP in addition to completing a program-directed preoperative diet experience no significant benefit to rate of readmission, reoperation, follow-up, or %EWL up to 12 months postoperation. Our findings suggest that undergoing bariatric surgery without completing an insurance-mandated WMP is safe and effective. Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

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 .

The role of intermediaries in delivering an occupational health and safety programme designed for small business - a case study of an insurance incentive programme in the agriculture sector

DEFF Research Database (Denmark)

Olsen, Kirsten Bendix; Hasle, Peter

2015-01-01

to the transformation and dissemination of a national OHS programme for small business that built on an Insurance incentive scheme – the New Zealand Workplace Safety Discount scheme. It is a case study of this scheme implementation in the agriculture sector. Data was collected from scheme documentation and semi......-structured interviews with the scheme owner, representatives from intermediary groups and the targeted small businesses. The interviews were tape recorded, transcribed and thematically analysed in relation to the scheme’s programme theory. The intermediaries introduced new programme mechanisms and recruitment...

The Promise of Tailoring Incentives for Healthy Behaviors.

Science.gov (United States)

Kullgren, Jeffrey T; Williams, Geoffrey C; Resnicow, Kenneth; An, Lawrence C; Rothberg, Amy; Volpp, Kevin G; Heisler, Michele

2016-01-01

To describe how tailoring financial incentives for healthy behaviors to employees' goals, values, and aspirations might improve the efficacy of incentives. We integrate insights from self-determination theory (SDT) with principles from behavioral economics in the design of financial incentives by linking how incentives could help meet an employee's life goals, values, or aspirations. Tailored financial incentives could be more effective than standard incentives in promoting autonomous motivation necessary to initiate healthy behaviors and sustain them after incentives are removed. Previous efforts to improve the design of financial incentives have tested different incentive designs that vary the size, schedule, timing, and target of incentives. Our strategy for tailoring incentives builds on strong evidence that difficult behavior changes are more successful when integrated with important life goals and values. We outline necessary research to examine the effectiveness of this approach among at-risk employees. Instead of offering simple financial rewards for engaging in healthy behaviors, existing programs could leverage incentives to promote employees' autonomous motivation for sustained health improvements. Effective application of these concepts could lead to programs more effective at improving health, potentially at lower cost. Our approach for the first time integrates key insights from SDT, behavioral economics, and tailoring to turn an extrinsic reward for behavior change into an internalized, self-sustaining motivator for long-term engagement in risk-reducing behaviors.

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...

Cost-effectiveness analysis of public education and incentive programs for controlling radon in the home. Final report

International Nuclear Information System (INIS)

Bierma, T.J.; Swartzman, D.

1988-12-01

The objective of this study was to evaluate the cost-effectiveness in Illinois of five radon public education and incentive program options. Programs evaluated included (1) no program, (2) a toll-free hotline and information packet, (3) free short-term monitors, (4) free confirmatory monitors, and (5) low-interest loans. Existing literature and expert opinion were used to estimate program costs and public responses under the various programs. Computer simulation, with Monte Carlo sampling, was used for uncertainty and sensitivity analysis. The cost-effectiveness model was analyzed based on assumed radon exposures to Illinois citizens. Results for standard conditions indicate that budget levels under approximately $30,000 do not warrant a radon education and incentive program. For budget levels of approximately $30,000 to $1 million, Program 2 was most effective, and Program 3 was most effective above this level. Sensitivity analyses indicate the results are relatively insensitive to input variable assumptions with the exception of public-response estimates. Study results suggest that all of the programs evaluated are likely to be relatively ineffective. Considerable improvement may be possible using more innovative approaches to public education

Federal Employees Health Benefits Program and Federal Employees Dental and Vision Insurance Program: eligibility for Pathway Programs participants. Interim final rule with request for comments.

Science.gov (United States)

2014-01-06

The U.S. Office of Personnel Management (OPM) is issuing an interim final regulation to update the Federal Employees Health Benefits Program (FEHBP) and the Federal Employees Dental and Vision Insurance Program (FEDVIP) regulations to reflect updated election opportunities for participants in the Pathways Programs. The Pathways Programs were created by Executive Order (E.O.) 13562, signed by the President on December 27, 2010, and are designed to enable the Federal Government to compete effectively for students and recent graduates by improving its recruitment efforts through internships and similar programs with Federal agencies. This interim final rule furthers these recruitment and retention efforts by providing health insurance, as well as dental and vision benefits, to eligible program participants and their families.

A Proposed Incentive System for Jefferson County Teachers.

Science.gov (United States)

Schlechty, Phillip C.; Ingwerson, Donald W.

1987-01-01

Outlines a teacher incentive plan developed for the Jefferson County (Kentucky) Public Schools and scheduled for pilot testing during the 1987-88 school year. The program is modeled after airline frequent flyer programs and is designed to encourage cooperative action and individual incentive among teachers. (MD)

Insurability and mitigation of flood losses in private households in Germany.

Science.gov (United States)

Thieken, Annegret H; Petrow, Theresia; Kreibich, Heidi; Merz, Bruno

2006-04-01

In Germany, flood insurance is provided by private insurers as a supplement to building or contents insurance. This article presents the results of a survey of insurance companies with regard to eligibility conditions for flood insurance changes after August 2002, when a severe flood caused 1.8 billion euro of insured losses in the Elbe and the Danube catchment areas, and the general role of insurance in flood risk management in Germany. Besides insurance coverage, governmental funding and public donations played an important role in loss compensation after the August 2002 flood. Therefore, this article also analyzes flood loss compensation, risk awareness, and mitigation in insured and uninsured private households. Insured households received loss compensation earlier. They also showed slightly better risk awareness and mitigation strategies. Appropriate incentives should be combined with flood insurance in order to strengthen future private flood loss mitigation. However, there is some evidence that the surveyed insurance companies do little to encourage precautionary measures. To overcome this problem, flood hazards and mitigation strategies should be better communicated to both insurance companies and property owners.

75 FR 30267 - Federal Long Term Care Insurance Program: Eligibility Changes

Science.gov (United States)

2010-06-01

... employees. OPM will supply an attestation document on its website for the use of employees, retirees, and... CARE INSURANCE PROGRAM 0 1. The authority citation for 5 CFR part 875 continues to read as follows...

Nigeria; Publication of Financial Sector Assessment Program Documentation––Detailed Assessment of Observance of Insurance Core Principles

OpenAIRE

International Monetary Fund

2013-01-01

Nigeria undertook a Financial Sector Assessment Program (FSAP), which included a review of the structure of Nigeria’s insurance market and the supervisory framework. The assessment was benchmarked against the Insurance Core Principles (ICPs) issued by the International Association of Insurance Supervisors (IAISs). It is advised that the National Insurance Commission (NAICOM) of Nigeria can expand the objective to include the creation of a fair, safe, and stable insurance sector for the benefi...

Incentivising flood risk adaptation through risk based insurance premiums : Trade-offs between affordability and risk reduction

NARCIS (Netherlands)

Hudson, Paul F.; Botzen, W.J.W.; Feyen, L.; Aerts, Jeroen C.J.H.

2016-01-01

The financial incentives offered by the risk-based pricing of insurance can stimulate policyholder adaptation to flood risk while potentially conflicting with affordability. We examine the trade-off between risk reduction and affordability in a model of public-private flood insurance in France and

Incentivising flood risk adaptation through ris based insurance premiums: trade-offs between affordability and risk reduction

NARCIS (Netherlands)

Hudson, P.G.M.B.; Botzen, W.J.W.; Feyen, L.; Aerts, J.C.J.H.

2016-01-01

The financial incentives offered by the risk-based pricing of insurance can stimulate policyholder adaptation to flood risk while potentially conflicting with affordability. We examine the trade-off between risk reduction and affordability in a model of public-private flood insurance in France and

Climate Change Impacts on pricing Long-Term Flood Insurance: A Comprehensive Study for the Netherlands

NARCIS (Netherlands)

Aerts, J.C.J.H.; Botzen, W.J.W.

2011-01-01

Recently long-term flood insurance contracts with a duration of 5, 10 or 15 years have been proposed as a solution for covering flood risk and mitigating increasing flood losses. Establishing a long-term relation between the policyholder and the insurer can provide better incentives to reduce risk

Insuring against health shocks: Health insurance and household choices.

Science.gov (United States)

Liu, Kai

2016-03-01

This paper provides empirical evidence on the role of public health insurance in mitigating adverse outcomes associated with health shocks. Exploiting the rollout of a universal health insurance program in rural China, I find that total household income and consumption are fully insured against health shocks even without access to health insurance. Household labor supply is an important insurance mechanism against health shocks. Access to health insurance helps households to maintain investment in children's human capital during negative health shocks, which suggests that one benefit of health insurance could arise from reducing the use of costly smoothing mechanisms. Copyright © 2016 Elsevier B.V. All rights reserved.

R&D Incentives for Neglected Diseases

Science.gov (United States)

Dimitri, Nicola

2012-01-01

Neglected diseases are typically characterized as those for which adequate drug treatment is lacking, and the potential return on effort in research and development (R&D), to produce new therapies, is too small for companies to invest significant resources in the field. In recent years various incentives schemes to stimulate R&D by pharmaceutical firms have been considered. Broadly speaking, these can be classified either as ‘push’ or ‘pull’ programs. Hybrid options, that include push and pull incentives, have also become increasingly popular. Supporters and critics of these various incentive schemes have argued in favor of their relative merits and limitations, although the view that no mechanism is a perfect fit for all situations appears to be widely held. For this reason, the debate on the advantages and disadvantages of different approaches has been important for policy decisions, but is dispersed in a variety of sources. With this in mind, the aim of this paper is to contribute to the understanding of the economic determinants behind R&D investments for neglected diseases by comparing the relative strength of different incentive schemes within a simple economic model, based on the assumption of profit maximizing firms. The analysis suggests that co-funded push programs are generally more efficient than pure pull programs. However, by setting appropriate intermediate goals hybrid incentive schemes could further improve efficiency. PMID:23284648

R&D incentives for neglected diseases.

Directory of Open Access Journals (Sweden)

Nicola Dimitri

Full Text Available Neglected diseases are typically characterized as those for which adequate drug treatment is lacking, and the potential return on effort in research and development (R&D, to produce new therapies, is too small for companies to invest significant resources in the field. In recent years various incentives schemes to stimulate R&D by pharmaceutical firms have been considered. Broadly speaking, these can be classified either as 'push' or 'pull' programs. Hybrid options, that include push and pull incentives, have also become increasingly popular. Supporters and critics of these various incentive schemes have argued in favor of their relative merits and limitations, although the view that no mechanism is a perfect fit for all situations appears to be widely held. For this reason, the debate on the advantages and disadvantages of different approaches has been important for policy decisions, but is dispersed in a variety of sources. With this in mind, the aim of this paper is to contribute to the understanding of the economic determinants behind R&D investments for neglected diseases by comparing the relative strength of different incentive schemes within a simple economic model, based on the assumption of profit maximizing firms. The analysis suggests that co-funded push programs are generally more efficient than pure pull programs. However, by setting appropriate intermediate goals hybrid incentive schemes could further improve efficiency.

R&D incentives for neglected diseases.

Science.gov (United States)

Dimitri, Nicola

2012-01-01

Neglected diseases are typically characterized as those for which adequate drug treatment is lacking, and the potential return on effort in research and development (R&D), to produce new therapies, is too small for companies to invest significant resources in the field. In recent years various incentives schemes to stimulate R&D by pharmaceutical firms have been considered. Broadly speaking, these can be classified either as 'push' or 'pull' programs. Hybrid options, that include push and pull incentives, have also become increasingly popular. Supporters and critics of these various incentive schemes have argued in favor of their relative merits and limitations, although the view that no mechanism is a perfect fit for all situations appears to be widely held. For this reason, the debate on the advantages and disadvantages of different approaches has been important for policy decisions, but is dispersed in a variety of sources. With this in mind, the aim of this paper is to contribute to the understanding of the economic determinants behind R&D investments for neglected diseases by comparing the relative strength of different incentive schemes within a simple economic model, based on the assumption of profit maximizing firms. The analysis suggests that co-funded push programs are generally more efficient than pure pull programs. However, by setting appropriate intermediate goals hybrid incentive schemes could further improve efficiency.

Defining appropriate incentive levels: A review of theory and practice

International Nuclear Information System (INIS)

Parfett, R.S.; Lodola, J.C.

1990-01-01

The theoretical and practical aspects related to determining the incentive levels for demand-side management (DSM) programs are discussed. The theoretical aspects comprise the efficiency criteria, from a social point of view; the equity issue, or ensuring that no one pays higher rates as a result of conservation programs; and the method of recovering the customer's investment, or the implicit discount rate method. The study of these theoretical aspects takes into account the perspectives of all the concerned parties and focuses on the need to harmonize the efficiency criteria which are in opposition. From this process are derived general criteria for aiding program planners and managers to determine the incentive levels for their DSM programs. Past experience has shown that incentive levels cannot be determined in an isolated manner. Other characteristics affecting the carrying out of DSM programs will also have repercussions on the success rate. To determine the appropriate incentives, it is important to have a clear understanding of what the DSM program intends to achieve. Factors such as the market sector, the technology chosen, and demographic characteristics can influence all aspects of the design and implementation of the program, including the type and level of incentive offered. When the goals of the program are clearly established and the intended market is clearly determined, a strategy should be formed which will have the greatest chance of fulfilling the program objectives. The role of each element in the program must be well understood. It is only at this stage that it is possible to determine an appropriate level of incentive. 7 refs

Insurance and Information : Firms as a Commitment Device

NARCIS (Netherlands)

Bovenberg, A.L.; Teulings, C.N.

2002-01-01

We explore the role of firms in insuring risk-averse workers.As a device that allows workers to commit to the delivery of their output, the firm arises endogenously as an alternative to the spot market if workers are suciently risk averse and the firm can base incentive payments on good

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

Tax incentives as a solution to the uninsured: evidence from the self-employed.

Science.gov (United States)

Gumus, Gulcin; Regan, Tracy L

2013-11-01

Between 1996 and 2003, a series of amendments were made to the Tax Reform Act of 1986 that gradually increased the tax deduction for health insurance purchases by the self-employed (SE) from 25 to 100 percent. We study how these changes have influenced the likelihood that a SE person has health insurance coverage as the policyholder. The Current Population Survey is used to construct a data set corresponding to 1995-2005. Both the difference-in-differences and price elasticity of demand estimates suggest that the series of tax deductions did not provide sufficient incentives for the SE to obtain health insurance coverage. © The Author(s) 2014.

Anti-double dipping rules for federal tax incentives

Energy Technology Data Exchange (ETDEWEB)

Ing, E.T.C. [Law Office of Edwin T.C. Ing, Washington, DC (United States)

1997-12-31

Political as well as technological changes are now reshaping the electric utility industry. While accommodating these changes, state legislative and regulatory agencies have the opportunity to promote public policies. In this regard, various state entities are evaluating appropriate incentives for renewable energy development so as to introduce greater competition in electric generation. For example, the California legislature is considering a supplemental production payment and the State of Iowa has instituted a low-interest loan program for wind and other alternative energy generation. By complementing the existing federal tax incentives, state incentives can spur the wind industry`s growth. If structured in the wrong way, however, state assistance programs will undercut the value of the federal tax incentives. The federal anti-double dipping rules apply to certain state programs. If a developer utilizes the wrong type of state assistance for a wind project, the anti-double dipping rules will reduce the federal tax incentives and this in turn will decrease the project`s profitability. Rather than suffer these results, very few if any developer will use the state program. Despite the time and effort a state may expend to enact a program for alternative energy development, the state assistance will be ineffectual. This paper reviews the counterproductive results which state assistance can have on a wind project because of the federal anti-double dipping rules.

Insurance coverage of customers induces dishonesty of sellers in markets for credence goods.

Science.gov (United States)

Kerschbamer, Rudolf; Neururer, Daniel; Sutter, Matthias

2016-07-05

Honesty is a fundamental pillar for cooperation in human societies and thus for their economic welfare. However, humans do not always act in an honest way. Here, we examine how insurance coverage affects the degree of honesty in credence goods markets. Such markets are plagued by strong incentives for fraudulent behavior of sellers, resulting in estimated annual costs of billions of dollars to customers and the society as a whole. Prime examples of credence goods are all kinds of repair services, the provision of medical treatments, the sale of software programs, and the provision of taxi rides in unfamiliar cities. We examine in a natural field experiment how computer repair shops take advantage of customers' insurance for repair costs. In a control treatment, the average repair price is about EUR 70, whereas the repair bill increases by more than 80% when the service provider is informed that an insurance would reimburse the bill. Our design allows decomposing the sources of this economically impressive difference, showing that it is mainly due to the overprovision of parts and overcharging of working time. A survey among repair shops shows that the higher bills are mainly ascribed to insured customers being less likely to be concerned about minimizing costs because a third party (the insurer) pays the bill. Overall, our results strongly suggest that insurance coverage greatly increases the extent of dishonesty in important sectors of the economy with potentially huge costs to customers and whole economies.

Minnesota's Nursing Facility Performance-Based Incentive Payment Program: An Innovative Model for Promoting Care Quality

Science.gov (United States)

Cooke, Valerie; Arling, Greg; Lewis, Teresa; Abrahamson, Kathleen A.; Mueller, Christine; Edstrom, Lisa

2010-01-01

Purpose: Minnesota's Nursing Facility Performance-Based Incentive Payment Program (PIPP) supports provider-initiated projects aimed at improving care quality and efficiency. PIPP moves beyond conventional pay for performance. It seeks to promote implementation of evidence-based practices, encourage innovation and risk taking, foster collaboration…

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

Financial incentives: only one piece of the workplace wellness puzzle comment on "corporate wellness programs: implementation challenges in the modern american workplace".

Science.gov (United States)

Busum, Kristin Van; Mattke, Soeren

2013-11-01

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.

VA Dental Insurance Program--federalism. Direct final rule; confirmation of effective date.

Science.gov (United States)

2014-03-20

The Department of Veterans Affairs (VA) published a direct final rule in the Federal Register on October 22, 2013, amending its regulations related to the VA Dental Insurance Program (VADIP), a pilot program to offer premium-based dental insurance to enrolled veterans and certain survivors and dependents of veterans. Specifically, this rule adds language to clarify the limited preemptive effect of certain criteria in the VADIP regulations. VA received no comments concerning this rule or its companion substantially identical proposed rule published in the Federal Register on October 23, 2013. This document confirms that the direct final rule became effective on December 23, 2013. In a companion document in this issue of the Federal Register, we are withdrawing as unnecessary the proposed rule.

Individual Savings Accounts and the Life-Cycle Approach to Social Insurance

DEFF Research Database (Denmark)

Sørensen, Peter Birch; Hansen, Martin Ino; Bovenberg, A. Lans

Using Danish data, we find that about three fourths of the taxes levied to finance public transfers actually finance benefits that do not redistribute between people but redistribute income over the life cycle of individual taxpayers. This provides a rationale for financing part of social insurance...... via mandatory individual savings accounts. An account system that offers liquidity insurance and a lifetime income guarantee helps to alleviate the dilemma between insurance and incentives. To illustrate this, we analyse a specific proposal for reform of the Danish system of social insurance......, involving the use of individual accounts. We estimate how the reform would affect the distribution of lifetime incomes, the public budget, and economic efficiency...

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…

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

Flood Catastrophe Model for Designing Optimal Flood Insurance Program : Estimating Location-Specific Premiums in the Netherlands

NARCIS (Netherlands)

Ermolieva, T.; Filatova, Tatiana; Ermoliev, Y.; Obersteiner, M.; de Bruijn, K.M.; Jeuken, A.

2017-01-01

As flood risks grow worldwide, a well-designed insurance program engaging various stakeholders becomes a vital instrument in flood risk management. The main challenge concerns the applicability of standard approaches for calculating insurance premiums of rare catastrophic losses. This article

THE INDIANA ENTERPRISE ZONE PROGRAM: FISCAL IMPACT OF A JOB CREATION TAX CREDIT

OpenAIRE

Low, Sarah A.

2004-01-01

This paper estimated the fiscal impact of a job creation tax credit, a proposed incentive for establishments participating in the Indiana enterprise zone program. State unemployment insurance files were utilized with GIS to obtain enterprise zone data. Labor demand and labor supply were estimated. Job creation due to the credit was calculated from empirical results.

Public Health Policy in Support of Insurance Coverage for Smoking Cessation Treatments.

Science.gov (United States)

Schwartz, Robert; Haji, Farzana; Babayan, Alexey; Longo, Christopher; Ferrence, Roberta

2017-05-01

Insurance coverage for evidence-based smoking cessation treatments (SCTs) promotes uptake and reduces smoking rates. Published studies in this area are based in the US where employers are the primary source of health insurance. In Ontario, Canada, publicly funded healthcare does not cover SCTs, but it can be supplemented with employer-sponsored benefit plans. This study explores factors affecting the inclusion/exclusion of smoking cessation (SC) benefits. In total, 17 interviews were conducted with eight employers (auto, retail, banking, municipal and university industries), four health insurers, two government representatives and three advisors/consultants. Overall, SCT coverage varied among industries; it was inconsistently restrictive and SCT differed by coverage amount and length of use. Barriers impeding coverage included the lack of the following: Canadian-specific return on investment (ROI), SC cost information, employer demand, government regulations/incentives and employee awareness of and demand. A Canadian evidence-based calculation of ROI for SC coupled with government incentives and public education may be needed to promote uptake of SCT coverage by employers. Copyright © 2017 Longwoods Publishing.

Life insurance, living benefits, and physician-assisted death.

Science.gov (United States)

Parker, Frederick R; Rubin, Harvey W; Winslade, William J

2004-01-01

One of the most significant concerns about the legalization of physician-assisted death in the United States relates to the possibility that a chronically or terminally ill person would choose to end her or his life for financial reasons. Because we believe that the life insurance industry is uniquely poised to help minimize any such incentive, we submit that it has a moral obligation to do so. In particular, we propose that the industry encourage greater flexibility in the payout of policy benefits in the event an insured should be diagnosed with a terminal illness or suffer from intractable pain.

Incentive mechanisms to promote energy efficiency programs in power distribution companies

International Nuclear Information System (INIS)

Osorio, Karim; Sauma, Enzo

2015-01-01

Power distribution companies (DISCOs) play an important role in promoting energy efficiency (hereafter EE), mainly due to the fact that they have detailed information regarding their clients' consumption patterns. However, under the traditional regulatory framework, DISCOs have disincentives to promote EE, due to the fact that a reduction in sales also means a reduction in their revenues and profits. Most regulatory policies encouraging EE have some embedded payment schemes that allow financing EE programs. In this paper, we focus on these EE-programs' payment schemes that are embedded into the regulatory policies. Specifically, this paper studies two models of the Principal–Agent bi-level type in order to analyze the economic effects of implementing different payment schemes to foster EE in DISCOs. The main difference between each model is that uncertainty in energy savings is considered by the electricity regulatory institution in only one of the models. In terms of the results, it is observed that, in general terms, it is more convenient for the regulator to adopt a performance-based incentive mechanism than a payment scheme financing only the fixed costs of implementing EE programs. However, if the electricity regulatory institution seeks a higher level of minimum expected utility, it is optimal to adopt a mixed system of compensation, which takes into account the fixed cost compensation and performance-based incentive payments. - Highlights: • We studied different payment schemes to promote energy efficiency in DISCOs. • We propose two bi-level models based on the Principal–Agent theory. • Uncertainty associated with energy savings is incorporated in one of the models. • A performance-based payment scheme is generally more convenient for the regulator. • A mixed payment scheme is optimal when a lower level of uncertainty is tolerated

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.

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.

Individual decision making in the non-purchase of long-term care insurance.

Science.gov (United States)

Curry, Leslie A; Robison, Julie; Shugrue, Noreen; Keenan, Patricia; Kapp, Marshall B

2009-08-01

Although prior research suggests that economic, behavioral, and psychosocial factors influence decisions not to purchase long-term care insurance, few studies have examined the interplay among these factors in depth and from the consumer's point of view. This study was intended to further illuminate these considerations, generate hypotheses about non-purchasing decisions, and inform the design of policies that are responsive to concerns and preferences of potential purchasers. Qualitative study using 32 in-depth interviews and 6 focus groups, following a grounded theory approach. Five themes characterize decisions not to purchase long-term care insurance: (a) the determination that a policy is "too costly" reflects highly individualized and complex trade-offs not solely economic in nature, (b) non-purchasers are skeptical about the viability and integrity of private insurance companies and seek an unbiased source of information, (c) family dynamics play an important role in insurance decisions, (d) contemplating personal risk for long-term care triggers psychological responses that have implications for decision making, and (e) non-purchasers feel inadequately informed and overwhelmed by the process of deciding whether to purchase long-term care insurance. States are seeking to offset escalating Medicaid long-term care expenditures through a variety of policy mechanisms, including stimulating individual purchase of long-term care insurance. Findings suggest that economic incentives such as lowering premiums will be necessary but not sufficient to attract appropriate candidates. Attention to behavioral and psychosocial factors is essential to designing incentives that are responsive to concerns and preferences of potential purchasers.

Flood Catastrophe Model for Designing Optimal Flood Insurance Program: Estimating Location-Specific Premiums in the Netherlands.

Science.gov (United States)

Ermolieva, T; Filatova, T; Ermoliev, Y; Obersteiner, M; de Bruijn, K M; Jeuken, A

2017-01-01

As flood risks grow worldwide, a well-designed insurance program engaging various stakeholders becomes a vital instrument in flood risk management. The main challenge concerns the applicability of standard approaches for calculating insurance premiums of rare catastrophic losses. This article focuses on the design of a flood-loss-sharing program involving private insurance based on location-specific exposures. The analysis is guided by a developed integrated catastrophe risk management (ICRM) model consisting of a GIS-based flood model and a stochastic optimization procedure with respect to location-specific risk exposures. To achieve the stability and robustness of the program towards floods with various recurrences, the ICRM uses stochastic optimization procedure, which relies on quantile-related risk functions of a systemic insolvency involving overpayments and underpayments of the stakeholders. Two alternative ways of calculating insurance premiums are compared: the robust derived with the ICRM and the traditional average annual loss approach. The applicability of the proposed model is illustrated in a case study of a Rotterdam area outside the main flood protection system in the Netherlands. Our numerical experiments demonstrate essential advantages of the robust premiums, namely, that they: (1) guarantee the program's solvency under all relevant flood scenarios rather than one average event; (2) establish a tradeoff between the security of the program and the welfare of locations; and (3) decrease the need for other risk transfer and risk reduction measures. © 2016 Society for Risk Analysis.

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.

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.

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.

Predictors of Weight Loss Maintenance following an Insurance-Sponsored Weight Management Program

OpenAIRE

Christiaan G. Abildso; Olivier Schmid; Megan Byrd; Sam Zizzi; Alessandro Quartiroli; Sean J. Fitzpatrick

2014-01-01

Intentional weight loss among overweight and obese adults (body mass index ≥ 25 kg/m2) is associated with numerous health benefits, but weight loss maintenance (WLM) following participation in weight management programming has proven to be elusive. Many individuals attempting to lose weight join formal programs, especially women, but these programs vary widely in focus, as do postprogram weight regain results. We surveyed 2,106 former participants in a community-based, insurance-sponsored wei...

Hospital Market Structure and the Behavior of Not-for-Profit Hospitals: Evidence from Responses to California's Disproportionate Share Program

OpenAIRE

Mark Duggan

2000-01-01

I exploit a plausibly exogenous change in hospital financial incentives to examine whether the behavior of private not-for-profit hospitals varies with the share of nearby hospitals organized as for-profit firms. My results show that not-for-profit hospitals in for-profit intensive areas are significantly more responsive to an increased incentive to treat low-income patients insured by the Medicaid program than are other not-for-profit providers. The heterogeneity in behavior is not due to di...

Demographic predictors of false negative self-reported tobacco use status in an insurance applicant population.

Science.gov (United States)

Palmier, James; Lanzrath, Brian; Dixon, Ammon; Idowu, Oluseun

2014-01-01

To identify and quantify demographic correlates of false-negative self-reporting of tobacco use in life insurance applicants. Several studies have assessed the sensitivity of self-reporting for tobacco use in various populations, but statistical examination of the causes of misreporting has been rarer. The very large (488,000 confirmed tobacco users) sample size, US-wide geographic scope, and unique incentive structure of the life insurance application process permit more robust and insurance industry-specific results in this study. Approximately 6.2 million life insurance applicants for whom both tobacco-use interview questions and a confirmatory urine cotinine test were completed between 1999 and 2012 were evaluated for consistency between self-reported and laboratory-confirmed tobacco-use status. The data set was subjected to logistic regression to identify predictors of false negative self-reports (FNSR). False-negative self-reporting was found to be strongly associated with male gender, applicant ages of less than 30 or greater than 60, and low cotinine positivity rates in the applicant's state of residence. Policy face value was also moderately predictive, values above $500,000 associated with moderately higher FNSR. The findings imply that FNSR in life insurance applicants may be the result of complex interactions among financial incentives, geography and presumptive peer groups, and gender.

Incentive regulation of investor-owned nuclear power plants by public utility regulators

International Nuclear Information System (INIS)

McKinney, M.D.; Elliot, D.B.

1993-01-01

The US Nuclear Regulatory Commission (NRC) periodically surveys the Federal Energy Regulatory Commission (FERC) and state regulatory commissions that regulate utility owners of nuclear power plants. The NRC is interested in identifying states that have established economic or performance incentive programs applicable to nuclear power plants, including states with new programs, how the programs are being implemented, and in determining the financial impact of the programs on the utilities. The NRC interest stems from the fact that such programs have the potential to adversely affect the safety of nuclear power plants. The information in this report was obtained from interviews conducted with each state regulatory agency that administers an incentive program and each utility that owns at least 10% of an affected nuclear power plant. The agreements, orders, and settlements that form the basis for each incentive program 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

An Implementation Research Approach to Evaluating Health Insurance Programs: Insights from India

Directory of Open Access Journals (Sweden)

Krishna D. Rao

2016-05-01

Full Text Available One of the distinguishing features of implementation research is the importance given to involve implementers in all aspects of research, and as users of research. We report on a recent implementation research effort in India, in which researchers worked together with program implementers from one of the longest serving government funded insurance schemes in India, the Rajiv Aarogyasri Scheme (RAS in the state of undivided Andhra Pradesh, that covers around 70 million people. This paper aims to both inform on the process of the collaborative research, as well as, how the nature of questions that emerged out of the collaborative exercise differed in scope from those typically asked of insurance program evaluations. Starting in 2012, and over the course of a year, staff from the Aarogyasri Health Care Trust (AHCT, and researchers held a series of meetings to identify research questions that could serve as a guide for an evaluation of the RAS. The research questions were derived from the application of a Logical Framework Approach (“log frame” to the RAS. The types of questions that emerged from this collaborative effort were compared with those seen in the published literature on evaluations of insurance programs in low- and middle-income countries (LMICs. In the published literature, 60% of the questions pertained to output/outcome of the program and the remaining 40%, relate to processes and inputs. In contrast, questions generated from the RAS participatory research process between implementers and researchers had a remarkably different distribution – 81% of questions looked at program input/processes, and 19% on outputs and outcomes. An implementation research approach can lead to a substantively different emphasis of research questions. While there are several challenges in collaborative research between implementers and researchers, an implementation research approach can lead to incorporating tacit knowledge of program implementers

Death Spiral or Euthanasia? The Demise of Generous Group Health Insurance Coverage

OpenAIRE

Mark V. Pauly; Olivia Mitchell; Yuhui Zeng

2004-01-01

Employers must determine which sorts of healthcare insurance plans to offer employees and also set employee premiums for each plan provided. Depending on how they structure the premiums that employees pay across different healthcare insurance plans, plan sponsors alter the incentives to choose one plan over another. If employees know they differ by risk level but premiums do not fully reflect these risk differences, this can give rise to a so-called "death spiral" due to adverse selection. In...

78 FR 77366 - Federal Employee Dental and Vision Insurance Program; Qualifying Life Event Amendments

Science.gov (United States)

2013-12-23

... the Federal Employees Health Benefits (FEHB) Program. DATES: Comment date: Comments are due on or... enrollment status under the Federal Employee Dental and Vision Insurance Program. OPM is proposing these... for FEDVIP enrollment changes and therefore better align FEDVIP with the Federal Employees Health...

Loss Modification Incentives for Insurers Under Expected Utility and Loss Aversion

NARCIS (Netherlands)

Soetevent, Adriaan R.; Zhou, Liting

We investigate whether a profit-maximizing insurer with the opportunity to modify the loss probability will engage in loss prevention or instead spend effort to increase the loss probability. First we study this question within a traditional expected utility framework; then we apply Koszegi and

45 CFR 96.87 - Leveraging incentive program.

Science.gov (United States)

2010-10-01

..., budget counseling, case management, and energy conservation education; (19) Training; (20) Installation... requirements. In such cases, incentive funds will be allocated among the involved entities that submit... LIHEAP heating, cooling, crisis, and/or weatherization assistance component(s) open and/or after the...

75 FR 8854 - Teacher Incentive Fund Program

Science.gov (United States)

2010-02-26

..., evaluation, retention, and advancement into instructional leadership roles. When the PBCS's implementation... responsibilities and leadership roles; and (4) Include helping teachers and principals to better understand and use... high-need schools by creating incentives for effective teachers and principals in these schools. DATES...

Stricter Employment Protection and Firms' Incentives to Sponsor Training

DEFF Research Database (Denmark)

Messe, Pierre-Jean; Rouland, Bénédicte

2014-01-01

to the unemployment insurance system, known as the Delalande tax. In 1999, the measure was subjected to a reform that increased the tax, but only for large firms. We find that this exogenous increase substantially raised firms' incentives to train workers aged 45–49 but had no impact on the training rates among...... workers aged over 50. From a simple model with endogenous firing and training decisions, we give a theoretical illustration of these results....

Risk reduction in a changing insurance climate: examples from the US and UK

Science.gov (United States)

Horn, Diane; McShane, Michael

2015-04-01

Coastal cities face a range of increasingly severe challenges as sea level rises, and adaptation to future flood risk will require more than structural defences. Many cities will not be able to rely solely on engineering structures for protection and will need to develop a suite of policy responses to increase their resilience to impacts of rising sea level. Insurance can be used as a risk-sharing mechanism to encourage adaptation to sea level rise, using pricing or restrictions on availability of cover to discourage new development in flood risk areas or to encourage the uptake of flood resilience measures. We draw on flood insurance policy lessons learned from the United States and the United Kingdom to propose risk-sharing among private insurers/reinsurers, government, and policyholders to alleviate major issues of the current programs, while still maintaining a holistic approach to managing flood risk. The UK and the US are almost polar opposites in the way flood insurance is implemented. Flood insurance in the US is fully public and in the UK fully private; however, in both countries the participants feel that the established system is unsustainable. In the US, flood coverage is excluded from property policies provided by private insurers, and is only available through the National Flood Insurance Program (NFIP), with the federal government acting as insurer of last resort. Flood risk reduction has been part of the NFIP remit since the introduction of the program in 1968. Following massive payments for flood claims related primarily to Hurricanes Katrina and Sandy, the NFIP is approximately 26 billion in debt, prompting calls to bring private insurance back into the flood insurance business. Two major Congressional modifications to the NFIP in 2012 and 2014 have pushed the contradictory goals of fully risk-based, yet affordable premiums. The private market has not been significantly involved in a risk-bearing role, but that is changing as private insurers

Terrorism Risk Insurance: An Overview

National Research Council Canada - National Science Library

Webel, Baird

2005-01-01

.... Addressing this problem, Congress enacted the Terrorism Risk Insurance Act of 2002 (TRIA) to create a temporary program to share future insured terrorism losses with the property-casualty insurance industry and policyholders...

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.

[Incentive for Regional Risk Selection in the German Risk Structure Compensation Scheme].

Science.gov (United States)

Wende, Danny

2017-10-01

The introduction of the new law GKV-FQWG strengthens the competition between statutory health insurance. If incentives for risk selection exist, they may force a battle for cheap customers. This study aims to document and discuss incentives for regional risk selection in the German risk structure compensation scheme. Identify regional autocorrelation with Moran's l on financial parameters of the risk structure compensation schema. Incentives for regional risk selection do indeed exist. The risk structure compensation schema reduces 91% of the effect and helps to reduce risk selection. Nevertheless, a connection between regional situation and competition could be shown (correlation: 69.5%). Only the integration of regional control variables into the risk compensation eliminates regional autocorrelation. The actual risk structure compensation is leading to regional inequalities and as a consequence to risk selection and distortion in competition. © Georg Thieme Verlag KG Stuttgart · New York.

Incentives for healthy behaviors: experience from Florida Medicaid's Enhanced Benefit Rewards program.

Science.gov (United States)

Hall, Allyson G; Lemak, Christy Harris; Landry, Amy Yarbrough; Duncan, R Paul

2013-04-01

Engaging individuals in their own health care proves challenging for policy makers, health plans, and providers. Florida Medicaid introduced the Enhanced Benefits Rewards (EBR) program in 2006, providing financial incentives as rewards to beneficiaries who engage in health care seeking and healthy behaviors. This study analyzed beneficiary survey data from 2009 to determine predictors associated with awareness of and participation in the EBR program. Non-English speakers, those in a racial and ethnic minority group, those with less than a high school education, and those with limited or no connection to a health care provider were associated with lower awareness of the program. Among those aware of the program, these factors were also associated with reduced likelihood of engaging in the program. Individuals in fair or poor health were also less likely to engage in an approved behavior. Individuals who speak Spanish at home and those without a high school diploma were more likely than other groups to spend their earned program credits. Findings underscore the fact that initial engagement in such a program can prove challenging as different groups are not equally likely to be aware of or participate in an approved activity or redeem a credit. Physicians may play important roles in encouraging participation in programs to incentivize healthy behaviors.

Investigating financial incentives for maternal health: an introduction.

Science.gov (United States)

Stanton, Mary Ellen; Higgs, Elizabeth S; Koblinsky, Marge

2013-12-01

Projection of current trends in maternal and neonatal mortality reduction shows that many countries will fall short of the UN Millennium Development Goal 4 and 5. Underutilization of maternal health services contributes to this poor progress toward reducing maternal and neonatal morbidity and mortality. Moreover, the quality of services continues to lag in many countries, with a negative effect on the health of women and their babies, including deterring women from seeking care. To enhance the use and provision of quality maternal care, countries and donors are increasingly using financial incentives. This paper introduces the JHPN Supplement, in which each paper reviews the evidence of the effectiveness of a specific financial incentive instrument with the aim of improving the use and quality of maternal healthcare and impact. The US Agency for International Development and the US National Institutes of Health convened a US Government Evidence Summit on Enhancing Provision and Use of Maternal Health Services through Financial Incentives on 24-25 April 2012 in Washington, DC. The Summit brought together leading global experts in finance, maternal health, and health systems from governments, academia, development organizations, and foundations to assess the evidence on whether financial incentives significantly and substantially increase provision, use and quality of maternal health services, and the contextual factors that impact the effectiveness of these incentives. Evidence review teams evaluated the multidisciplinary evidence of various financial mechanisms, including supply-side incentives (e.g. performance-based financing, user fees, and various insurance mechanisms) and demand-side incentives (e.g. conditional cash transfers, vouchers, user fee exemptions, and subsidies for care-seeking). At the Summit, the teams presented a synthesis of evidence and initial recommendations on practice, policy, and research for discussion. The Summit enabled structured

76 FR 30539 - Historic Preservation Certifications for Federal Income Tax Incentives

Science.gov (United States)

2011-05-26

... Preservation Certifications for Federal Income Tax Incentives AGENCY: National Park Service, Interior. ACTION... historic structures'' or ``certified rehabilitations'' for Federal income tax incentives. (3) This rule... changes proposed in the rule are purely technical. Moreover, the tax incentives program involves purely...

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.

Climate Risk and Production Shocks: Using Index Insurance to Link Climate Science to Policy for Sustainable Development

Science.gov (United States)

McCarney, G. R.; Osgood, D. E.

2011-12-01

Smallholder farmers in developing countries are often severely impacted by droughts and other climate related events. However, agricultural insurance programs are largely unavailable in lower-income countries because of limitations in traditional loss-based indemnity insurance. As a result, it is often the case that farmers who are the most vulnerable to climate shocks lack access to the insurance tools that could help to reduce their production risk. Index insurance, a recent financial innovation, has the potential to increase access to insurance for smallholder farmers (Barrett et al. 2007). Index insurance allows farmers to insure their production risk based on a weather index (such as total seasonal rainfall) rather than on crop yields. The use of a weather index addresses many of the perverse incentive problems found in traditional crop insurance, and greatly reduces the costs of insuring smallholder farmers. The trade-off in index insurance, however, is limited accuracy in calibrating payouts to actual losses, a phenomenon commonly known as basis risk. While index insurance has promise as a risk-smoothing instrument, many argue it has greater promise as a mechanism for improving access to credit for smallholder farmers in developing countries (e.g. Barnett, Barrett & Skees 2008). In these areas, farmers are often fully exposed to climate shocks, which greatly affect their willingness to borrow. By smoothing the uncertainty in climate shocks, insurance may allow farmers to take credit for productive risks. There has been much discussion as to the optimal strategy for combining index insurance with credit, specifically if the financial institutions or the individual farmers themselves should hold the insurance policy. Many existing insurance implementations insure the farmer directly. However, since a weather index is a proxy for yield loss based on regional data, there is basis risk due to uninsured idiosyncratic differences between farmers. As a response to

School Insurance.

Science.gov (United States)

1964

The importance of insurance in the school budget is the theme of this comprehensive bulletin on the practices and policies for Texas school districts. Also considered is the development of desirable school board policies in purchasing insurance and operating the program. Areas of discussion are: risks to be covered, amount of coverage, values,…

Acceptance of selective contracting : The role of trust in the health insurer

NARCIS (Netherlands)

Bes, R.E.; Wendel, S.; Curfs, E.C.; Groenewegen, P.P.; de Jong, J.D

2013-01-01

Background In a demand oriented health care system based on managed competition, health insurers have incentives to become prudent buyers of care on behalf of their enrolees. They are allowed to selectively contract care providers. This is supposed to stimulate competition between care providers and

Acceptance of selective contracting: the role of trust in the health insurer.

NARCIS (Netherlands)

Bes, R.E.; Wendel, S.; Curfs, E.C.; Groenewegen, P.P.; Jong, J.D. de

2013-01-01

Background: In a demand oriented health care system based on managed competition, health insurers have incentives to become prudent buyers of care on behalf of their enrolees. They are allowed to selectively contract care providers. This is supposed to stimulate competition between care providers

42 CFR 403.220 - Supplemental Health Insurance Panel.

Science.gov (United States)

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Supplemental Health Insurance Panel. 403.220... Programs § 403.220 Supplemental Health Insurance Panel. (a) Membership. The Supplemental Health Insurance... determines whether or not a State regulatory program for Medicare supplemental health insurance policies...

Performance-based financial incentives for diabetes care: an effective strategy?

Science.gov (United States)

Latham, Lesley P; Marshall, Emily Gard

2015-02-01

The use of financial incentives provided to primary care physicians who achieve target management or clinical outcomes has been advocated to support the fulfillment of care recommendations for patients with diabetes. This article explores the characteristics of incentive models implemented in the context of universal healthcare systems in the United Kingdom, Australia, Taiwan and Canada; the extent to which these interventions have been successful in improving diabetes outcomes; and the key challenges and concerns around implementing incentive models. Research in the effect of incentives in the United Kingdom demonstrates some improvements in process outcomes and achievement of cholesterol, blood pressure and glycated hemoglobin (A1C) targets. Evidence of the efficacy of programs implemented outside of the United Kingdom is very limited but suggests that physicians participating in these enhanced billing incentive programs were already completing the guideline-recommended care prior to the introduction of the incentive. A shift to pay-for-performance programs may have important implications for professionalism and patient-centred care. In the absence of definitive evidence that financial incentives drive the quality of diabetes management at the level of primary care, policy makers should proceed with caution. It is important to look beyond simply modifying physicians' behaviours and address the factors and systemic barriers that make it challenging for patients and physicians to manage diabetes in partnership. Copyright © 2015 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

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.

Why are financial incentives not effective at influencing some smokers to quit? Results of a process evaluation of a worksite trial assessing the efficacy of financial incentives for smoking cessation.

Science.gov (United States)

Kim, Annice; Kamyab, Kian; Zhu, Jingsan; Volpp, Kevin

2011-01-01

Process evaluation of a worksite intervention in which employees were offered $750 to complete a cessation program and to quit smoking. Awareness and attitudes about financial incentives were assessed following a randomized controlled trial of 878 smokers at a US-based company. Cessation program attendance was higher in incentive group versus control (20.2% vs 7.1%, P motivated to quit and reported that they would have quit for less money, said incentives were "not at all" or only "somewhat" important. Most nonquitters in the incentive group reported that even $1500 would not have motivated them to quit. Financial incentives are ineffective at motivating some smokers to quit. Internal motivation and readiness to quit need to be sufficiently high for relatively modest incentives to be effective.

Rule Versus the Causality Rule in Insurance Law

DEFF Research Database (Denmark)

Lando, Henrik

When the Buyer of insurance has negligently kept silent or misrepresented a (material) fact to the Seller, one of two rules will determine the extent to which cover will consequently be reduced. The pro-rata rule lowers cover in proportion to how much the Seller would have increased the premium had...... he been correctly informed; the causality rule provides either zero cover if the omitted fact has caused the insurance event, or full cover if the event would have occurred regardless of the fact. This article explores which rule is more efficient. Using the framework proposed by Picard and Dixit...... it subjects the risk averse Buyer of insurance to less variance. This implies that the pro rata rule should apply when there is significant risk for a Buyer of unintentional misrepresentation, and when the incentive to intentionally misrepresent can be curtailed through frequent verification of the Buyer...

44 CFR 61.17 - Group Flood Insurance Policy.

Science.gov (United States)

2010-10-01

... U.S.C. 5174) of an Individuals and Households Program (IHP) award for flood damage as a result of... flood-damage losses sustained by the insured property in the course of any subsequent flooding event..., DEPARTMENT OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program INSURANCE...

The emerging market for supplemental long term care insurance in Germany in the context of the 2013 Pflege-Bahr reform.

Science.gov (United States)

Nadash, Pamela; Cuellar, Alison Evans

2017-06-01

The growing cost of long term care is burdening many countries' health and social care systems, causing them to encourage individuals and families to protect themselves against the financial risk posed by long term care needs. Germany's public long-term care insurance program, which mandates coverage for most Germans, is well-known, but fewer are aware of Germany's growing voluntary, supplemental private long-term care insurance market. This paper discusses German policymakers' 2013 effort to expand it by subsidizing the purchase of qualified policies. We provide data on market expansions and the extent to which policy goals are being achieved, finding that public subsidies for purchasing supplemental policies boosted the market, although the effect of this stimulus diminished over time. Meanwhile, sales growth in the unsubsidized market appears to have slowed, despite design features that create incentives for lower-risk individuals to seek better deals there. Thus, although subsidies for cheap, low-benefit policies seem to have achieved the goal of market expansion, the overall impact and long-term sustainability of these products is unclear; conclusions about its impact are further muddied by significant expansions to Germany's core program. The German example reinforces the examples of the US and France private long term care insurance markets, to show how such products flourish best when supplementing a public program. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Is a diabetes pay-for-performance program cost-effective under the National Health Insurance in Taiwan?

Science.gov (United States)

Tan, Elise Chia-Hui; Pwu, Raoh-Fang; Chen, Duan-Rung; Yang, Ming-Chin

2014-03-01

In October 2001, a pay-for-performance (P4P) program for diabetes was implemented by the National Health Insurance (NHI), a single-payer program, in Taiwan. However, only limited information is available regarding the influence of this program on the patient's health-related quality of life. The aim of this study was to estimate the costs and consequences of enrolling patients in the P4P program from a single-payer perspective. A retrospective observational study of 529 diabetic patients was conducted between 2004 and 2005. The data used in the study were obtained from the National Health Interview Survey (NHIS) in Taiwan. Direct cost data were obtained from NHI claims data, which were linked to respondents in the NHIS using scrambled individual identification. The generic SF36 health instrument was employed to measure the quality-of-life-related health status and transformed into a utility index. Patients enrolled in the P4P program for at least 3 months were categorized as the P4P group. Following propensity score matching, 260 patients were included in the study. Outcomes included life-years, quality-adjusted life-years (QALYs), diabetes-related medical costs, overall medical costs, and incremental cost-effectiveness ratios (ICERs). A single-payer perspective was assumed, and costs were expressed in US dollars. Nonparametric bootstrapping was conducted to estimate confidence intervals for cost-effectiveness ratios. Following matching, no significant difference was noted between two groups with regard to the patients' age, gender, education, family income, smoking status, BMI, or whether insulin was used. The P4P group had an increase of 0.08 (95 % CI 0.077-0.080) in QALYs, and the additional diabetes-related medical cost was US$422.74 (95 % CI US$413.58-US$435.05), yielding an ICER of US$5413.93 (95 % CI US$5226.83-US$5562.97) per QALY gained. Our results provides decision makers with valuable information regarding the impact of the P4P program of diabetes care

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.

7 CFR 2201.24 - Insurance.

Science.gov (United States)

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Insurance. 2201.24 Section 2201.24 Agriculture Regulations of the Department of Agriculture (Continued) LOCAL TELEVISION LOAN GUARANTEE BOARD LOCAL TELEVISION LOAN GUARANTEE PROGRAM-PROGRAM REGULATIONS Loan Guarantees § 2201.24 Insurance. The Borrower of a...

Strengthening insurance partnerships in the face of climate change - Insights from an agent-based model of flood insurance in the UK.

Science.gov (United States)

Crick, Florence; Jenkins, Katie; Surminski, Swenja

2018-04-25

Multisectoral partnerships are increasingly cited as a mechanism to deliver and improve disaster risk management. Yet, partnerships are not a panacea and more research is required to understand the role that they can play in disaster risk management and particularly disaster risk reduction. This paper investigates how partnerships can incentivise flood risk reduction by focusing on the UK public-private partnership on flood insurance. Developing the right flood insurance arrangements to incentivise flood risk reduction and adaptation to climate change is a key challenge. In the face of rising flood risks due to climate change and socio-economic development insurance partnerships can no longer afford to focus only on the risk transfer function. However, while expectations of the insurance industry have traditionally been high when it comes to flood risk management, the insurance industry alone will not provide the solution to the challenge of rising risks. The case of flood insurance in the UK illustrates this: even national government and industry together cannot fully address these risks and other actors need to be involved to create strong incentives for risk reduction. Using an agent-based model focused on surface water flood risk in London we analyse how other partners could strengthen the insurance partnership by reducing flood risk and thus helping to maintain affordable insurance premiums. Our findings are relevant for wider discussions on the potential of insurance schemes to incentivise flood risk management and climate adaptation in the UK and also internationally. Copyright © 2018. Published by Elsevier B.V.

Improving Risk Management and Resiliency: A Plan for a Proactive National Policy on Insurance Practices in FEMA’s Public Assistance Program

Science.gov (United States)

2013-12-01

and reduce insurance costs. 178 Department of Finance and Deregulation , “Managing the Cost of Damage to Road Infrastructure Caused by Natural...MANAGEMENT AND RESILIENCY: A PLAN FOR A PROACTIVE NATIONAL POLICY ON INSURANCE PRACTICES IN FEMA’S PUBLIC ASSISTANCE PROGRAM by Gregory W. Eaton...AND RESILIENCY: A PLAN FOR A PROACTIVE NATIONAL POLICY ON INSURANCE PRACTICES IN FEMA’S PUBLIC ASSISTANCE PROGRAM 5. FUNDING NUMBERS 6. AUTHOR(S

Deposit Insurance and Risk Shifting in a Strong Regulatory Environment

DEFF Research Database (Denmark)

Bartholdy, Jan; Justesen, Lene Gilje

This study provides empirical evidence on the moral hazard implications of introducing deposit insurance into a strong regulatory environment. Denmark offers a unique setting because commercial banks and savings banks have different ownership structures, but are subject to the same set...... of regulations. The ownership structure in savings banks implies that they have no incentive to increase risk after the implementation of a deposit insurance scheme whereas commercial banks have. Also, at the time of introduction, Denmark had high capital requirements and a strict closure policy. Using...... a difference-in-difference framework we show that commercial banks did not increase their risk compared to savings banks when deposit insurance was introduced. The results also hold for large commercial banks, indicating that the systemic risk did not increase either. Thus for a system with high capital...

Do insurers respond to risk adjustment? A long-term, nationwide analysis from Switzerland.

Science.gov (United States)

von Wyl, Viktor; Beck, Konstantin

2016-03-01

Community rating in social health insurance calls for risk adjustment in order to eliminate incentives for risk selection. Swiss risk adjustment is known to be insufficient, and substantial risk selection incentives remain. This study develops five indicators to monitor residual risk selection. Three indicators target activities of conglomerates of insurers (with the same ownership), which steer enrollees into specific carriers based on applicants' risk profiles. As a proxy for their market power, those indicators estimate the amount of premium-, health care cost-, and risk-adjustment transfer variability that is attributable to conglomerates. Two additional indicators, derived from linear regression, describe the amount of residual cost differences between insurers that are not covered by risk adjustment. All indicators measuring conglomerate-based risk selection activities showed increases between 1996 and 2009, paralleling the establishment of new conglomerates. At their maxima in 2009, the indicator values imply that 56% of the net risk adjustment volume, 34% of premium variability, and 51% cost variability in the market were attributable to conglomerates. From 2010 onwards, all indicators decreased, coinciding with a pre-announced risk adjustment reform implemented in 2012. Likewise, the regression-based indicators suggest that the volume and variance of residual cost differences between insurers that are not equaled out by risk adjustment have decreased markedly since 2009 as a result of the latest reform. Our analysis demonstrates that risk-selection, especially by conglomerates, is a real phenomenon in Switzerland. However, insurers seem to have reduced risk selection activities to optimize their losses and gains from the latest risk adjustment reform.

Terminating the Audit of the National Flood Insurance Program’s Fiscal 1980 Financial Statements.

Science.gov (United States)

1981-09-21

7 AD-A107 188 GENERAL ACCOUNTING OFFICE WASHINGTON DC ACCOUNTING A ETC F/G 5/1 TERMINATING THE AUDIT OF THE NATIONAL FLOOD INSURANCE PROGRAN S-,-ETC...Management Agency Dear Mr. Giuffrida: A Subject: Terminating the Audit of the National Floodr .) Insurance Program’s Fiscal 1980 Financial...objective of the audit was to express an opinion on the NFIP’s < fiscal 1980 financial statements. We will not meet this objec- tive, however, because

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...

Financing geothermal resource development in the Pacific Region states

Energy Technology Data Exchange (ETDEWEB)

1978-08-15

State and federal tax treatment as an incentive to development and non-tax financial incentives such as: the federal geothermal loan guarantee program, the federal geothermal reservoir insurance, and state financial incentives are discussed. (MHR)

Conjoint Analysis of Farmers’ Response to Conservation Incentives

Directory of Open Access Journals (Sweden)

David Conner

2016-07-01

Full Text Available Environmental degradation threatens the long term resiliency of the US food and farming system. While USDA has provided conservation incentives for the adoption of best management practices (BMPs, only a small percentage of farms have participated in such conservation programs. This study uses conjoint analysis to examine Vermont farmers’ underlying preferences and willingness-to-accept (WTA incentives for three common BMPs. Based on the results of this survey, we hypothesize that federal cost share programs’ payments are below preferred incentive levels and that less familiar and more complex BMPs require a higher payment. Our implications focus on strategies to test these hypotheses and align incentive payments and other non-monetary options to increase BMP adoption.

Health Care Access and Use Among Low-Income Children on Subsidized Insurance Programs in California.

OpenAIRE

Christopher Trenholm; Anna Saltzman; Shanna Shulman; Michael Cousineau; Dana Hughes

2008-01-01

This paper summarizes the CaliforniaKids and Healthy Kids programs—county-based insurance programs in California for low-income children. The study examined features of both programs, use of basic health care services by the children enrolled, and typical experiences accessing inpatient and other high-cost care. Children enrolled in the two programs made substantial use of outpatient health care, despite important variation in program features. The study concludes with recommendations on ho...

Increasing health insurance coverage through an extended Federal Employees Health Benefits Program.

Science.gov (United States)

Fuchs, B C

2001-01-01

The Federal Employees Health Benefits Program (FEHBP) could be combined with health insurance tax credits to extend coverage to the uninsured. An extended FEHBP, or "E-FEHBP," would be open to all individuals who were not covered through work or public programs and who also were eligible for the tax credits on the basis of income. E-FEHBP also would be open to employees of very small firms, regardless of their eligibility for tax credits. Most plans available to FEHBP participants would be required to offer enrollment to E-FEHBP participants, although premiums would be rated separately. High-risk individuals would be diverted to a separate high-risk pool, the cost of which would be subsidized by the federal government. E-FEHBP would be administered by the states, or if a state declined, by an entity that contracted with the Office of Personnel Management. While E-FEHBP would provide group insurance to people who otherwise could not get it, premiums could exceed the tax-credit amount and some people still might find the coverage unaffordable.

Linking performance incentives to ethical practice

Directory of Open Access Journals (Sweden)

Boudi FB

2018-02-01

Full Text Available No abstract available. Article truncated after 150 words. Health spending is a huge part of the United States economy as it is a large business. We all have seen increasing inclusion of corporate practices in health care. One such inclusion is the incentive programs which have at their core the goal of production of the desired behavioral outcomes directly related either to performance output or extraordinary achievement. However, management influence on the organization’s ethical environment and culture can inadvertently encourage or endorse unethical behavior despite the best intentions. One way would be failing to link performance incentives to ethical practice. When leaders create strong incentives to accomplish a goal without creating equally strong incentives to adhere to ethical practice in achieving the desired goal, they effectively set the stage for ethical malpractice. Incentivizing ethical practice is equally important as incentivizing other behaviors (1. In the health care industry, unlike in the sales industry, professionalism and patient care are …

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...

Empirical studies of regulatory restructuring and incentives

Science.gov (United States)

Knittel, Christopher Roland

gas is also an input into the generation of electricity. However because these firms are regulated, these differing incentives would only be acted upon if regulation is imperfect in some way. Chapter 2 analyzes these issues. In particular, I estimate equilibrium pricing and investment equations that capture the relative incentives of single and dual-product electricity firms. The results imply that both electricity prices and reliance on natural gas generation are higher in a dual-product setting, both suggesting that regulators respond to the relative incentives of electricity and natural gas firms. Chapter 3 analyzes electricity firm production incentives when regulated via performance based regulation. Although many electricity markets are currently considering adopting a competitive market for electricity generation, and still others have already done so, the vast majority of electricity markets remain tightly regulated. Within this traditional regulatory environment, the use of incentive regulation schemes in US electricity markets has grown during the past two decades. While every state has some program that it refers to as an incentive regulation program, these programs differ in both their goals and how they attempt to meet these goals. In this chapter, I discuss the wide array of programs that have been utilized to alter the incentives of US investor-owned utilities (IOUs). In addition, using stochastic frontier methods, I provide empirical analysis of the impact that a number of incentive regulation programs have on the efficiency of a large set of coal and natural gas generator units.

Physician Quality Reporting System Program Updates and the Impact on Emergency Medicine Practice.

Science.gov (United States)

Wiler, Jennifer L; Granovsky, Michael; Cantrill, Stephen V; Newell, Richard; Venkatesh, Arjun K; Schuur, Jeremiah D

2016-03-01

In 2007, the Centers for Medicaid and Medicare Services (CMS) created a novel payment program to create incentives for physician's to focus on quality of care measures and report quality performance for the first time. Initially termed "The Physician Voluntary Reporting Program," various Congressional actions, including the Tax Relief and Health Care Act of 2006 (TRHCA) and Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) further strengthened and ensconced this program, eventually leading to the quality program termed today as the Physician Quality Reporting System (PQRS). As a result of passage of the Affordable Care Act of 2010, the PQRS program has expanded to include both the "traditional PQRS" reporting program and the newer "Value Modifier" program (VM). For the first time, these programs were designed to include pay-for-performance incentives for all physicians providing care to Medicare beneficiaries and to measure the cost of care. The recent passage of the Medicare Access and Children's Health Insurance Program (CHIP) Reauthorization Act in March of 2015 includes changes to these payment programs that will have an even more profound impact on emergency care providers. We describe the implications of these important federal policy changes for emergency physicians.

The insurance and risk management industries: new players in the delivery of energy-efficient and renewable energy products and services

International Nuclear Information System (INIS)

Mills, Evan

2003-01-01

The insurance and risk management industries are typically considered to have little interest in energy issues, other than those associated with large energy supply systems. The historical involvement of these industries in the development and deployment of familiar loss-prevention technologies such as automobile air bags, fire prevention/suppression systems, and anti-theft devices, evidences a tradition of mediating and facilitating the use of technology to improve safety and otherwise reduce the likelihood of losses. Through an examination of the connection between risk management and energy technology, we have identified nearly 80 examples of energy-efficient and renewable energy technologies that offer loss-prevention benefits (such as improved fire safety). This article presents the business case for insurer involvement in the sustainable energy sector and documents early case studies of insurer efforts along these lines. We have mapped these opportunities onto the appropriate market segments (life, health, property, liability, business interruption, etc.). We review steps taken by 53 forward-looking insurers and reinsurers, 5 brokers, 7 insurance organizations, and 13 non-insurance organizations. We group the approaches into the categories of: information, education, and demonstration; financial incentives; specialized policies and insurance products; direct investment; customer services and inspections; codes, standards, and policies; research and development; in-house energy management; and an emerging concept informally known as 'carbon insurance'. While most companies have made only a modest effort to position themselves in the 'green' marketplace, a few have comprehensive environmental programs that include energy efficiency and renewable energy activities

34 CFR 682.505 - Insurance premium.

Science.gov (United States)

2010-07-01

... 34 Education 3 2010-07-01 2010-07-01 false Insurance premium. 682.505 Section 682.505 Education... § 682.505 Insurance premium. (a) General. The Secretary charges the lender an insurance premium for each Federal GSL Program loan that is guaranteed, except that no insurance premium is charged on a Federal...

75 FR 75469 - Priority Setting for the Children's Health Insurance Program Reauthorization Act (CHIPRA...

Science.gov (United States)

2010-12-03

... Advisor, Child Health and Quality Improvement, Office of Extramural Research, Education, and Priority...: Importance has several dimensions: To what extent is the topic important to children's health outcomes... Setting for the Children's Health Insurance Program Reauthorization Act (CHIPRA) Pediatric Quality...

Medicaid/CHIP Program; Medicaid Program and Children's Health Insurance Program (CHIP); Changes to the Medicaid Eligibility Quality Control and Payment Error Rate Measurement Programs in Response to the Affordable Care Act. Final rule.

Science.gov (United States)

2017-07-05

This final rule updates the Medicaid Eligibility Quality Control (MEQC) and Payment Error Rate Measurement (PERM) programs based on the changes to Medicaid and the Children's Health Insurance Program (CHIP) eligibility under the Patient Protection and Affordable Care Act. This rule also implements various other improvements to the PERM program.

24 CFR 206.102 - General Insurance Fund.

Science.gov (United States)

2010-04-01

... Insurance Fund. [60 FR 42761, Aug. 16, 1995] Mortgage Insurance Premiums ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false General Insurance Fund. 206.102... URBAN DEVELOPMENT MORTGAGE AND LOAN INSURANCE PROGRAMS UNDER NATIONAL HOUSING ACT AND OTHER AUTHORITIES...

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

The evolution of the State Children's Health Insurance Program (SCHIP) in New York: changing program features and enrollee characteristics.

Science.gov (United States)

Dick, Andrew W; Klein, Jonathan D; Shone, Laura P; Zwanziger, Jack; Yu, Hao; Szilagyi, Peter G

2003-12-01

The State Children's Health Insurance Program (SCHIP) has been operating for >5 years. Policy makers are interested in the characteristics of children who have enrolled and changes in the health care needs of enrolled children as programs mature. New York State's SCHIP evolved from a similar statewide health insurance program that was developed in 1991 (Child Health Plus [CHPlus]). Understanding how current SCHIP enrollees differ from early CHPlus enrollees together with how program features changed during the period may shed light on how best to serve the evolving SCHIP population. To 1) describe changes in the characteristics of children enrolled in 1994 CHPlus and 2001 SCHIP; 2) determine if changes in the near-poor, age-eligible population during the time period could account for the evolution of enrollment; and 3) describe changes in the program during the period that could be responsible for the enrollment changes. New York State, stratified into 4 regions: New York City, New York City environs, upstate urban counties, and upstate rural counties. Retrospective telephone interviews of parents of 2 cohorts of CHPlus enrollees: 1) children who enrolled in CHPlus in 1993 to 1994 and 2) children who enrolled in New York's SCHIP in 2000 to 2001. The Current Population Survey (CPS) 1992 to 1994 and 1999 to 2001 were used to identify secular trends that could explain differences in the CHPlus and SCHIP enrollees. PROGRAM CHARACTERISTICS: 1994 CHPlus and 2001 SCHIP were similar in design, both limiting eligibility by age, family income, and insurance status. SCHIP 2001 included 1) expansion of eligibility to adolescents 13 to 19 years old; 2) expansion of benefits to include hospitalizations, mental health, and dental benefits; 3) changes in premium contributions; 4) more participating insurance plans, limited to managed care; 5) expansions in marketing and outreach; and 6) a combined enrollment application for SCHIP and several low-income programs including Medicaid

Children's health insurance program premiums adversely affect enrollment, especially among lower-income children.

Science.gov (United States)

Abdus, Salam; Hudson, Julie; Hill, Steven C; Selden, Thomas M

2014-08-01

Both Medicaid and the Children's Health Insurance Program (CHIP), which are run by the states and funded by federal and state dollars, offer health insurance coverage for low-income children. Thirty-three states charged premiums for children at some income ranges in CHIP or Medicaid in 2013. Using data from the 1999-2010 Medical Expenditure Panel Surveys, we show that the relationship between premiums and coverage varies considerably by income level and by parental access to employer-sponsored insurance. Among children with family incomes above 150 percent of the federal poverty level, a $10 increase in monthly premiums is associated with a 1.6-percentage-point reduction in Medicaid or CHIP coverage. In this income range, the increase in uninsurance may be higher among those children whose parents lack an offer of employer-sponsored insurance than among those whose parents have such an offer. Among children with family incomes of 101-150 percent of poverty, a $10 increase in monthly premiums is associated with a 6.7-percentage-point reduction in Medicaid or CHIP coverage and a 3.3-percentage-point increase in uninsurance. In this income range, the increase in uninsurance is even larger among children whose parents lack offers of employer coverage. Project HOPE—The People-to-People Health Foundation, Inc.

School Insurance: Managing the Local Program. Bulletin, 1959, No. 23

Science.gov (United States)

Finchum, R. N.; Viles, N. E.

1959-01-01

This study is the second in a series of publications by the Office of Education on school insurance. Data for this study were adapted from many sources. Among these sources were books of a technical nature, professional magazine articles, State insurance guides, research studies, insurance rating schedules, insurance company bulletins, and…

The Effect of Incentives and Meta-incentives on the Evolution of Cooperation.

Directory of Open Access Journals (Sweden)

Isamu Okada

2015-05-01

Full Text Available Although positive incentives for cooperators and/or negative incentives for free-riders in social dilemmas play an important role in maintaining cooperation, there is still the outstanding issue of who should pay the cost of incentives. The second-order free-rider problem, in which players who do not provide the incentives dominate in a game, is a well-known academic challenge. In order to meet this challenge, we devise and analyze a meta-incentive game that integrates positive incentives (rewards and negative incentives (punishments with second-order incentives, which are incentives for other players' incentives. The critical assumption of our model is that players who tend to provide incentives to other players for their cooperative or non-cooperative behavior also tend to provide incentives to their incentive behaviors. In this paper, we solve the replicator dynamics for a simple version of the game and analytically categorize the game types into four groups. We find that the second-order free-rider problem is completely resolved without any third-order or higher (meta incentive under the assumption. To do so, a second-order costly incentive, which is given individually (peer-to-peer after playing donation games, is needed. The paper concludes that (1 second-order incentives for first-order reward are necessary for cooperative regimes, (2 a system without first-order rewards cannot maintain a cooperative regime, (3 a system with first-order rewards and no incentives for rewards is the worst because it never reaches cooperation, and (4 a system with rewards for incentives is more likely to be a cooperative regime than a system with punishments for incentives when the cost-effect ratio of incentives is sufficiently large. This solution is general and strong in the sense that the game does not need any centralized institution or proactive system for incentives.

The Effect of Incentives and Meta-incentives on the Evolution of Cooperation.

Science.gov (United States)

Okada, Isamu; Yamamoto, Hitoshi; Toriumi, Fujio; Sasaki, Tatsuya

2015-05-01

Although positive incentives for cooperators and/or negative incentives for free-riders in social dilemmas play an important role in maintaining cooperation, there is still the outstanding issue of who should pay the cost of incentives. The second-order free-rider problem, in which players who do not provide the incentives dominate in a game, is a well-known academic challenge. In order to meet this challenge, we devise and analyze a meta-incentive game that integrates positive incentives (rewards) and negative incentives (punishments) with second-order incentives, which are incentives for other players' incentives. The critical assumption of our model is that players who tend to provide incentives to other players for their cooperative or non-cooperative behavior also tend to provide incentives to their incentive behaviors. In this paper, we solve the replicator dynamics for a simple version of the game and analytically categorize the game types into four groups. We find that the second-order free-rider problem is completely resolved without any third-order or higher (meta) incentive under the assumption. To do so, a second-order costly incentive, which is given individually (peer-to-peer) after playing donation games, is needed. The paper concludes that (1) second-order incentives for first-order reward are necessary for cooperative regimes, (2) a system without first-order rewards cannot maintain a cooperative regime, (3) a system with first-order rewards and no incentives for rewards is the worst because it never reaches cooperation, and (4) a system with rewards for incentives is more likely to be a cooperative regime than a system with punishments for incentives when the cost-effect ratio of incentives is sufficiently large. This solution is general and strong in the sense that the game does not need any centralized institution or proactive system for incentives.

The cost of policy simplification in conservation incentive programs

DEFF Research Database (Denmark)

Armsworth, Paul R.; Acs, Szvetlana; Dallimer, Martin

2012-01-01

of biodiversity. Common policy simplifications result in a 49100% loss in biodiversity benefits depending on the conservation target chosen. Failure to differentiate prices for conservation improvements in space is particularly problematic. Additional implementation costs that accompany more complicated policies......Incentive payments to private landowners provide a common strategy to conserve biodiversity and enhance the supply of goods and services from ecosystems. To deliver cost-effective improvements in biodiversity, payment schemes must trade-off inefficiencies that result from over-simplified policies...... with the administrative burden of implementing more complex incentive designs. We examine the effectiveness of different payment schemes using field parameterized, ecological economic models of extensive grazing farms. We focus on profit maximising farm management plans and use bird species as a policy-relevant indicator...

42 CFR 60.14 - The insurance premium.

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false The insurance premium. 60.14 Section 60.14 Public... LOAN PROGRAM The Loan § 60.14 The insurance premium. (a) General. (1) The Secretary insures each lender... lender an insurance premium. The insurance premium is due to the Secretary on the date of disbursement of...

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…

Economic incentive in community nursing: attraction, rejection or indifference?

Directory of Open Access Journals (Sweden)

Kingma Mireille

2003-04-01

Full Text Available Abstract Background It is hard to imagine any period in time when economic issues were more visible in health sector decision-making. The search for measures that maximize available resources has never been greater than within the present decade. A staff payroll represents 60%-70% of budgeted health service funds. The cost-effective use of human resources is thus an objective of paramount importance. Using incentives and disincentives to direct individuals' energies and behaviour is common practice in all work settings, of which the health care system is no exception. The range and influence of economic incentives/disincentives affecting community nurses are the subject of this discussion paper. The tendency by nurses to disregard, and in many cases, deny a direct impact of economic incentives/disincentives on their motivation and professional conduct is of particular interest. The goal of recent research was to determine if economic incentives/disincentives in community nursing exist, whether they have a perceivable impact and in what areas. Conclusion Understanding the value system of community nurses and how they respond to economic incentives/disincentives facilitates the development of reward systems more likely to be relevant and strategic. If nurse rewards are to become more effective organizational tools, the data suggest that future initiatives should: • Improve nurses' salary/income relativities (e.g. comparable pay/rates; • Provide just compensation for job-related expenses (e.g. petrol, clothing; • Introduce promotional opportunities within the clinical area, rewarding skill and competence development; • Make available a range of financed rewards. - Direct (e.g. subsidized education, additional leave, insurance benefits; - Indirect (e.g. better working conditions, access to professional support network, greater participation in decision-making bodies.

Behavioral Therapy, Incentives Enhance Addiction Treatment

Science.gov (United States)

... Research News From NIH Behavioral Therapy, Incentives Enhance Addiction Treatment Past Issues / Summer 2006 Table of Contents ... that people who are trying to end their addiction to marijuana can benefit from a treatment program ...

24 CFR 200.100 - Insurance endorsement.

Science.gov (United States)

2010-04-01

... a commitment for insured advances, initial endorsement of the credit instrument shall occur before... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Insurance endorsement. 200.100... Endorsement Generally Applicable to Multifamily and Health Care Facility Mortgage Insurance Programs; and...

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

Geothermal reservoir insurance study. Final report

Energy Technology Data Exchange (ETDEWEB)

1981-10-09

The principal goal of this study was to provide analysis of and recommendations on the need for and feasibility of a geothermal reservoir insurance program. Five major tasks are reported: perception of risk by major market sectors, status of private sector insurance programs, analysis of reservoir risks, alternative government roles, and recommendations.

Relative Affordability of Health Insurance Premiums under CHIP Expansion Programs and the ACA.

Science.gov (United States)

Gresenz, Carole Roan; Laugesen, Miriam J; Yesus, Ambeshie; Escarce, José J

2011-10-01

Affordability is integral to the success of health care reforms aimed at ensuring universal access to health insurance coverage, and affordability determinations have major policy and practical consequences. This article describes factors that influenced the determination of affordability benchmarks and premium-contribution requirements for Children's Health Insurance Program (CHIP) expansions in three states that sought to universalize access to coverage for youth. It also compares subsidy levels developed in these states to the premium subsidy schedule under the Affordable Care Act (ACA) for health insurance plans purchased through an exchange. We find sizeable variability in premium-contribution requirements for children's coverage as a percentage of family income across the three states and in the progressivity and regressivity of the premium-contribution schedules developed. These findings underscore the ambiguity and subjectivity of affordability standards. Further, our analyses suggest that while the ACA increases the affordability of family coverage for families with incomes below 400 percent of the federal poverty level, the evolution of CHIP over the next five to ten years will continue to have significant implications for low-income families.

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.

Healthy and Ready to Learn: Effects of a School-Based Public Health Insurance Outreach Program for Kindergarten-Aged Children

Science.gov (United States)

Jenkins, Jade Marcus

2018-01-01

Background: Rates of child insurance coverage have increased due to expansions in public programs, but many eligible children remain uninsured. Uninsured children are less likely to receive preventative care, which leads to poorer health and achievement in the long term. This study is an evaluation of a school-based health insurance outreach…

Measuring Provider Performance for Physicians Participating in the Merit-Based Incentive Payment System.

Science.gov (United States)

Squitieri, Lee; Chung, Kevin C

2017-07-01

In 2017, the Centers for Medicare and Medicaid Services began requiring all eligible providers to participate in the Quality Payment Program or face financial reimbursement penalty. The Quality Payment Program outlines two paths for provider participation: the Merit-Based Incentive Payment System and Advanced Alternative Payment Models. For the first performance period beginning in January of 2017, the Centers for Medicare and Medicaid Services estimates that approximately 83 to 90 percent of eligible providers will not qualify for participation in an Advanced Alternative Payment Model and therefore must participate in the Merit-Based Incentive Payment System program. The Merit-Based Incentive Payment System path replaces existing quality-reporting programs and adds several new measures to evaluate providers using four categories of data: (1) quality, (2) cost/resource use, (3) improvement activities, and (4) advancing care information. These categories will be combined to calculate a weighted composite score for each provider or provider group. Composite Merit-Based Incentive Payment System scores based on 2017 performance data will be used to adjust reimbursed payment in 2019. In this article, the authors provide relevant background for understanding value-based provider performance measurement. The authors also discuss Merit-Based Incentive Payment System reporting requirements and scoring methodology to provide plastic surgeons with the necessary information to critically evaluate their own practice capabilities in the context of current performance metrics under the Quality Payment Program.

Review and analysis of the Mental Health Nurse Incentive Program.

Science.gov (United States)

Happell, Brenda; Platania-Phung, Chris

2017-09-04

Objective The aim of the present study was to review and synthesise research on the Mental Health Nurse Incentive Program (MHNIP) to ascertain the benefits and limitations of this initiative for people with mental illness, general practitioners, mental health nurses and the wider community. Methods An electronic and manual search was made of the research literature for MHNIP in May 2017. Features of studies, including cohorts and findings, were tabulated and cross-study patterns in program processes and outcomes were closely compared. Results Seventeen reports of primary research data have been released. Triangulation of data from different cohorts, regions and design show that the program has been successful on the primary objectives of increased access to primary mental health care, and has received positive feedback from all major stakeholders. Although the program has been broadly beneficial to consumer health, there are inequities in access for people with mental illness. Conclusions The MHNIP greatly benefits the health of people with mental illness. Larger and more representative sampling of consumers is needed, as well as intensive case studies to provide a more comprehensive and effective understanding of the benefits and limitations of the program as it evolves with the establishment of primary health networks. What is known about the topic? The MHNIP is designed to increase access to mental health care in primary care settings such as general practice clinics. Studies have reported favourable views about the program. However, research is limited and further investigation is required to demonstrate the strengths and limitations of the program. What does this paper add? All studies reviewed reported that the MHNIP had positive implications for people with severe and persistent mental illness. Qualitative research has been most prevalent for mental health nurse views and research on Health of the Nation Outcome Scale scores for recipients of the program

Nuclear insurance fire risk

International Nuclear Information System (INIS)

Dressler, E.G.

2001-01-01

Nuclear facilities operate under the constant risk that radioactive materials could be accidentally released off-site and cause injuries to people or damages to the property of others. Management of this nuclear risk, therefore, is very important to nuclear operators, financial stakeholders and the general public. Operators of these facilities normally retain a portion of this risk and transfer the remainder to others through an insurance mechanism. Since the nuclear loss exposure could be very high, insurers usually assess their risk first-hand by sending insurance engineers to conduct a nuclear insurance inspection. Because a serious fire can greatly increase the probability of an off-site release of radiation, fire safety should be included in the nuclear insurance inspection. This paper reviews essential elements of a facility's fire safety program as a key factor in underwriting nuclear third-party liability insurance. (author)

Health Insurance for Cancer Care in Asia: Thailand

OpenAIRE

Pongpak Pittayapan

2016-01-01

Thailand has a universal multi-payer system with two main types of health insurance: National Health Security Office or public health insurance and private insurance. National health insurance is designed for people who are not eligible to be members of any employment-based health insurance program. Although private health insurance is also available, all Thai citizens are required to be enrolled in either national health insurance or employees? health insurance. There are many differences be...

Optimal Incentives for Public Sector Workers: The Case of Teacher-Designed Incentive Pay in Texas. Working Paper 2009-05

Science.gov (United States)

Taylor, Lori L.; Springer, Matthew G.

2009-01-01

Pay for performance is a popular public education reform, and millions of dollars are currently being targeted for pay for performance programs. These reforms are popular because economic and management theories suggest that well-designed incentive pay programs could improve teacher effectiveness. There is little evidence about the characteristics…

24 CFR 203.443 - Insurance premium.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Insurance premium. 203.443 Section... premium. All of the provisions of §§ 203.260 through 203.269 1 concerning mortgage insurance premiums... DEVELOPMENT MORTGAGE AND LOAN INSURANCE PROGRAMS UNDER NATIONAL HOUSING ACT AND OTHER AUTHORITIES SINGLE...

The Effect of Disability Insurance on Health Investment: Evidence from the Veterans Benefits Administration's Disability Compensation Program

Science.gov (United States)

Singleton, Perry

2009-01-01

I examine whether individuals respond to monetary incentives to detect latent medical conditions. The effect is identified by a policy that deemed diabetes associated with herbicide exposure a compensable disability under the Veterans Benefits Administration's Disability Compensation program. Since a diagnosis is a requisite for benefit…

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).

Identifying cost-minimizing strategies for guaranteeing target dairy income over feed cost via use of the Livestock Gross Margin dairy insurance program.

Science.gov (United States)

Valvekar, M; Cabrera, V E; Gould, B W

2010-07-01

Milk and feed price volatility are the major source of dairy farm risk. Since August 2008 a new federally reinsured insurance program has been available to many US dairy farmers to help minimize the negative effects of adverse price movements. This insurance program is referred to as Livestock Gross Margin Insurance for Dairy Cattle. Given the flexibility in contract design, the dairy farmer has to make 3 critical decisions when purchasing this insurance: 1) the percentage of monthly milk production to be covered, 3) declared feed equivalents used to produce this milk, and 3) the level of gross margin not covered by insurance (i.e., deductible). The objective of this analysis was to provide an optimal strategy of how a dairy farmer could incorporate this insurance program to help manage the variability in net farm income. In this analysis we assumed that a risk-neutral dairy farmer wants to design an insurance contract such that a target guaranteed income over feed cost is obtained at least cost. We undertook this analysis for a representative Wisconsin dairy farm (herd size: 120 cows) producing 8,873 kg (19,545 lb) of milk/cow per year. Wisconsin statistical data indicates that dairy farms of similar size must require an income over feed cost of at least $110/Mg ($5/cwt) of milk to be profitable during the coverage period. Therefore, using data for the July 2009 insurance contract to insure $110/Mg of milk, the least cost contract was found to have a premium of $1.22/Mg ($0.055/cwt) of milk produced insuring approximately 52% of the production with variable monthly production covered during the period of September 2009 to June 2010. This premium represented 1.10% of the desired IOFC. We compared the above optimal strategy with an alternative nonoptimal strategy, defined as a contract insuring the same proportion of milk as the optimal (52%) but with a constant amount insured across all contract months. The premium was found to be almost twice the level obtained

The Children's Health Insurance Program Reauthorization Act Evaluation Findings on Children's Health Insurance Coverage in an Evolving Health Care Landscape.

Science.gov (United States)

Harrington, Mary E

2015-01-01

The Children's Health Insurance Program (CHIP) Reauthorization Act (CHIPRA) reauthorized CHIP through federal fiscal year 2019 and, together with provisions in the Affordable Care Act, federal funding for the program was extended through federal fiscal year 2015. Congressional action is required or federal funding for the program will end in September 2015. This supplement to Academic Pediatrics is intended to inform discussions about CHIP's future. Most of the new research presented comes from a large evaluation of CHIP mandated by Congress in the CHIPRA. Since CHIP started in 1997, millions of lower-income children have secured health insurance coverage and needed care, reducing the financial burdens and stress on their families. States made substantial progress in simplifying enrollment and retention. When implemented optimally, Express Lane Eligibility has the potential to help cover more of the millions of eligible children who remain uninsured. Children move frequently between Medicaid and CHIP, and many experienced a gap in coverage with this transition. CHIP enrollees had good access to care. For nearly every health care access, use, care, and cost measure examined, CHIP enrollees fared better than uninsured children. Access in CHIP was similar to private coverage for most measures, but financial burdens were substantially lower and access to weekend and nighttime care was not as good. The Affordable Care Act coverage options have the potential to reduce uninsured rates among children, but complex transition issues must first be resolved to ensure families have access to affordable coverage, leading many stakeholders to recommend funding for CHIP be continued. Copyright © 2015 Academic Pediatric Association. All rights reserved.

Time for a change in how new antibiotics are reimbursed: Development of an insurance framework for funding new antibiotics based on a policy of risk mitigation.

Science.gov (United States)

Towse, Adrian; Hoyle, Christopher K; Goodall, Jonathan; Hirsch, Mark; Mestre-Ferrandiz, Jorge; Rex, John H

2017-10-01

Healthcare systems depend on the availability of new antibiotics. However, there is a lack of treatments for infections caused by multidrug resistant (MDR) pathogens and a weak development pipeline of new therapies. One core challenge to the development of new antibiotics targeting MDR pathogens is that expected revenues are insufficient to drive long-term investment. In the USA and Europe, financial incentives have focussed on supporting R&D, reducing regulatory burden, and extending market exclusivity. Using resistance data to estimate global revenues, we demonstrate that the combined effects of these incentives are unlikely to rekindle investment in antibiotics. We analyse two supplemental approaches: a commercial incentive (a premium price model) and a new business model (an insurance model). A premium price model is familiar and readily implemented but the required price and local budget impact is highly uncertain and sensitive to cross-sectional and longitudinal variation in prevalence of antibiotic resistance. An insurance model delivering risk mitigation for payers, providers and manufacturers would provide an incentive to drive investment in the development of new antibiotics while also facilitating antibiotic conservation. We suggest significant efforts should be made to test the insurance model as one route to stimulate investment in novel antibiotics. Copyright © 2017 Office of Health Economics. Published by Elsevier B.V. All rights reserved.

Physician Quality Reporting System Program Updates and the Impact on Emergency Medicine Practice

Science.gov (United States)

Wiler, Jennifer L.; Granovsky, Michael; Cantrill, Stephen V.; Newell, Richard; Venkatesh, Arjun K.; Schuur, Jeremiah D.

2016-01-01

In 2007, the Centers for Medicaid and Medicare Services (CMS) created a novel payment program to create incentives for physician’s to focus on quality of care measures and report quality performance for the first time. Initially termed “The Physician Voluntary Reporting Program,” various Congressional actions, including the Tax Relief and Health Care Act of 2006 (TRHCA) and Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) further strengthened and ensconced this program, eventually leading to the quality program termed today as the Physician Quality Reporting System (PQRS). As a result of passage of the Affordable Care Act of 2010, the PQRS program has expanded to include both the “traditional PQRS” reporting program and the newer “Value Modifier” program (VM). For the first time, these programs were designed to include pay-for-performance incentives for all physicians providing care to Medicare beneficiaries and to measure the cost of care. The recent passage of the Medicare Access and Children’s Health Insurance Program (CHIP) Reauthorization Act in March of 2015 includes changes to these payment programs that will have an even more profound impact on emergency care providers. We describe the implications of these important federal policy changes for emergency physicians. PMID:26973757

Physician Quality Reporting System Program Updates and the Impact on Emergency Medicine Practice

Directory of Open Access Journals (Sweden)

Jennifer L. Wiler, MD, MBA

2016-03-01

Full Text Available In 2007, the Centers for Medicaid and Medicare Services (CMS created a novel payment program to create incentives for physician’s to focus on quality of care measures and report quality performance for the first time. Initially termed “The Physician Voluntary Reporting Program,” various Congressional actions, including the Tax Relief and Health Care Act of 2006 (TRHCA and Medicare Improvements for Patients and Providers Act of 2008 (MIPPA further strengthened and ensconced this program, eventually leading to the quality program termed today as the Physician Quality Reporting System (PQRS. As a result of passage of the Affordable Care Act of 2010, the PQRS program has expanded to include both the “traditional PQRS” reporting program and the newer “Value Modifier” program (VM. For the first time, these programs were designed to include pay-for-performance incentives for all physicians providing care to Medicare beneficiaries and to measure the cost of care. The recent passage of the Medicare Access and Children’s Health Insurance Program (CHIP Reauthorization Act in March of 2015 includes changes to these payment programs that will have an even more profound impact on emergency care providers. We describe the implications of these important federal policy changes for emergency physicians.

Miles, speed, and technology: Traffic safety under oligopolistic insurance

NARCIS (Netherlands)

Dementieva, M.; Verhoef, E.T.

2016-01-01

We study road safety when insurance companies have market power, and can influence drivers' behavior via insurance premiums. We obtain first- and second-best premiums for different insurance market structures. The insurance program consists of an insurance premium, and marginal dependencies of that

Insurance Regulation: The NAIC Accreditation Program Can be Improved

National Research Council Canada - National Science Library

DIngell, John

2001-01-01

... environment of the insurance industry and insurance regulation. In addition, it has revised the way accreditation reviews are performed and scored and has improved training for members of review teams.

Blood donor incentives: A step forward or backward

Directory of Open Access Journals (Sweden)

Abolghasemi Hassan

2010-01-01

Full Text Available Dramatic increase in blood usage and critical seasonal blood shortages are faced by various countries. Countries which previously reached 100% voluntary nonremunerated donation have been led to offer different kinds of incentives to recruit blood donors and meet their blood demands. In some cases, these incentives are considered monetary and are in complete contrast with International standards like World Health Organization (WHO. It seems that attitudes toward sole dependency on nonremunerated voluntary blood donation have been changed in recent years and experts in some developed countries are reevaluating partial reliance on paid donation. On the other hand, besides the effects of such incentives on blood safety, several economic and psychological studies have shown that incentives have discouraging effects on pro-social behaviors like blood donation and will reduce the number of blood donors in long term. With regard to the results of such studies, it seems that implementing incentive-based blood donor recruitment programs to meet blood requirements by some countries is becoming a challenge for blood banks.

Financial incentives for return of service in underserved areas: a systematic review

Directory of Open Access Journals (Sweden)

Bärnighausen Till

2009-05-01

Full Text Available Abstract Background In many geographic regions, both in developing and in developed countries, the number of health workers is insufficient to achieve population health goals. Financial incentives for return of service are intended to alleviate health worker shortages: A (future health worker enters into a contract to work for a number of years in an underserved area in exchange for a financial pay-off. Methods We carried out systematic literature searches of PubMed, the Excerpta Medica database, the Cumulative Index to Nursing and Allied Health Literature, and the National Health Services Economic Evaluation Database for studies evaluating outcomes of financial-incentive programs published up to February 2009. To identify articles for review, we combined three search themes (health workers or students, underserved areas, and financial incentives. In the initial search, we identified 10,495 unique articles, 10,302 of which were excluded based on their titles or abstracts. We conducted full-text reviews of the remaining 193 articles and of 26 additional articles identified in reference lists or by colleagues. Forty-three articles were included in the final review. We extracted from these articles information on the financial-incentive programs (name, location, period of operation, objectives, target groups, definition of underserved area, financial incentives and obligation and information on the individual studies (authors, publication dates, types of study outcomes, study design, sample criteria and sample size, data sources, outcome measures and study findings, conclusions, and methodological limitations. We reviewed program results (descriptions of recruitment, retention, and participant satisfaction, program effects (effectiveness in influencing health workers to provide care, to remain, and to be satisfied with work and personal life in underserved areas, and program impacts (effectiveness in influencing health systems and health outcomes

Pre-Existing Condition Insurance Plan Data

Data.gov (United States)

U.S. Department of Health & Human Services — The Affordable Care Act created the new Pre-Existing Condition Insurance Plan (PCIP) program to make health insurance available to Americans denied coverage by...

The ABCs of HIPCs (health insurance purchasing cooperatives).

Science.gov (United States)

Wicks, E K; Curtis, R E; Haugh, K

1993-01-01

HIPCs, or health care purchasing cooperatives, are attracting widespread interest as a key element of the managed competition approach to health reform. HIPCs perform several useful roles for individuals and small employers unable to obtain health insurance coverage in the current system by spreading risk more evenly and purchasing coverage in a given region or market area. While HIPCs are generally associated with managed competition, they are also compatible with reform strategies that require employers to pay for coverage or those that provide incentives for expanded coverage.

Partnership insurance: an innovation to meet long-term care financing needs in an era of federal minimalism.

Science.gov (United States)

Meiners, Mark R; McKay, Hunter L; Mahoney, Kevin J

2002-01-01

In the case of long-term care financing, federal minimalism is not new news. Long-term care has long played a weak "third fiddle" to national health reform concerns about the uninsured and catastrophic expenditures on prescription drugs. The states have been left to struggle with the issue of long-term financing as part of their responsibilities in funding and administering the means-tested Medicaid program. Recently, the environment has become even more challenging. Much of what is on the national agenda for health and welfare reform has been delegated to the states. This "devolution" of responsibilities has created many competing priorities for both the attention and resources of states. This context of evolving federal minimalism calls for creative solutions that balance competing points of view. In this article, we provide some background and insights from one such effort: a collaboration between state governments and private insurers to put into operation an insurance-based approach to long-term care financing that uses Medicaid as an incentive to encourage potential purchasers.

The impact of an m-Health financial incentives program on the physical activity and diet of Australian truck drivers

OpenAIRE

Gilson, Nicholas D.; Pavey, Toby G; Wright, Olivia RL; Vandelanotte, Corneel; Duncan, Mitch J; Gomersall, Sjaan; Trost, Stewart G.; Brown, Wendy J.

2017-01-01

Abstract Background Chronic diseases are high in truck drivers and have been linked to work routines that promote inactivity and poor diets. This feasibility study examined the extent to which an m-Health financial incentives program facilitated physical activity and healthy dietary choices in Australian truck drivers. Methods Nineteen men (mean [SD] age = 47.5 [9.8] years; BMI = 31.2 [4.6] kg/m2) completed the 20-week program, and used an activity tracker and smartphone application (Jawbone ...

Acceptance of selective contracting: the role of trust in the health insurer.

Science.gov (United States)

Bes, Romy E; Wendel, Sonja; Curfs, Emile C; Groenewegen, Peter P; de Jong, Judith D

2013-10-02

In a demand oriented health care system based on managed competition, health insurers have incentives to become prudent buyers of care on behalf of their enrolees. They are allowed to selectively contract care providers. This is supposed to stimulate competition between care providers and both increase the quality of care and contain costs in the health care system. However, health insurers are reluctant to implement selective contracting; they believe their enrolees will not accept this. One reason, insurers believe, is that enrolees do not trust their health insurer. However, this has never been studied. This paper aims to study the role played by enrolees' trust in the health insurer on their acceptance of selective contracting. An online survey was conducted among 4,422 people insured through a large Dutch health insurance company. Trust in the health insurer, trust in the purchasing strategy of the health insurer and acceptance of selective contracting were measured using multiple item scales. A regression model was constructed to analyse the results. Trust in the health insurer turned out to be an important prerequisite for the acceptance of selective contracting among their enrolees. The association of trust in the purchasing strategy of the health insurer with acceptance of selective contracting is stronger for older people than younger people. Furthermore, it was found that men and healthier people accepted selective contracting by their health insurer more readily. This was also true for younger people with a low level of trust in their health insurer. This study provides insight into factors that influence people's acceptance of selective contracting by their health insurer. This may help health insurers to implement selective contracting in a way their enrolees will accept and, thus, help systems of managed competition to develop.

Acceptance of selective contracting: the role of trust in the health insurer

Science.gov (United States)

2013-01-01

Background In a demand oriented health care system based on managed competition, health insurers have incentives to become prudent buyers of care on behalf of their enrolees. They are allowed to selectively contract care providers. This is supposed to stimulate competition between care providers and both increase the quality of care and contain costs in the health care system. However, health insurers are reluctant to implement selective contracting; they believe their enrolees will not accept this. One reason, insurers believe, is that enrolees do not trust their health insurer. However, this has never been studied. This paper aims to study the role played by enrolees’ trust in the health insurer on their acceptance of selective contracting. Methods An online survey was conducted among 4,422 people insured through a large Dutch health insurance company. Trust in the health insurer, trust in the purchasing strategy of the health insurer and acceptance of selective contracting were measured using multiple item scales. A regression model was constructed to analyse the results. Results Trust in the health insurer turned out to be an important prerequisite for the acceptance of selective contracting among their enrolees. The association of trust in the purchasing strategy of the health insurer with acceptance of selective contracting is stronger for older people than younger people. Furthermore, it was found that men and healthier people accepted selective contracting by their health insurer more readily. This was also true for younger people with a low level of trust in their health insurer. Conclusion This study provides insight into factors that influence people’s acceptance of selective contracting by their health insurer. This may help health insurers to implement selective contracting in a way their enrolees will accept and, thus, help systems of managed competition to develop. PMID:24083663

The Effect of Incentives and Meta-incentives on the Evolution of Cooperation

OpenAIRE

Okada, Isamu; Yamamoto, Hitoshi; Toriumi, Fujio; Sasaki, Tatsuya

2015-01-01

Although positive incentives for cooperators and/or negative incentives for free-riders in social dilemmas play an important role in maintaining cooperation, there is still the outstanding issue of who should pay the cost of incentives. The second-order free-rider problem, in which players who do not provide the incentives dominate in a game, is a well-known academic challenge. In order to meet this challenge, we devise and analyze a meta-incentive game that integrates positive incentives (re...

A 5-year evaluation of a smoking cessation incentive program for chemical employees.

Science.gov (United States)

Olsen, G W; Lacy, S E; Sprafka, J M; Arceneaux, T G; Potts, T A; Kravat, B A; Gondek, M R; Bond, G G

1991-11-01

This 5-year study of the Dow Chemical Texas Operations 1984-1985 Smoking Cessation Incentive Program (SCIP) evaluated the smoking habits of 1,097 participants and 1,174 nonparticipants. We observed, via questionnaire and saliva cotinine data, that participants were 2.3 times more likely to be long-term (greater than or equal to 5 years) nonusers of tobacco than nonparticipants (10.2% vs 4.4%, P less than or equal to 0.01). However, smoking cessation rates for 3-4 years, 1-2 years, and less than 1 year were similar for participants who remained smokers at the conclusion of SCIP and nonparticipants. Age and the interaction between the management job category and having quit smoking for at least 30 days sometime prior to the worksite program were important predictors of smoking cessation among participants. Thirty-six percent of the participants who were considered exsmokers of 6 months duration at the conclusion of the program in 1985 remained long-term quitters 5 years later. Stress and enjoyment of smoking were the two most important reasons provided by participants for recidivism. The results of this 5-year evaluation demonstrate the heterogeneity of employee participation and success with a worksite smoking cessation program.

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

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

How do patients and providers react to different incentives in the Chinese multiple health security systems?

Science.gov (United States)

Zhang, Chun-Yu; Hashimoto, Hideki

2015-03-05

China has achieved universal health insurance coverage. This study examined how patients and hospitals react to the different designs of the plans and to monitoring of patients by the local authority in the Chinese multiple health security schemes. The sample for analysis consisted of 1006 orthopedic inpatients who were admitted between January and December 2011 at a tertiary teaching hospital located in Beijing. We conducted general linear regression analyses to investigate whether medical expenditure and length of stay differed according to the different incentives. Patients under plans with lower copayment rates consumed significantly more medication compared with those under plans with higher copayment rates. Under plans with an annual ceiling for insurance coverage, patients spent significantly more in the second half of the year than in the first half of the year. The length of stay was shorter among patients when there were government monitoring and a penalty to the hospital service provider. Our results indicate that the different designs and monitoring of the health security systems in China cause opportunistic behavior by patients and providers. Reformation is necessary to reduce those incentives, and improve equity and efficiency in healthcare use.

The spillover effects of health insurance benefit mandates on public insurance coverage: Evidence from veterans.

Science.gov (United States)

Li, Xiaoxue; Ye, Jinqi

2017-09-01

This study examines how regulations in private health insurance markets affect coverage of public insurance. We focus on mental health parity laws, which mandate private health insurance to provide equal coverage for mental and physical health services. The implementation of mental health parity laws may improve a quality dimension of private health insurance but at increased costs. We graphically develop a conceptual framework and then empirically examine whether the regulations shift individuals from private to public insurance. We exploit state-by-year variation in policy implementation in 1999-2008 and focus on a sample of veterans, who have better access to public insurance than non-veterans. Using data from the Current Population Survey, we find that the parity laws reduce employer-sponsored insurance (ESI) coverage by 2.1% points. The drop in ESI is largely offset by enrollment gains in public insurance, namely through the Veterans Affairs (VA) benefit and Medicaid/Medicare programs. Copyright © 2017 Elsevier B.V. All rights reserved.

Provider and Patient Directed Financial Incentives to Improve Care and Outcomes for Patients with Diabetes

Science.gov (United States)

Lorincz, Ilona S.; Lawson, Brittany C. T.

2012-01-01

Incentive programs directed at both providers and patients have become increasingly widespread. Pay-for-performance (P4P) where providers receive financial incentives to carry out specific care or improve clinical outcomes has been widely implemented. The existing literature indicates they probably spur initial gains which then level off or partially revert if incentives are withdrawn. The literature also indicates that process measures are easier to influence through P4P programs but that intermediate outcomes such as glucose, blood pressure, and cholesterol control are harder to influence, and the long term impact of P4P programs on health is largely unknown. Programs directed at patients show greater promise as a means to influence patient behavior and intermediate outcomes such as weight loss; however, the evidence for long term effects are lacking. In combination, both patient and provider incentives are potentially powerful tools but whether they are cost-effective has yet to be determined. PMID:23225214

Making solar laws work: a study of state solar energy incentives

Energy Technology Data Exchange (ETDEWEB)

Roessner, J.D.

1980-11-01

The results of a research investigation of solar financial and research, demonstration, and development (RD and D) incentive programs in 18 states are summarized. The investigation focuses upon implementation - the organization and administrative processes required to convert a law into a viable program. Eleven financial and 12 RD and D programs were investigated. Results indicate that four conditions are common to successful implementation of both types of incentive programs: the opportunity to use solar energy as a heating source; characteristics of the agency selected to complement the law; involvement of outside groups in program implementation; and the specificity of guidance given to those responsible for implementation. Other conditions specific to the implementation of each type of program are discussed as well as the implications of these findings for state and federal policy makers.

Nudge or not: can incentives change health behaviours?

Science.gov (United States)

Ries, Nola M

2012-01-01

The approach of "nudging" people toward healthier behaviours is currently in vogue, and user financial incentives (UFIs) are one possible nudge tool. Interesting debates arise as to the criteria UFIs must meet to qualify as a nudge. The more pressing issue, however, is to determine how UFIs can be structured and implemented to motivate and sustain health behaviour change. To date, Canadian public health strategies to promote physical activity and balanced nutrition focus mainly on information provision, with some product regulation measures and indirect financial incentives. Governments cannot afford direct UFI programs to incent all 60% of overweight and obese Canadians to reduce their body mass, but governments could consider UFIs targeted to specific risk groups where a shorter-term intervention could have long-term payoffs.

77 FR 30377 - Health Insurance Premium Tax Credit

Science.gov (United States)

2012-05-23

... Health Insurance Premium Tax Credit AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Final regulations. SUMMARY: This document contains final regulations relating to the health insurance premium tax... categories of immigrants described in the Children's Health Insurance Program Reauthorization Act. One...

The impact of a proactive chronic care management program on hospital admission rates in a German health insurance society.

Science.gov (United States)

Hamar, Brent; Wells, Aaron; Gandy, William; Haaf, Andreas; Coberley, Carter; Pope, James E; Rula, Elizabeth Y

2010-12-01

Hospital admissions are the source of significant health care expenses, although a large proportion of these admissions can be avoided through proper management of chronic disease. In the present study, we evaluate the impact of a proactive chronic care management program for members of a German insurance society who suffer from chronic disease. Specifically, we tested the impact of nurse-delivered care calls on hospital admission rates. Study participants were insured individuals with coronary artery disease, heart failure, diabetes, or chronic obstructive pulmonary disease who consented to participate in the chronic care management program. Intervention (n  = 17,319) and Comparison (n  = 5668) groups were defined based on records of participating (or not participating) in telephonic interactions. Changes in admission rates were calculated from the year prior to (Base) and year after program commencement. Comparative analyses were adjusted for age, sex, region of residence, and disease severity (stratification of 3 [least severe] to 1 [most severe]). Overall, the admission rate in the Intervention group decreased by 6.2% compared with a 14.9% increase in the Comparison group (P  management care calls can help reduce hospital admissions among German health insurance members with chronic disease.

Country Review of Energy-Efficiency Financial Incentives in the Residential Sector

Energy Technology Data Exchange (ETDEWEB)

Can, Stephane de la Rue du; Shah, Nihar; Phadke, Amol

2011-07-13

A large variety of energy-efficiency policy measures exist. Some are mandatory, some are informative, and some use financial incentives to promote diffusion of efficient equipment. From country to country, financial incentives vary considerably in scope and form, the type of framework used to implement them, and the actors that administer them. They range from rebate programs administered by utilities under an Energy-Efficiency Resource Standards (EERS) regulatory framework (California, USA) to the distribution of Eco-points rewarding customers for buying highly efficient appliances (Japan). All have the primary objective of transforming the current market to accelerate the diffusion of efficient technologies by addressing up-front cost barriers faced by consumers; in most instances, efficient technologies require a greater initial investment than conventional technologies. In this paper, we review the different market transformation measures involving the use of financial incentives in the countries belonging to the Major Economies Forum. We characterize the main types of measures, discuss their mechanisms, and provide information on program impacts to the extent that ex-ante or ex-post evaluations have been conducted. Finally, we identify best practices in financial incentive programs and opportunities for coordination between Major Economies Forum countries as envisioned under the Super Efficient Appliance Deployment (SEAD) initiative.

Stimulating household flood risk mitigation investments through insurance and subsidies: an Agent-Based Modelling approach

Science.gov (United States)

Haer, Toon; Botzen, Wouter; de Moel, Hans; Aerts, Jeroen

2015-04-01

In the period 1998-2009, floods triggered roughly 52 billion euro in insured economic losses making floods the most costly natural hazard in Europe. Climate change and socio/economic trends are expected to further aggrevate floods losses in many regions. Research shows that flood risk can be significantly reduced if households install protective measures, and that the implementation of such measures can be stimulated through flood insurance schemes and subsidies. However, the effectiveness of such incentives to stimulate implementation of loss-reducing measures greatly depends on the decision process of individuals and is hardly studied. In our study, we developed an Agent-Based Model that integrates flood damage models, insurance mechanisms, subsidies, and household behaviour models to assess the effectiveness of different economic tools on stimulating households to invest in loss-reducing measures. Since the effectiveness depends on the decision making process of individuals, the study compares different household decision models ranging from standard economic models, to economic models for decision making under risk, to more complex decision models integrating economic models and risk perceptions, opinion dynamics, and the influence of flood experience. The results show the effectiveness of incentives to stimulate investment in loss-reducing measures for different household behavior types, while assuming climate change scenarios. It shows how complex decision models can better reproduce observed real-world behaviour compared to traditional economic models. Furthermore, since flood events are included in the simulations, the results provide an analysis of the dynamics in insured and uninsured losses for households, the costs of reducing risk by implementing loss-reducing measures, the capacity of the insurance market, and the cost of government subsidies under different scenarios. The model has been applied to the City of Rotterdam in The Netherlands.

Russian Federation Financial Sector Assessment Program : Insurance Core Principles Assessment

OpenAIRE

World Bank; International Monetary Fund

2016-01-01

With about RUB 988bn (USD 26bn) in gross premium written, in 2014, the Russian insurance industry ranked 27th in the world. Non-life insurance premium accounted for 89 percent of GPW while life insurance for only 11 percent. In 2015, the industry also faced with the consequences of the Western economic sanctions which effectively closed access to the high quality Western reinsurance capaci...

Incentive Compatibility

OpenAIRE

Ledyard, John O.

1987-01-01

Incentive compatibility is described and discussed. A summary of the current state of understanding is provided. Key words are: incentive compatibility, game theory, implementation, mechanism, Bayes, Nash, and revelation.

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.

Tax Incentives : Using Tax Incentives to Attract Foreign Direct Investment

OpenAIRE

Morisset, Jacques

2003-01-01

The increasing mobility of international firms and the gradual elimination of barriers to global capital flows have stimulated competition among governments to attract foreign direct investment, often through tax incentives. This note reviews the debate about the effectiveness of tax incentives, examining two much-contested questions: can tax incentives attract foreign investment? And what...

Switching benefits and costs in competitive health insurance markets: A conceptual framework and empirical evidence from the Netherlands.

Science.gov (United States)

Duijmelinck, Daniëlle M I D; Mosca, Ilaria; van de Ven, Wynand P M M

2015-05-01

Competitive health insurance markets will only enhance cost-containment, efficiency, quality, and consumer responsiveness if all consumers feel free to easily switch insurer. Consumers will switch insurer if their perceived switching benefits outweigh their perceived switching costs. We developed a conceptual framework with potential switching benefits and costs in competitive health insurance markets. Moreover, we used a questionnaire among Dutch consumers (1091 respondents) to empirically examine the relevance of the different switching benefits and costs in consumers' decision to (not) switch insurer. Price, insurers' service quality, insurers' contracted provider network, the benefits of supplementary insurance, and welcome gifts are potential switching benefits. Transaction costs, learning costs, 'benefit loss' costs, uncertainty costs, the costs of (not) switching provider, and sunk costs are potential switching costs. In 2013 most Dutch consumers switched insurer because of (1) price and (2) benefits of supplementary insurance. Nearly half of the non-switchers - and particularly unhealthy consumers - mentioned one of the switching costs as their main reason for not switching. Because unhealthy consumers feel not free to easily switch insurer, insurers have reduced incentives to invest in high-quality care for them. Therefore, policymakers should develop strategies to increase consumer choice. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Effectiveness of a Program Using a Vehicle Tracking System, Incentives, and Disincentives to Reduce the Speeding Behavior of Drivers with ADHD

Science.gov (United States)

Markham, Paula T.; Porter, Bryan E.; Ball, J. D.

2013-01-01

Objective: In this article, the authors investigated the effectiveness of a behavior modification program using global positioning system (GPS) vehicle tracking devices with contingency incentives and disincentives to reduce the speeding behavior of drivers with ADHD. Method: Using an AB multiple-baseline design, six participants drove a 5-mile…

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...

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...

Incentive-Based Primary Care: Cost and Utilization Analysis.

Science.gov (United States)

Hollander, Marcus J; Kadlec, Helena

2015-01-01

In its fee-for-service funding model for primary care, British Columbia, Canada, introduced incentive payments to general practitioners as pay for performance for providing enhanced, guidelines-based care to patients with chronic conditions. Evaluation of the program was conducted at the health care system level. To examine the impact of the incentive payments on annual health care costs and hospital utilization patterns in British Columbia. The study used Ministry of Health administrative data for Fiscal Year 2010-2011 for patients with diabetes, congestive heart failure, chronic obstructive pulmonary disease, and/or hypertension. In each disease group, cost and utilization were compared across patients who did, and did not, receive incentive-based care. Health care costs (eg, primary care, hospital) and utilization measures (eg, hospital days, readmissions). After controlling for patients' age, sex, service needs level, and continuity of care (defined as attachment to a general practice), the incentives reduced the net annual health care costs, in Canadian dollars, for patients with hypertension (by approximately Can$308 per patient), chronic obstructive pulmonary disease (by Can$496), and congestive heart failure (by Can$96), but not diabetes (incentives cost about Can$148 more per patient). The incentives were also associated with fewer hospital days, fewer admissions and readmissions, and shorter lengths of hospital stays for all 4 groups. Although the available literature on pay for performance shows mixed results, we showed that the funding model used in British Columbia using incentive payments for primary care might reduce health care costs and hospital utilization.

Do Tax Incentives Affect Business Location? Evidence from State Film Incentives

OpenAIRE

Patrick Button

2015-01-01

I provide the first estimates of the impacts of recently-popular U.S. state film incentives on filming location, establishment location, and employment in the film industry. Filming in this industry is relatively insensitive to locational characteristics, and these incentives are numerous and strong, so this is a good case study to bound the effects of tax incentives on business location. I compile a detailed database of incentives across U.S. states, matching this with TV series and feature ...

HUD Insured Hospitals

Data.gov (United States)

Department of Housing and Urban Development — The Office of Healthcare Programs (OHP), previously known as the Office of Insured Health Care Facilities, is located within the Office of Housing and administers...

State Children's Health Insurance Program. CMS Should Improve Efforts to Assess whether SCHIP is Substituting for Private Insurance: Report to the Chairman, Committee on Finance, U.S. Senate. GAO-09-252

Science.gov (United States)

US Government Accountability Office, 2009

2009-01-01

Congress created the State Children's Health Insurance Program (SCHIP) to reduce the number of uninsured children in low-income families that do not qualify for Medicaid. States have flexibility in structuring their SCHIP programs, and their income eligibility limits vary. Concerns have been raised that individuals might substitute SCHIP for…

Retroactive insurance may fund TMI-2 cleanup

International Nuclear Information System (INIS)

Anon.

1981-01-01

A Pennsylvania task force recommended that nuclear utilities insure their plants with a mandatory national property insurance program. The proposed Nuclear Powerplant Property Damage Insurance Act of 1981 will cover the cleanup costs of onsite damage in excess of $350 million for a single accident ($50 million when private insurance is added on) and a ceiling of two billion dollars. Participation in the insurance pool would be in conjunction with licensing and would permit no grandfathering. Total payout for Three Mile Island-2 would cover 75% of the cleanup costs, the remainder to be apportioned among other parties. The insurance pool will have a $750 million goal supported by utility premiums

Does economic incentive matter for rational use of medicine? China's experience from the essential medicines program.

Science.gov (United States)

Chen, Mingsheng; Wang, Lijie; Chen, Wen; Zhang, Luying; Jiang, Hongli; Mao, Wenhui

2014-03-01

Before the new round of healthcare reform in China, primary healthcare providers could obtain a fixed 15 % or greater mark-up of profits by prescribing and selling medicines. There were concerns that this perverse incentive was a key cause of irrational medicine use. China's new Essential Medicines Program (EMP) was launched in 2009 as part of the national health sector reform initiatives. One of its core policies was to eliminate primary care providers' economic incentives to overprescribe or prescribe unnecessarily expensive drugs, which were regarded as consequences of China's traditional financing system for health institutions. The objective of the study was to measure changes in prescribing patterns in primary healthcare facilities after the removal of the economic incentives for physicians to overprescribe as a result of the implementation of the EMP. A comparison design was applied to 8,258 prescriptions in 2007 and 8,278 prescriptions in 2010, from 83 primary healthcare facilities nationwide. Indicators were adopted to evaluate medicine utilization, which included overall number of medicines, average number of Western and traditional Chinese medicines, pharmaceutical expenditure per outpatient prescription, and proportion of prescriptions that contained two or more antibiotics. We further assessed the use of medicines (antibiotics, infusion, hormones, and intravenous injection) per disease-specific prescription for hypertension, diabetes, coronary artery heart disease, bronchitis, upper respiratory tract infection, and gastritis. A difference-in-difference analysis was employed to evaluate the net policy effect. Overall changes in indicators were not found to be statistically significant between the 2 years. The results varied for different diseases. The number of Western drugs per outpatient prescription decreased while that of traditional Chinese medicines increased. Overuse of antibiotics remained an extensive problem in the treatment of many diseases

24 CFR 213.256 - Premiums; insurance upon completion.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Premiums; insurance upon completion... HOUSING AND URBAN DEVELOPMENT MORTGAGE AND LOAN INSURANCE PROGRAMS UNDER NATIONAL HOUSING ACT AND OTHER AUTHORITIES COOPERATIVE HOUSING MORTGAGE INSURANCE Contract Rights and Obligations-Projects § 213.256 Premiums...

Financial risk protection from social health insurance.

Science.gov (United States)

Barnes, Kayleigh; Mukherji, Arnab; Mullen, Patrick; Sood, Neeraj

2017-09-01

This paper estimates the impact of social health insurance on financial risk by utilizing data from a natural experiment created by the phased roll-out of a social health insurance program for the poor in India. We estimate the distributional impact of insurance on of out-of-pocket costs and incorporate these results with a stylized expected utility model to compute associated welfare effects. We adjust the standard model, accounting for conditions of developing countries by incorporating consumption floors, informal borrowing, and asset selling which allow us to separate the value of financial risk reduction from consumption smoothing and asset protection. Results show that insurance reduces out-of-pocket costs, particularly in higher quantiles of the distribution. We find reductions in the frequency and amount of money borrowed for health reasons. Finally, we find that the value of financial risk reduction outweighs total per household costs of the insurance program by two to five times. Copyright © 2017. Published by Elsevier B.V.

7 CFR 1980.481 - Insured loans.

Science.gov (United States)

2010-01-01

... REGULATIONS (CONTINUED) GENERAL Business and Industrial Loan Program § 1980.481 Insured loans. Applications...) Constructing and equipping industrial plants for lease to private businesses (not including loans for operating... concurrence prior to approval. B. Applications from private parties for insured loans will not be encouraged...

Effects of Pay-As-You-Drive vehicle insurance on young drivers' speed choice : Results of a Dutch field experiment

NARCIS (Netherlands)

Bolderdijk, J.W.; Knockaert, J.; Steg, L.; Verhoef, E.T.

Speeding is an important cause for young drivers' involvement in traffic accidents. A reduction in driving speeds of this group could result in fewer accidents. One way of reducing driving speed is offering explicit financial incentives. In collaboration with five Dutch car insurance companies, we

Creating New Incentives for Risk Identification and Insurance Process for the Electric Utility Industry (initial award through Award Modification 2); Energy & Risk Transfer Assessment (Award Modifications 3 - 6)

Energy Technology Data Exchange (ETDEWEB)

Michael Ebert

2008-02-28

This is the final report for the DOE-NETL grant entitled 'Creating New Incentives for Risk Identification & Insurance Processes for the Electric Utility Industry' and later, 'Energy & Risk Transfer Assessment'. It reflects work done on projects from 15 August 2004 to 29 February 2008. Projects were on a variety of topics, including commercial insurance for electrical utilities, the Electrical Reliability Organization, cost recovery by Gulf State electrical utilities after major hurricanes, and review of state energy emergency plans. This Final Technical Report documents and summarizes all work performed during the award period, which in this case is from 15 August 2004 (date of notification of original award) through 29 February 2008. This report presents this information in a comprehensive, integrated fashion that clearly shows a logical and synergistic research trajectory, and is augmented with findings and conclusions drawn from the research as a whole. Four major research projects were undertaken and completed during the 42 month period of activities conducted and funded by the award; these are: (1) Creating New Incentives for Risk Identification and Insurance Process for the Electric Utility Industry (also referred to as the 'commercial insurance' research). Three major deliverables were produced: a pre-conference white paper, a two-day facilitated stakeholders workshop conducted at George Mason University, and a post-workshop report with findings and recommendations. All deliverables from this work are published on the CIP website at http://cipp.gmu.edu/projects/DoE-NETL-2005.php. (2) The New Electric Reliability Organization (ERO): an examination of critical issues associated with governance, standards development and implementation, and jurisdiction (also referred to as the 'ERO study'). Four major deliverables were produced: a series of preliminary memoranda for the staff of the Office of Electricity Delivery and

Linking mortgage finance incentives to a voluntary home energy rating system: Insight into consensus building

International Nuclear Information System (INIS)

Jenior, M.-M.

1994-01-01

A collaborative consensus process was created to implement a program linking voluntary home energy rating systems (HERS) to mortgage incentives. The participants involved many of the stakeholders or interest groups who have a role in implementing and who will be affected by energy efficiency mortgate incentive programs linked to HERS. The participants included representatives from the primary and secondary mortgage market; real estate, home building, and remodeling industries; utilities; state, local, consumer, and environmental organizations; and home energy rating providers. The participants defined the actions required to implement as well as the technical requirements of a program linking home energy ratings and mortgage finance. Building on the recommendations of the collaborative process, members of the collaborative continue to take initiatives to put a Home Energy Rating Systems Council into place, in planning pilot programs for developing and testing ways to link HERS and mortgage programs, and in making home buyers and owners aware of existing mortgage incentives. At the same time, mortgage providers are working to develop uniformity among mortgage incentive programs and with the US Department of Energy to develop procedures to verify the relative accuracy of HERS calculation tools and their application, and with the emerging HERS Council to develop the guidelines for voluntary HERS required under the Energy Policy Act of 1992

The impact of an m-Health financial incentives program on the physical activity and diet of Australian truck drivers.

Science.gov (United States)

Gilson, Nicholas D; Pavey, Toby G; Wright, Olivia Rl; Vandelanotte, Corneel; Duncan, Mitch J; Gomersall, Sjaan; Trost, Stewart G; Brown, Wendy J

2017-05-18

Chronic diseases are high in truck drivers and have been linked to work routines that promote inactivity and poor diets. This feasibility study examined the extent to which an m-Health financial incentives program facilitated physical activity and healthy dietary choices in Australian truck drivers. Nineteen men (mean [SD] age = 47.5 [9.8] years; BMI = 31.2 [4.6] kg/m 2 ) completed the 20-week program, and used an activity tracker and smartphone application (Jawbone UP™) to regulate small positive changes in occupational physical activity, and fruit, vegetable, saturated fat and processed/refined sugar food/beverage choices. Measures (baseline, end-program, 2-months follow-up; April-December 2014) were accelerometer-determined proportions of work time spent physically active, and a workday dietary questionnaire. Statistical (repeated measures ANOVA) and thematic (interviews) analyses assessed program impact. Non-significant increases in the mean proportions of work time spent physically active were found at end-program and follow-up (+1%; 7 mins/day). Fruit (p = 0.023) and vegetable (p = 0.024) consumption significantly increased by one serve/day at end-program. Non-significant improvements in saturated fat (5%) and processed/refined sugar (1%) food/beverage choices were found at end-program and follow-up. Overall, 65% (n = 11) of drivers demonstrated positive changes in physical activity, and at least one dietary choice (e.g. saturated fat) at follow-up. Drivers found the financial incentives component of the program to be a less effective facilitator of change than the activity tracker and smartphone application, although this technology was easier to use for monitoring of physical activity than healthy dietary choices. Not all drivers benefitted from the program. However, positive changes for different health behaviours were observed in the majority of participants. Outcomes from this feasibility study inform future intervention development for

The impact of an m-Health financial incentives program on the physical activity and diet of Australian truck drivers

Directory of Open Access Journals (Sweden)

Nicholas D. Gilson

2017-05-01

Full Text Available Abstract Background Chronic diseases are high in truck drivers and have been linked to work routines that promote inactivity and poor diets. This feasibility study examined the extent to which an m-Health financial incentives program facilitated physical activity and healthy dietary choices in Australian truck drivers. Methods Nineteen men (mean [SD] age = 47.5 [9.8] years; BMI = 31.2 [4.6] kg/m2 completed the 20-week program, and used an activity tracker and smartphone application (Jawbone UP™ to regulate small positive changes in occupational physical activity, and fruit, vegetable, saturated fat and processed/refined sugar food/beverage choices. Measures (baseline, end-program, 2-months follow-up; April–December 2014 were accelerometer-determined proportions of work time spent physically active, and a workday dietary questionnaire. Statistical (repeated measures ANOVA and thematic (interviews analyses assessed program impact. Results Non-significant increases in the mean proportions of work time spent physically active were found at end-program and follow-up (+1%; 7 mins/day. Fruit (p = 0.023 and vegetable (p = 0.024 consumption significantly increased by one serve/day at end-program. Non-significant improvements in saturated fat (5% and processed/refined sugar (1% food/beverage choices were found at end-program and follow-up. Overall, 65% (n = 11 of drivers demonstrated positive changes in physical activity, and at least one dietary choice (e.g. saturated fat at follow-up. Drivers found the financial incentives component of the program to be a less effective facilitator of change than the activity tracker and smartphone application, although this technology was easier to use for monitoring of physical activity than healthy dietary choices. Conclusions Not all drivers benefitted from the program. However, positive changes for different health behaviours were observed in the majority of participants. Outcomes from this

Voluntary Public Unemployment Insurance

DEFF Research Database (Denmark)

O. Parsons, Donald; Tranæs, Torben; Bie Lilleør, Helene

Denmark has drawn much attention for its active labor market policies, but is almost unique in offering a voluntary public unemployment insurance program requiring a significant premium payment. A safety net program – a less generous, means-tested social assistance plan – completes the system...

The effects of exercise program on burnout and metabolic syndrome components in banking and insurance workers.

Science.gov (United States)

Tsai, Han Hui; Yeh, Ching Ying; Su, Chien Tien; Chen, Chiou Jong; Peng, Shu Mei; Chen, Ruey Yu

2013-01-01

To explore the effectiveness of exercise program for banking and insurance workers and clarify the association between exercise, burnout, and metabolic syndrome components. In the process of the study, a practicable worksite exercise program was developed for bank and insurance enterprises. A three-month (12-wk) exercise course was conducted, and its benefits evaluated. Levels of burnout and metabolic syndrome components were analyzed after exercise intervention. After intervention, the indicators of burnout and metabolic syndrome components were significantly improved in both low and high intensity groups, and the improvement were expressed in reduction of waist circumference, systolic blood pressure, person burnout and work-related burnout. A dose-response of burnouts and metabolic syndrome components with exercise intensity are shown (psyndrome components were independently associated with burnout and exercise intensity in the crude model. After adjustment for potential confounders, waist circumference and systolic blood pressure differences showed significant associations with exercise intensity (pburnouts and metabolic syndrome components.

Consumer-choice health plan (first of two parts). Inflation and inequity in health care today: alternatives for cost control and an analysis of proposals for national health insurance.

Science.gov (United States)

Enthoven, A C

1978-03-23

The financing system for medical costs in this country suffers from severe inflation and inequity. The tax-supported system of fee for service for doctors, third-party intermediaries and cost reimbursement for hospitals produces inflation by rewarding cost-increasing behavior and failing to provide incentives for economy. The system is inequitable because the government pays more on behalf of those who choose more costly systems of care, because tax benefits subsidize the health insurance of the well-to-do, while not helping many low-income people, and because employment health insurance does not guarantee continuity of coverage and is regressive in its financing. Analysis of previous proposals for national health insurance shows none to be capable of solving most of these problems. Direct economic regulation by government will not improve the situation. Cost controls through incentives and regulated competition in the private sector are most likely to be effective.

The Effects of Incentives in Acquisition Competition on Program Outcomes

Science.gov (United States)

2012-06-01

organizational, management, and cultural issues (Madachy, EFFECTS OF INCENTIVES IN ACQUISITION COMPETITION 5 2008, Frangos , 1998). In the SEI’s direct...change from the task force on defense acquisition law and oversight Forrester, J. W. (1971). Principles of systems. Pegasus Communications. Frangos , S

Sugar daddy. Most Americans know Medicare as the health insurance program for the elderly, but to providers, it's a jobs program, a capital financier and a safety net.

Science.gov (United States)

Hallam, K; Gardner, J

1999-11-08

Most Americans know Medicare as the health insurance program that covers the elderly. But to providers it's much more that. The program pays for medical education, finances capital projects and subsidizes care for the indigent. Should Medicare continue making those add-on payments? Is that the program's mission? The debate is intensifying.

Financial incentives for DSM [demand-side management]: Theory and practice

International Nuclear Information System (INIS)

Reid, M.W.

1990-01-01

Recent efforts to provide incentives for electric utilities in the USA to undertake demand-side management (DSM) programs are reviewed. The major need for incentives is seen as the overcoming of disincentives inherent in traditional regulation that affect utilities' interest in, and motivation for, DSM programs. These disincentives include the failure to recover all program costs, loss of revenues, and loss of financial opportunity. In addition, utilities seldom perceive DSM as a low-risk proposition; principal areas of concern include regulatory risk, competitive risk, and balance sheet risk. In view of these disincentives and risks, any DSM program therefore should provide for full and timely recovery of all program costs; adjust for DSM-induced revenue losses; and counterbalance risk and loss of financial opportunity by providing a bonus above cost. Three utility-specific incentive proposals are presented for the case of utilities in New York, Massachusetts, and Pennsylvania. Each of these programs meets the goal of overcoming the disincentives that surround utility DSM programs. The most significant differences across the mechanisms are found in the bonus component. Mechanisms that reduce the utility's uncertainty about the receipt of a bonus by providing it in a lump sum will likely prove more powerful motivators than those that spread the bonus out over a period of years. Use of preapproved per-unit or per-customer impact measurements reduces uncertainty and thus increases the apparent value of the bonus. Annual review of program plans and assumed impacts, supported by continuing evaluation activities, minimizes the risk that the utilities will gamble with the system or receive excessive awards. 6 refs

Incentives, Teachers, and Gender at Work

Science.gov (United States)

Robert, Sarah A.

2013-01-01

Incentive pay programs have become panacea for a multitude of educational challenges. When aimed at teachers the assumption is that rewards entice them to work in particular ways or particular schools. However, the assumption is based on an economic formula that does not take into consideration the gendered nature of policy processes. This study…

42 CFR 457.80 - Current State child health insurance coverage and coordination.

Science.gov (United States)

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Current State child health insurance coverage and... HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES Introduction; State Plans for Child Health Insurance Programs and Outreach Strategies...

Small sustainable monetary incentives versus charitable donations to promote exercise: Rationale, design, and baseline data from a randomized pilot study.

Science.gov (United States)

Williams, David M; Lee, Harold H; Connell, Lauren; Boyle, Holly; Emerson, Jessica; Strohacker, Kelley; Galárraga, Omar

2018-03-01

Regular physical activity (PA) enhances weight-loss and reduces risk of chronic disease. However, as few as 10% of U.S. adults engage in regular PA. Incentive programs to promote PA have shown some promise, but have typically used incentives that are too large to sustain over time and have not demonstrated habit formation or been tested in community settings. This report presents the rationale and design of a randomized pilot study testing the feasibility and preliminary efficacy of small monetary incentives for PA (n=25) versus charitable donations in the same amount (n=25) versus control (n=25) over 12months among 75 low-active but otherwise healthy adults at a local YMCA. Incentives are based on YMCA attendance, which is verified by electronic swipe card data and is the primary study outcome, with self-reported minutes/week of PA assessed as a secondary outcome. Incentives are intentionally small enough-$1/session, maximum of $5/week-such that they could be indefinitely sustained by community organizations, privately-owned health clubs, healthcare organizations, or employers (e.g., employer fitness facilities). Costs of the incentive program for the sponsoring organization may be partially offset by increases in membership resulting from the appeal of the program. Moreover, if efficacious, the charitable donation incentive program may have the added benefit of building social capital for the sponsoring organization and potentially serving as a tax write-off, thus further offsetting the cost of the incentives. Findings will also have implications for the use of financially sustainable community-based incentive programs for other health-related behaviors (e.g., weight loss, smoking). Copyright © 2018 Elsevier Inc. All rights reserved.

Moral Hazard: How The National Flood Insurance Program Is Limiting Risk Reduction

Science.gov (United States)

2016-12-01

Improvements,” YouTube video, posted by Gary Taylor, October 15, 2014, https://www.youtube.com/watch?v=Wt3lMwCRhd0&list=PLADFiMUo5Nk7 ajNQxa8N5s9G1IJ4gRrsZ...disaster assistance. A review of our history shows that federal intervention in disaster recovery before the Great Depression was essentially non...Service, 2011), https://www.fas.org/sgp/crs/misc/R40650.pdf, Summary. 84 Patricia Griggs, “The National Flood Insurance Program,” YouTube video

State tax incentives for persons giving informal care to the elderly

Science.gov (United States)

Hendrickson, Michael C.

1988-01-01

Programs for informal caregivers of frail elderly can be adopted by States to address some of the problems associated with an expanding and costly long-term care system. In this article, highlights are given from a 3-year study of Idaho and Arizona tax incentive programs. Characteristics of informal caregivers and elderly participants are described, and elderly participants are compared with elderly nonparticipants and with the general elderly population. Tax incentives were positively related to the level of service and financial support provided by informal caregivers. Data were inadequate to determine whether the induced informal help substituted for public expenditures. PMID:10312965

State tax incentives for person giving informal care of the elderly.

Science.gov (United States)

Hendrickson, M C

1988-12-01

Programs for informal caregivers of frail elderly can be adopted by States to address some of the problems associated with an expanding and costly long-term care system. In this article, highlights are given from a 3-year study of Idaho and Arizona tax incentive programs. Characteristics of informal caregivers and elderly participants are described, and elderly participants are compared with elderly nonparticipants and with the general elderly population. Tax incentives were positively related to the level of service and financial support provided by informal caregivers. Data were inadequate to determine whether the induced informal help substituted for public expenditures.

77 FR 31814 - National Flood Insurance Program (NFIP); Insurance Coverage and Rates

Science.gov (United States)

2012-05-30

... trade-off: Participating local governments would adopt and enforce flood mitigation standards that make... needed for flood mitigation efforts. This information is reflected in a community's Flood Insurance Rate... mitigation funding authorized by FEMA. Under the proposed rule, if the owner of a target repetitive flood...

Public Incentives for Hiring and Training Employees: An Employer's Guide. Workforce Brief #8.

Science.gov (United States)

Bergman, Terri

The six sections of this brief provide the following information: (1) the types of public incentives available to employers for hiring and training of employees, including increasing economic activity and increasing labor market supply; (2) federally operated incentive programs (Welfare-to-Work Tax Credit, Work Opportunity Tax Credit, Employee…

The case and opportunity for public-supported financial incentives to implement integrated pest management.

Science.gov (United States)

Brewer, Michael J; Hoard, Robert J; Landis, Joy N; Elworth, Lawrence E

2004-12-01

Food, water, and worker protection regulations have driven availability, and loss, of pesticides for use in pest management programs. In response, public-supported research and extension projects have targeted investigation and demonstration of reduced-risk integrated pest management (IPM) techniques. But these new techniques often result in higher financial burden to the grower, which is counter to the IPM principle that economic competitiveness is critical to have IPM adopted. As authorized by the 2002 Farm Bill and administered by the U.S. Department of Agriculture (USDA) Natural Resources Conservation Service (NRCS), conservation programs exist for delivering public-supported financial incentives to growers to increase environmental stewardship on lands in production. NRCS conservation programs are described, and the case for providing financial incentives to growers for implementing IPM is presented. We also explored the opportunity and challenge to use one key program, the Environmental Quality Incentives Program (EQIP), to aid grower adoption of IPM. The EQIP fund distribution to growers from 1997 to 2002 during the last Farm Bill cycle totaled approximately 1.05 billion dollars with a portion of funds supporting an NRCS-designed pest management practice. The average percentage of allocation of EQIP funds to this pest management practice among states was 0.77 +/- 0.009% (mean +/- SD). Using Michigan as an example, vegetable and fruit grower recognition of the program's use to implement IPM was modest (25% of growers surveyed), and their recognition of its use in aiding implementation of IPM was improved after educational efforts (74%). Proposals designed to enhance program usefulness in implementing IPM were delivered through the NRCS advisory process in Michigan. Modifications for using the NRCS pest management practice to address resource concerns were adopted, incentive rates for pest management were adjusted, and an expanded incentive structure for IPM

Public and private health insurance premiums: how do they affect the health insurance status of low-income childless adults?

Science.gov (United States)

Guy, Gery P; Adams, E Kathleen; Atherly, Adam

2012-01-01

The Patient Protection and Affordable Care Act (ACA) will substantially increase public health insurance eligibility and alter the costs of insurance coverage. Using Current Population Survey (CPS) data from the period 2000-2008, we examine the effects of public and private health insurance premiums on the insurance status of low-income childless adults, a population substantially affected by the ACA. Results show higher public premiums to be associated with a decrease in the probability of having public insurance and an increase in the probability of being uninsured, while increased private premiums decrease the probability of having private insurance. Eligibility for premium assistance programs and increased subsidy levels are associated with lower rates of uninsurance. The magnitudes of the effects are quite modest and provide important implications for insurance expansions for childless adults under the ACA.

Health Insurance and Risk of Divorce: Does Having Your Own Insurance Matter?

Science.gov (United States)

Sohn, Heeju

2016-01-01

Most American adults under 65 obtain health insurance through their employers or their spouses’ employers. The absence of a universal healthcare system in the United States puts Americans at considerable risk for losing their coverage when transitioning out of jobs or marriages. Scholars have found evidence of reduced job mobility among individuals who are dependent on their employers for healthcare coverage. This paper finds similar relationships between insurance and divorce. I apply the hazard model to married individuals in the longitudinal Survey of Income Program Participation (N=17,388) and find lower divorce rates among people who are insured through their partners’ plans without alternative sources of their own. Furthermore, I find gender differences in the relationship between healthcare coverage and divorce rates: insurance dependent women have lower rates of divorce than men in similar situations. These findings draw attention to the importance of considering family processes when debating and evaluating health policies. PMID:26949269

Patient attitudes about financial incentives for diabetes self-management: A survey.

Science.gov (United States)

Blondon, Katherine S

2015-06-10

To study the acceptability of incentives for behavior changes in individuals with diabetes, comparing financial incentives to self-rewards and non-financial incentives. A national online survey of United States adults with diabetes was conducted in March 2013 (n = 153). This survey was designed for this study, with iterative testing and modifications in a pilot population. We measured the demographics of individuals, their interest in incentives, as well as the perceived challenge of diabetes self-management tasks, and expectations of incentives to improve diabetes self-management (financial, non-financial and self-rewards). Using an ordered logistic regression model, we assessed the association between a 32-point score of the perceived challenge of the self-management tasks and the three types of rewards. Ninety-six percent of individuals were interested in financial incentives, 60% in non-financial incentives and 72% in self-rewards. Patients were less likely to use financial incentives when they perceived the behavior to be more challenging (odds ratio of using financial incentives of 0.82 (95%CI: 0.72-0.93) for each point of the behavior score). While the effectiveness of incentives may vary according to the perceived level of challenge of each behavior, participants did not expect to need large amounts to motivate them to modify their behavior. The expected average amounts needed to motivate a 5 lb weight loss in our population and to maintain this weight change for a year was $258 (interquartile range of $10-100) and $713 (interquartile range of $25-250) for a 15 lb weight loss. The difference in mean amount estimates for 5 lb and 15 lb weight loss was significant (P < 0.001). Individuals with diabetes are willing to consider financial incentives to improve diabetes self-management. Future studies are needed to explore incentive programs and their effectiveness for diabetes.

78 FR 44580 - Mortgage and Loan Insurance Programs Under the National Housing Act-Debenture Interest Rates

Science.gov (United States)

2013-07-24

... Programs Under the National Housing Act--Debenture Interest Rates AGENCY: Office of the Assistant Secretary... in the interest rates to be paid on debentures issued with respect to a loan or mortgage insured by... interest rate for debentures issued under section 221(g)(4) of the Act during the 6-month period beginning...

75 FR 41510 - Mortgage and Loan Insurance Programs Under the National Housing Act-Debenture Interest Rates

Science.gov (United States)

2010-07-16

... Programs Under the National Housing Act--Debenture Interest Rates AGENCY: Office of the Assistant Secretary... in the interest rates to be paid on debentures issued with respect to a loan or mortgage insured by...). The interest rate for debentures issued under section 221(g)(4) of the Act during the 6-month period...

78 FR 4427 - Mortgage and Loan Insurance Programs Under the National Housing Act-Debenture Interest Rates

Science.gov (United States)

2013-01-22

... Programs Under the National Housing Act--Debenture Interest Rates AGENCY: Office of the Assistant Secretary... in the interest rates to be paid on debentures issued with respect to a loan or mortgage insured by... interest rate for debentures issued under section 221(g)(4) of the Act during the 6-month period beginning...

75 FR 5339 - Mortgage and Loan Insurance Programs Under the National Housing Act-Debenture Interest Rates

Science.gov (United States)

2010-02-02

... Programs Under the National Housing Act--Debenture Interest Rates AGENCY: Office of the Assistant Secretary... in the interest rates to be paid on debentures issued with respect to a loan or mortgage insured by... interest rate for debentures issued under section 221(g)(4) of the Act during the 6-month period beginning...

77 FR 4359 - Mortgage and Loan Insurance Programs Under the National Housing Act-Debenture Interest Rates

Science.gov (United States)

2012-01-27

... Programs Under the National Housing Act--Debenture Interest Rates AGENCY: Office of the Assistant Secretary... in the interest rates to be paid on debentures issued with respect to a loan or mortgage insured by...). The interest rate for debentures issued under section 221(g)(4) of the Act during the 6-month period...

76 FR 4127 - Mortgage and Loan Insurance Programs Under the National Housing Act-Debenture Interest Rates

Science.gov (United States)

2011-01-24

... Programs Under the National Housing Act--Debenture Interest Rates AGENCY: Office of the Assistant Secretary... in the interest rates to be paid on debentures issued with respect to a loan or mortgage insured by... interest rate for debentures issued under section 221(g)(4) of the Act during the 6-month period beginning...

76 FR 47225 - Mortgage and Loan Insurance Programs Under the National Housing Act-Debenture Interest Rates

Science.gov (United States)

2011-08-04

... Programs Under the National Housing Act--Debenture Interest Rates AGENCY: Office of the Assistant Secretary... in the interest rates to be paid on debentures issued with respect to a loan or mortgage insured by... interest rate for debentures issued under section 221(g)(4) of the Act during the 6-month period beginning...

77 FR 42754 - Mortgage and Loan Insurance Programs Under the National Housing Act-Debenture Interest Rates

Science.gov (United States)

2012-07-20

... Programs Under the National Housing Act--Debenture Interest Rates AGENCY: Office of the Assistant Secretary... in the interest rates to be paid on debentures issued with respect to a loan or mortgage insured by... interest rate for debentures issued under section 221(g)(4) of the Act during the 6-month period beginning...

Managing Transit Ridership with Short-Term Economic Incentives

Science.gov (United States)

1982-08-01

It is the purpose of this booklet to give the reader an overview of the variety, : type, and nature of short-term economic incentive programs that have been : introduced by transit properties over the past few years. 3054k, 55p.

The United States nuclear insurance program: an update of recent developments and trends

International Nuclear Information System (INIS)

Cummings, L.G.

1978-01-01

There are numerous developments concerning nuclear insurance in the United States at present. The debate on the constitutionality of the Price-Anderson Act questions the principle of the limitation of the operators liability. The insurance market is undergoing changes with the reorganisation of the four main pools, NELIA (Nuclear Energy Liability Insurance Association), NEPIA (Nuclear Energy Property Insurance Association), MAELU (Mutual Atomic Energy Liability Underwriters), MAERP (Mutual Atomic Energy Reinsurance Pool). Insurance premiums for damage have been revised on several occasions following industrial demand and the development of the insurance market capacity. (NEA) [fr

Incentives, health promotion and equality.

Science.gov (United States)

Voigt, Kristin

2012-07-01

The use of incentives to encourage individuals to adopt 'healthier' behaviours is an increasingly popular instrument in health policy. Much of the literature has been critical of 'negative' incentives, often due to concerns about equality; 'positive' incentives, however, have largely been welcomed as an instrument for the improvement of population health and possibly the reduction of health inequalities. The aim of this paper is to provide a more systematic assessment of the use of incentives from the perspective of equality. The paper begins with an overview of existing and proposed incentive schemes. I then suggest that the distinction between 'positive' and 'negative' incentives - or 'carrots' and 'sticks' - is of limited use in distinguishing those incentive schemes that raise concerns of equality from those that do not. The paper assesses incentive schemes with respect to two important considerations of equality: equality of access and equality of outcomes. While our assessment of incentive schemes will, ultimately, depend on various empirical facts, the paper aims to advance the debate by identifying some of the empirical questions we need to ask. The paper concludes by considering a number of trade-offs and caveats relevant to the assessment of incentive schemes.

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

Reducing the Impact of R.I.F.--An Incentive Program.

Science.gov (United States)

Brooks, Carl

A northern Illinois school district (School District 300), forced by budget cuts to curtail its teaching staff, used incentives and the decisionmaking methods of William Ouchi's Theory Z to reduce layoffs. The superintendent and the teachers' union leadership established a Transfer Council of six administrators and nine teachers to plan staff…

American nuclear insurers

International Nuclear Information System (INIS)

Oliveira, R.A.

1988-01-01

Nuclear liability insurance covers liability for damages directly caused by the nuclear energy hazard. This coverage includes offsite bodily injury and property damage sustained by members of the general public, and bodily injury to onsite third party personnel. Recent nuclear liability claims allege bodily injury and property damage resulting from releases or radioactive materials to the environmental and occupational radiation worker exposures. Routine reactor operations involving radioactive waste have the potential to result in such claims. The nuclear insurance Pools believe that one way such claims can be minimized is through the implementation of an effective radioactive waste management program

Incentive policies for promoting wind power production in Brazil: Scenarios for the Alternative Energy Sources Incentive Program (PROINFA) under the New Brazilian electric power sector regulation

International Nuclear Information System (INIS)

Dutra, Ricardo Marques; Szklo, Alexandre Salem

2008-01-01

The Alternative Energy Sources Incentive Program (PROINFA) was designed in 2002 to stimulate the electricity generation from three energy sources (wind, biomass and small-scale hydro) in Brazil. The Program was divided into two phases. The first one uses feed-in tariffs for promoting the development of 3300 MW. The second one that was originally based on feed-in tariffs was modified in 2003, in order to be based on biddings for renewables. These biddings are capped to limit their impact on the final electricity tariff. Due to this bound, the highest-cost power option promoted by PROINFA (wind power generation) might have development problems. Simulating different scenarios for the biddings, it was verified that the only way to reach the original goal set by PROINFA (10% of the annual electricity consumption provided by alternative sources up to 2020) and, simultaneously, not overcome the bidding bound is to promote biomass-fired power generation alone, during the Program's second phase. However, this action contradicts one of the targets of the Program, which is to diversify the energy matrix. An alternative option could be biddings for renewables according to specific criteria (complementarities, industrial and technological development and cost), based not only on their cost-effectiveness. (author)

Association Between Type of Health Insurance and Elective Cesarean Deliveries: New Jersey, 2004–2007