Pharmaceutical policies: effects of cap and co-payment on rational use of medicines.

Science.gov (United States)

Luiza, Vera Lucia; Chaves, Luisa A; Silva, Rondineli M; Emmerick, Isabel Cristina M; Chaves, Gabriela C; Fonseca de Araújo, Silvia Cristina; Moraes, Elaine L; Oxman, Andrew D

2015-05-08

Growing expenditures on prescription medicines represent a major challenge to many health systems. Cap and co-payment policies are intended as an incentive to deter unnecessary or marginal utilisation, and to reduce third-party payer expenditures by shifting parts of the financial burden from insurers to patients, thus increasing their financial responsibility for prescription medicines. Direct patient payment policies include caps (maximum numbers of prescriptions or medicines that are reimbursed), fixed co-payments (patients pay a fixed amount per prescription or medicine), co-insurance (patients pay a percentage of the price), ceilings (patients pay the full price or part of the cost up to a ceiling, after which medicines are free or are available at reduced cost) and tier co-payments (differential co-payments usually assigned to generic and brand medicines). This is the first update of the original review. To determine the effects of cap and co-payment (cost-sharing) policies on use of medicines, healthcare utilisation, health outcomes and costs (expenditures). For this update, we searched the following databases and websites: The Cochrane Central Register of Controlled Trials (CENTRAL) (including the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register, Cochrane Library; MEDLINE, Ovid; EMBASE, Ovid; IPSA, EBSCO; EconLit, ProQuest; Worldwide Political Science Abstracts, ProQuest; PAIS International, ProQuest; INRUD Bibliography; WHOLIS, WHO; LILACS), VHL; Global Health Library WHO; PubMed, NHL; SCOPUS; SciELO, BIREME; OpenGrey; JOLIS Library Network; OECD Library; World Bank e-Library; World Health Organization, WHO; World Bank Documents & Reports; International Clinical Trials Registry Platform (ICTRP), WHO; ClinicalTrials.gov, NIH. We searched all databases during January and February 2013, apart from SciELO, which we searched in January 2012, and ICTRP and ClinicalTrials.gov, which we searched in March 2014. We defined

Policy harmonized approach for the EU agricultural sector modelling

Directory of Open Access Journals (Sweden)

G. SALPUTRA

2008-12-01

Full Text Available Policy harmonized (PH approach allows for the quantitative assessment of the impact of various elements of EU CAP direct support schemes, where the production effects of direct payments are accounted through reaction prices formed by producer price and policy price add-ons. Using the AGMEMOD model the impacts of two possible EU agricultural policy scenarios upon beef production have been analysed – full decoupling with a switch from historical to regional Single Payment scheme or alternatively with re-distribution of country direct payment envelopes via introduction of EU-wide flat area payment. The PH approach, by systematizing and harmonizing the management and use of policy data, ensures that projected differential policy impacts arising from changes in common EU policies reflect the likely actual differential impact as opposed to differences in how “common” policies are implemented within analytical models. In the second section of the paper the AGMEMOD model’s structure is explained. The policy harmonized evaluation method is presented in the third section. Results from an application of the PH approach are presented and discussed in the paper’s penultimate section, while section 5 concludes.;

Payment for Environmental Services: mobilising an epistemic community to construct dominant policy

NARCIS (Netherlands)

Rodriguez de Francisco, J.C.; Boelens, R.A.

2015-01-01

The alleged capacity of Payment for Environmental Services (PES) to reach conservation policy goals, while reducing poverty in a cost-effective manner, makes it an extremely attractive development instrument for policymakers and international funding agencies. This article reconstructs the process

24 CFR Appendix A to Part 4001 - Calculation of Upfront Payment or Future Appreciation Payment

Science.gov (United States)

2010-04-01

... depend on actual appreciation of the property as determined in accordance with 24 CFR 4001.120. Payment... Future Appreciation Payment A Appendix A to Part 4001 Housing and Urban Development Regulations Relating... Future Appreciation Payment Subordinate mortgage lien holder's cumulative combined loan-to-value ratio...

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...

Legal policy justification for the crime of non-covered use of payment cards

Directory of Open Access Journals (Sweden)

Vuković Igor

2014-01-01

Full Text Available In this paper the authors discuss the legal policy reasons for the crime of non-covered use of payments cards (Criminal Code, Art. 228(1. In the first part of the paper the ratio legis of this crime is explained. It is concluded that the non-covered use of payment cards deserves to be criminally sanctioned only when, based of the card's use, the card issuer becomes personally liable for payment to the third party not privy to the contract between the issuer and the card-holder. Conversely, criminal proscribing is not justified when debit cards are used at the point-of-sale or the ATM of another bank, since here the issuer authorizes the payment transaction and thereby participates in assuming his own obligation to pay to the third party. The second part of the paper contains critical analysis of the proscribed non-covered use of payment cards in the Serbian Criminal Code. In this respect the authors show the lack of clarity and certain discrepancies with the explained ratio legis of such a crime. Based on the comprehensive analysis of the issues regarding the justification of criminal proscribing in this field, in the last part of the paper the authors suggest possible solutions de lege ferenda.

Balance of Payments of East Asian Countries: Impact of the Coordinated Monetary Policy

Directory of Open Access Journals (Sweden)

Yana Valeryevna Dyomina

2014-03-01

Full Text Available The paper examines the equilibrium state of balance of payments of East Asian countries by means of the monetary policy instruments. For this purpose the author determines the value of the equilibrium exchange rate of AMU (Asian Monetary Unit against the U.S. dollar. The equilibrium exchange rate is the one that smoothes values of net merchandise exports and net capital exports. The author employs panel data regression analysis (using statistics of trade and capital (foreign direct investment flows between East Asian countries and the United States to obtain quantitative estimation of trade and investment effects of the coordinated monetary policy. The paper shows that transition of East Asian region (China, Japan, Republic of Korea, Indonesia, Malaysia, Vietnam, the Philippines and Thailand to the single currency (AMU will have a negative effect on the balance of payments of the studied countries: this will increase the mismatch between commodity and capital flows

20 CFR 627.430 - Grant payments.

Science.gov (United States)

2010-04-01

... after receipt of a proper request for reimbursement. (e) Working capital advance payments. If a... working capital, the awarding agency may provide cash on a working capital advance payment basis. Under... reimburse the subrecipient for its actual cash disbursements. The working capital advance method of payment...

Central bank policy under significant balance-of-payment shocks and structural shifts

Directory of Open Access Journals (Sweden)

Andrey Sinyakov

2016-09-01

Full Text Available In this paper, we analyze a number of monetary and FX policy alternatives using the model of a small open oil-exporting economy hit by severe balance-of-payment shocks, such as those that simultaneously affected the Russian economy in 2014–2015. For our purposes, we modify Romer's (2013 IS-MP general equilibrium model by adding a structure similar to the Russian economy (tradables and oil vs. non-tradables. In the model, we consider an optimal policy mix that includes a floating exchange rate, FX liquidity provision by a central bank and temporary tightening of monetary policy. The flexible exchange rate works as a shock absorber, helping restore aggregate demand and domestic production. If inflation expectations are not anchored, contractionary monetary policy helps to stabilize them. Financial stability risks are addressed by lending FX liquidity to the banking sector.

Perceived impact of the Medicare policy to adjust payment for health care-associated infections

Science.gov (United States)

Lee, Grace M.; Hartmann, Christine W.; Graham, Denise; Kassler, William; Linn, Maya Dutta; Krein, Sarah; Saint, Sanjay; Goldmann, Donald A.; Fridkin, Scott; Horan, Teresa; Jernigan, John; Jha, Ashish

2014-01-01

Background In 2008, the Centers for Medicare and Medicaid Services (CMS) ceased additional payment for hospitalizations resulting in complications deemed preventable, including several health care-associated infections. We sought to understand the impact of the CMS payment policy on infection prevention efforts. Methods A national survey of infection preventionists from a random sample of US hospitals was conducted in December 2010. Results Eighty-one percent reported increased attention to HAIs targeted by the CMS policy, whereas one-third reported spending less time on nontargeted HAIs. Only 15% reported increased funding for infection control as a result of the CMS policy, whereas most reported stable (77%) funding. Respondents reported faster removal of urinary (71%) and central venous (50%) catheters as a result of the CMS policy, whereas routine urine and blood cultures on admission occurred infrequently (27% and 13%, respectively). Resource shifting (ie, less time spent on nontargeted HAIs) occurred more commonly in large hospitals (odds ratio, 2.3; 95% confidence interval: 1.0–5.1; P = .038) but less often in hospitals where front-line staff were receptive to changes in clinical processes (odds ratio, 0.5; 95% confidence interval: 0.3–0.8; P = .005). Conclusion Infection preventionists reported greater hospital attention to preventing targeted HAIs as a result of the CMS nonpayment policy. Whether the increased focus and greater engagement in HAI prevention practices has led to better patient outcomes is unclear. PMID:22541855

20 CFR 437.21 - Payment.

Science.gov (United States)

2010-04-01

...) Working capital advances. If a grantee cannot meet the criteria for advance payments described in... lacks sufficient working capital, SSA may provide cash or a working capital advance basis. Under this... its actual cash disbursements. The working capital advance method of payment may not be used by...

Line-of-Credit Payment Scheme and Its Impact on the Retailer’s Ordering Policy with Inventory-Level-Dependent Demand

Directory of Open Access Journals (Sweden)

Tao Jia

2016-01-01

Full Text Available Practically, the supplier frequently offers the retailer credit period to stimulate his/her ordering quantity. However, such credit-period-only policy may lead to the dilemma that the supplier’s account receivable increases with sale volume during delay period, especially for the item with inventory-level-dependent demand. Thus, a line-of-credit (LOC payment scheme is usually adopted by the supplier for better controlling account receivables. In this paper, the two-parameter LOC clause is firstly applied to develop an economic order quantity (EOQ model with inventory-level-dependent demand, aiming to explore its influences on the retailer’s ordering policy. Under this new policy, the retailer will be granted full delay payment if his/her order quantity is below a predetermined quantity. Otherwise, the retailer should make immediate payment for the excess part. After analyzing the relationships among parameters, two distinct cases and several theoretical results can be derived. From numerical examples, two incentives, a longer credit period and a lower rate of the retailer’s capital opportunity cost, should account for the retailer’s excessive ordering policy. And a well-designed LOC clause can be applied to induce the retailer to place an appropriate ordering quantity and ensure the supplier maintains a reasonable account receivable.

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

Science.gov (United States)

2013-08-19

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

Medicare Program; Cancellation of Advancing Care Coordination Through Episode Payment and Cardiac Rehabilitation Incentive Payment Models; Changes to Comprehensive Care for Joint Replacement Payment Model: Extreme and Uncontrollable Circumstances Policy for the Comprehensive Care for Joint Replacement Payment Model. Final rule; interim final rule with comment period.

Science.gov (United States)

2017-12-01

This final rule cancels the Episode Payment Models (EPMs) and Cardiac Rehabilitation (CR) Incentive Payment Model and rescinds the regulations governing these models. It also implements certain revisions to the Comprehensive Care for Joint Replacement (CJR) model, including: Giving certain hospitals selected for participation in the CJR model a one-time option to choose whether to continue their participation in the model; technical refinements and clarifications for certain payment, reconciliation and quality provisions; and a change to increase the pool of eligible clinicians that qualify as affiliated practitioners under the Advanced Alternative Payment Model (Advanced APM) track. An interim final rule with comment period is being issued in conjunction with this final rule in order to address the need for a policy to provide some flexibility in the determination of episode costs for providers located in areas impacted by extreme and uncontrollable circumstances.

Institutional dimensions of Payments for Ecosystem Services. An analysis of Mexico's carbon forestry programme

International Nuclear Information System (INIS)

Corbera, Esteve; Brown, Katrina; Soberanis, Carmen Gonzalez

2009-01-01

This article proposes a multi-dimensional framework for understanding the development and effectiveness of Payments for Ecosystem Services (PES) schemes, framed around the notions of institutional design, performance and interplay. The framework is applied in the context of Mexico's Programme of Payments for Carbon, Biodiversity and Agro-forestry Services (PSA-CABSA), with an emphasis on its carbon component. The analysis shows that PSA-CABSA was promoted by civil society and its rules have been subject to continuous modifications over time. In the case of the carbon component, changes have been due to an original misunderstanding of how carbon projects should be designed, implemented, and carbon traded in actual markets. From a performance point of view, the paper shows that the programme has been well received by rural communities, and carbon payments have contributed to increase household income and to enhance forest management practices and organisational skills. The paper also highlights sources of institutional interplay with local institutions and international climate policy, and it reveals the importance of capacity and scale issues in securing an effective and fair implementation of PES. The conclusion provides some policy recommendations for the future development of PES initiatives in Mexico and elsewhere. (author)

Hospitalization of nursing home residents: the effects of states' Medicaid payment and bed-hold policies.

Science.gov (United States)

Intrator, Orna; Grabowski, David C; Zinn, Jacqueline; Schleinitz, Mark; Feng, Zhanlian; Miller, Susan; Mor, Vince

2007-08-01

Hospitalizations of nursing home residents are costly and expose residents to iatrogenic disease and social and psychological harm. Economic constraints imposed by payers of care, predominantly Medicaid policies, are hypothesized to impact hospitalizations. Federally mandated resident assessments were merged with Medicare claims and eligibility files to determine hospitalizations and death within 150 days of baseline assessment. Nursing home and market characteristics were obtained from the Online Survey Certification and Reporting, and the Area Resource File, respectively. States' average daily Medicaid nursing home payments and bed-hold policies were obtained independently. Prospective cohort study of 570,614 older (> or =65-year-old), non-MCO (Medicare Managed Care), long-stay (> or =90 days) residents in 8,997 urban, freestanding nursing homes assessed between April and June 2000, using multilevel models to test the impact of state policies on hospitalizations controlling for resident, nursing home, and market characteristics. Overall, 99,379 (17.4 percent) residents were hospitalized with rates varying from 8.4 percent in Utah to 24.9 percent in Louisiana. Higher Medicaid per diem was associated with lower odds of hospitalizations (5 percent lower for each $10 above average $103.5, confidence intervals [CI] 0.91-0.99). Hospitalization odds were higher by 36 percent in states with bed-hold policies (CI: 1.12-1.63). State Medicaid bed-hold policy and per-diem payment have important implications for nursing home hospitalizations, which are predominantly financed by Medicare. This study emphasizes the importance of properly aligning state Medicaid and federal Medicare policies in regards to the subsidy of acute, maintenance, and preventive care in the nursing home setting.

29 CFR 1470.21 - Payment.

Science.gov (United States)

2010-07-01

... grantee's or subgrantee's actual rate of disbursement. (e) Working capital advances. If a grantee cannot... capital, the awarding agency may provide cash or a working capital advance basis. Under this procedure the... reimburse the grantee for its actual cash disbursements. The working capital advance method of payment shall...

14 CFR 1273.21 - Payment.

Science.gov (United States)

2010-01-01

... grantee's or subgrantee's actual rate of disbursement. (e) Working capital advances. If a grantee cannot... capital, the awarding agency may provide cash on a working capital advance basis. Under this procedure the... reimburse the grantee for its actual cash disbursements. The working capital advance method of payment shall...

45 CFR 2541.210 - Payment.

Science.gov (United States)

2010-10-01

... grantee's or subgrantee's actual rate of disbursement. (e) Working capital advances. If a grantee cannot... capital, the awarding agency may provide cash on a working capital advance basis. Under this procedure the... reimburse the grantee for its actual cash disbursements. The working capital advance method of payment shall...

Barriers to universal health coverage in Republic of Moldova: a policy analysis of formal and informal out-of-pocket payments.

Science.gov (United States)

Vian, Taryn; Feeley, Frank G; Domente, Silviu; Negruta, Ala; Matei, Andrei; Habicht, Jarno

2015-08-11

Universal Health Coverage seeks to assure that everyone can obtain the health services they need without financial hardship. Countries which rely heavily on out-of-pocket (OOP) payments, including informal payments (IP), to finance total health expenditures are not likely to achieve universal coverage. The Republic of Moldova is committed to promoting universal coverage, reducing inequities, and expanding financial protection. To achieve these goals, the country must reduce the proportion of total health expenditures paid by households. This study documents the extent of OOP payments and IP in Moldova, analyses trends over time, and identifies factors which may be driving these payments. The study includes analysis of household budget survey data and previous research and policy documents. The team also conducted a review of administrative law intended to control OOP payments and IPs. Focus groups, interviews, and a policy dialogue with key stakeholders were held to validate and discuss findings. OOP payments account for 45% of total health expenditures. Sixteen percent of outpatients and 30% of inpatients reporting that they made OOP payments when seeking care at a health facility in 2012, more than two-thirds of whom also reported paying for medicines at a pharmacy. Among those who paid anything, 36% of outpatients and 82% of inpatients reported paying informally, with the proportion increasing over time for inpatient care. Although many patients consider these payments to be gifts, around one-third of IPs appear to be forced, posing a threat to health care access. Patients perceive that payments are driven by the limited list of reimbursable medicines, a desire to receive better treatment, and fear or extortion. Providers suggested irrational prescribing and ordering of tests as drivers. Providers may believe that IPs are gifts and do not cause harm for patients and the health system in general. Efforts to expand financial protection should focus on reducing

Effects of Medicare payment reform: evidence from the home health interim and prospective payment systems.

Science.gov (United States)

Huckfeldt, Peter J; Sood, Neeraj; Escarce, José J; Grabowski, David C; Newhouse, Joseph P

2014-03-01

Medicare continues to implement payment reforms that shift reimbursement from fee-for-service toward episode-based payment, affecting average and marginal payment. We contrast the effects of two reforms for home health agencies. The home health interim payment system in 1997 lowered both types of payment; our conceptual model predicts a decline in the likelihood of use and costs, both of which we find. The home health prospective payment system in 2000 raised average but lowered marginal payment with theoretically ambiguous effects; we find a modest increase in use and costs. We find little substantive effect of either policy on readmissions or mortality. Copyright © 2014 Elsevier B.V. All rights reserved.

Introducing payment for performance in the health sector of Tanzania- the policy process.

Science.gov (United States)

Chimhutu, Victor; Tjomsland, Marit; Songstad, Nils Gunnar; Mrisho, Mwifadhi; Moland, Karen Marie

2015-09-02

Prompted by the need to achieve progress in health outcomes, payment for performance (P4P) schemes are becoming popular policy options in the health systems in many low income countries. This paper describes the policy process behind the introduction of a payment for performance scheme in the health sector of Tanzania illuminating in particular the interests of and roles played by the Government of Norway, the Government of Tanzania and the other development partners. The study employed a qualitative research design using in-depth interviews (IDIs), observations and document reviews. Thirteen IDIs with key-informants representing the views of ten donor agencies and government departments influential in the process of introducing the P4P scheme in Tanzania were conducted in Dar es Salaam, Tanzania and Oslo, Norway. Data was collected on the main trends and thematic priorities in development aid policy, countries and actors perceived to be proponents and opponents to the P4P scheme, and P4P agenda setting in Tanzania. The initial introduction of P4P in the health sector of Tanzania was controversial. The actors involved including the bilateral donors in the Health Basket Fund, the World Bank, the Tanzanian Government and high level politicians outside the Health Basket Fund fought for their values and interests and formed alliances that shifted in the course of the process. The process was characterized by high political pressure, conflicts, changing alliances, and, as it evolved, consensus building. The P4P policy process was highly political with external actors playing a significant role in influencing the agenda in Tanzania, leaving less space for the Government of Tanzania to provide leadership in the process. Norway in particular, took a leading role in setting the agenda. The process of introducing P4P became long and frustrating causing mistrust among partners in the Health Basket Fund.

Effect of medicare payment on rural health care systems.

Science.gov (United States)

McBride, Timothy D; Mueller, Keith J

2002-01-01

Medicare payments constitute a significant share of patient-generated revenues for rural providers, more so than for urban providers. Therefore, Medicare payment policies influence the behavior of rural providers and determine their financial viability. Health services researchers need to contribute to the understanding of the implications of changes in fee-for-service payment policy, prospects for change because of the payment to Medicare+Choice risk plans, and implications for rural providers inherent in any restructuring of the Medicare program. This article outlines the basic policy choices, implications for rural providers and Medicare beneficiaries, impacts of existing research, and suggestions for further research. Topics for further research include implications of the Critical Access Hospital program, understanding how changes in payment to rural hospitals affect patient care, developing improved formulas for paying rural hospitals, determining the payment-to-cost ratio for physicians, measuring the impact of changes in the payment methodology used to pay for services delivered by rural health clinics and federally qualified health centers, accounting for the reasons for differences in historical Medicare expenditures across rural counties and between rural and urban counties, explicating all reasons for Medicare+Choice plans withdrawing from some rural areas and entering others, measuring the rural impact of proposals to add a prescription drug benefit to the Medicare program, and measuring the impact of Medicare payment policies on rural economies.

The operations of the free maternal care policy and out of pocket payments during childbirth in rural Northern Ghana

OpenAIRE

Dalinjong, Philip Ayizem; Wang, Alex Y.; Homer, Caroline S. E.

2017-01-01

Background To promote skilled attendance at births and reduce maternal deaths, the government of Ghana introduced the free maternal care policy under the National Health Insurance Scheme (NHIS) in 2008. The objective is to eliminate financial barriers associated with the use of services. But studies elsewhere showed that out of pocket (OOP) payments still exist in the midst of fee exemptions. The aim of this study was to estimate OOP payments and the financial impact on women during childbirt...

Empirical Models of Demand for Out-Patient Physician Services and Their Relevance to the Assessment of Patient Payment Policies: A Critical Review of the Literature

Directory of Open Access Journals (Sweden)

Olga Skriabikova

2010-06-01

Full Text Available This paper reviews the existing empirical micro-level models of demand for out-patient physician services where the size of patient payment is included either directly as an independent variable (when a flat-rate co-payment fee or indirectly as a level of deductibles and/or co-insurance defined by the insurance coverage. The paper also discusses the relevance of these models for the assessment of patient payment policies. For this purpose, a systematic literature review is carried out. In total, 46 relevant publications were identified. These publications are classified into categories based on their general approach to demand modeling, specifications of data collection, data analysis, and main empirical findings. The analysis indicates a rising research interest in the empirical micro-level models of demand for out-patient physician services that incorporate the size of patient payment. Overall, the size of patient payments, consumer socio-economic and demographic features, and quality of services provided emerge as important determinants of demand for out-patient physician services. However, there is a great variety in the modeling approaches and inconsistencies in the findings regarding the impact of price on demand for out-patient physician services. Hitherto, the empirical research fails to offer policy-makers a clear strategy on how to develop a country-specific model of demand for out-patient physician services suitable for the assessment of patient payment policies in their countries. In particular, theoretically important factors, such as provider behavior, consumer attitudes, experience and culture, and informal patient payments, are not considered. Although we recognize that it is difficult to measure these factors and to incorporate them in the demand models, it is apparent that there is a gap in research for the construction of effective patient payment schemes.

Empirical models of demand for out-patient physician services and their relevance to the assessment of patient payment policies: a critical review of the literature.

Science.gov (United States)

Skriabikova, Olga; Pavlova, Milena; Groot, Wim

2010-06-01

This paper reviews the existing empirical micro-level models of demand for out-patient physician services where the size of patient payment is included either directly as an independent variable (when a flat-rate co-payment fee) or indirectly as a level of deductibles and/or co-insurance defined by the insurance coverage. The paper also discusses the relevance of these models for the assessment of patient payment policies. For this purpose, a systematic literature review is carried out. In total, 46 relevant publications were identified. These publications are classified into categories based on their general approach to demand modeling, specifications of data collection, data analysis, and main empirical findings. The analysis indicates a rising research interest in the empirical micro-level models of demand for out-patient physician services that incorporate the size of patient payment. Overall, the size of patient payments, consumer socio-economic and demographic features, and quality of services provided emerge as important determinants of demand for out-patient physician services. However, there is a great variety in the modeling approaches and inconsistencies in the findings regarding the impact of price on demand for out-patient physician services. Hitherto, the empirical research fails to offer policy-makers a clear strategy on how to develop a country-specific model of demand for out-patient physician services suitable for the assessment of patient payment policies in their countries. In particular, theoretically important factors, such as provider behavior, consumer attitudes, experience and culture, and informal patient payments, are not considered. Although we recognize that it is difficult to measure these factors and to incorporate them in the demand models, it is apparent that there is a gap in research for the construction of effective patient payment schemes.

AN OPTIMAL REPLENISHMENT POLICY FOR DETERIORATING ITEMS WITH RAMP TYPE DEMAND UNDER PERMISSIBLE DELAY IN PAYMENTS

Directory of Open Access Journals (Sweden)

Dr. Sanjay Jain

2010-10-01

Full Text Available The aim of this paper is to develop an optimal replenishment policy for inventory models of deteriorating items with ramp type demand under permissible delay in payments. Deterioration of items begins on their arrival in stock.  An example is also presented to illustrate the application of developed model.

Risk-adjusted payment and performance assessment for primary care.

Science.gov (United States)

Ash, Arlene S; Ellis, Randall P

2012-08-01

Many wish to change incentives for primary care practices through bundled population-based payments and substantial performance feedback and bonus payments. Recognizing patient differences in costs and outcomes is crucial, but customized risk adjustment for such purposes is underdeveloped. Using MarketScan's claims-based data on 17.4 million commercially insured lives, we modeled bundled payment to support expected primary care activity levels (PCAL) and 9 patient outcomes for performance assessment. We evaluated models using 457,000 people assigned to 436 primary care physician panels, and among 13,000 people in a distinct multipayer medical home implementation with commercially insured, Medicare, and Medicaid patients. Each outcome is separately predicted from age, sex, and diagnoses. We define the PCAL outcome as a subset of all costs that proxies the bundled payment needed for comprehensive primary care. Other expected outcomes are used to establish targets against which actual performance can be fairly judged. We evaluate model performance using R(2)'s at patient and practice levels, and within policy-relevant subgroups. The PCAL model explains 67% of variation in its outcome, performing well across diverse patient ages, payers, plan types, and provider specialties; it explains 72% of practice-level variation. In 9 performance measures, the outcome-specific models explain 17%-86% of variation at the practice level, often substantially outperforming a generic score like the one used for full capitation payments in Medicare: for example, with grouped R(2)'s of 47% versus 5% for predicting "prescriptions for antibiotics of concern." Existing data can support the risk-adjusted bundled payment calculations and performance assessments needed to encourage desired transformations in primary care.

Informal payments for health care in transition economies.

Science.gov (United States)

Ensor, Tim

2004-01-01

There is considerable evidence that unofficial payments are deeply embedded in the markets for health care in transition countries. Numerous surveys indicate that these payments provide a significant but possibly distorting contribution to health care financing. Unofficial payments can be characterised into three groups: cost contributions, including supplies and salaries, misuse of market position and payments for additional services. There is evidence from across the region on the presence of payment in each category although it is often difficult to distinguish between payment types. Regulatory policy must address a number of issues. Imposing penalties may help to reduce some payments but if the system is simply unable to provide services, such sanctions will drive workers into the private sector. There appears to be some support for formalising payments in order to reduce unofficial charges although the impact must be monitored and the danger is that formal fees add to the burden of payment. Regulation might also attempt to increase the amount of competition, provide information on good performing facilities and develop the legal basis of patient rights. Ultimately, unless governments address the endemic nature of payments across all sectors, policy interventions are unlikely to be fully effective.

Co-payments for general practitioners in Denmark

DEFF Research Database (Denmark)

Hansen, Camilla; Andrioti, Despena

2017-01-01

BACKGROUND: The increasing health expenditure for general practitioners (GPs) in Denmark requires that other ways of financing the health system are investigated. This study aims to analyse possibilities for implementing out-of-pocket payments to GPs in Denmark. METHODS: The study was conducted...... as a literature review with 11 articles included. The Health Policy Triangle and the Kingdon Model were used in analysing and discussing the implementation of a cost-sharing policy with an emphasis on the out-of-pocket payments method. RESULTS: The Danish Parliament has expressed mixed opinions about out......-of-pocket payments, whereas the Danish population, the GPs and the media are against introducing payments. The public debate and the fact that Danes are used to healthcare being free of charge both work against introducing co-payments. However, experiences from Sweden, Norway and OECD countries serve to promote...

14 CFR 1215.115 - Payment and billing.

Science.gov (United States)

2010-01-01

... is applicable toward TDRSS operational services. (b) The procedure for billing and payment of... billings as the actual service time is tabulated. Amounts due to the user will be credited to the next... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Payment and billing. 1215.115 Section 1215...

Substantiation of Payment Conditions for Products

Directory of Open Access Journals (Sweden)

I. M. Babuk

2004-01-01

Full Text Available The paper proposes a model that presupposes granting more favorable payment (discount conditions with the purpose to expedite payments for products. Dependence for calculation of discount rate has been deduced on the basis of information about an actual cost of debtor’s accounts receivable. The example of discount calculation depending on a maturity of debtor’s accounts receivable is given in the paper.

Effects of physician payment reform on provision of home dialysis.

Science.gov (United States)

Erickson, Kevin F; Winkelmayer, Wolfgang C; Chertow, Glenn M; Bhattacharya, Jay

2016-06-01

Patients with end-stage renal disease can receive dialysis at home or in-center. In 2004, CMS reformed physician payment for in-center hemodialysis care from a capitated to a tiered fee-for-service model, augmenting physician payment for frequent in-center visits. We evaluated whether payment reform influenced dialysis modality assignment. Cohort study of patients starting dialysis in the United States in the 3 years before and the 3 years after payment reform. We conducted difference-in-difference analyses comparing patients with traditional Medicare coverage (who were affected by the policy) to others with Medicare Advantage (who were unaffected by the policy). We also examined whether the policy had a more pronounced influence on dialysis modality assignment in areas with lower costs of traveling to dialysis facilities. Patients with traditional Medicare coverage experienced a 0.7% (95% CI, 0.2%-1.1%; P = .003) reduction in the absolute probability of home dialysis use following payment reform compared with patients with Medicare Advantage. Patients living in areas with larger dialysis facilities (where payment reform made in-center hemodialysis comparatively more lucrative for physicians) experienced a 0.9% (95% CI, 0.5%-1.4%; P home dialysis use following payment reform compared with patients living in areas with smaller facilities (where payment reform made in-center hemodialysis comparatively less lucrative for physicians). The transition from a capitated to a tiered fee-for-service payment model for in-center hemodialysis care resulted in fewer patients receiving home dialysis. This area of policy failure highlights the importance of considering unintended consequences of future physician payment reform efforts.

Permissible Delay in Payments

Directory of Open Access Journals (Sweden)

Yung-Fu Huang

2007-01-01

Full Text Available The main purpose of this paper wants to investigate the optimal retailer's lot-sizing policy with two warehouses under partially permissible delay in payments within the economic order quantity (EOQ framework. In this paper, we want to extend that fully permissible delay in payments to the supplier would offer the retailer partially permissible delay in payments. That is, the retailer must make a partial payment to the supplier when the order is received. Then the retailer must pay off the remaining balance at the end of the permissible delay period. In addition, we want to add the assumption that the retailer's storage space is limited. That is, the retailer will rent the warehouse to store these exceeding items when the order quantity is larger than retailer's storage space. Under these conditions, we model the retailer's inventory system as a cost minimization problem to determine the retailer's optimal cycle time and optimal order quantity. Three theorems are developed to efficiently determine the optimal replenishment policy for the retailer. Finally, numerical examples are given to illustrate these theorems and obtained a lot of managerial insights.

Episodic payments (bundling): PART I.

Science.gov (United States)

Jacofsky, D J

2017-10-01

Episodic, or bundled payments, is a concept now familiar to most in the healthcare arena, but the models are often misunderstood. Under a traditional fee-for-service model, each provider bills separately for their services which creates financial incentives to maximise volumes. Under a bundled payment, a single entity, often referred to as a convener (maybe the hospital, the physician group, or a third party) assumes the risk through a payer contract for all services provided within a defined episode of care, and receives a single (bundled) payment for all services provided for that episode. The time frame around the intervention is variable, but defined in advance, as are included and excluded costs. Timing of the actual payment in a bundle may either be before the episode occurs (prospective payment model), or after the end of the episode through a reconciliation (retrospective payment model). In either case, the defined costs over the defined time frame are borne by the convener. Cite this article: Bone Joint J 2017;99-B:1280-5. ©2017 The British Editorial Society of Bone & Joint Surgery.

The operations of the free maternal care policy and out of pocket payments during childbirth in rural Northern Ghana.

Science.gov (United States)

Dalinjong, Philip Ayizem; Wang, Alex Y; Homer, Caroline S E

2017-11-22

To promote skilled attendance at births and reduce maternal deaths, the government of Ghana introduced the free maternal care policy under the National Health Insurance Scheme (NHIS) in 2008. The objective is to eliminate financial barriers associated with the use of services. But studies elsewhere showed that out of pocket (OOP) payments still exist in the midst of fee exemptions. The aim of this study was to estimate OOP payments and the financial impact on women during childbirth in one rural and poor area of Northern Ghana; the Kassena-Nankana municipality. Costs were taken from the perspective of women. Quantitative and qualitative data collection techniques were used in a convergent parallel mixed methods study. The study used structured questionnaire (n = 353) and focus group discussions (FGDs =7) to collect data from women who gave birth in health facilities. Quantitative data from the questionnaire were analysed, using descriptive statistics. Qualitative data from the FGDs were recorded, transcribed and analysed to determine common themes. The overall mean OOP payments during childbirth was GH¢33.50 (US$17), constituting 5.6% of the average monthly household income. Over one-third (36%, n = 145) of women incurred OOP payments which exceeded 10% of average monthly household income (potentially catastrophic). Sixty-nine percent (n = 245) of the women perceived that the NHIS did not cover all expenses incurred during childbirth; which was confirmed in the FGDs. Both survey and FGDs demonstrated that women made OOP payments for drugs and other supplies. The FGDs showed women bought disinfectants, soaps, rubber pads and clothing for newborns as well. Seventy-five percent (n = 264) of the women used savings, but 19% had to sell assets to finance the payments; this was supported in the FGDs. The NHIS policy has not eliminated financial barriers associated with childbirth which impacts the welfare of some women. Women continued to make OOP

Transaction costs of farmers’ participation in forest management: Policy implications of payments for environmental services schemes in Vietnam

Directory of Open Access Journals (Sweden)

Areeya Manasboonphempool

2015-11-01

Full Text Available Recent research on payments for environmental services (PES has observed that high transaction costs (TCs are incurred through the implementation of PES schemes and farmer participation. TCs incurred by households are considered to be an obstacle to the participation in and efficiency of PES policies. This study aims to understand transactions related to previous forest plantation programmes and to estimate the actual TCs incurred by farmers who participated in these programmes in a mountainous area of northwestern Vietnam. In addition, this study examines determinants of households’ TCs to test the hypothesis of whether the amount of TCs varies according to household characteristics. Results show that average TCs are not likely to be a constraint for participation since they are about 200,000 VND (USD 10 per household per contract, which is equivalent to one person’s average earnings for about two days of labour. However, TCs amount to more than one-third of the programmes’ benefits, which is relatively high compared to PES programmes in developed countries. This implies that rather than aiming to reduce TCs, an appropriate agenda for policy improvement is to balance the level of TCs with PES programme benefits to enhance the overall attractiveness of afforestation programmes for smallholder farmers. Regression analysis reveals that education, gender and perception towards PES programmes have significant effects on the magnitude of TCs. The analyses also points out the importance of local conditions on the level of TCs, with some unexpected results.

Regional impacts of abolishing direct payments

DEFF Research Database (Denmark)

Uthes, Sandra; Priorr, Annette; Zander, Peter

2011-01-01

The direct payment system of the Common Agricultural Policy (CAP) provides income transfers to European farmers. Recently, several countries including England and Sweden have advocated the elimination of direct payments after 2013. The extent to which an elimination of direct payments would affect...... with different production orientations and land management types was modeled under the presence and absence of direct payments using a combination of agent-based and bio-economic modeling. We found that the initial characteristics of the regions, such as the historical farm structure and regional site conditions...

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

Science.gov (United States)

Ginsburg, Paul B

2012-09-01

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

Economic and regional consequences of direct payments under the current CAP philosophy

Directory of Open Access Journals (Sweden)

Věra Bečvářová

2011-01-01

Full Text Available The paper deals with one of the key instruments of the actual EU Common Agricultural Policy (the CAP, the direct payments. The economic as well as the regional implications of application for direct payments in the CAP strategy are evaluated there. The study deals with the economic costs, direct and indirect effects of such type of subsidy in general and a demonstration thereof in the context of the development of the European model of agriculture. Based on the economic principle of this type of transfer evalution, the processes of the income redistribution in the framework of global/common policy in general is characterized. It explains the causes as well as the nature of implementation of this instrument in the reform processes in the last twenty years, focusing on the reasons and consequences of different application in the original and the new EU member states. It considers the question of whether this type of support to agriculture is truly a tool that does not interfere with market conditions affect the respective competitive ability of agricultural producers. In the context of changes to income support in agriculture in the CAP development process, the effect of decoupled payments on the pricing within the agricultural commodity markets is specified. At the same time the work deals with a broader social context and social impact of the differing forms of support in European regions.

Effects of Physician Payment Reform on Provision of Home Dialysis

Science.gov (United States)

Erickson, Kevin F.; Winkelmayer, Wolfgang C.; Chertow, Glenn M.; Bhattacharya, Jay

2016-01-01

Objectives Patients with end-stage renal disease can receive dialysis at home or in-center. In 2004 the Centers for Medicare and Medicaid Services reformed physician payment for in-center hemodialysis care from a capitated to a tiered fee-for-service model, augmenting physician payment for frequent in-center visits. We evaluated whether payment reform influenced dialysis modality assignment. Study Design Cohort study of patients starting dialysis in the US in the three years before and after payment reform. Methods We conducted difference-in-difference analyses comparing patients with Traditional Medicare coverage (who were affected by the policy) to others with Medicare Advantage (who were unaffected by the policy). We also examined whether the policy had a more pronounced influence on dialysis modality assignment in areas with lower costs of traveling to dialysis facilities. Results Patients with Traditional Medicare coverage experienced a 0.7% (95% CI 0.2%–1.1%; p=0.003) reduction in the absolute probability of home dialysis use following payment reform compared to patients with Medicare Advantage. Patients living in areas with larger dialysis facilities (where payment reform made in-center hemodialysis comparatively more lucrative for physicians) experienced a 0.9% (95% CI 0.5%–1.4%; ppayment model for dialysis care resulted in fewer patients receiving home dialysis. This area of policy failure highlights the importance of considering unintended consequences of future physician payment reform efforts. PMID:27355909

No hospital left behind? Education policy lessons for value-based payment in healthcare.

Science.gov (United States)

Maurer, Kristin A; Ryan, Andrew M

2016-01-01

Value-based payment systems have been widely implemented in healthcare in an effort to improve the quality of care. However, these programs have not broadly improved quality, and some evidence suggests that they may increase inequities in care. No Child Left Behind is a parallel effort in education to address uneven achievement and inequalities. Yet, by penalizing the lowest performers, No Child Left Behind's approach to accountability has led to a number of unintended consequences. This article draws lessons from education policy, arguing that financial incentives should be designed to support the lowest performers to improve quality. © 2015 Society of Hospital Medicine.

Equity in out-of-pocket payment in Chile.

Science.gov (United States)

Mondaca, Alicia Lorena Núñez; Chi, Chunhuei

2017-05-04

To assess the distribution of financial burden in Chile, with a focus on the burden and progressivity of out-of-pocket payment. Based on the principle of ability to pay, we explore factors that contribute to inequities in the health system finance and issues about the burden of out-of-pocket payment, as well as the progressivity and redistributive effect of out-of-pocket payment in Chile. Our analysis is based on data from the 2006 National Survey on Satisfaction and Out-of-Pocket Payments. Results from this study indicate evidence of inequity, in spite of the progressivity of the healthcare system. Our analysis also identifies relevant policy variables such as education, insurance system, and method of payment that should be taken into consideration in the ongoing debates and research in improving the Chilean system. In order to reduce the detected disparities among income groups, healthcare priorities should target low-income groups. Furthermore, policies should explore changes in the access to education and its impact on equity.

TARGET - NEW PAYMENT SYSTEM FOR THE EURO AREA

Directory of Open Access Journals (Sweden)

ELENA VIOLETA DRĂGOI

2015-04-01

Full Text Available At EU level, the funds transfer systems have undergone significant changes starting with the introduction of euro. The launch of the euro, the emergence of new technologies, introduction of financial innovations and the globalization have led to reorganization of funds transfer systems` infrastructure. The paper aims to offer an analysis of actual payment system for Euro area, a trans-European funds transfer system with gross settlement in real-time for payments in euro TARGET- to increase economical and operational efficiency of payments and also to reduce the risks in the electronic funds transfer system by creating efficient and secure payment systems.

ASPECTS OF THE FUTURE COMMON AGRICULTURAL POLICY

Directory of Open Access Journals (Sweden)

Paolo GAJO

2013-01-01

Full Text Available The paper aimed to present the main CAP reforms imposed by the actual situation of agriculture development in the EU. The Common Agriculture Policy is focused on decoupling, modulation and cross-compliance. The single payment scheme will assure aids only for farms where production complies with environment, food safety, animal and plant health, animal welfare, and agricultural land maintenance in good condition. The new legislation provides the introduction of "green payments" related to the adoption of agricultural practices beneficial for the climate and the environment. The demographic growth imposes more production and a better distribution of food in the world. The EU has to be prepared to produce more because of the mass emigration to the rich countries from the region where food demand can not be covered.

Telehealth and Medicare - Payment Policy, Current Use...

Data.gov (United States)

U.S. Department of Health & Human Services — Despite legislative changes from 2001 to 2008 that increased Medicare payment rates for telehealth and decreased regulatory burdens, the study Telehealth and...

NAAG Tobacco Settlement Payments

Data.gov (United States)

U.S. Department of Health & Human Services — 1999-2016. National Association of Attorneys General (NAAG). Policy—Tobacco Settlement Payments. The National Association of Attorneys General (NAAG) provides...

Assessing the Effectiveness of Payments for Ecosystem Services: an Agent-Based Modeling Approach

Directory of Open Access Journals (Sweden)

Xiaodong Chen

2014-03-01

Full Text Available Payments for ecosystem services (PES have increasingly been implemented to protect and restore ecosystems worldwide. The effectiveness of conservation investments in PES may differ under alternative policy scenarios and may not be sustainable because of uncertainties in human responses to policies and dynamic human-nature interactions. To assess the impacts of these interactions on the effectiveness of PES programs, we developed a spatially explicit agent-based model: human and natural interactions under policies (HANIP. We used HANIP to study the effectiveness of China's Natural Forest Conservation Program (NFCP and alternative policy scenarios in a coupled human-nature system, China's Wolong Nature Reserve, where indigenous people's use of fuelwood affects forests. We estimated the effects of the current NFCP, which provides a cash payment, and an alternative payment scenario that provides an electricity payment by comparing forest dynamics under these policies to forest dynamics under a scenario in which no payment is provided. In 2007, there were 337 km² of forests in the study area of 515 km². Under the baseline projection in which no payment is provided, the forest area is expected to be 234 km² in 2030. Under the current NFCP, there are likely to be 379 km² of forests in 2030, or an increase of 145 km² of forests to the baseline projection. If the cash payment is replaced with an electricity payment, there are likely to be 435 km² of forests in 2030, or an increase of 201 km² of forests to the baseline projection. However, the effectiveness of the NFCP may be threatened by the behavior of newly formed households if they are not included in the payment scheme. In addition, the effects of socio-demographic factors on forests will also differ under different policy scenarios. Human and natural interactions under policies (HANIP and its modeling framework may also be used to assess the effectiveness of many other PES programs around

Direct payments as an instrument of the environmental policy Płatności obszarowe jako instrument polityki ochrony środowiska

Directory of Open Access Journals (Sweden)

Adrian Sadłowski

2011-12-01

Full Text Available Agriculture is the area of human activity that is accompanied by the formation of positive and negative external environmental effects. In order to motivate farmers to conduct production activities in a way that reduces the negative impact of these activities on the environment, the so-called principle of cross compliance has been incorporated into the direct support system. This study characterises the area payments as an instrument of the environmental policy and is a review of the European Commission’s different proposals for the reform of direct payments through the prism of environmental functions of this instrument.

Strategies of Dividend policy of the companies listed on the Warsaw Stock Exchange

Directory of Open Access Journals (Sweden)

Jabłoński Bartłomiej

2015-06-01

Full Text Available Research into the determinants of companies’ decisions about paying out dividends, which has been described in the Polish specialist literature, concentrates mainly on the dividends actually paid out. The research presented in the article refers to declarations of the companies included in their dividend policies. The aim of the article is to present an attitude to dividend policy exhibited by the companies listed on the Warsaw stock exchange. A particular attempt was made at identifying various formulas of constructing dividend policies by the companies and the declared conditions for dividend payments and their amounts. 118 dividend companies took part in the research and they were selected from among the companies listed on the Warsaw stock exchange in the years 2006-2012. The authors have analysed the dividend policy of the companies in terms of its components and the way it was formulated, as well as the determinants of decisions about dividend payments declared by the companies. The results of the analysis were referred to the types of strategies of the dividend policy presented in the specialist literature. The research results indicate that the boards of many companies do not consider formulating and publicising the principles of making dividend payments to be a relevant area of investor relations. The dividend policy of the companies is usually formulated too generally, with the use of general statements. Satisfying capital needs for the planned development processes appears to be a basic determinant of the distribution of profit, which is why residual dividend policy is prevalent in the analysed companies.

Making the CMS payment policy for healthcare-associated infections work: organizational factors that matter.

Science.gov (United States)

Hoff, Timothy; Hartmann, Christine W; Soerensen, Christina; Wroe, Peter; Dutta-Linn, Maya; Lee, Grace

2011-01-01

Healthcare-associated infections (HAIs) are among the most common adverse events in hospitals, and the morbidity and mortality associated with them are significant. In 2008, the Centers for Medicare and Medicaid Services (CMS) implemented a new financial policy that no longer provides payment to hospitals for services related to certain infections not present on admission and deemed preventable. At present, little is known about how this policy is being implemented in hospital settings. One key goal of the policy is for it to serve as a quality improvement driver within hospitals, providing the rationale and motivation for hospitals to engage in greater infection-related surveillance and prevention activities. This article examines the role organizational factors, such as leadership and culture, play in the effectiveness of the CMS policy as a quality improvement (QI) driver within hospital settings. Between late 2009 and early 2010, interviews were conducted with 36 infection preventionists working at a national sample of 36 hospitals. We found preliminary evidence that hospital executive behavior, a proactive infection control (IC) culture, and clinical staff engagement played a favorable role in enhancing the recognition, acceptance, and significance of the CMS policy as a QI driver within hospitals. We also found several other contextual factors that may impede the degree to which the above factors facilitate links between the CMS policy and hospital QI activities.

Universal financial protection through National Health Insurance: a stakeholder analysis of the proposed one-time premium payment policy in Ghana.

Science.gov (United States)

Abiiro, Gilbert Abotisem; McIntyre, Di

2013-05-01

Extending coverage to the informal sector is a key challenge to achieving universal coverage through contributory health insurance schemes. Ghana introduced a mandatory National Health Insurance system in 2004 to provide financial protection for both the formal and informal sectors through a combination of taxes and annual premium payments. As part of its election promise in 2008, the current government (then in opposition) promised to make the payment of premiums 'one-time'. This has been a very controversial policy issue in Ghana. This study sought to contribute to assessing the feasibility of the proposed policy by exploring the understandings of various stakeholders on the policy, their interests or concerns, potential positions, power and influences on it, as well as the general prospects and challenges for its implementation. Data were gathered from a review of relevant documents in the public domain, 28 key informant interviews and six focus group discussions with key stakeholders in Accra and two other districts. The results show that there is a lot of confusion in stakeholders' understanding of the policy issue, and, because of the uncertainties surrounding it, most powerful stakeholders are yet to take clear positions on it. However, stakeholders raised concerns that revolved around issues such as: the meaning of a one-time premium within an insurance scheme context, the affordability of the one-time premium, financing sources and sustainability of the policy, as well as the likely impact of the policy on equity in access to health care. Policy-makers need to clearly explain the meaning of the one-time premium policy and how it will be funded, and critically consider the concerns raised by stakeholders before proceeding with further attempts to implement it. For other countries planning universal coverage reforms, it is important that the terminology of their reforms clearly reflects policy objectives.

Medicare program; clarification of Medicare's accrual basis of accounting policy--HCFA. Final rule.

Science.gov (United States)

1995-06-27

This final rule revises the Medicare regulations to clarify the concept of "accrual basis of accounting" to indicate that expenses must be incurred by a provider of health care services before Medicare will pay its share of those expenses. This rule does not signify a change in policy but, rather, incorporates into the regulations Medicare's longstanding policy regarding the circumstances under which we recognize, for the purposes of program payment, a provider's claim for costs for which it has not actually expended funds during the current cost reporting period.

32 CFR 22.810 - Payments.

Science.gov (United States)

2010-07-01

..., whenever electronic commerce is used (i.e., EDI to request and authorize payments and electronic funds...) Expanding on these Governmentwide policies, DoD policy is for DoD Components to use electronic commerce, to... request by the administrative grants officer, when it is not possible to use electronic commerce and paper...

The formal-informal patient payment mix in European countries. Governance, economics, culture or all of these?

Science.gov (United States)

Tambor, Marzena; Pavlova, Milena; Golinowska, Stanisława; Sowada, Christoph; Groot, Wim

2013-12-01

Cost-sharing for health care is high on the policy agenda in many European countries that struggle with deficits in their public budget. However, such policy often meets with public opposition, which might delay or even prevent its implementation. Increased reliance on patient payments may also have adverse equity effects, especially in countries where informal patient payments are widespread. The factors which might influence the presence of both, formal and informal payments can be found in economic, governance and cultural differences between countries. The aim of this paper is to review the formal-informal payment mix in Europe and to outline factors associated with this mix. We use quantitative analyses of macro-data for 35 European countries and a qualitative description of selected country experiences. The results suggest that the presence of obligatory cost-sharing for health care services is associated with governance factors, while informal patient payments are a multi-cause phenomenon. A consensus-based policy, supported by evidence and stakeholders' engagement, might contribute to a more sustainable patient payment policy. In some European countries, the implementation of cost-sharing requires policy actions to reduce other patient payment obligations, including measures to eliminate informal payments. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

7 CFR 792.4 - Demand for payment of debts.

Science.gov (United States)

2010-01-01

... 7 Agriculture 7 2010-01-01 2010-01-01 false Demand for payment of debts. 792.4 Section 792.4... AGRICULTURE PROVISIONS COMMON TO MORE THAN ONE PROGRAM DEBT SETTLEMENT POLICIES AND PROCEDURES § 792.4 Demand for payment of debts. (a) When a debt is due FSA, an initial written demand for payment of such amount...

The role of network bridging organisations in compensation payments for agri-environmental services under the EU Common Agricultural Policy.

Science.gov (United States)

Dedeurwaerdere, Tom; Polard, Audrey; Melindi-Ghidi, Paolo

2015-11-01

Compensation payments to farmers for the provision of agri-environmental services are a well-established policy scheme under the EU Common Agricultural Policy. However, in spite of the success in most EU countries in the uptake of the programme by farmers, the impact of the scheme on the long term commitment of farmers to change their practices remains poorly documented. To explore this issue, this paper presents the results of structured field interviews and a quantitative survey in the Walloon Region of Belgium. The main finding of this study is that farmers who have periodic contacts with network bridging organisations that foster cooperation and social learning in the agri-environmental landscapes show a higher commitment to change. This effect is observed both for farmers with high and low concern for biodiversity depletion. Support for network bridging organisations is foreseen under the EU Leader programme and the EU regulation 1306/2013, which could open-up interesting opportunities for enhancing the effectiveness of the current payment scheme for agri-environmental services.

12 CFR 230.7 - Payment of interest.

Science.gov (United States)

2010-01-01

... crediting policies. This section does not require institutions to compound or credit interest at any... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Payment of interest. 230.7 Section 230.7 Banks... IN SAVINGS (REGULATION DD) § 230.7 Payment of interest. (a) Permissible methods—(1) Balance on which...

[Physician payment mechanisms. An instrument of health policy].

Science.gov (United States)

Nigenda, G

1994-01-01

Payment mechanisms for physicians have always been subject of debate. The profession tends to prefer fee-for-services, while health care institutions prefer to pay doctors by salary or capitation. The definition of the payment mechanism is not an administrative decision, it is frequently the output of an intense political negotiation. Recently an increase in salaried physicians has been observed, even in countries where the profession is powerful. In nations like Mexico, where the State is the dominant actor, salary or capitation can be used as an instrument to encourage quality of care and better geographic distribution. In this paper, several country cases are reviewed.

Payment Reform Pilot In Beijing Hospitals Reduced Expenditures And Out-Of-Pocket Payments Per Admission.

Science.gov (United States)

Jian, Weiyan; Lu, Ming; Chan, Kit Yee; Poon, Adrienne N; Han, Wei; Hu, Mu; Yip, Winnie

2015-10-01

In 2009 China announced plans to reform provider payment methods at public hospitals by moving from fee-for-service (FFS) to prospective and aggregated payment methods that included the use of diagnosis-related groups (DRGs) to control health expenditures. In October 2011 health policy makers selected six Beijing hospitals to pioneer the first DRG payment system in China. We used hospital discharge data from the six pilot hospitals and eight other hospitals, which continued to use FFS and served as controls, from the period 2010-12 to evaluate the pilot's impact on cost containment through a difference-in-differences methods design. Our study found that DRG payment led to reductions of 6.2 percent and 10.5 percent, respectively, in health expenditures and out-of-pocket payments by patients per hospital admission. We did not find evidence of any increase in hospital readmission rates or cost shifting from cases eligible for DRG payment to ineligible cases. However, hospitals continued to use FFS payments for patients who were older and had more complications than other patients, which reduced the effectiveness of payment reform. Continuous evidence-based monitoring and evaluation linked with adequate management systems are necessary to enable China and other low- and middle-income countries to broadly implement DRGs and refine payment systems. Project HOPE—The People-to-People Health Foundation, Inc.

49 CFR 24.301 - Payment for actual reasonable moving and related expenses.

Science.gov (United States)

2010-10-01

.... (See appendix A, § 24.301(e).) (f) Advertising signs. The amount of a payment for direct loss of an advertising sign, which is personal property shall be the lesser of: (1) The depreciated reproduction cost of... computation under § 24.401(c)(2)(iii)); (2) Interest on a loan to cover moving expenses; (3) Loss of goodwill...

Greening CAP payments: a missed opportunity?

Energy Technology Data Exchange (ETDEWEB)

Matthews, Alan

2013-01-15

At an important point in the current reform of the Common Agricultural Policy (CAP), a new IIEA policy brief by Professor Alan Matthews, one of the EU’s foremost experts on the topic, considers proposals to green direct farm payments. Professor Matthews argues that proposed greening of direct payments – the key innovation in the current round of CAP Reform – look likely to fail. While greening may survive as a concept, the likely outcome of the negotiations between Agriculture Ministers and the European Parliament will deliver little practical environmental benefit. The paper examines the rationale underpinning greening, arguing that it exists to justify the continuation of a large agricultural budget, explores reasons for the apparent failure of the proposals, and reflects on the implications for future efforts to better integrate environmental objectives into EU agriculture policy. This is the first in a series of Environment Nexus policy briefs by leading experts in the fields of agriculture, energy, climate change and water.

An index approach to performance-based payments for water quality.

Science.gov (United States)

Maille, Peter; Collins, Alan R

2012-05-30

In this paper we describe elements of a field research project that presented farmers with economic incentives to control nitrate runoff. The approach used is novel in that payments are based on ambient water quality and water quantity produced by a watershed rather than proxies for water quality conservation. Also, payments are made based on water quality relative to a control watershed, and therefore, account for stochastic fluctuations in background nitrate levels. Finally, the program pays farmers as a group to elicit team behavior. We present our approach to modeling that allowed us to estimate prices for water and resulting payment levels. We then compare these preliminary estimates to the actual values recorded over 33 months of fieldwork. We find that our actual payments were 29% less than our preliminary estimates, due in part to the failure of our ecological model to estimate discharge accurately. Despite this shortfall, the program attracted the participation of 53% of the farmers in the watershed, and resulted in substantial nitrate abatement activity. Given this favorable response, we propose that research efforts focus on implementing field trials of group-level performance-based payments. Ideally these programs would be low risk and control for naturally occurring contamination. Copyright © 2012 Elsevier Ltd. All rights reserved.

Theoretical vs. actual energy consumption of labelled dwellings in the Netherlands: Discrepancies and policy implications

International Nuclear Information System (INIS)

Majcen, D.; Itard, L.C.M.; Visscher, H.

2013-01-01

In Europe, the Energy Performance of Buildings Directive (EPBD) provides for compulsory energy performance certification (labelling) for all existing dwellings. In the Netherlands, a labelling scheme was introduced in 2008. Certificates contain the energy label of the dwelling and corresponding theoretical gas and electricity consumption, calculated based on the dwellings physical characteristics, its heating, ventilation and cooling systems and standard use characteristics. This paper reports on a large-scale study of around 200,000 dwellings comparing labels and theoretical energy use with data on actual energy use. The study shows that dwellings with a low energy label actually consume much less energy than predicted by the label, but on the other hand, energy-efficient dwellings consume more than predicted. In practice, policy targets are set according to the theoretical rather than the actual consumptions of the building stock. In line with identified discrepancies, the study shows that whereas most energy reduction targets can be met according to the theoretical energy consumption of the dwelling stock, the future actual energy reduction potential is much lower and fails to meet most of the current energy reduction targets. - Highlights: ► Actual gas consumption in Dutch dwellings is lower than the theoretical. ► In the dwellings with label A–B, theoretical gas consumption is lower than actual gas consumption. ► In less efficient dwellings, theoretical gas consumption is much higher than the actual. ► Most current energy reduction targets are unachievable if modelled with actual instead of theoretical energy consumption

Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2018; Medicare Shared Savings Program Requirements; and Medicare Diabetes Prevention Program. Final rule.

Science.gov (United States)

2017-11-15

This major final rule addresses changes to the Medicare physician fee schedule (PFS) and other Medicare Part B payment policies such as changes to the Medicare Shared Savings Program, to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services, as well as changes in the statute. In addition, this final rule includes policies necessary to begin offering the expanded Medicare Diabetes Prevention Program model.

Investment under Uncertain Climate Policy

DEFF Research Database (Denmark)

Barradale, Merrill Jones

2014-01-01

This paper introduces the concept of payment probability as an important component of carbon risk (the financial risk associated with CO2 emissions under uncertain climate policy). In modeling power plant investment decisions, most existing literature uses the expected carbon price (e.g., the price...... actually be faced in the case of a particular investment. This concept helps explain both the surge of activity in 2005–2006 and the subsequent decline in interest in coal-fired power plant development in the U.S. The data for this case study comes from an extensive online survey of 700 U.S. energy...... design better incentives for investing in low-carbon technologies...

77 FR 45061 - Hospital Outpatient Prospective and Ambulatory Surgical Center Payment Systems and Quality...

Science.gov (United States)

2012-07-30

...-associated infection HCERA Health Care and Education Reconciliation Act of 2010, Public Law 111-152 HCPCS..., Nonimplantable Biologicals, and Therapeutic Radiopharmaceuticals (``Threshold-Packaged Drugs'') c. Proposed... Biologicals b. Proposed CY 2013 Payment Policy 4. Proposed Payment Policy for Therapeutic Radiopharmaceuticals...

7 CFR 1951.11 - Application of payments on real estate accounts.

Science.gov (United States)

2010-01-01

... 7 Agriculture 14 2010-01-01 2009-01-01 true Application of payments on real estate accounts. 1951... Servicing Policies § 1951.11 Application of payments on real estate accounts. (a) Regular payments. If a borrower owes more than one type of real estate loan, or has received initial and subsequent real estate...

Exploring interactions between payment for hydrologic service policies, landowner decisions, and ecohydrology in a Mexican cloud forest watershed: Is there a disconnect between the policy and the resource?

Science.gov (United States)

Asbjornsen, H.; Geissert, D.; Gomez-Tagle, A.; Holwerda, F.; Manson, R.; Perez-Maqueo, O.; Munoz-Villers, L.; Scullion, J.

2013-05-01

Payment for hydrologic service (PHS) programs are increasingly being used as a means to incentivize watershed protection by compensating upstream 'water producers' with payments made by downstream 'water consumers'. However, the effectiveness of PHS programs in achieving their target goals is often poorly understood. Here, we draw from insights obtained from socioeconomic and ecohydrological research in Veracruz, Mexico to explore interactions between PHS policies, landowner decisions, and hydrologic services. GIS analysis of land-cover changes during 2003-2009 combined with interviews of PHS participants indicated that despite lower deforestation rates on properties receiving PES payments, other factors were likely to have a greater influence on land use decisions than PHS payments per se, including opportunity costs and personal conservation ethic. The interviews also highlighted a general lack of trust and cooperation between the citizen participants and government administrators, which was reflected in the relatively low level of knowledge of the PHS programs' regulations and goals, the role of forests in protecting water resources, and a low level of co-financing by the private sector. An important premise of PHS programs is that protecting existing forest cover (and planting trees) will enhance water supply, especially in upland cloud forests that are due to their perceived role as water producers. Measurements of climate, steamflow, canopy fog interception, plant transpiration, soil water dynamics, and hydrologic flow paths were collected over a 3-year period to assess stand water balance and streamflow response under four different land covers: mature cloud forest, pasture, regenerating cloud forest, pine reforestation. Results suggested relatively minor additional inputs of fog to increasing streamflow in cloud forest watersheds, while conversion of forest to pasture did not markedly decrease dry season flows, but did increase annual flows due to lower

Investment under uncertain climate policy: A practitioners' perspective on carbon risk

International Nuclear Information System (INIS)

Barradale, Merrill Jones

2014-01-01

This paper introduces the concept of payment probability as an important component of carbon risk (the financial risk associated with CO 2 emissions under uncertain climate policy). In modeling power plant investment decisions, most existing literature uses the expected carbon price (e.g., the price of traded permits or carbon tax) as a proxy for carbon risk. In contrast, this paper identifies expected carbon payment as a more accurate measure of carbon risk as perceived by industry practitioners. This measure of carbon risk incorporates both expected price and the probability that this price would actually be faced in the case of a particular investment. This concept helps explain both the surge of activity in 2005–2006 and the subsequent decline in interest in coal-fired power plant development in the U.S. The data for this case study comes from an extensive online survey of 700 U.S. energy professionals completed in 2006, as well as interviews conducted with industry representatives from 2007 to 2009. By analyzing industry views on policy uncertainty and future carbon legislation, we gain a better understanding of investor attitudes toward carbon risk. This understanding will help policy makers design better incentives for investing in low-carbon technologies. - Highlights: • A new model of carbon risk that incorporates payment probability is presented. • A survey of 700 U.S. energy professionals conducted in 2006 provides data on beliefs about future climate policy. • The vast majority of respondents expected climate policy to be enacted, but also expected it to be lax. • This data is used to analyze investor attitudes toward carbon risk

Towards a stakeholders' consensus on patient payment policy: the views of health-care consumers, providers, insurers and policy makers in six Central and Eastern European countries.

Science.gov (United States)

Tambor, Marzena; Pavlova, Milena; Golinowska, Stanisława; Sowada, Christoph; Groot, Wim

2015-08-01

Although patient charges for health-care services may contribute to a more sustainable health-care financing, they often raise public opposition, which impedes their introduction. Thus, a consensus among the main stakeholders on the presence and role of patient charges should be worked out to assure their successful implementation. To analyse the acceptability of formal patient charges for health-care services in a basic package among different health-care system stakeholders in six Central and Eastern European countries (Bulgaria, Hungary, Lithuania, Poland, Romania and Ukraine). Qualitative data were collected in 2009 via focus group discussions and in-depth interviews with health-care consumers, providers, policy makers and insurers. The same participants were asked to fill in a self-administrative questionnaire. Qualitative and quantitative data are analysed separately to outline similarities and differences in the opinions between the stakeholder groups and across countries. There is a rather weak consensus on patient charges in the countries. Health policy makers and insurers strongly advocate patient charges. Health-care providers overall support charges but their financial profits from the system strongly affects their approval. Consumers are against paying for services, mostly due to poor quality and access to health-care services and inability to pay. To build consensus on patient charges, the payment policy should be responsive to consumers' needs with regard to quality and equity. Transparency and accountability in the health-care system should be improved to enhance public trust and acceptance of patient payments. © 2012 John Wiley & Sons Ltd.

Evaluating Industry Payments Among Dermatology Clinical Practice Guidelines Authors.

Science.gov (United States)

Checketts, Jake X; Sims, Matthew Thomas; Vassar, Matt

2017-12-01

It is well documented that financial conflicts of interest influence medical research and clinical practice. Prior to the Open Payments provisions of the Affordable Care Act, financial ties became apparent only through self-disclosure. The nature of financial interests has not been studied among physicians who develop dermatology clinical practice guidelines. To evaluate payments received by physicians who author dermatology clinical practice guidelines, compare disclosure statements for accuracy, determine whether pharmaceutical companies from which the authors received payments manufactured products related to the guidelines, and examine the extent to which the American Academy of Dermatology enforced their Administrative Regulations for guideline development. Three American Academy of Dermatology guidelines published from 2013 to 2016 were retrieved. Double data extraction was used to record financial payments received by 49 guideline authors using the Open Payments database. Payments received by the authors from the date of the initial literature search to the date of publication were used to evaluate disclosure statement accuracy, detail the companies providing payments, and evaluate Administrative Regulations enforcement. This study is applicable to clinical practice guideline panels drafting recommendations, physicians using clinical practice guidelines to inform patient care, and those establishing policies for guideline development. Our main outcomes are the monetary values and types of payments received by physicians who author dermatology guidelines and the accuracy of disclosure statements. Data were collected from the Open Payments database and analyzed descriptively. Of the 49 authors evaluated, 40 received at least 1 reported industry payment, 31 accepted more than $1000, 25 accepted more than $10 000, and 18 accepted more than $50 000. Financial payments amounted to a mean of $157 177 per author. The total reimbursement among the 49 authors

46 CFR 308.507 - Security for payment of premiums.

Science.gov (United States)

2010-10-01

....507 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Cargo Insurance Ii-Open Policy War Risk Cargo Insurance § 308.507 Security for payment of... collateral deposit fund or a surety bond, to secure the payment of the premiums, in an amount which shall at...

Standardization of Type 2 Diabetes Outpatient Expenditure with Bundled Payment Method in China

Directory of Open Access Journals (Sweden)

Guo-Chao Xu

2016-01-01

Conclusions: We argued that it is feasible to implement bundled payment on type 2 diabetes outpatient services. Bundled payment is effective to control the increase of outpatient expenditure. Further improvements are needed for the implementation of bundled payment reimbursement standards, together with relevant policies and measures.

Conditions for acceptance and usage of mobile payment procedures

OpenAIRE

Pousttchi, Key

2003-01-01

Mobile payment (MP) is crucial for, but not limited to mobile commerce. The key to mobile payment acceptance is in the hands of customers. In this paper we examine the conditions for acceptance and actual usage of MP procedures by the customer. We identify essential conditions which belong to the categories costs, security and convenience. Different preferences lead to an individual set of essential conditions for any single user. We propose a scheme for their representation and comparison an...

12 CFR 412.5 - Policy.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Policy. 412.5 Section 412.5 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES ACCEPTANCE OF PAYMENT FROM A NON-FEDERAL SOURCE FOR TRAVEL EXPENSES § 412.5 Policy. As provided in this part, Eximbank may accept payment from a non-Federal source...

The estimate of regional balances of payments in Croatia

Directory of Open Access Journals (Sweden)

Petar Filipić

2016-03-01

Full Text Available Neither the region, as part of the state, nor regional development has occupied the centre of attention in the theory of international trade. There are several reasons, both theoretical and methodological, as well as entirely practical, including the want of any adequate statistics, particularly those necessary for the construction of Croatian regional balances of payments. Accordingly, there are several objectives to this work. After the introduction in which reference is made to the limitations of the running of individual regional economic policies, comes a chapter in which the content of an ideal regional balance of payments is defined. On the way from the ideal to the objective content of regional balances of payments, that is, one reflecting the available data, many methodological problems had to be solved and suitable statistics set up. In the sequel, the analysis of the balances of payments reveals a whole scale of regions that are negative or positive in terms of foreign currency. Although the quantities of the individual balances and items are interesting in themselves, it is important to understand that the different regional exposures to monetary policy possibly require a selective approach from economic policy. At the end, making use of the regional balances of payments, the influence of the depreciation of the kuna on the gross domestic product of the regions is analysed. It is established that in some hypothetical depreciation, if foreign currency transactions were treated ceteris paribus in relation to other economic aggregates, there would be important gains and losses, which would lead to ever greater developmental inequality in Croatia.

Changing physician incentives for affordable, quality cancer care: results of an episode payment model.

Science.gov (United States)

Newcomer, Lee N; Gould, Bruce; Page, Ray D; Donelan, Sheila A; Perkins, Monica

2014-09-01

This study tested the combination of an episode payment coupled with actionable use and quality data as an incentive to improve quality and reduce costs. Medical oncologists were paid a single fee, in lieu of any drug margin, to treat their patients. Chemotherapy medications were reimbursed at the average sales price, a proxy for actual cost. Five volunteer medical groups were compared with a large national payer registry of fee-for-service patients with cancer to examine the difference in cost before and after the initiation of the payment change. Between October 2009 and December 2012, the five groups treated 810 patients with breast, colon, and lung cancer using the episode payments. The registry-predicted fee-for-service cost of the episodes cohort was $98,121,388, but the actual cost was $64,760,116. The predicted cost of chemotherapy drugs was $7,519,504, but the actual cost was $20,979,417. There was no difference between the groups on multiple quality measures. Modifying the current fee-for-service payment system for cancer therapy with feedback data and financial incentives that reward outcomes and cost efficiency resulted in a significant total cost reduction. Eliminating existing financial chemotherapy drug incentives paradoxically increased the use of chemotherapy. Copyright © 2014 by American Society of Clinical Oncology.

From disclosure to transparency: the use of company payment data.

Science.gov (United States)

Chimonas, Susan; Frosch, Zachary; Rothman, David J

2011-01-10

It has become standard practice in medical journals to require authors to disclose their relationships with industry. However, these requirements vary among journals and often lack specificity. As a result, disclosures may not consistently reveal author-industry ties. We examined the 2007 physician payment information from 5 orthopedic device companies to evaluate the current journal disclosure system. We compared company payment information for recipients of $1 million or more with disclosures in the recipients' journal articles. Payment data were obtained from Biomet, DePuy, Smith & Nephew, Stryker, and Zimmer. Disclosures were obtained in the acknowledgments section, conflict of interest statements, and financial disclosures of recipients' published articles. We also assessed variations in disclosure by authorship position, payment-article relatedness, and journal disclosure policies. Of the 41 individuals who received $1 million or more in 2007, 32 had published articles relating to orthopedics between January 1, 2008, and January 15, 2009. Disclosures of company payments varied considerably. Prominent authorship position and article-payment relatedness were associated with greater disclosure, although nondisclosure rates remained high (46% among first-, sole-, and senior-authored articles and 50% among articles directly or indirectly related to payments). The accuracy of disclosures did not vary with the strength of journals' disclosure policies. Current journal disclosure practices do not yield complete or consistent information regarding authors' industry ties. Medical journals, along with other medical institutions, should consider new strategies to facilitate accurate and complete transparency.

Perceptions of inpatient rehabilitation changes after the Centers for Medicare and Medicaid Service 2010 regulatory updates contrasted with actual performance.

Science.gov (United States)

Riggs, Richard V; Roberts, Pamela S; DiVita, Margaret A; Niewczyk, Paulette; Granger, Carl V

2014-01-01

To compare and contrast subjective perceptions with objective compliance of the impact of the 2010 Centers for Medicare and Medicaid Service updates of the Medicare Benefit Policy Manual. Cross-sectional survey. An electronic survey was sent by the Uniform Data System for Medical Rehabilitation to all enrolled inpatient rehabilitation facility subscribers (n = 817). The survey was sent April 15, 2011, and responses were tabulated if they were received by May 15, 2011. Comparing and contrasting of the subjective perception to objective evaluation and/or compliance with the Medicare Benefit Policy Manual on case mix index, length of stay, admissions by diagnostic category as well as perception of preadmission screening, postadmission evaluation, plan of care, and interdisciplinary conferencing. Twenty-five percent of the 817 facilities responded, for a total of 209 responses. Complete data were present in 148 of the respondents. For most diagnostic categories, perception of change did not mirror reality of change; neither did the perception between change in case mix index and length of stay. Perception did match reality in stroke and multiple trauma cases; respondents perceived an increase in admissions for the 2 impairments, and there was an overall increase in reality. Comparison with actual data identified that gaps exist between diagnostic category perceptions and actual diagnostic category admission performance. Regulations such as the 75%-60% rule and audit focus on non-neurologic conditions as well as actual inpatient rehabilitation facility program payment reports may have influenced respondents perceptions to change associated with the Medicare Benefit Policy Manual modifications. This disparity between perception and actual data may have implications for programmatic planning, forecasting, and resource allocation. Copyright © 2014 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Will Changes to Medicare Payment Rates Alter Hospice's Cost-Saving Ability?

Science.gov (United States)

Taylor, Donald H; Bhavsar, Nrupen A; Bull, Janet H; Kassner, Cordt T; Olson, Andrew; Boucher, Nathan A

2018-05-01

On January 1, 2016, Medicare implemented a new "two-tiered" model for hospice services, with per diem rates increased for days 1 through 60, decreased for days 61 and greater, and service intensity add-on payments made retrospectively for the last seven days of life. To estimate whether the Medicare hospice benefit's potential for cost savings will change as a result of the January 2016 change in payment structure. Analysis of decedents' claims records using propensity score matching, logistic regression, and sensitivity analysis. All age-eligible Medicare decedents who received care and died in North Carolina in calendar years 2009 and 2010. Costs to Medicare for hospice and other healthcare services. Medicare costs were reduced from hospice election until death using both 2009-2010 and new 2016 payment structures and rates. Mean cost savings were $1,527 with actual payment rates, and would have been $2,105 with the new payment rates (p payment rate change. Cost savings were found for all primary diagnoses analyzed except dementia.

Examination of Industry Payments to Radiation Oncologists in 2014 Using the Centers for Medicare and Medicaid Services Open Payments Database

Energy Technology Data Exchange (ETDEWEB)

Jairam, Vikram [Yale School of Medicine, New Haven, Connecticut (United States); Yu, James B., E-mail: james.b.yu@yale.edu [Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut (United States)

2016-01-01

Purpose: To use the Centers for Medicare and Medicaid Services Open Payments database to characterize payments made to radiation oncologists and compare their payment profile with that of medical and surgical oncologists. Methods and Materials: The June 2015 release of the Open Payments database was accessed, containing all payments made to physicians in 2014. The general payments dataset was used for analysis. Data on payments made to medical, surgical, and radiation oncologists was obtained and compared. Within radiation oncology, data regarding payment category, sponsorship, and geographic distribution were identified. Basic statistics including mean, median, range, and sum were calculated by provider and by transaction. Results: Among the 3 oncologic specialties, radiation oncology had the smallest proportion (58%) of compensated physicians and the lowest mean ($1620) and median ($112) payment per provider. Surgical oncology had the highest proportion (84%) of compensated physicians, whereas medical oncology had the highest mean ($6371) and median ($448) payment per physician. Within radiation oncology, nonconsulting services accounted for the most money to physicians ($1,042,556), whereas the majority of the sponsors were medical device companies (52%). Radiation oncologists in the West accepted the most money ($2,041,603) of any US Census region. Conclusions: Radiation oncologists in 2014 received a large number of payments from industry, although less than their medical or surgical counterparts. As the Open Payments database continues to be improved, it remains to be seen whether this information will be used by patients to inform choice of providers or by lawmakers to enact policy regulating physician–industry relationships.

THE BALANCE OF PAYMENTS SUSTAINABILITY AND THE EUROZONE ACCESSION CONVERGENCE CRITERIA

Directory of Open Access Journals (Sweden)

NEGREA Adrian

2010-12-01

Full Text Available The main purpose of the balance of payments (BoP is identified as representing the long term need of equilibrium and stability of the international payments and revenues. The purpose of this paper is to determine the factors that influence the balance of payments of a certain country, by using a rigorous classification that reveals the complexity of these factors. Our conclusions are very relevant, especially for countries like Romania, because, in order to achieve the external equilibrium, it seems that every county must adopt a mix of internal economic policies, and although theoretically this can be realised, sometimes in practice it can prove to be impossible on account of inability or refusing to combine the appropriate economic policies.

Home Dialysis in the Prospective Payment System Era.

Science.gov (United States)

Lin, Eugene; Cheng, Xingxing S; Chin, Kuo-Kai; Zubair, Talhah; Chertow, Glenn M; Bendavid, Eran; Bhattacharya, Jayanta

2017-10-01

The ESRD Prospective Payment System introduced two incentives to increase home dialysis use: bundling injectable medications into a single payment for treatment and paying for home dialysis training. We evaluated the effects of the ESRD Prospective Payment System on home dialysis use by patients starting dialysis in the United States from January 1, 2006 to August 31, 2013. We analyzed data on dialysis modality, insurance type, and comorbidities from the United States Renal Data System. We estimated the effect of the policy on home dialysis use with multivariable logistic regression and compared the effect on Medicare Parts A/B beneficiaries with the effect on patients with other types of insurance. The ESRD Prospective Payment System associated with a 5.0% (95% confidence interval [95% CI], 4.0% to 6.0%) increase in home dialysis use by the end of the study period. Home dialysis use increased by 5.8% (95% CI, 4.3% to 6.9%) among Medicare beneficiaries and 4.1% (95% CI, 2.3% to 5.4%) among patients covered by other forms of health insurance. The difference between these groups was not statistically significant (1.8%; 95% CI, -0.2% to 3.8%). Conversely, in both populations, the training add-on did not associate with increases in home dialysis use beyond the effect of the policy. The ESRD Prospective Payment System bundling, but not the training add-on, associated with substantial increases in home dialysis, which were identical for both Medicare and non-Medicare patients. These spill-over effects suggest that major payment changes in Medicare can affect all patients with ESRD. Copyright © 2017 by the American Society of Nephrology.

Evaluating The Role Of Payment Policy In Driving Vertical Integration In The Oncology Market.

Science.gov (United States)

Alpert, Abby; Hsi, Helen; Jacobson, Mireille

2017-04-01

The health care industry has experienced massive consolidation over the past decade. Much of the consolidation has been vertical (with hospitals acquiring physician practices) instead of horizontal (with physician practices or hospitals merging with similar entities). We documented the increase in vertical integration in the market for cancer care in the period 2003-15, finding that the rate of hospital or health system ownership of practices doubled from about 30 percent to about 60 percent. The two most commonly cited explanations for this consolidation are a 2005 Medicare Part B payment reform that dramatically reduced reimbursement for chemotherapy drugs, and the expansion of hospital eligibility for the 340B Drug Discount Program under the Affordable Care Act (ACA). To evaluate the evidence for these explanations, we used difference-in-differences methods to assess whether consolidation increased more in areas with greater exposure to each policy than in areas with less exposure. We found little evidence that either policy contributed to vertical integration. Rather, increased consolidation in the market for cancer care may be part of a broader post-ACA trend toward integrated health care systems. Project HOPE—The People-to-People Health Foundation, Inc.

78 FR 48911 - Agency Information Collection Activities: Submission to OMB for Reinstatement, With Change, of a...

Science.gov (United States)

2013-08-12

... written reimbursement policy to ensure that the FCU makes payments to its director within the guidelines... comparing the policy to the actual reimbursements. DATES: Comments will be accepted until October 11, 2013... reimbursement policy to ensure that the FCU makes payments to its director within the guidelines that the FCU...

Medicare program; revisions to payment policies under the physician fee schedule, clinical laboratory fee schedule & other revisions to Part B for CY 2014. Final rule with comment period.

Science.gov (United States)

2013-12-10

This major final rule with comment period addresses changes to the physician fee schedule, clinical laboratory fee schedule, and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. This final rule with comment period also includes a discussion in the Supplementary Information regarding various programs. (See the Table of Contents for a listing of the specific issues addressed in the final rule with comment period.)

Evaluating EU Regional Policy: Many Empirical Specifications, One (Unpleasant) Result

DEFF Research Database (Denmark)

Breidenbach, Philipp; Mitze, Timo; Schmidt, Christoph

Numerous studies have focused on the role of EU regional policy in fostering growth and convergence among European regions, why conducting another one? We argue that two facts are still lacking in the actual academic debate in order to get a sound empirical identification strategy and reliable...... regions with a GDP p.c. of less than 75% of the EU average. These payments shall represent the main instrument to fulfill the central aim of European regional policy, the boost of convergence and harmonic growth over the EU. They represent about two third of the whole European cohesion policy. In our...... results: First, one should take the theoretical underpinnings of regional growth models more serious, and second, a likewise careful account of the role of spatial dependence in the underlying data is needed. Though research has increasingly become aware of the latter point as important control factor...

Danish Balance of Payments Support

DEFF Research Database (Denmark)

Tarp, Finn; Kragh, Mads Váczy

This study is an analysis of Danish Balance for Payments Support (BOP) covering the period 1988-94. This aid instrument has not so far been used as an active tool to further Danish policy conditionalities vis-à-vis the reform process in developing countries. On the contrary, BOP has mainly been...

A cash flow oriented EOQ model under permissible delay in payments

African Journals Online (AJOL)

A cash flow oriented EOQ model under permissible delay in payments. RP Tripathi, SS Misra, HS Shukla. Abstract. This study presents an inventory model to determine an optimal ordering policy for non-deteriorating items and timedependent demand rate with delay in payments permitted by the supplier under inflation and ...

The Effect of the Common Agricultural Policy Reform by 2013 on Direct Payments in Relation to Animal Welfare in the European Union - Review

Directory of Open Access Journals (Sweden)

Marek Angelovič

2011-10-01

Full Text Available The primary role of agriculture is to provide food and the European Union should be able to contribute to rising world food demand. The Common Agriculture Policy covers the wide variety of measures used to support and protect the European Union farmers. The most important measure within the Common Agriculture Policy is direct payments paid directly to farmers to protect their income. The Common Agriculture Policy is due to be reformed by 2013. The main object of the Common Agriculture Policy, which is a provision of safe, healthy choice of food at transparent and affordable prices, will remain unchanged, but further changes of the Common Agriculture Policy are necessary to respond to the new challenges such as animal welfare, global food security, natural resources such as water, air, biodiversity and soil, climate changes, increasing globalization and rising price volatility.

Introducing out-of-pocket payment for general practice in Denmark: feasibility and support.

Science.gov (United States)

Poulsen, Camilla Aavang

2014-07-01

The financing of General Practice (GP) is a much-debated topic. In spite of out-of-pocket (OOP) payment for other primary health care provided by self-employed professionals, there is no OOP payment for the use of GP in Denmark. This article aims to explore the arguments, the actors and the decision-making context. An analysis of the healthcare-policy debate in Parliament and the media from 1990 until September 2012. The materials are parliamentary hearings/discussions and newspaper articles. Kingdon's model on Policy Windows and the Advocacy Coalition framework by Sabatier and Jenkins are used to investigate explanations. The arguments from the proponents are: that OOP payment for GP will reduce pressure on the primary sector; that the current allocation of OOP payment in the sector is historically conditioned; and that resistance towards OOP payment is based on emotions. The main argument from the opponents is that OOP payment will increase social inequality in health. There is little connection between the attitudes and ideological backgrounds of the political parties. Despite factors such as perceived expert/scientific evidence for OOP payment, changes of government, financial crisis and a market-based reform wave, no government has introduced OOP payment for GP. This article suggests that governmental positions, public- and especially health-professional support are important factors in the decision-making context. Copyright © 2014. Published by Elsevier Ireland Ltd.

Measuring equity in household's health care payments (Tehran-Iran 2013): technical points for health policy decision makers.

Science.gov (United States)

Rezapour, Aziz; Ebadifard Azar, Farbod; Azami Aghdash, Saber; Tanoomand, Asghar; Hosseini Shokouh, Seyed Morteza; Yousefzadeh, Negar; Atefi Manesh, Pezhman; Sarabi Asiabar, Ali

2015-01-01

Households' financial protection against health payments and expenditures and equity in utilization of health care services are of the most important tasks of governments. This study aims to measuring equity in household's health care payments according to fairness in financial contribution (FFC) and Kakwani indices in Tehran-Iran, 2013. This cross-sectional study was conducted in 2014.The study sample size was estimated to be 2200 households. Households were selected using stratified-cluster sampling including typical families who reside in the city of Tehran. The data were analyzed through Excel and Stata v.11software. Recall period for the inpatient care was 1 year and for outpatient1 month. The indicator of FFC for households in health financing was estimated to be 0.68 and the trend of the indicator was ascending by the rise in the ranking of households' financial level. The Kakwani index was estimated to be a negative number (-0.00125) which indicated the descending trend of health financing system. By redistribution of incomes or the exempt of the poorest quintiles from health payments, Kakwani index was estimated to be a positive number (0.090555) which indicated the ascending trend of health financing system. According to this study, the equity indices in health care financing denote injustice and a descending trend in the health care financing system. This finding clearly shows that deliberate policy making in health financing by national health authorities and protecting low-income households against health expenditures are required to improve the equity in health.

Four Alternative Policies to Restore Balance of Payments Equilibrium

NARCIS (Netherlands)

J. Tinbergen (Jan)

1952-01-01

textabstractStimulated by Fleming's study on a related subject, the author compares four methods to eliminate balance of payments disequilibria between high-employment countries forming a closed group: (i) "discriminatory" import duties and subsidies, (ii) "discriminatory" duties only or the

MEDICARE PAYMENTS AND SYSTEM-LEVEL HEALTH-CARE USE

Science.gov (United States)

ROBBINS, JACOB A.

2015-01-01

The rapid growth of Medicare managed care over the past decade has the potential to increase the efficiency of health-care delivery. Improvements in care management for some may improve efficiency system-wide, with implications for optimal payment policy in public insurance programs. These system-level effects may depend on local health-care market structure and vary based on patient characteristics. We use exogenous variation in the Medicare payment schedule to isolate the effects of market-level managed care enrollment on the quantity and quality of care delivered. We find that in areas with greater enrollment of Medicare beneficiaries in managed care, the non–managed care beneficiaries have fewer days in the hospital but more outpatient visits, consistent with a substitution of less expensive outpatient care for more expensive inpatient care, particularly at high levels of managed care. We find no evidence that care is of lower quality. Optimal payment policies for Medicare managed care enrollees that account for system-level spillovers may thus be higher than those that do not. PMID:27042687

Enhancing Medicares Hospital Acquired Conditions Policy

Data.gov (United States)

U.S. Department of Health & Human Services — The current Medicare policy of non-payment to hospitals for Hospital Acquired Conditions (HAC) seeks to avoid payment for preventable complications identified within...

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

Science.gov (United States)

2017-08-14

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

78 FR 71528 - Federal Management Regulation (FMR); Transportation Payment and Audit

Science.gov (United States)

2013-11-29

... Payment and Audit AGENCY: Office of Government-wide Policy (OGP), General Services Administration (GSA...--TRANSPORTATION PAYMENT AND AUDIT 0 1. The authority citation for 41 CFR part 102-118 continues to read as follows....580 May a TSP appeal a prepayment audit decision of the GSA Audit Division? Yes, the TSP may appeal to...

41 CFR 102-38.290 - What types of payment may we accept?

Science.gov (United States)

2010-07-01

... payment policy that protects the Government against fraud. Acceptable payments include, but are not limited to, the following: (a) U.S. currency or any form of credit instrument made payable on demand in U.S. currency, e.g., cashier's check, money order. Promissory notes and postdated credit instruments...

MACRA, Alternative Payment Models, and the Physician-Focused Payment Model: Implications for Radiology.

Science.gov (United States)

Rosenkrantz, Andrew B; Nicola, Gregory N; Allen, Bibb; Hughes, Danny R; Hirsch, Joshua A

2017-06-01

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 describes alternative payment models (APMs) as new approaches to health care payment that incentivize higher quality and value. MACRA incentivizes increasing APM participation by all physician specialties over the coming years. Some APMs will be deemed Advanced APMs; clinicians who are a Qualifying Participant in an Advanced APM will receive substantial benefits under MACRA including an automatic 5% payment bonus, regardless of their performance and savings within the APM, and a larger payment rate increase beginning in 2026. Existing APMs are most relevant to primary care physicians, and opportunities for radiologists to participate in Advanced APMs fulfilling Qualified Participant requirements are limited. Physician-Focused Payment Models (PFPMs), as described in MACRA, are APMs that target physicians' Medicare payments based on quality and cost of physician services. PFPMs must address a new issue or specialty compared with existing APMs and will thus foster a more diverse range of APMs encompassing a wider range of specialties. The PFPM Technical Advisory Committee is a new independent agency that will review proposals for new PFPMs and provide recommendations to CMS regarding their approval. The PFPM Technical Advisory Committee comprises largely primary care physicians and health policy experts and is not required to consult clinical experts when reviewing new specialist-proposed PFPMs. As PFPMs provide a compelling opportunity for radiologists to demonstrate and be rewarded for their unique contributions toward patient care, radiologists should embrace this new model and actively partner with other stakeholders in developing radiology-relevant PFPMs. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

48 CFR 871.207 - Payment of tuition or fees.

Science.gov (United States)

2010-10-01

... prorated on the basis of attendance, regardless of the refund policy. (3) If an institution customarily charges for the amount of credit or number of hours of attendance for which a trainee enrolls, payment may... policy providing for a graduated scale of charges for purposes of determining refunds may be paid part or...

Evaluating Interactions of Forest Conservation Policies on Avoided Deforestation

Science.gov (United States)

Robalino, Juan; Sandoval, Catalina; Barton, David N.; Chacon, Adriana; Pfaff, Alexander

2015-01-01

We estimate the effects on deforestation that have resulted from policy interactions between parks and payments and between park buffers and payments in Costa Rica between 2000 and 2005. We show that the characteristics of the areas where protected and unprotected lands are located differ significantly. Additionally, we find that land characteristics of each of the policies and of the places where they interact also differ significantly. To adequately estimate the effects of the policies and their interactions, we use matching methods. Matching is implemented not only to define adequate control groups, as in previous research, but also to define those groups of locations under the influence of policies that are comparable to each other. We find that it is more effective to locate parks and payments away from each other, rather than in the same location or near each other. The high levels of enforcement inside both parks and lands with payments, and the presence of conservation spillovers that reduce deforestation near parks, significantly reduce the potential impact of combining these two policies. PMID:25909323

Evaluating interactions of forest conservation policies on avoided deforestation.

Directory of Open Access Journals (Sweden)

Juan Robalino

Full Text Available We estimate the effects on deforestation that have resulted from policy interactions between parks and payments and between park buffers and payments in Costa Rica between 2000 and 2005. We show that the characteristics of the areas where protected and unprotected lands are located differ significantly. Additionally, we find that land characteristics of each of the policies and of the places where they interact also differ significantly. To adequately estimate the effects of the policies and their interactions, we use matching methods. Matching is implemented not only to define adequate control groups, as in previous research, but also to define those groups of locations under the influence of policies that are comparable to each other. We find that it is more effective to locate parks and payments away from each other, rather than in the same location or near each other. The high levels of enforcement inside both parks and lands with payments, and the presence of conservation spillovers that reduce deforestation near parks, significantly reduce the potential impact of combining these two policies.

Evaluating interactions of forest conservation policies on avoided deforestation.

Science.gov (United States)

Robalino, Juan; Sandoval, Catalina; Barton, David N; Chacon, Adriana; Pfaff, Alexander

2015-01-01

We estimate the effects on deforestation that have resulted from policy interactions between parks and payments and between park buffers and payments in Costa Rica between 2000 and 2005. We show that the characteristics of the areas where protected and unprotected lands are located differ significantly. Additionally, we find that land characteristics of each of the policies and of the places where they interact also differ significantly. To adequately estimate the effects of the policies and their interactions, we use matching methods. Matching is implemented not only to define adequate control groups, as in previous research, but also to define those groups of locations under the influence of policies that are comparable to each other. We find that it is more effective to locate parks and payments away from each other, rather than in the same location or near each other. The high levels of enforcement inside both parks and lands with payments, and the presence of conservation spillovers that reduce deforestation near parks, significantly reduce the potential impact of combining these two policies.

75 FR 20526 - Section 111 and Interest Payments

Science.gov (United States)

2010-04-20

... required to be paid on any royalty underpayment or late payment from a particular accounting period if the... particular accounting period if the interest charge is less than or equal to five dollars.'' after ``then the accrual period shall end on the date of the actual receipt by the Copyright Office.'' Dated: April 14...

Society of Gynecologic Oncology Future of Physician Payment Reform Task Force report: The Endometrial Cancer Alternative Payment Model (ECAP).

Science.gov (United States)

Ko, Emily M; Havrilesky, Laura J; Alvarez, Ronald D; Zivanovic, Oliver; Boyd, Leslie R; Jewell, Elizabeth L; Timmins, Patrick F; Gibb, Randall S; Jhingran, Anuja; Cohn, David E; Dowdy, Sean C; Powell, Matthew A; Chalas, Eva; Huang, Yongmei; Rathbun, Jill; Wright, Jason D

2018-05-01

Health care in the United States is in the midst of a significant transformation from a "fee for service" to a "fee for value" based model. The Medicare Access and CHIP Reauthorization Act of 2015 has only accelerated this transition. Anticipating these reforms, the Society of Gynecologic Oncology developed the Future of Physician Payment Reform Task Force (PPRTF) in 2015 to develop strategies to ensure fair value based reimbursement policies for gynecologic cancer care. The PPRTF elected as a first task to develop an Alternative Payment Model for thesurgical management of low risk endometrial cancer. The history, rationale, and conceptual framework for the development of an Endometrial Cancer Alternative Payment Model are described in this white paper, as well as directions forfuture efforts. Copyright © 2018 Elsevier Inc. All rights reserved.

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...

Payments by US pharmaceutical and medical device manufacturers to US medical journal editors: retrospective observational study

Science.gov (United States)

Bell, Chaim M; Matelski, John J; Detsky, Allan S; Cram, Peter

2017-01-01

Objective To estimate financial payments from industry to US journal editors. Design Retrospective observational study. Setting 52 influential (high impact factor for their specialty) US medical journals from 26 specialties and US Open Payments database, 2014. Participants 713 editors at the associate level and above identified from each journal’s online masthead. Main outcome measures All general payments (eg, personal income) and research related payments from pharmaceutical and medical device manufacturers to eligible physicians in 2014. Percentages of editors receiving payments and the magnitude of such payments were compared across journals and by specialty. Journal websites were also reviewed to determine if conflict of interest policies for editors were readily accessible. Results Of 713 eligible editors, 361 (50.6%) received some (>$0) general payments in 2014, and 139 (19.5%) received research payments. The median general payment was $11 (£8; €9) (interquartile range $0-2923) and the median research payment was $0 ($0-0). The mean general payment was $28 136 (SD $415 045), and the mean research payment was $37 963 (SD $175 239). The highest median general payments were received by journal editors from endocrinology ($7207, $0-85 816), cardiology ($2664, $0-12 912), gastroenterology ($696, $0-20 002), rheumatology ($515, $0-14 280), and urology ($480, $90-669). For high impact general medicine journals, median payments were $0 ($0-14). A review of the 52 journal websites revealed that editor conflict of interest policies were readily accessible (ie, within five minutes) for 17/52 (32.7%) of journals. Conclusions Industry payments to journal editors are common and often large, particularly for certain subspecialties. Journals should consider the potential impact of such payments on public trust in published research. PMID:29074628

THE IMPACT OF COMPENSATION PAYMENTS ON EMPLOYMENT, IN REGIONAL STRUCTURES

Directory of Open Access Journals (Sweden)

Nicoleta JULA

2015-07-01

Full Text Available Compensation payments are considered active labour market policies designed to increase efficiency, to mitigate unemployment and to sustaining employment. We tested this hypothesis for the period 1993-2013, in territorial structures (42 counties through a dynamic panel model (confirmed by Granger causality tests – Toda-Yamamoto version, and by means of error correction model. We found that the dynamics of regional employment are positively related to expenditure incurred for active policies and there are negatively correlated with the ratio between the unemployment average indemnity (and support allowance and the average net nominal monthly salary earnings. But, the connexion between employment and compensation payments converges extremely slowly for a long-term stable relationship.

48 CFR 970.3200 - Policy.

Science.gov (United States)

2010-10-01

... DOE MANAGEMENT AND OPERATING CONTRACTS Contract Financing 970.3200 Policy. It is the policy of the Department of Energy (DOE) to finance management and operating contracts through advance payments and the use...

48 CFR 225.7501 - Policy.

Science.gov (United States)

2010-10-01

... DEFENSE SOCIOECONOMIC PROGRAMS FOREIGN ACQUISITION Balance of Payments Program 225.7501 Policy. Acquire... significantly impair the quality at the point of consumption; (ii) An end product or construction material, by... comparative cost of application of the Balance of Payments Program to the total acquisition; or (v) Use of a...

Medicare program; revision to accrual basis of accounting policy--HCFA. Proposed rule.

Science.gov (United States)

1998-05-18

Current policy provides that payroll taxes a provider becomes obligated to remit to governmental agencies are included in allowable costs under Medicare only in the cost reporting period in which payment (upon which the payroll taxes are based) is actually made to an employee. Therefore, for payroll accrued in one year but not paid until the next year, the associated payroll taxes on the payroll are not an allowable cost until the next year. This proposed rule would make one exception, in the situation where payment would be made to the employee in the current year but for the fact the regularly scheduled payment date is after the end of the year. In that case, the rule would require allowance in the current year of accrued taxes on payroll that is accrued through the end of the year but not paid until the beginning of the next year, thus allowing accrued taxes on end-of-the year payroll in the same year that the accrual of the payroll itself is allowed. The effect of this proposal is not on the allowability of cost but rather only on the timing of payment; that is, the cost of payroll taxes on and-of-the-year payroll would be allowable in the current period rather than in the following period.

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

Science.gov (United States)

2015-11-13

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

Towards Patient-Centered Conflicts of Interest Policy

Directory of Open Access Journals (Sweden)

Peter D. Young

2018-02-01

Full Text Available Financial conflicts of interest exist between industry and physicians, and these relationships have the power to influence physicians’ medical practice. Transparency about conflicts matters for ensuring adequate informed consent, controlling healthcare expenditure, and encouraging physicians’ reflection on professionalism. The US Centers for Medicare & Medicaid Services (CMS launched the Open Payments Program (OPP to publicly disclose and bring transparency to the relationships between industry and physicians in the United States. We set out to explore user awareness of the database and the ease of accessibility to disclosed information, however, as we show, both awareness and actual use are very low. Two practical policies can greatly enhance its intended function and help alleviate ethical tension. The first is to provide data for individual physicians not merely in absolute terms, but in meaningful context, that is, in relation to the zip code, city, and state averages. The second increases access to the OPP dataset by adding hyperlinks from physicians’ professional websites directly to their Open Payments disclosure pages. These changes considerably improve transparency and the utility of available data, and can furthermore enhance professionalism and accountability by encouraging physicians to reflect more actively on their own practices.

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

Science.gov (United States)

Conrad, Douglas A

2015-12-01

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

A model to determine payments associated with radiology procedures.

Science.gov (United States)

Mabotuwana, Thusitha; Hall, Christopher S; Thomas, Shiby; Wald, Christoph

2017-12-01

Across the United States, there is a growing number of patients in Accountable Care Organizations and under risk contracts with commercial insurance. This is due to proliferation of new value-based payment models and care delivery reform efforts. In this context, the business model of radiology within a hospital or health system context is shifting from a primary profit-center to a cost-center with a goal of cost savings. Radiology departments need to increasingly understand how the transactional nature of the business relates to financial rewards. The main challenge with current reporting systems is that the information is presented only at an aggregated level, and often not broken down further, for instance, by type of exam. As such, the primary objective of this research is to provide better visibility into payments associated with individual radiology procedures in order to better calibrate expense/capital structure of the imaging enterprise to the actual revenue or value-add to the organization it belongs to. We propose a methodology that can be used to determine technical payments at a procedure level. We use a proportion based model to allocate payments to individual radiology procedures based on total charges (which also includes non-radiology related charges). Using a production dataset containing 424,250 radiology exams we calculated the overall average technical charge for Radiology to be $873.08 per procedure and the corresponding average payment to be $326.43 (range: $48.27 for XR and $2750.11 for PET/CT) resulting in an average payment percentage of 37.39% across all exams. We describe how charges associated with a procedure can be used to approximate technical payments at a more granular level with a focus on Radiology. The methodology is generalizable to approximate payment for other services as well. Understanding payments associated with each procedure can be useful during strategic practice planning. Charge-to-total charge ratio can be used to

Payments by US pharmaceutical and medical device manufacturers to US medical journal editors: retrospective observational study.

Science.gov (United States)

Liu, Jessica J; Bell, Chaim M; Matelski, John J; Detsky, Allan S; Cram, Peter

2017-10-26

Objective  To estimate financial payments from industry to US journal editors. Design  Retrospective observational study. Setting  52 influential (high impact factor for their specialty) US medical journals from 26 specialties and US Open Payments database, 2014. Participants  713 editors at the associate level and above identified from each journal's online masthead. Main outcome measures  All general payments (eg, personal income) and research related payments from pharmaceutical and medical device manufacturers to eligible physicians in 2014. Percentages of editors receiving payments and the magnitude of such payments were compared across journals and by specialty. Journal websites were also reviewed to determine if conflict of interest policies for editors were readily accessible. Results  Of 713 eligible editors, 361 (50.6%) received some (>$0) general payments in 2014, and 139 (19.5%) received research payments. The median general payment was $11 (£8; €9) (interquartile range $0-2923) and the median research payment was $0 ($0-0). The mean general payment was $28 136 (SD $415 045), and the mean research payment was $37 963 (SD $175 239). The highest median general payments were received by journal editors from endocrinology ($7207, $0-85 816), cardiology ($2664, $0-12 912), gastroenterology ($696, $0-20 002), rheumatology ($515, $0-14 280), and urology ($480, $90-669). For high impact general medicine journals, median payments were $0 ($0-14). A review of the 52 journal websites revealed that editor conflict of interest policies were readily accessible (ie, within five minutes) for 17/52 (32.7%) of journals. Conclusions  Industry payments to journal editors are common and often large, particularly for certain subspecialties. Journals should consider the potential impact of such payments on public trust in published research. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a

Preparing for budget-based payment methodologies: global payment and episode-based payment.

Science.gov (United States)

Hudson, Mark E

2015-10-01

Use of budget-based payment methodologies (capitation and episode-based bundled payment) has been demonstrated to drive value in healthcare delivery. With a focus on high-volume, high-cost surgical procedures, inclusion of anaesthesiology services in these methodologies is likely. This review provides a summary of budget-based payment methodologies and practical information necessary for anaesthesiologists to prepare for participation in these programmes. Although few examples of anaesthesiologists' participation in these models exist, an understanding of the structure of these programmes and opportunities for participation are available. Prospective preparation in developing anaesthesiology-specific bundled payment profiles and early participation in pathway development associated with selected episodes of care are essential for successful participation as a gainsharing partner. With significant opportunity to contribute to care coordination and cost management, anaesthesiology can play an important role in budget-based payment programmes and should expect to participate as full gainsharing partners. Precise costing methodologies and accurate economic modelling, along with identification of quality management and cost control opportunities, will help identify participation opportunities and appropriate payment and gainsharing agreements. Anaesthesiology-specific examples with budget-based payment models are needed to help guide increased participation in these programmes.

Actualization rate and environment policies: a review on the debate

International Nuclear Information System (INIS)

2011-01-01

The aim of this report is to present the theoretical basis which underlies the actualization of future values of gains and losses associated with the degradation of the environment on a long term, and even on a very long term. After having recalled some elements related to the actualization rate, the report discusses how to determine the actualization rate parameters through a descriptive or prescriptive approach, and outlines the multiplicity of choices and the sensitivity to parameters. It discusses the impact of relative prices and which hypothesis on these relative prices is to be retained. It finally discusses how risks are to be taken into account

Games policy makers and providers play: introducing case-mix-based payment to hospital chronic care units in Japan.

Science.gov (United States)

Ikegami, Naoki

2009-06-01

Case-mix-based payment was developed for hospital chronic care units in Japan to replace the flat per diem rate and encourage the admission of patients with higher medical acuity and was part of a policy initiative to make the tariff more evidence based. However, although the criteria for grouping patients were developed from a statistical analysis of resource use, the tariff was subsequently set below costs, particularly for the groups with the lowest medical acuity, both because of the prime minister's decision to decrease total health expenditures and because of the health ministry's decision to target the reductions on chronic care units. Providers quickly adapted to the new payment system mainly by reclassifying their patients to higher medical acuity groups. Some hospitals reported high prevalence rates of urinary tract infections and pressure ulcers. The government responded by issuing directives to providers to calculate the prevalence rates and document the care that has been mandated for the patients at risk. However, in order to monitor compliance and to evaluate whether the patient is being billed for the appropriate case-mix group, the government must invest in developing a comprehensive patient-level database and in training staff for making on-site inspections.

Liquidity Constraints and the Centralized Home Mortgage Policy in China

DEFF Research Database (Denmark)

Gao, Cixiu

2017-01-01

This paper investigates China's centralized mortgage policy in general, and evaluates the policy change in 2011: the minimum down payment was dramatically raised to 60% of the home price. Using our previously developed structural model, we recover the unobserved liquidity wealth levels of individ......This paper investigates China's centralized mortgage policy in general, and evaluates the policy change in 2011: the minimum down payment was dramatically raised to 60% of the home price. Using our previously developed structural model, we recover the unobserved liquidity wealth levels...

Improving the Methods for Accounting the Coverages of Payments to Employees

Directory of Open Access Journals (Sweden)

Zhurakovska Iryna V.

2017-03-01

Full Text Available The article is aimed at exploring the theoretical and practical problems of accounting the coverages of payments to employees and developing on this basis ways of addressing them. An analysis of both the international and the national accounting standards, practices of domestic enterprises, as well as scientific works of scientists, has helped to identify the problematic issues of accounting the coverages of payments to employees, including: ignoring the disclosure in accounting and reporting, absence of an adequate documentary support, complexity of the calculation methods, etc. The authors have suggested ways to improve accounting of payments to employees: documentation of coverages through the development of a Statement of the accrued coverages, simplification of calculation of payments to employees together with the related reflecting in the analytical accounting, disclosure in the accounting policy, and so forth. Such decisions would improve accounting the coverages of payments to employees, increase the frequency of applying such coverages in enterprises and their disclosure in the financial statements.

75 FR 78901 - Payment for Inpatient and Outpatient Health Care Professional Services at Non-Departmental...

Science.gov (United States)

2010-12-17

... ESRD service providers who exercise this option, and we will not have any difficulty identifying these...,000 patients. This reinforces the conclusion that the number of VA-funded patients in the community... Payment Policy, MedPAC found that most payment adequacy indicators for dialysis services are positive and...

Designer policy for carbon and biodiversity co-benefits under global change

Science.gov (United States)

Bryan, Brett A.; Runting, Rebecca K.; Capon, Tim; Perring, Michael P.; Cunningham, Shaun C.; Kragt, Marit E.; Nolan, Martin; Law, Elizabeth A.; Renwick, Anna R.; Eber, Sue; Christian, Rochelle; Wilson, Kerrie A.

2016-03-01

Carbon payments can help mitigate both climate change and biodiversity decline through the reforestation of agricultural land. However, to achieve biodiversity co-benefits, carbon payments often require support from other policy mechanisms such as regulation, targeting, and complementary incentives. We evaluated 14 policy mechanisms for supplying carbon and biodiversity co-benefits through reforestation of carbon plantings (CP) and environmental plantings (EP) in Australia’s 85.3 Mha agricultural land under global change. The reference policy--uniform payments (bidders are paid the same price) with land-use competition (both CP and EP eligible for payments), targeting carbon--achieved significant carbon sequestration but negligible biodiversity co-benefits. Land-use regulation (only EP eligible) and two additional incentives complementing the reference policy (biodiversity premium, carbon levy) increased biodiversity co-benefits, but mostly inefficiently. Discriminatory payments (bidders are paid their bid price) with land-use competition were efficient, and with multifunctional targeting of both carbon and biodiversity co-benefits increased the biodiversity co-benefits almost 100-fold. Our findings were robust to uncertainty in global outlook, and to key agricultural productivity and land-use adoption assumptions. The results suggest clear policy directions, but careful mechanism design will be key to realising these efficiencies in practice. Choices remain for society about the amount of carbon and biodiversity co-benefits desired, and the price it is prepared to pay for them.

31 CFR 500.585 - Payments for services rendered by North Korea to United States aircraft authorized.

Science.gov (United States)

2010-07-01

... North Korea to United States aircraft authorized. 500.585 Section 500.585 Money and Finance: Treasury... TREASURY FOREIGN ASSETS CONTROL REGULATIONS Licenses, Authorizations and Statements of Licensing Policy § 500.585 Payments for services rendered by North Korea to United States aircraft authorized. Payments...

Medicare program; revision to accrual basis of accounting policy. Health Care Financing Administration (HCFA), HHS. Final rule.

Science.gov (United States)

1999-09-27

Medicare policy provides that payroll taxes that a provider becomes obligated to remit to governmental agencies are included in allowable costs only in the cost reporting period in which payment (upon which the payroll taxes are based) is actually made to an employee. Therefore, for payroll accrued in 1 year but not paid until the next year, the associated payroll taxes are not an allowable cost until the next year. This final rule provides for an exception when payment would be made to the employee in the current year but for the fact the regularly scheduled payment date is after the end of the year. In that case, the rule requires allowance in the current year of accrued taxes on payroll that is accrued through the end of the year but not paid until the beginning of the next year, thus allowing accrued taxes on end-of-the year payroll in the same year that the accrual of the payroll itself is allowed. The effect of this rule is not on the allowability of cost but rather only on the timing of payment; that is, the cost of payroll taxes on end-of-the-year payroll is allowable in the current period rather than in the following period.

Association of Informal Clinical Integration of Physicians With Cardiac Surgery Payments.

Science.gov (United States)

Funk, Russell J; Owen-Smith, Jason; Kaufman, Samuel A; Nallamothu, Brahmajee K; Hollingsworth, John M

2018-05-01

To reduce inefficiency and waste associated with care fragmentation, many current programs target greater clinical integration among physicians. However, these programs have led to only modest Medicare spending reductions. Most programs focus on formal integration, which often bears little resemblance to actual physician interaction patterns. To examine how physician interaction patterns vary between health systems and to assess whether variation in informal integration is associated with care delivery payments. National Medicare data from January 1, 2008, through December 31, 2011, identified 253 545 Medicare beneficiaries (aged ≥66 years) from 1186 health systems where Medicare beneficiaries underwent coronary artery bypass grafting (CABG) procedures. Interactions were mapped between all physicians who treated these patients-including primary care physicians and surgical and medical specialists-within a health system during their surgical episode. The level of informal integration was measured in these networks of interacting physicians. Multivariate regression models were fitted to evaluate associations between payments for each surgical episode made on a beneficiary's behalf and the level of informal integration in the health system where the patient was treated. The informal integration level of a health system. Price-standardized total surgical episode and component payments. The total 253 545 study participants included 175 520 men (69.2%; mean [SD] age, 74.51 [5.75] years) and 78 024 women (34.3%; 75.67 [5.91] years). One beneficiary of the 253 545 participants did not have sex information. The low level of informal clinical integration included 84 598 patients (33.4%; mean [SD] age, 75.00 [5.93] years); medium level, 84 442 (33.30%; 74.94 [5.87] years); and high level, 84 505 (33.34%; 74.66 [5.72] years) (P integration levels varied across health systems. After adjusting for patient, health-system, and community factors, higher levels

31 CFR 598.504 - Payments and transfers to blocked accounts in U.S. financial institutions.

Science.gov (United States)

2010-07-01

... accounts in U.S. financial institutions. 598.504 Section 598.504 Money and Finance: Treasury Regulations... Policy § 598.504 Payments and transfers to blocked accounts in U.S. financial institutions. Any payment... that comes within the possession or control of a U.S. financial institution must be blocked in an...

Payments under the Common Agricultural Policy as a determinant of development of different types of agricultural holdings

Directory of Open Access Journals (Sweden)

Czyżewski Andrzej

2016-12-01

Full Text Available The main aim of this article was to investigate the influence of payments under the CAP on economic development of different types of farms. The main source of data was FADN database. A period of research covers the years of 2004-2013. The article referred to previous results of research in the field of payments and its role for the economic situation of agricultural holdings. Then the share of payments in agricultural income was examined as well as the use of subsidies on investments. The process of accumulation, both in real and theoretical approach, and influence of this phenomenon on change of economic size were also presented. In addition the paper analysed the changes in return on equity in order to show the changes in economic efficiency of farms. The analyses that were conducted showed a significant role of payments in the formation of incomes and accumulation. On the other hand payments may lead to decrease in efficiency. In long term there is a risk that dependence on payments in functioning of farm will be excessive.

Research of Smart Payment System of Power Grid Using Strongly Sub-feasible SQP Algorithm

Directory of Open Access Journals (Sweden)

Yang Fang

2017-01-01

Full Text Available With the continuous development and perfection of “Internet + Electricity”, the regional grid operation has gradually realized the Internet-based automation. In order to improve the smart level of regional grid operation, this paper analyzes the status quo of power grid terminal in Fujian local power (group company, and introduces the strongly sub-feasible sequence quadratic programming (SQP. The smart payment system based on strongly sub-feasible SQP algorithm is described by its structure, function and implementation process. Through the information technology to improve the efficiency of the service, so that payment staff and smart terminal of self-service payment system has been information between the interactive mode, the actual operation effect is good.

Regional variation in Medicare payments for medical imaging: radiologists versus nonradiologists.

Science.gov (United States)

Rosman, David A; Nsiah, Eugene; Hughes, Danny R; Duszak, Richard

2015-05-01

The purpose of this article was to study regional variation in Medicare Physician Fee Schedule (MPFS) payments for medical imaging to radiologists compared with nonradiologists. Using a 5% random sample of all Medicare enrollees, which covered approximately 2.5 million Part B beneficiaries in 2011, total professional-only, technical-only, and global MPFS spending was calculated on a state-by-state and United States Census Bureau regional basis for all Medicare Berenson-Eggers Type of Service-defined medical imaging services. Payments to radiologists versus nonradiologists were identified and variation was analyzed. Nationally, mean MPFS medical imaging spending per Medicare beneficiary was $207.17 ($95.71 [46.2%] to radiologists vs $111.46 [53.8%] to nonradiologists). Of professional-only (typically interpretation) payments, 20.6% went to nonradiologists. Of technical-only (typically owned equipment) payments, 84.9% went to nonradiologists. Of global (both professional and technical) payments, 70.1% went to nonradiologists. The percentage of MPFS medical imaging spending on nonradiologists ranged from 32% (Minnesota) to 69.5% (South Carolina). The percentage of MPFS payments for medical imaging to nonradiologists exceeded those to radiologists in 58.8% of states. The relative percentage of MPFS payments to nonradiologists was highest in the South (58.5%) and lowest in the Northeast (48.0%). Nationally, 53.8% of MPFS payments for medical imaging services are made to nonradiologists, who claim a majority of MPFS payments in most states dominated by noninterpretive payments. This majority spending on nonradiologists may have implications in bundled and capitated payment models for radiology services. Medical imaging payment policy initiatives must consider the roles of all provider groups and associated regional variation.

31 CFR 547.504 - Payments and transfers to blocked accounts in U.S. financial institutions.

Science.gov (United States)

2010-07-01

... accounts in U.S. financial institutions. 547.504 Section 547.504 Money and Finance: Treasury Regulations... Policy § 547.504 Payments and transfers to blocked accounts in U.S. financial institutions. Any payment... institution must be blocked in an account on the books of that financial institution. A transfer of funds or...

38 CFR 9.5 - Payment of proceeds.

Science.gov (United States)

2010-07-01

..., discounted to the date of his or her death at the same rate used for inclusion of interest in the computation... remain unpaid will be discounted to the date of payment at the same rate used for inclusion of interest... is extended due to total disability converts the group insurance to an individual policy which is...

Health Care Payments in Vietnam: Patients’ Quagmire of Caring for Health versus Economic Destitution

Directory of Open Access Journals (Sweden)

Andre Pekerti

2017-09-01

Full Text Available In the last three decades many developing and middle-income nations’ health care systems have been financed via out-of-pocket payments by individuals. User fees charges, however, may not be the best approach or thenmost equitable approach to finance and/or reform health services in developing nations. This study investigates the status of Vietnam’s current health system as a result of implementing user fees policies. A recent mandate by the government to increase the universal cover to 100% attempts to tackle inadequate insurance cover, one of the four major factors contributing to the high and increasing probability of destitution for Vietnamese patients (the other three being: non-residency, long stay in hospital, and high cost of treatment. Empirical results however suggest that this may be catastrophic for low-income earners: if insurance cover reimbursement decreases below 50% of actual health expenditures, the probability of Vietnamese falling into destitution will rise further. Our findings provide policy implications and directions to improve Vietnam’s health care system, in particular by ensuring the utilization of health services and financial protection for the people.

78 FR 43281 - Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule, Clinical...

Science.gov (United States)

2013-07-19

... Index MFP Multi-Factor Productivity MIEA-TRHCA The Medicare Improvements and Extension Act, Division B... calculating direct PE RVUs from the top- down to the bottom-up methodology beginning in CY 2007. We adopted a... $20 million. 2. Calculation of Payments Based on RVUs To calculate the payment for each physicians...

Structuring payment to medical homes after the affordable care act.

Science.gov (United States)

Edwards, Samuel T; Abrams, Melinda K; Baron, Richard J; Berenson, Robert A; Rich, Eugene C; Rosenthal, Gary E; Rosenthal, Meredith B; Landon, Bruce E

2014-10-01

The Patient-Centered Medical Home (PCMH) is a leading model of primary care reform, a critical element of which is payment reform for primary care services. With the passage of the Affordable Care Act, the Accountable Care Organization (ACO) has emerged as a model of delivery system reform, and while there is theoretical alignment between the PCMH and ACOs, the discussion of physician payment within each model has remained distinct. Here we compare payment for medical homes with that for accountable care organizations, consider opportunities for integration, and discuss implications for policy makers and payers considering ACO models. The PCMH and ACO are complementary approaches to reformed care delivery: the PCMH ultimately requires strong integration with specialists and hospitals as seen under ACOs, and ACOs likely will require a high functioning primary care system as embodied by the PCMH. Aligning payment incentives within the ACO will be critical to achieving this integration and enhancing the care coordination role of primary care in these settings.

48 CFR 2832.903 - Policy.

Science.gov (United States)

2010-10-01

... 2832.903 Federal Acquisition Regulations System DEPARTMENT OF JUSTICE General Contracting Requirements CONTRACT FINANCING Prompt Payment 2832.903 Policy. The HCA is responsible for promulgating policies and procedures to implement FAR 32.9 and to ensure that, when specifying due dates, full consideration will be...

Payment Instrument Characteristics

DEFF Research Database (Denmark)

Holst, Jacques; Kjeldsen, Martin; Hedman, Jonas

2015-01-01

Over the last decade, we have witnessed payment innovations that fundamentally have changed the ways we pay. Payment innovations, such as mobile payments and on-line banking, include characteristics or features that are essential to understand if we want to know how and why payers choose among...... payment innovations. Using the Repertory Grid technique to explore 15 payers’ perception of six payment instruments, including coins, banknotes, debit cards, credit cards, mobile payments, and on-line banking, we identify 16 payment characteristics. The characteristics aggregate seventy-six unique...

Payment card rewards programs and consumer payment choice

OpenAIRE

Andrew Ching; Fumiko Hayashi

2006-01-01

Card payments have been growing very rapidly. To continue the growth, payment card networks keep adding new merchants and card issuers try to stimulate their existing customers’ card usage by providing rewards. This paper seeks to analyze the effects of payment card rewards programs on consumer payment choice, by using consumer survey data. Specifically, we examine whether credit/debit reward receivers use credit/debit cards relatively more often than other consumers, if so how much more ofte...

Agricultural policy schemes

DEFF Research Database (Denmark)

Hansen, Henning Otte

2016-01-01

Agricultural support is a very important element in agricultural policy in many countries. Agricultural support is basically an instrument to meet the overall objectives of the agricultural policy – objectives set by society. There are a great number of instruments and ways of intervention...... in agricultural policy and they have different functions and impacts. Market price support and deficiency payments are two very important instruments in agricultural policy; however, they belong to two different support regimes or support systems. Market price support operates in the so-called high price system...

Community oncology in an era of payment reform.

Science.gov (United States)

Cox, John V; Ward, Jeffery C; Hornberger, John C; Temel, Jennifer S; McAneny, Barbara L

2014-01-01

Patients and payers (government and private) are frustrated with the fee-for-service system (FFS) of payment for outpatient health services. FFS rewards volume and highly valued services, including expensive diagnostics and therapeutics, over lesser valued cognitive services. Proposed payment schemes would incent collaboration and coordination of care among providers and reward quality. In oncology, new payment schemes must address the high costs of all services, particularly drugs, while preserving the robust distribution of sites of service available to patients in the United States. Information technology and personalized cancer care are changing the practice of oncology. Twenty-first century oncology will require increasing cognitive work and shared decision making, both of which are not well regarded in the FFS model. A high proportion of health care dollars are consumed in the final months of life. Effective delivery of palliative and end-of-life care must be addressed by practice and by new models of payment. Value-based reimbursement schemes will require oncology practices to change how they are structured. Lessons drawn from the principles of primary care's Patient Centered Medical Home (PCMH) will help oncology practice to prepare for new schemes. PCMH principles place a premium on proactively addressing toxicities of therapies, coordinating care with other providers, and engaging patients in shared decision making, supporting the ideal of value defined in the triple aim-to measurably improve patient experience and quality of care at less cost. Payment reform will be disruptive to all. Oncology must be engaged in policy discussions and guide rational shifts in priorities defined by new payment models.

The Future of the Mobile Payment as Electronic Payment System

OpenAIRE

Bezovski, Zlatko

2016-01-01

The development of the Internet and the arrival of e-commerce fostered digitalization in the payment processes by providing a variety of electronic payment options including payment cards (credit and debit), digital and mobile wallets, electronic cash, contactless payment methods etc. Mobile payment services with their increasing popularity are presently under the phase of transition, heading towards a promising future of tentative possibilities along with the innovation in technology. In thi...

Medicare program; revisions to payment policies under the Physician Fee Schedule, Clinical Laboratory Fee Schedule, access to identifiable data for the Center for Medicare and Medicaid Innovation Models & other revisions to Part B for CY 2015. Final rule with comment period.

Science.gov (United States)

2014-11-13

This major final rule with comment period addresses changes to the physician fee schedule, and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services, as well as changes in the statute. See the Table of Contents for a listing of the specific issues addressed in this rule.

Efficacy and efficiency of Agri-environmental payments in impacts of crops' management

Science.gov (United States)

Blasi, Emanuele; Martella, Angelo; Passeri, Nicolo; Ghini, Paolo

2015-04-01

Since the 90s, in Europe the Common Agricultural Policy (CAP) started to activate measures for improving the sustainability of European agriculture, these measures were systematized in 2000 with the tools of rural development, pursuing a synergistic environmental action trough the agri-environmental payments. Since their definition, those payments were designed to ensure the protection, maintenance and enhancement of natural resources (water, soil, forests), biodiversity (species and habitat), and landscape. In particular initiatives as set aside, afforestation, organic agriculture, integrated pest management, low input and precision agriculture have enriched the agricultural management practices. The aim of this work is to check the trend between agro-environmental subsidies and environmental performance (based on Ecological Indicators and CO2 evaluation) at country level in EU, in order to study the regulatory framework impact in addressing the European cropping system towards sustainability. In particular soils and their land use can storage CO2 as pool and so provide environmental services and, on the other hand the agricultural practices can stimulate the emission and the environmental footprint. Impacts (so called emissions/footprints and storage/environmental services) will be compared with the Agri-environmental Payments for calculating performances due to environmental management practices, supported by political initiatives. Such analysis sustains the European policy makers towards more suitable agricultural policies and in particular it can address national sustainability through agricultural practices.

Generating electricity with forest biomass: Consistency and payment timeframe effects in choice experiments

International Nuclear Information System (INIS)

Soliño, Mario; Farizo, Begoña A.; Vázquez, María X.; Prada, Albino

2012-01-01

This paper presents a choice experiment analyzing the consumers' preferences towards a policy for replacing conventional electricity with electricity generated from forest biomass. The results show that consumers specially prefer the effects related to the lower risk of forest fires and to the decrease in pressure on non-renewable resources. The article also presents a methodological test in relation to the payment timeframe and its effect on marginal willingness to pay and consistency of responses using choice experiments. The most frequent and realistic payments are associated with lower presence of inconsistent responses. Finally, we cannot reject the null hypothesis of no effects of payment timeframe on marginal willingness to pay. - Highlights: ▶ Analysis of preferences towards electricity generated from forest biomass. ▶ Lowering the risk of forest fires is a high valued external effect. ▶ Less pressure on non-renewable resources is highly valued. ▶ Frequent payments are associated with lower presence of inconsistent responses. ▶ Effects of payment timeframe on marginal willingness to pay.

Drug Policy in Bulgaria.

Science.gov (United States)

Dimova, Antoniya; Rohova, Maria; Atanasova, Elka; Kawalec, Paweł; Czok, Katarzyna

2017-09-01

Bulgaria has a mixed public-private health care financing system. Health care is financed mainly from compulsory health insurance contributions and out-of-pocket payments. Out-of-pocket payments constitute a large share of the total health care expenditure (44.14% in 2014). The share of drugs expenditure for outpatient treatment was 42.3% of the total health care expenditure in 2014, covered mainly by private payments (78.6% of the total pharmaceutical expenditure). The drug policy is run by the Ministry of Health (MoH), the National Council on Prices and Reimbursement of Medicinal Products, and the Health Technology Assessment Commission. The MoH defines diseases for which the National Health Insurance Fund (NHIF) pays for medicines. The National Council on Prices and Reimbursement of Medicinal Products maintains a positive drug list (PDL) and sets drug prices. Health technology assessment was introduced in 2015 for medicinal products belonging to a new international nonproprietary name group. The PDL defines prescription medicines that are paid for by the NHIF, the MoH, and the health care establishments; exact patient co-payments and reimbursement levels; as well as the ceiling prices for drugs not covered by the NHIF, including over-the-counter medicines. The reimbursement level can be 100%, 75%, or up to 50%. The PDL is revised monthly in all cases except for price increase. Physicians are not assigned with pharmaceutical budgets, there is a brand prescribing practice, and the substitution of prescribed medicines by pharmacists is prohibited. Policies toward cost containment and effectiveness increase include introduction of a reference pricing system, obligation to the NHIF to conduct mandatory centralized bargaining of discounts for medicinal products included in the PDL, public tendering for medicines for hospital treatment, reduction of markup margins of wholesalers and retailers, patient co-payment, and the introduction of health technology assessment

Variation in Payment Rates under Medicare's Inpatient Prospective Payment System.

Science.gov (United States)

Krinsky, Sam; Ryan, Andrew M; Mijanovich, Tod; Blustein, Jan

2017-04-01

To measure variation in payment rates under Medicare's Inpatient Prospective Payment System (IPPS) and identify the main payment adjustments that drive variation. Medicare cost reports for all Medicare-certified hospitals, 1987-2013, and Dartmouth Atlas geographic files. We measure the Medicare payment rate as a hospital's total acute inpatient Medicare Part A payment, divided by the standard IPPS payment for its geographic area. We assess variation using several measures, both within local markets and nationally. We perform a factor decomposition to identify the share of variation attributable to specific adjustments. We also describe the characteristics of hospitals receiving different payment rates and evaluate changes in the magnitude of the main adjustments over time. Data downloaded from the Centers for Medicare and Medicaid Services, the National Bureau of Economic Research, and the Dartmouth Atlas. In 2013, Medicare paid for acute inpatient discharges at a rate 31 percent above the IPPS base. For the top 10 percent of discharges, the mean rate was double the IPPS base. Variations were driven by adjustments for medical education and care to low-income populations. The magnitude of variation has increased over time. Adjustments are a large and growing share of Medicare hospital payments, and they create significant variation in payment rates. © Health Research and Educational Trust.

Payment Platform

DEFF Research Database (Denmark)

Hjelholt, Morten; Damsgaard, Jan

2012-01-01

thoroughly and substitute current payment standards in the decades to come. This paper portrays how digital payment platforms evolve in socio-technical niches and how various technological platforms aim for institutional attention in their attempt to challenge earlier platforms and standards. The paper...... applies a co-evolutionary multilevel perspective to model the interplay and processes between technology and society wherein digital payment platforms potentially will substitute other payment platforms just like the credit card negated the check. On this basis this paper formulate a multilevel conceptual...

Understanding informal payments for health care: the example of Bulgaria.

Science.gov (United States)

Balabanova, Dina; McKee, Martin

2002-12-01

Throughout the 1990s, in response to funding deficits, out-of-pocket payment has grown as a share of total expenditure in countries in transition. A clear policy response to informal payments is, however, lacking. The current study explores informal payments in Bulgaria within a conceptual framework developed by triangulating information using a variety of methodologies. To estimate the scale and determinants of informal payments in the health sector of Bulgaria and to identify who benefits, the characteristics and timing of payments, and the reasons for paying. Data were derived from a national representative survey of 1547 individuals complemented by in-depth interviews and focus groups with over 100 respondents, conducted in Bulgaria in 1997. Informal payments are defined as a monetary or in-kind transaction between a patient and a staff member for services that are officially free of charge in the state sector. Informal payments are relatively common in Bulgaria, especially if in the form of gifts. Informal cash payments are universal for operations and childbirth, clear-cut and life-threatening procedures, in hospitals or elite urban facilities or well-known physicians. Most gifts were given at the end of treatment and most cash payments-before or during treatment. Wealthier, better educated, younger respondents tend to pay more often, as a means of obtaining better-quality treatment in a de facto two-tier system. Since the transition, informal payments had become frequent, explicit, solicited by staff, increasingly in cash, and less affordable. Informal payments stem from the low income of staff, patients seeking better treatment; acute funding shortages; and from tradition. Attitudes to informal payments range from strongly negative (if solicited) to tolerant (if patient-initiated), depending on the circumstances. The study provides important new insights into the incidence and nature of informal payments in the health sector in Bulgaria. Payments were less

Taxonomy of Payments

DEFF Research Database (Denmark)

Hedman, Jonas; Tan, Felix B.; Holst, Jacques

2017-01-01

that impact payers’ choice of payment instruments. Design/methodology/approach: Through in-depth interviews using the repertory grid technique, the authors explored 15 payers’ perceptions of six payment instruments, including coins, banknotes, debit cards, credit cards, mobile payments, and online banking....... The approach draws heavily on organizational systematics to better understand payers’ choice of payment instruments. Findings: A four-category taxonomy of payments was developed. The authors refer to the taxonomy as the 4Ps: the purchase, the payer, the payment instrument, and the physical technology...... or checks. Research limitations/implications: The findings suggest that payers view payment instruments in a much broader sense, including context, control, or cultural beliefs. Consequently, the authors suggest that researchers try to understand the essence of an innovation before assuming any economic...

Retailer’s replenishment policies under conditions of permissible delay in payments

Directory of Open Access Journals (Sweden)

Huang Yung-Fu

2004-01-01

Full Text Available Goyal (1985 is frequently cited when the inventory systems under conditions of permissible delay in payments are discussed. Goyal implicitly assumed that: 1. The unit selling price and the unit purchasing price are equal; 2. At the end of the credit period, the account is settled. The retailer starts paying for higher interest charges on the items in stock and returns money of the remaining balance immediately when the items are sold. But these assumptions are debatable in real-life situations. The main purpose of this paper is to modify Goyal’s model to allow the unit selling price and the unit purchasing price not necessarily be equal to reflect the real-life situations. Furthermore, this paper will adopt different payment rule. We assume that the retailer uses sales revenue during the permissible credit period to make payment to the supplier at the end of the credit period. If it is not enough to pay off the purchasing cost of all items, the retailer will pay off the remaining balance by taking loan from the bank. So, the retailer starts paying for the interest charges on the amount of loan from the bank after the account is settled. Then the retailer will return money to the bank at the end of the inventory cycle. Under these conditions, we model the retailer’s inventory system as a cost minimization problem to determine the retailer’s optimal cycle time and optimal order quantity. Four cases are developed to efficiently determine the optimal cycle time and the optimal order quantity. Numerical examples are given to illustrate these cases. Comparing with Goyal’s model, we also find that the optimal cycle times in this paper are not longer than those of Goyal’s model.

Patient Perception of Value in Bundled Payments for Total Joint Arthroplasty.

Science.gov (United States)

Schwartz, Adam J; Fraser, James F; Shannon, Allison M; Jackson, Nikki T; Raghu, T S

2016-12-01

A central concern for providers in a bundled payment model is determining how the bundle is distributed. Prior studies have shown that current reimbursement rates are often not aligned with patients' values. While willingness-to-pay (WTP) surveys are perhaps useful in a fee-for-service arrangement to determine overall reimbursement, the percentage of payment distribution might be as or more important in a bundled payment model. All patients undergoing primary total joint arthroplasty by a single surgeon were offered participation in a preoperative WTP survey. At a minimum 3 months postoperatively, patients were mailed instructions for an online follow-up survey asking how they would allocate a hypothetical bonus payment. From January through December 2014, 45 patients agreed to participate in the preoperative WTP survey. Twenty patients who were minimum 3 months postoperative also completed the follow-up survey. Patients valued total knee and hip arthroplasty at $28,438 (95% confidence interval [CI]: $20,551-36,324) and $39,479 (95% CI: $27,848-$51,112), respectively. At 3 months postoperatively, patients distributed a hypothetical bonus payment 55.5% to the surgeon (95% CI: 47.8%-63.1%), 38% to the hospital (95% CI: 30.3%-45.7%), and 6.5% (95% CI: -1.2% to 14.2%) to the implant manufacturer (P < .001). The data suggest that total joint arthroplasty patients have vastly different perceptions of payment distributions than what actually exists. In contrast to the findings of this study, the true distribution of payments for an episode of care averages 65% to the hospital, 27% to the implant manufacturer, and 8% to the surgeon. While many drivers of payment distribution exist, this study suggests that patients would allocate a larger proportion of a bundled payment to surgeons than is currently disbursed. This finding may also provide a plausible explanation for patients' consistent overestimation of surgeon reimbursements. Copyright © 2016 Elsevier Inc. All rights

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

Science.gov (United States)

2015-08-17

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

US hospital payment adjustments for innovative technology lag behind those in Germany, France, and Japan.

Science.gov (United States)

Hernandez, John; Machacz, Susanne F; Robinson, James C

2015-02-01

Medicare pioneered add-on payments to facilitate the adoption of innovative technologies under its hospital prospective payment system. US policy makers are now experimenting with broader value-based payment initiatives, but these have not been adjusted for innovation. This article examines the structure, processes, and experience with Medicare's hospital new technology add-on payment program since its inception in 2001 and compares it with analogous payment systems in Germany, France, and Japan. Between 2001 and 2015 CMS approved nineteen of fifty-three applications for the new technology add-on payment program. We found that the program resulted in $201.7 million in Medicare payments in fiscal years 2002-13-less than half the level anticipated by Congress and only 34 percent of the amount projected by CMS. The US program approved considerably fewer innovative technologies, compared to analogous technology payment mechanisms in Germany, France and Japan. We conclude that it is important to adjust payments for new medical innovations within prospective and value-based payment systems explicitly as well as implicitly. The most straightforward method to use in adjusting value-based payments is for the insurer to retrospectively adjust spending targets to account for the cost of new technologies. If CMS made such retrospective adjustments, it would not financially penalize hospitals for adopting beneficial innovations. Project HOPE—The People-to-People Health Foundation, Inc.

Impact of Exchange Rate on Balance of Payment in Nigeria ...

African Journals Online (AJOL)

Exchange rate policies have to be used along with the fiscal and monetary instruments to get meaningful results. This implies that our balance of payments problems can be solved simultaneously from two angles, namely, boosting supply and managing demand. Export diversification and promotion, import substitution and ...

How to buy a medical home? Policy options and practical questions.

Science.gov (United States)

Berenson, Robert A; Rich, Eugene C

2010-06-01

In this paper, we describe a range of payment options to support the PCMH, identifying their conceptual strengths and weaknesses. These include enhanced FFS payment for office visits to the PCMH; paying additional FFS for "new" PCMH services; variations of traditional FFS combined with new PCMH-oriented per patient per month capitation; and combined capitation payments for traditional primary care medical services as well as new medical home services. In discussing options for PCMH payment reform we consider issues in patient severity adjustment, performance payment, and the role of payments to community service organizations to collaborate with the PCMH. We also highlight some of the practical challenges that can complicate reimbursement reform for primary care and the PCMH. Through this discussion we identify key dimensions to provider payment reform relevant to promoting enhanced primary care through the patient centered medical home. These consist of paying for the basic medical home services, rewarding excellent performance of medical homes, incentivizing medical home connections to other community health care resources, and overcoming implementation challenges to medical home payments. Each of these overarching policy issues invokes a substantial subset of policy relevant research questions that collectively comprise a robust research agenda. We conclude that the conceptual strengths and weaknesses of available payment models for medical home functions invoke a complex array of options with varying levels of real-world feasibility. The different needs of patients and communities, and varying characteristics of practices must also be factors guiding PCMH payment reform. Indeed, it may be that different circumstances will require different payment approaches in various combinations.

Changes in out-of-pocket payments for healthcare in Vietnam and its impact on equity in payments, 1992-2002.

Science.gov (United States)

Chaudhuri, Anoshua; Roy, Kakoli

2008-10-01

be because the rich could avail of health insurance more than those at lower incomes and as a consequence, were able to use the healthcare system more effectively without paying a high OOP payment. In contrast, the poor either incurred higher OOP payments or were discouraged from seeking treatments until their ailment became serious. This inequality becomes exacerbated in 1998 when insurance take-up rates were not high, but the impact of privatization and deregulation was already occurring. By 2002, insurance take-up rates were much higher, and poverty alleviation policies (e.g., free health insurance and health fund membership targeted for the poor) were instituted, which may have resulted in a less regressive system.

The Direct Payments in the European Model of Agriculture

Directory of Open Access Journals (Sweden)

Věra Bečvářová

2008-01-01

Full Text Available The paper deals with the evaluation of economic contexts of the direct payments, as a targeted lump-sum financial transfer to the recipient’s income, employment in agricultural policy. Based upon the basic types of subsidies and their economic costs evaluation from the point of view of their deforming effects as well as transaction costs the direct payments are analysed generally as a type of support without a distorting effect on the gathering and transmission of market signals. The direct payments imply that the predominant flow from public funding to agriculture is paid independently from the volume of the present production (its amount and structure and make possible to choose the best structure of farm activities. However, their additional expenses are evaluated as a relatively very high. The transaction costs are high because the realisation of their objective (increase of the recipients’ income requires detailed personal information. Budgetary costs may also become extraordinarily high in the long term. On the basis at above the positive as well as negative components of their capacity for producers’ decision-making processes and their impact on the competitiveness in the framework of the modern agriculture are evaluated. In the following part of the paper the relationships effects of decoupled payments and agrarian markets are evaluated. Results of analyses indicate, the decoupled payments are not fully production neutral. Four topics of influence through which decoupled payments could affect production decisions are bringing to the attention as follows: wealth and investment effects (direct wealth effect, a wealth-facilitated increased investment effect, and a secondary wealth effect resulting from the increase in investment, sector consolidation effects, payment basis effects, and producer risk and expectations effects.

Tiered co-payments, pricing, and demand in reference price markets for pharmaceuticals.

Science.gov (United States)

Herr, Annika; Suppliet, Moritz

2017-12-01

Health insurance companies curb price-insensitive behavior and the moral hazard of insureds by means of cost-sharing, such as tiered co-payments or reference pricing in drug markets. This paper evaluates the effect of price limits - below which drugs are exempt from co-payments - on prices and on demand. First, using a difference-in-differences estimation strategy, we find that the new policy decreases prices by 5 percent for generics and increases prices by 4 percent for brand-name drugs in the German reference price market. Second, estimating a nested-logit demand model, we show that consumers appreciate co-payment exempt drugs and calculate lower price elasticities for brand-name drugs than for generics. This explains the different price responses of brand-name and generic drugs and shows that price-related co-payment tiers are an effective tool to steer demand to low-priced drugs. Copyright © 2017 Elsevier B.V. All rights reserved.

Prediction Model of Dividend Payment of Czech Joint Stock Companies

Directory of Open Access Journals (Sweden)

Sejkora František

2016-12-01

Full Text Available The dividend payment is the very important part of investment decision for many stockholders. Results of this text identify finance factors that influence the management in dividend policy within the examined branch “Production and distribution of electric energy, gas and water”. Seven regressive models were created and they identify and define the effect of individual factors on the dividend payment among individual owner’s types. The retained earnings, the rate of return of invested assets in total and the size of company have the positive effect on the dividend payment. For the purpose of better interpretation the individual factors were quantified in form of the chance that the company will pay the dividend when compared to the fact that the company is not going to pay any dividend. The resulting regressive model was subsequently validated using the classification table and the receiver operating characteristic curve.

48 CFR 42.703-1 - Policy.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Policy. 42.703-1 Section... CONTRACT ADMINISTRATION AND AUDIT SERVICES Indirect Cost Rates 42.703-1 Policy. (a) A single agency (see 42... indirect costs under cost-reimbursement contracts and in determining progress payments under fixed-price...

Medicare program; revision to accrual basis of accounting policy. Department of Health and Human Services (HHS), Health Care Financing Administration (HCFA). Final rule.

Science.gov (United States)

1999-09-27

Medicare policy provides that payroll taxes that a provider becomes obligated to remit to governmental agencies are included in allowable costs only in the cost reporting period in which payment (upon which the payroll taxes are based) is actually made to an employee. Therefore, for payroll accrued in 1 year but not paid until the next year, the associated payroll taxes are not an allowable cost until the next year. This final rule provides for an exception when payment would be made to the employee in the current year but for the fact that regularly scheduled payment date is after the end of the year. In that case, the rule requires allowance in the current year of accrued taxes on payroll that is accrued through the end of the year but not paid until the beginning of the next year, thus allowing accrued taxes on end-of-the year payroll in the same year that the accrual of the payroll itself is allowed. The effect of this rule is not on the allowability of cost but rather only on the timing of payment; that is, the cost of payroll taxes on end-of-the-year payroll is allowable in the current period rather than in the following period.

PERCEPTIONS OF EXECUTIVE PAYMENT ABUSE IN PUBLIC INSTITUTIONS

Directory of Open Access Journals (Sweden)

Tudor Pendiuc

2013-07-01

Full Text Available In the aftermath of the financial crisis, executive compensation abuse has been deeply criticized. Thus, the actuality of research is undeniable. The article highlights the importance of learning from other institutions’ past and present executive compensation abuse experiences by presenting the participants’ shared experiences (having to do with executive compensation abuse and by studying how participants perceive executive compensation abuse. The main objective of this research lies in exploring participants’ shared experiences concerning executive compensation abuse, as well as their perceptions, discrepancies and unsolved questions – presented within an ample, interconnected qualitative and quantitative methodological approach. A sample of 20 individuals was chosen for the triangulation method. From the resultant triangulation six new themes derive from the interview/questionnaire questions specifically referring to executive payment abuse namely: (a ethics means distinguishing between right and wrong, (b perspectives of ethical behaviour, (c types of executive payment abuse, (d the participant’s perceptions of institution and colleagues.

Internet cigarette vendor compliance with credit card payment and shipping bans.

Science.gov (United States)

Williams, Rebecca S; Ribisl, Kurt M

2014-02-01

Most Internet cigarette sales have violated taxation and youth access laws, leading to landmark 2005 agreements with credit card companies, PayPal, and private shippers (United Parcel Service, Federal Express, DHL) to cease participation in these transactions. Despite their promise at the time, loopholes allowed for check payment and U.S. Postal Service (USPS) shipping. This study assessed actual vendor compliance with the payment and shipping bans using a purchase survey. In late 2007 and early 2008, an adult buyer attempted to order cigarettes from the 97 most popular Internet cigarette vendors (ICVs) using banned payment and shipping methods. When banned payment or shipping methods were unavailable, purchases were attempted with alternate methods (e.g., checks, e-checks, USPS). Twenty-seven of 100 orders were placed with (banned) credit cards; 23 were successfully received. Seventy-one orders were placed with checks (60 successfully received). Four orders were delivered using banned shippers; 79 of 83 successfully received orders were delivered by the USPS. About a quarter of ICVs violated the payment ban, others adapted by accepting checks. Most vendors complied with the shipping ban, perhaps because USPS was an easy substitute shipping option. Better enforcement of the bans is needed; the 2009 Prevent All Cigarette Trafficking Act closed the USPS loophole by making cigarettes nonmailable material; evaluation of enforcement efforts and adaptations by vendors are needed. These sorts of bans are a promising approach to controlling the sale of restricted goods online.

73 Impact of Exchange Rate on Balance of Payment in Nigeria (Pp ...

African Journals Online (AJOL)

User

2011-07-21

Jul 21, 2011 ... exchange rate to the economic well-being of every country that opens its doors to ... anchor for price stability. Changes in ... payment) of Nigeria economy. ..... policy inadequacies) as well as the social and political instability. In.

Monetary Policy Implications of Electronic Money

OpenAIRE

Berentsen, Aleksander

1997-01-01

The term digital money refers to various proposed electronic payment mechanisms designed for use by consumers to make retail payments. Digital money products have the potential to replace central bank currency, thereby affecting the money supply. This paper studies the effect of replacing central bank currency on the narrowly defined stock of money under various assumptions regarding regulatory policies and monetary operations of central banks and the reaction of the banking system.

Analysis of the distributional impact of out-of-pocket health payments: evidence from a public health insurance program for the poor in Mexico.

Science.gov (United States)

Garcia-Diaz, Rocio; Sosa-Rubi, Sandra G; Sosa-Rub, Sandra G

2011-07-01

Many governments have health programs focused on improving health among the poor and these have an impact on out-of-pocket health payments made by individuals. Therefore, one of the objectives of these programs is to reach the poorest and reduce their out-of-pocket expenditure. In this paper we propose the distributional poverty impact approach to measure the poverty impact of out-of-pocket health payments of different health financing policies. This approach is comparable to the impoverishment methodology proposed by Wagstaff and van Doorslaer (2003) that compares poverty indices before and after out-of-pocket health payments. In order to escape the specification of a particular poverty index, we use the marginal dominance approach that uses non-intersecting curves and can rank poverty reducing health financing policies. We present an empirical application of the out-of-pocket health payments for an innovative social financing policy implemented in Mexico named Seguro Popular. The paper finds evidence that Seguro Popular program has a better distributional poverty impact when families face illness when compared to other poverty reducing policies. The empirical dominance approach uses data from Mexico in 2006 and considers international poverty standards of $2 per person per day. Copyright © 2011 Elsevier B.V. All rights reserved.

Specialty Payment Model Opportunities and Assessment: Oncology Model Design Report.

Science.gov (United States)

Huckfeldt, Peter J; Chan, Chris; Hirshman, Samuel; Kofner, Aaron; Liu, Jodi L; Mulcahy, Andrew W; Popescu, Ioana; Stevens, Clare; Timbie, Justin W; Hussey, Peter S

2015-07-15

This article describes research related to the design of a payment model for specialty oncology services for possible testing by the Center for Medicare and Medicaid Innovation at the Centers for Medicare & Medicaid Services (CMS). Cancer is a common and costly condition. Episode-based payment, which aims to create incentives for high-quality, low-cost care, has been identified as a promising alternative payment model for oncology care. Episode-based payment systems can provide flexibility to health care providers to select among the most effective and efficient treatment alternatives, including activities that are not currently reimbursed under Medicare payment policies. However, the model design also needs to ensure that high-quality care is delivered and that beneficial treatments are not withheld from patients. CMS asked MITRE and RAND to conduct analyses to inform design decisions related to an episode-based oncology model for Medicare beneficiaries undergoing chemotherapy treatment for cancer. In particular, this study focuses on analyses of Medicare claims data related to the definition of the initiation of an episode of chemotherapy, patterns of spending during and surrounding episodes of chemotherapy, and attribution of episodes of chemotherapy to physician practices. We found that the time between the primary cancer diagnosis and chemotherapy initiation varied widely across patients, ranging from one day to over seven years, with a median of 2.4 months. The average level of total monthly payments varied considerably across cancers, with the highest spending peak of $9,972 for lymphoma, and peaks of $3,109 for breast cancer and $2,135 for prostate cancer.

75 FR 36271 - Real Estate Settlement Procedures Act (RESPA): Home Warranty Companies' Payments to Real Estate...

Science.gov (United States)

2010-06-25

... Estate Settlement Procedures Act (RESPA): Home Warranty Companies' Payments to Real Estate Brokers and... RESPA and HUD's implementing RESPA regulations, services performed by real estate brokers and agents as additional settlement services in a real estate transaction are compensable if the services are actual...

Medicare program; payment policies under the physician fee schedule, five-year review of work relative value units, clinical laboratory fee schedule: signature on requisition, and other revisions to part B for CY 2012. Final rule with comment period.

Science.gov (United States)

2011-11-28

This final rule with comment period addresses changes to the physician fee schedule and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. It also addresses, implements or discusses certain statutory provisions including provisions of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act) and the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008. In addition, this final rule with comment period discusses payments for Part B drugs; Clinical Laboratory Fee Schedule: Signature on Requisition; Physician Quality Reporting System; the Electronic Prescribing (eRx) Incentive Program; the Physician Resource-Use Feedback Program and the value modifier; productivity adjustment for ambulatory surgical center payment system and the ambulance, clinical laboratory, and durable medical equipment prosthetics orthotics and supplies (DMEPOS) fee schedules; and other Part B related issues.

A MECHANISM AND DETERMINANTS OF AN AGENCY-COST EXPLANATION FOR DIVIDEND PAYMENTS

Directory of Open Access Journals (Sweden)

Jogiyanto Hartono

2003-06-01

Full Text Available This study explains the dividend puzzle using the agency-cost frame work suggested by Easterbrook (1984. Easterbrook hypothesized that shareholders in firms, who increase cash dividend payout and ‘simultaneously' raise debts to finance their investments are likely to be wealthier than those in firms who only increase their cash dividend payout. He provided the mechanism that shareholders use the dividend payments to force managers to go to the capital markets to raise funds. Therefore, he argued that dividend policy influences the financing policy. A system of simultaneous equation using three-stage generalized least square method is used to test the hypotheses. Among the variables to proxy the investment opportunity set, market-to-book ratio, market-to-book assets ratio and accounting earnings-per-share-to-price ratio are the best proxies. Attempt is made to obtain better proxies for the investment opportunity set using an instrument variable method. The system is robust to alternate investment opportunity variables as well as to the instrumental variables. The findings are as follows. For the firms that increase cash dividend payout and raise debt simultaneously, (a dividend policy is not a shareholders' mechanism, but a manager's accounting-based decision with accounting earnings and retained earnings as the major determinants, (b dividend policy influences financing policy, but not the other way around, (c increasing dividend payment decreases shareholders' wealth, but increasing debt subsequently increases shareholders' wealth with a net effect positive to shareholders' wealth, and (d dividend policy is independent from investment policy.

Uganda; Financial System Stability Assessment, including Reports on the Observance of Standards and Codes on the following topics: Monetary and Financial Policy Transparency, Banking Supervision, Securities Regulation, and Payment Systems

OpenAIRE

International Monetary Fund

2003-01-01

This paper presents findings of Uganda’s Financial System Stability Assessment, including Reports on the Observance of Standards and Codes on Monetary and Financial Policy Transparency, Banking Supervision, Securities Regulation, Insurance Regulation, Corporate Governance, and Payment Systems. The banking system in Uganda, which dominates the financial system, is fundamentally sound, more resilient than in the past, and currently poses no threat to macroeconomic stability. A major disruption ...

42 CFR 413.350 - Periodic interim payments for skilled nursing facilities receiving payment under the skilled...

Science.gov (United States)

2010-10-01

... facilities receiving payment under the skilled nursing facility prospective payment system for Part A... nursing facilities receiving payment under the skilled nursing facility prospective payment system for... SNF receiving payment under the prospective payment system may receive periodic interim payments (PIP...

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

Science.gov (United States)

2010-04-01

... EN payment systems? 411.525 Section 411.525 Employees' Benefits SOCIAL SECURITY ADMINISTRATION THE TICKET TO WORK AND SELF-SUFFICIENCY PROGRAM Employment Network Payment Systems § 411.525 What payments are available under each of the EN payment systems? (a) For payments for outcome payment months, both...

NASA policy on pricing shuttle launch services

Science.gov (United States)

Smith, J. M.

1977-01-01

The paper explains the rationale behind key elements of the pricing policy for STS, the major features of the non-government user policy, and some of the stimulating features of the policy which will open space to a wide range of new users. Attention is given to such major policy features as payment schedule, cost and standard services, the two phase pricing structure, optional services, shared flights, cancellation and postponement, and earnest money.

Electronic payment systems

OpenAIRE

Mláka, Michal

2010-01-01

This bachelor thesis analysis issue of electronic payment systems. It discusses their use for payments on the internet and sending funds via e-mail. The first part is devoted to the theoretical definition and legislation of the issuance of electronic money and activities of electronic money institutions. The main part of the work clearly focuses on the use of e-wallets, which is an integral part of electronic payment systems. E-wallet of electronic payment system Moneybookers is considered as...

Use of Payment Technology

DEFF Research Database (Denmark)

Xiao, Xiao; Hedman, Jonas; Runnemark, Emma

2015-01-01

Drawing on the theory of consumption value, this research-in-progress strives to provide a theoretical explanation of payment technology use by investigating the relationship between consumers’ perceptions of different consumption values associated with a certain payment technology and their choice...... to use the technology. We conducted the study in the context of Denmark, a Northern European country, with three well established payment technologies: cash, payment cards, and Internet banking. Following a focus group of identifying and defining four types of consumption values associated with each...... payment technology, a survey was then conducted by a national statistics agency in the country. Preliminary results have shown that different consumption values matter for the use of different payment technologies. The findings will potentially contribute to a better understanding of consumer payment...

Micro-economic analysis of alternative policies for Dutch dairy farming

NARCIS (Netherlands)

Boots, M.

1999-01-01

The dairy sector is to a large extent influenced and restricted by environmental and agricultural policies. These policies are often very detailed in nature and oriented at the farm level. That is, policy measures and regulations, such as taxes and support payments often depend on local

Payment of research participants: current practice and policies of Irish research ethics committees.

LENUS (Irish Health Repository)

Roche, Eric

2013-09-01

Payment of research participants helps to increase recruitment for research studies, but can pose ethical dilemmas. Research ethics committees (RECs) have a centrally important role in guiding this practice, but standardisation of the ethical approval process in Ireland is lacking.

Fundamental Reform of Payment for Adult Primary Care: Comprehensive Payment for Comprehensive Care

Science.gov (United States)

Berenson, Robert A.; Schoenbaum, Stephen C.; Gardner, Laurence B.

2007-01-01

Primary care is essential to the effective and efficient functioning of health care delivery systems, yet there is an impending crisis in the field due in part to a dysfunctional payment system. We present a fundamentally new model of payment for primary care, replacing encounter-based imbursement with comprehensive payment for comprehensive care. Unlike former iterations of primary care capitation (which simply bundled inadequate fee-for-service payments), our comprehensive payment model represents new investment in adult primary care, with substantial increases in payment over current levels. The comprehensive payment is directed to practices to include support for the modern systems and teams essential to the delivery of comprehensive, coordinated care. Income to primary physicians is increased commensurate with the high level of responsibility expected. To ensure optimal allocation of resources and the rewarding of desired outcomes, the comprehensive payment is needs/risk-adjusted and performance-based. Our model establishes a new social contract with the primary care community, substantially increasing payment in return for achieving important societal health system goals, including improved accessibility, quality, safety, and efficiency. Attainment of these goals should help offset and justify the costs of the investment. Field tests of this and other new models of payment for primary care are urgently needed. PMID:17356977

Medicaid provider reimbursement policy for adult immunizations.

Science.gov (United States)

Stewart, Alexandra M; Lindley, Megan C; Cox, Marisa A

2015-10-26

State Medicaid programs establish provider reimbursement policy for adult immunizations based on: costs, private insurance payments, and percentage of Medicare payments for equivalent services. Each program determines provider eligibility, payment amount, and permissible settings for administration. Total reimbursement consists of different combinations of Current Procedural Terminology codes: vaccine, vaccine administration, and visit. Determine how Medicaid programs in the 50 states and the District of Columbia approach provider reimbursement for adult immunizations. Observational analysis using document review and a survey. Medicaid administrators in 50 states and the District of Columbia. Whether fee-for-service programs reimburse providers for: vaccines; their administration; and/or office visits when provided to adult enrollees. We assessed whether adult vaccination services are reimbursed when administered by a wide range of providers in a wide range of settings. Medicaid programs use one of 4 payment methods for adults: (1) a vaccine and an administration code; (2) a vaccine and visit code; (3) a vaccine code; and (4) a vaccine, visit, and administration code. Study results do not reflect any changes related to implementation of national health reform. Nine of fifty one programs did not respond to the survey or declined to participate, limiting the information available to researchers. Medicaid reimbursement policy for adult vaccines impacts provider participation and enrollee access and uptake. While programs have generally increased reimbursement levels since 2003, each program could assess whether current policies reflect the most effective approach to encourage providers to increase vaccination services. Copyright © 2015 Elsevier Ltd. All rights reserved.

Medicaid provider reimbursement policy for adult immunizations☆

Science.gov (United States)

Stewart, Alexandra M.; Lindley, Megan C.; Cox, Marisa A.

2015-01-01

Background State Medicaid programs establish provider reimbursement policy for adult immunizations based on: costs, private insurance payments, and percentage of Medicare payments for equivalent services. Each program determines provider eligibility, payment amount, and permissible settings for administration. Total reimbursement consists of different combinations of Current Procedural Terminology codes: vaccine, vaccine administration, and visit. Objective Determine how Medicaid programs in the 50 states and the District of Columbia approach provider reimbursement for adult immunizations. Design Observational analysis using document review and a survey. Setting and participants Medicaid administrators in 50 states and the District of Columbia. Measurements Whether fee-for-service programs reimburse providers for: vaccines; their administration; and/or office visits when provided to adult enrollees. We assessed whether adult vaccination services are reimbursed when administered by a wide range of providers in a wide range of settings. Results Medicaid programs use one of 4 payment methods for adults: (1) a vaccine and an administration code; (2) a vaccine and visit code; (3) a vaccine code; and (4) a vaccine, visit, and administration code. Limitations Study results do not reflect any changes related to implementation of national health reform. Nine of fifty one programs did not respond to the survey or declined to participate, limiting the information available to researchers. Conclusions Medicaid reimbursement policy for adult vaccines impacts provider participation and enrollee access and uptake. While programs have generally increased reimbursement levels since 2003, each program could assess whether current policies reflect the most effective approach to encourage providers to increase vaccination services. PMID:26403369

Evaluation of foreign currency payment ability of China Nuclear Power Engineering Corporate

International Nuclear Information System (INIS)

Jiang Zhiqiong; Lu Gang; Zhang Qibo; Wen Suiru; Wu Weiwei

2009-01-01

Through this paper, after making a detailed research into the current foreign currency policy of China and the experience of China Nuclear Power Engineering Corporate(CNPEC) during LA2 project, the author evaluates the current ability of foreign currency settlement ability and defines the applicable process in CNPEC, in order to meet the future needs of CNPEC to make foreign currency payment for the multiple nuclear power projects. To ensure the foreign payment can be settled successfully, CNPEC should pay more attention to the import duty, foreign currency loan, clearing method, remittance after verification, as well as the financial risk management of foreign currency loan. On the premise that CNPEC can also get entitlement of import duty and value added tax preference, the author makes the point about how to enhance the capacity of foreign currency payment of CNPEC. (authors)

Unbundling payments for radioisotopes from radiopharmaceuticals and from diagnostic procedures: A tool to support the implementation of full-cost recovery. NEA discussion document

International Nuclear Information System (INIS)

2012-01-01

The objective of the NEA's HLG-MR policy approach is to ensure a long-term secure supply. The HLG-MR has determined that to attain that objective, a necessary (but not sufficient) requirement is that irradiation services in the 99 Mo/ 99m Tc supply chain must be provided on a full-cost recovery (FCR) basis (OECD-NEA, 2011). The HLG-MR policy approach also recommended that supply chain participants should implement payment reforms that promote full-cost recovery within their reimbursement systems. Reforms might include separate radioisotope pricing or auditing, separate radioisotope payment, differential radioisotope payment for FCR, or other approaches to promote a complete transition to full-cost recovery

Strategic interaction among hospitals and nursing facilities: the efficiency effects of payment systems and vertical integration.

Science.gov (United States)

Banks, D; Parker, E; Wendel, J

2001-03-01

Rising post-acute care expenditures for Medicare transfer patients and increasing vertical integration between hospitals and nursing facilities raise questions about the links between payment system structure, the incentive for vertical integration and the impact on efficiency. In the United States, policy-makers are responding to these concerns by initiating prospective payments to nursing facilities, and are exploring the bundling of payments to hospitals. This paper develops a static profit-maximization model of the strategic interaction between the transferring hospital and a receiving nursing facility. This model suggests that the post-1984 system of prospective payment for hospital care, coupled with nursing facility payments that reimburse for services performed, induces inefficient under-provision of hospital services and encourages vertical integration. It further indicates that the extension of prospective payment to nursing facilities will not eliminate the incentive to vertically integrate, and will not result in efficient production unless such integration takes place. Bundling prospective payments for hospitals and nursing facilities will neither remove the incentive for vertical integration nor induce production efficiency without such vertical integration. However, bundled payment will induce efficient production, with or without vertical integration, if nursing facilities are reimbursed for services performed. Copyright 2001 John Wiley & Sons, Ltd.

A comparative analysis of capacity adequacy policies

International Nuclear Information System (INIS)

Doorman, Gerard; Botterud, Audun; Wolfgang, Ove

2007-06-01

In this paper a stochastic dynamic optimization model is used to analyze the effect of different generation adequacy policies in restructured power systems. The expansion decisions of profit-maximizing investors are simulated under a number of different market designs: Energy Only with and without a price cap, Capacity Payment, Capacity Obligation, Capacity Subscription, and Demand Elasticity. The results show that the overall social welfare is reduced compared to a centralized social welfare optimization for all policies except Capacity Subscription and Demand Elasticity. In particular, an energy only market with a low price cap leads to a significant increase in involuntary load shedding. Capacity payments and obligations give additional investment incentives and more generating capacity, but also result in a considerable transfer of wealth from consumers to producers due to the capacity payments. Increased demand elasticity increases social welfare, but also results in a transfer from producers to consumers, compared to the theoretical social welfare optimum. In contrast, the capacity subscription policy increases the social welfare, and both producers and consumers benefit. This is possible because capacity subscription explicitly utilizes differences in consumers' preferences for uninterrupted supply. This advantage must be weighed against the cost of implementation, which is not included in the model.

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

Science.gov (United States)

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

2017-01-01

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

How different types of participant payments alter task performance

Directory of Open Access Journals (Sweden)

Gary L. Brase

2009-08-01

Full Text Available Researchers typically use incentives (such as money or course credit in order to obtain participants who engage in the specific behaviors of interest to the researcher. There is, however, little understanding or agreement on the effects of different types and levels of incentives used. Some results in the domain of statistical reasoning suggest that performance differences --- previously deemed theoretically important --- may actually be due to differences in incentive types across studies. 704 participants completed one of five variants of a statistical reasoning task, for which they received either course credit, flat fee payment, or performance-based payment incentives. Successful task completion was more frequent with performance-based incentives than with either of the other incentive types. Performance on moderately difficult tasks (compared to very easy and very hard tasks was most sensitive to incentives. These results can help resolve existing debates about inconsistent findings, guide more accurate comparisons across studies, and be applied beyond research settings.

Nonresearch Industry Payments to Radiologists: Characteristics and Associations With Regional Medical Imaging Utilization.

Science.gov (United States)

Kokabi, Nima; Junn, Jacqueline C; Xing, Minzhi; Hemingway, Jennifer; Hughes, Danny R; Duszak, Richard

2017-03-01

To evaluate characteristics of nonresearch industry payments to radiologists and associations with regional diagnostic imaging utilization. Using 2014 CMS Open Payment data, all disclosed nonresearch-related industry payments to radiologists were identified. Health Resources and Services Administration Area Health Resources Files were used to identify actual and population-weighted numbers of radiologists by state. Utilizing the 5% random beneficiary sample CMS Research Identifiable Files from 2014, average Medicare imaging spending per beneficiary in each state was calculated. Average frequency and dollar amounts of nonresearch nonroyalty payments to radiologists were calculated at the state level. Using the Pearson correlation coefficient, the relationship between frequency and amounts of nonresearch payments to radiologists versus per-beneficiary Medicare imaging spending was evaluated at the state level. Overall, 2,008 radiologists (1,670 diagnostic, 338 interventional) received nonresearch nonroyalty payments from industry, representing 5.2% of all 38,857 radiologists nationwide. A total of 4,975 individual transfers translated to 2.5 ± 1.3 discrete payments per receiving radiologist with a mean of $432 ± $1,976 (median $26; range $1-$34,050). Food and beverage expenses constituted the vast majority of disclosed transfers (4,111; 83%), followed by travel and lodging (444; 9%), consulting fees (279; 6%), and educational expenses (51; 1%). Considerable geographic variation in payments was observed, ranging from 0% of radiologists in Vermont to 12.9% in the District of Columbia. No correlation was identified between average per-beneficiary Medicare imaging spending and the proportion of nonresearch-funded radiologists in each state (r = 0.06). Similarly, no correlation was identified between average per-beneficiary Medicare imaging spending and the average nonresearch transfer amount to radiologists in each state (r = -0.08). In 2014, only a small minority of

Payment - National

Data.gov (United States)

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

Security of payment in Malaysian construction industry: issues on sub-contract's direct payment

OpenAIRE

Supardi, Azizan; Adnan, Hamimah

2011-01-01

In Malaysia, sub-contractors have to bear with the current structure of payment mechanisms in the standard forms of contract, which are payment upon certification, direct payment from the employer, and contingent or conditional payment. However, „direct payment‟ provision is applied for in most of the nominated sub-contracts and not to the domestic sub-contractors; thus the Construction Industry Payment and Adjudication (CIPA) Act is proposed. This paper, though, is to disclose the findings o...

Payment - State

Data.gov (United States)

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

Evaluation and Policy Learning

DEFF Research Database (Denmark)

Borrás, Susana; Højlund, Steven

2015-01-01

This article examines how evaluation induces policy learning – a question largely neglected by the scholarly literature on evaluation and policy learning. Following a learner's perspective, the article attempts to ascertain who the learners are, and what, and how, learners actually learn from...... evaluations. In so doing, it focuses on what different types of learners actually learn within the context of the evaluation framework (the set of administrative structures defining the evaluation goals and process). Taking the empirical case of three EU programme evaluations, the patterns of policy learning...... emanating from them are examined. The findings are that only two types of actors involved in the evaluation are actually learning (programme units and external evaluators), that learners learn different things (programme overview, small-scale programme adjustments, policy change and evaluation methods...

75 FR 40039 - Medicare Program; Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B...

Science.gov (United States)

2010-07-13

... INFORMATION CONTACT: Rebecca Cole, (410) 786-4497, for issues related to physician payment and for all other... issues related to renal dialysis provisions and payments for end-stage renal disease facilities. Diane...-State Renal Disease Related Services for Home Dialysis (CPT Codes 90963, 90964, 90965, and 90966) 1. End...

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

Science.gov (United States)

2016-08-22

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

Fingerprint start the next generation of payment method : Fingerprint payment: a new mode of mobile payment

OpenAIRE

Wu, Chong

2016-01-01

In the generation of mobile internet, fingerprint payment is one of the most popular topics at the moment. China has a big market and many users are using the mobile payment methods. There are a large number of mobile phones equipped with fingerprint recognition technology. As we know, fingerprint payment brings us more convenience and safety. We do not need to use many bankcards, and fingerprint also eliminates the users from the trouble of queuing to pay. However, users send traditional dig...

The relevance of systematic reviews on pharmaceutical policy to low- and middle-income countries.

Science.gov (United States)

Gray, Andrew Lofts; Suleman, Fatima

2015-10-01

Low- and middle-income countries (LMICs) rely on available evidence when devising and implementing pharmaceutical policies. Aim of the review To provide a critical overview of systematic reviews of pharmaceutical policies, with particular focus on the relevance of such reviews in low- and middle-income countries. A search for systematic reviews (SRs) of studies of the interventions of interest was conducted until May 2009 in MEDLINE, EconLit, CINAHL, the Cochrane site, ProQuest, EMBASE, JOLIS, ISI Web of Science, International Pharmaceutical Abstracts, International Network for Rational Use of Drugs, National Technical Information Service, Public Affairs Information Service, SourceOECD, the System for Information on Grey Literature in Europe, and the WHO library database. The search was updated to July 2013, based on the yields of the initial search strategy. 20 SRs that met all inclusion criteria were retrieved in full text. Four SRs were subsequently rejected on the basis of quality considerations and the findings of 16 SRs were extracted and their applicability in LMICs considered. Of these, 5 were Cochrane Reviews. All included SRs were published in English. SRs related to registration and classification policies, marketing policies, prescribing policies, reimbursement policies, policies on price and payments, co-payments and caps and multi-component policies were retrieved. No SRs related to patent and profit policies, sales and dispensing policies, policies that regulate the provision of health insurance, or policies on patient information were retrieved. Only one of the systematic reviews retrieved utilised a study conducted in a developing country. The direct applicability of the evidence from these SRs in LMICs is limited. However, as middle-income countries move towards universal health coverage, the multi-component policies that govern reimbursement for medicines, and which impose caps on payments and co-payments by patients, may become more applicable

[What do family medicine trainees think about gratitude payment?

Science.gov (United States)

Győrffy, Zsuzsa; Kalabay, László; Mohos, András; Márkus, Bernadett; Nánási, Anna; Rinfel, József; Girasek, Edmond; Torzsa, Péter

2017-07-01

The issue of gratuity is one of the most important health policy issues in Hungary. The authors' aim is to investigate the attitude of Hungarian family medicine trainees towards gratitude payment. Quantitative, paper-based survey among trainees from four Departments of Family Medicine in Hungary (n = 152). More than 50 percent of the residents do not approve of accepting gratitude money. Men (pgratitude patients feel (52%). According to the participants, the least influencing factor was the low salary of physicians (14.4%). They believe that accepting gratuity is a corruption, and it's humiliating for doctors (80-80%). Family medicine residents approve of gratitude money even less as compared to the results of previous studies, but related to other gratitude payment issues we have found similar opinions. Orv Hetil. 2017; 158(26): 1028-1035.

Financial sustainability versus access and quality in a challenged health system: an examination of the capitation policy debate in Ghana.

Science.gov (United States)

Atuoye, Kilian Nasung; Vercillo, Siera; Antabe, Roger; Galaa, Sylvester Zackaria; Luginaah, Isaac

2016-11-01

Policy makers in low and middle-income countries are frequently confronted with challenges of increasing health access for poor populations in a sustainable manner. After several years of trying out different health financing mechanisms, health insurance has recently emerged as a pro-poor health financing policy. Capitation, a fixed fee periodically paid to health service providers for anticipated services, is one of the payment policies in health insurance. This article examines claims and counter-claims made by coalitions and individual stakeholders in a capitation payment policy debate within Ghana's National Health Insurance Scheme. Using content analysis of public and parliamentary proceedings, we situate the debate within policy making and health insurance literature. We found that the ongoing capitation payment debate stems from challenges in implementation of earlier health insurance claims payment systems, which reflect broader systemic challenges facing the health insurance scheme in Ghana. The study illustrates the extent to which various sub-systems in the policy debate advance arguments to legitimize their claims about the contested capitation payment system. In addition, we found that the health of poor communities, women and children are being used as surrogates for political and individual arguments in the policy debate. The article recommends a more holistic and participatory approach through persuasion and negotiation to join interests and core evidence together in the capitation policy making in Ghana and elsewhere with similar contexts. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

42 CFR 457.226 - Fiscal policies and accountability.

Science.gov (United States)

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Fiscal policies and accountability. 457.226 Section 457.226 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Claims; Reduction of Federal Medical Payments § 457.226 Fiscal policies and accountability. A State plan...

Payment Cards

Directory of Open Access Journals (Sweden)

Kantnerová Liběna

2016-09-01

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

36 CFR 51.79 - May the Director waive payment of a franchise fee or other payments?

Science.gov (United States)

2010-07-01

... payment of a franchise fee or other payments? 51.79 Section 51.79 Parks, Forests, and Public Property....79 May the Director waive payment of a franchise fee or other payments? The Director may not waive the concessioner's payment of a franchise fee or other payments or consideration required by a...

Superconductivity: actual stage forcasting and subsidies for national policy

International Nuclear Information System (INIS)

Morato, S.P.

1987-01-01

An overview on the situation of metallic superconductors, their applications and market, and a brief history about the superconductivity at high T c (new ceramic superconductors), describing the actual level of research and development in the world and national plans are presented. Some comments about incentives and markets for rare earths are done. The scientific and technological challengers are discussed and some suggestions to lead a superconductivity national program are proposed. (M.C.K.) [pt

Global payment for health services as a solution in the financial crisis in Europe.

Science.gov (United States)

Schrijvers, Guus

2012-10-01

In these financial difficult years many European governments used global ceilings to control costs of health services. Two scenarios are thinkable. The first is that all individual providers get a budget for their own costs: general practitioners, specialists, hospitals, nursing homes and mental health institutes. The second scenario is to work with global budgets for health care providers servicing a total population. Scientists and policy makers in Europe, North America and Asia need time to design new payment systems based on the idea of global budgeting, bundled payment and shared savings.

Co-payments in the NHS: an analysis of the normative arguments.

Science.gov (United States)

Weale, Albert; Clark, Sarah

2010-04-01

During 2008, some forms of patient co-payments - in particular, patients paying privately for additional medicines as part of an episode of care in the National Health Service - became controversial in political and policy terms in the UK. In response, the UK Government published a report, the Richards' Review, examining the issues. Richards offered a particular policy solution, but also touched on fundamental principles of social value. Using the methods of normative policy analysis, we seek to understand these principles of social value, accepting the Richards' framework according to which the relevant arguments can be grouped under the broad headings of equity and autonomy. None of the arguments on either side are decisive, and, in part, the policy decision turns on uncertain empirical conjectures.

The financial burden of out-of-pocket patient payments in the European Union and accession countries: Results of a systematic literature review

NARCIS (Netherlands)

Moser, K.; Pavlova, M.; Groot, W.

2014-01-01

A major issue for public health policy is to reduce the poverty and catastrophic effects of out-of-pocket payments. This paper reviews empirical studies that analyze the financial burden of out-of-pocket payments and factors that are associated with this burden for households in the EU and accession

42 CFR 419.31 - Ambulatory payment classification (APC) system and payment weights.

Science.gov (United States)

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Ambulatory payment classification (APC) system and... Outpatient Services § 419.31 Ambulatory payment classification (APC) system and payment weights. (a) APC... of resource use into APC groups. Except as specified in paragraph (a)(2) of this section, items and...

Retail payments and economic growth

OpenAIRE

Hasan, Iftekhar; De Renzis, Tania; Schmiedel , Heiko

2012-01-01

This paper examines the fundamental relationship between retail payments and overall economic growth. Using data from across 27 European markets over the period 1995–2009, the results confirm that migration to efficient electronic retail payments stimulates overall economic growth, consumption and trade. Among different payment instruments, this relationship is strongest for card payments, followed by credit transfers and direct debits. Cheque payments are found to have a relatively low macro...

The effect of state medicaid case-mix payment on nursing home resident acuity.

Science.gov (United States)

Feng, Zhanlian; Grabowski, David C; Intrator, Orna; Mor, Vincent

2006-08-01

To examine the relationship between Medicaid case-mix payment and nursing home resident acuity. Longitudinal Minimum Data Set (MDS) resident assessments from 1999 to 2002 and Online Survey Certification and Reporting (OSCAR) data from 1996 to 2002, for all freestanding nursing homes in the 48 contiguous U.S. states. We used a facility fixed-effects model to examine the effect of introducing state case-mix payment on changes in nursing home case-mix acuity. Facility acuity was measured by aggregating the nursing case-mix index (NCMI) from the MDS using the Resource Utilization Group (Version III) resident classification system, separately for new admits and long-stay residents, and by an OSCAR-derived index combining a range of activity of daily living dependencies and special treatment measures. We followed facilities over the study period to create a longitudinal data file based on the MDS and OSCAR, respectively, and linked facilities with longitudinal data on state case-mix payment policies for the same period. Across three acuity measures and two data sources, we found that states shifting to case-mix payment increased nursing home acuity levels over the study period. Specifically, we observed a 2.5 percent increase in the average acuity of new admits and a 1.3 to 1.4 percent increase in the acuity of long-stay residents, following the introduction of case-mix payment. The adoption of case-mix payment increased access to care for higher acuity Medicaid residents.

Open Payments Data

Data.gov (United States)

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

Impacts of Alternative Implementations of the Single Farm Payment on Organi-cally and Conventionally Producing Farms in Austria

OpenAIRE

Schmid, Erwin; Sinabell, Franz

2007-01-01

In 2003, the Common Agricultural Policy underwent a substantial reform. Direct pay-ments that were linked to the production of certain crops and livestock were abolished. Alternatively, the Single Farm Payment was introduced in EU-15 Member States. We investigate the distributional consequences of alternative implementation choices for organic farms in Austria. Results show that net-returns of farms and the distribution of farm revenues depend on the particular implementation of the reform.

20 CFR 411.550 - How are the outcome payments calculated under the outcome payment system?

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false How are the outcome payments calculated under the outcome payment system? 411.550 Section 411.550 Employees' Benefits SOCIAL SECURITY ADMINISTRATION... the outcome payments calculated under the outcome payment system? The amount of each monthly outcome...

42 CFR 412.540 - Method of payment for preadmission services under the long-term care hospital prospective payment...

Science.gov (United States)

2010-10-01

... the long-term care hospital prospective payment system. 412.540 Section 412.540 Public Health CENTERS... PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Long-Term Care Hospitals... payment system. The prospective payment system includes payment for inpatient operating costs of...

How does the possibility to defer pension payments affect the labour supply of elderly Danish workers?

DEFF Research Database (Denmark)

Amilon, Anna; Nielsen, Torben Heien

2010-01-01

This chapter investigates the effects of a recent Danish policy reform on the number of hours worked after age 65. In short, the policy reform involved the option to defer pension payments and a reduction in the official retirement age from 67 to 65. Using a quasi-experimental design, we find tha...... positions that choose to defer their pensions. The results, therefore, indicate that the reform has mainly improved the situation of an already well-off group.......This chapter investigates the effects of a recent Danish policy reform on the number of hours worked after age 65. In short, the policy reform involved the option to defer pension payments and a reduction in the official retirement age from 67 to 65. Using a quasi-experimental design, we find...... that the reform has had a small positive impact on the number of hours worked at age 65. In the longer term (from age 65 to 67) the effect disappears, probably due to the reduction in the official retirement age causing people to retire earlier. It is mainly men, the highly educated and people holding advanced...

Two-part payments for the reimbursement of investments in health technologies.

Science.gov (United States)

Levaggi, Rosella; Moretto, Michele; Pertile, Paolo

2014-04-01

The paper studies the impact of alternative reimbursement systems on two provider decisions: whether to adopt a technology whose provision requires a sunk investment cost and how many patients to treat with it. Using a simple economic model we show that the optimal pricing policy involves a two-part payment: a price equal to the marginal cost of the patient whose benefit of treatment equals the cost of provision, and a separate payment for the partial reimbursement of capital costs. Departures from this scheme, which are frequent in DRG tariff systems designed around the world, lead to a trade-off between the objective of making effective technologies available to patients and the need to ensure appropriateness in use. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

42 CFR 412.404 - Conditions for payment under the prospective payment system for inpatient hospital services of...

Science.gov (United States)

2010-10-01

... payment system for inpatient hospital services of psychiatric facilities. 412.404 Section 412.404 Public... PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Inpatient Hospital... must meet the conditions of this section to receive payment under the prospective payment system...

Meta-analysis of institutional-economic factors explaining the environmental performance of payments for watershed services

NARCIS (Netherlands)

Brouwer, R.; Tesfaye, A.; Pauw, W.P.

2011-01-01

Payments for ecosystem services (PES) are a relatively new economic policy instrument, and the factors that drive and explain their environmental performance are poorly understood. Here a meta-analysis of causal relationships between the institutional design and environmental performance of 47

42 CFR 412.521 - Basis of payment.

Science.gov (United States)

2010-10-01

... PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Long-Term Care Hospitals § 412.521 Basis of payment. (a) Method of payment. (1) Under the prospective payment system, long... furnished to Medicare beneficiaries. (2) The amount of payment under the prospective payment system is based...

Balance of payments adjustment mechanisms in the Euro area

Directory of Open Access Journals (Sweden)

Pavel HNÁT

2012-06-01

Full Text Available The article aims at analysing the current situation in the Euro area with respect to the balance of payments adjustment mechanism that should normally be at place. Internally, the Euro area membership represents a combination of the fixed exchange rate, capital mobility and no monetary policy autonomy; externally, the Euro area countries apply floating exchange rates with high capital mobility, and autonomous monetary policy. Member states thus cannot use the monetary instruments to prevent external influences; they can only use fiscal policies, which are limited by the Stability and Growth Pact and debt constraint. When external imbalance occurs (such as today, the economies of member states are exposed to the price and income adjustment processes as well as to their own fiscal and ECB policy impacts. This article shows that all these factors interfere and influence real effects of automatic adjustment mechanisms which in some cases cannot come forth at all. Factors within domestic economic policies that limit the restoration of external balance within the Euro area thus create an important outcome of this paper.

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

Directory of Open Access Journals (Sweden)

Felipe Franz Wienke

2016-12-01

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

24 CFR 206.19 - Payment options.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Payment options. 206.19 Section 206... CONVERSION MORTGAGE INSURANCE Eligibility; Endorsement Eligible Mortgages § 206.19 Payment options. (a) Term payment option. Under the term payment option, equal monthly payments are made by the mortgagee to the...

An inventory model with a new credit drift: Flexible trade credit policy

Directory of Open Access Journals (Sweden)

Ankit Prakash Tyagi

2016-01-01

Full Text Available In most of the published articles dealing with optimal order quantity model under permissible delay in payments, it is assumed that the supplier only put forwards fully permissible delay in payments if retailer ordered a bulky sufficient quantity otherwise permissible delay in payments would not be permitted. Practically, in competitive market environments and recession phases of business, every supplier wants to attract more retailers by the help of providing good facilities for trading. Necessity of order quantity may put a negative pressure on supplier’s demand. So, within the economic order quantity (EOQ framework the main purpose of this paper is to broaden this extreme case by introducing a new credit policy, Flexible Trade Credit Policy (FTCP, for supplier which can help him provide more free space of trading to retailers. This policy, after adopting by suppliers, not only provides attractive trading environments for retailers but also enhances the demand of supplier due to the large number of new retailers. Here in, under this policy, an inventory system is investigated as a cost minimization problem to establish the retailer’s optimal inventory cycle time and optimal order quantity. Three theorems are established to describe and to lighten optimal replenishment policies for the retailer. Finally, numerical examples are considered to illustrate all these theorems and managerial insights are given based on considered numerical examples.

Framework for Mobile Payments Integration

DEFF Research Database (Denmark)

Carton, Fergal; Hedman, Jonas; Damsgaard, Jan

2012-01-01

consumers and merchants. These instruments are centralised, costly and lack decision support functionality. The ubiquity of the mobile phone has provided a decentralised platform for managing payment processes in a new way, but the value proposition for customers has yet to be elaborated clearly....... This inertia has stalled the design of sustainable revenue models for a mobile payments ecosystem. Merchants and consumers in the meantime are being seduced by the convenience of on‑line and mobile payment solutions. Adopting the purchase and payment process as the unit of analysis, the current mobile payment...

24 CFR 983.352 - Vacancy payment.

Science.gov (United States)

2010-04-01

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

38 CFR 21.430 - Accountability for authorization and payment of training and rehabilitation services.

Science.gov (United States)

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Accountability for... Vocational Rehabilitation and Employment Under 38 U.S.C. Chapter 31 Accountability § 21.430 Accountability... policies and procedures which provide accountability in the authorization and payment of program costs for...

42 CFR 412.604 - Conditions for payment under the prospective payment system for inpatient rehabilitation facilities.

Science.gov (United States)

2010-10-01

... payment system for inpatient rehabilitation facilities. 412.604 Section 412.604 Public Health CENTERS FOR... SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment for Inpatient Rehabilitation Hospitals and Rehabilitation Units § 412.604 Conditions for payment under the prospective payment system for inpatient...

PAYMENT CAPACITY SENSITIVITY FACTORS

Directory of Open Access Journals (Sweden)

Daniel BRÎNDESCU – OLARIU

2014-11-01

The results of the study facilitate the determination and classification of the main sensitivity factors for the payment capacity at sample level, the establishment of general benchmarks for the payment capacity (as no such benchmarks currently exist in the Romanian literature and the identification of the mechanisms through which the variation of different factors impacts the payment capacity.

Pathways to DRG-based hospital payment systems in Japan, Korea, and Thailand.

Science.gov (United States)

Annear, Peter Leslie; Kwon, Soonman; Lorenzoni, Luca; Duckett, Stephen; Huntington, Dale; Langenbrunner, John C; Murakami, Yuki; Shon, Changwoo; Xu, Ke

2018-05-07

Countries in Asia are working towards achieving universal health coverage while ensuring improved quality of care. One element is controlling hospital costs through payment reforms. In this paper we review experiences in using Diagnosis Related Groups (DRG) based hospital payments in three Asian countries and ask if there is an "Asian way to DRGs". We focus first on technical issues and follow with a discussion of implementation challenges and policy questions. We reviewed the literature and worked as an expert team to investigate existing documentation from Japan, Republic of Korea, and Thailand. We reviewed the design of case-based payment systems, their experience with implementation, evidence about impact on service delivery, and lessons drawn for the Asian region. We found that countries must first establish adequate infrastructure, human resource capacity and information management systems. Capping of volumes and prices is sometimes essential along with a high degree of hospital autonomy. Rather than introduce a complete classification system in one stroke, these countries have phased in DRGs, in some cases with hospitals volunteering to participate as a first step (Korea), and in others using a blend of different units for hospital payment, including length of stay, and fee-for-service (Japan). Case-based payment systems are not a panacea. Their value is dependent on their design and implementation and the capacity of the health system. Copyright © 2018 Elsevier B.V. All rights reserved.

42 CFR 412.125 - Effect of change of ownership on payments under the prospective payment systems.

Science.gov (United States)

2010-10-01

... prospective payment systems. 412.125 Section 412.125 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Payments to Hospitals Under the Prospective Payment Systems § 412.125 Effect of change of...

Payment reform in the patient-centered medical home: Enabling and sustaining integrated behavioral health care.

Science.gov (United States)

Miller, Benjamin F; Ross, Kaile M; Davis, Melinda M; Melek, Stephen P; Kathol, Roger; Gordon, Patrick

2017-01-01

The patient-centered medical home (PCMH) is a promising framework for the redesign of primary care and more recently specialty care. As defined by the Agency for Healthcare Research and Quality, the PCMH framework has 5 attributes: comprehensive care, patient-centered care, coordinated care, accessible services, and quality and safety. Evidence increasingly demonstrates that for the PCMH to best achieve the Triple Aim (improved outcomes, decreased cost, and enhanced patient experience), treatment for behavioral health (including mental health, substance use, and life stressors) must be integrated as a central tenet. However, challenges to implementing the PCMH framework are compounded for real-world practitioners because payment reform rarely happens concurrently. Nowhere is this more evident than in attempts to integrate behavioral health clinicians into primary care. As behavioral health clinicians find opportunities to work in integrated settings, a comprehensive understanding of payment models is integral to the dialogue. This article describes alternatives to the traditional fee for service (FFS) model, including modified FFS, pay for performance, bundled payments, and global payments (i.e., capitation). We suggest that global payment structures provide the best fit to enable and sustain integrated behavioral health clinicians in ways that align with the Triple Aim. Finally, we present recommendations that offer specific, actionable steps to achieve payment reform, complement PCMH, and support integration efforts through policy. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Catastrophic Economic Consequences of Healthcare Payments: Effects on Poverty Estimates in Egypt, Jordan, and Palestine

Directory of Open Access Journals (Sweden)

Ahmed Shoukry Rashad

2015-11-01

Full Text Available Healthcare payments could drive households with no health insurance coverage into financial catastrophe, which might lead them to cut spending on necessities, sell assets, or use credit. In extreme cases, healthcare payments could have devastating consequences on the household economic status that would push them into extreme poverty. Using nationally representative surveys from three Arab countries, namely, Egypt, Jordan, and Palestine, this paper examines the incidence, intensity and distribution of catastrophic health payments, and assesses the poverty impact of out-of-pocket health payments (OOP. The OOP for healthcare were considered catastrophic if it exceeded 10% of a household’s total expenditure or 40% of non-food expenditure. The poverty impact was evaluated using poverty head counts and poverty gaps before and after OOP. Results show that OOP exacerbate households’ living severely in Egypt, pushing more than one-fifth of the population into a financial catastrophe and 3% into extreme poverty in 2011. However, in Jordan and Palestine, the disruptive impact of OOP remains modest over time. In the three countries, the catastrophic health payment is the problem of the better off households. Poverty alleviation policies should help reduce the reliance on OOP to finance healthcare. Moving toward universal health coverage could also be a promising option to protect households from the catastrophic economic consequences of health care payments.

Trends in US malpractice payments in dentistry compared to other health professions - dentistry payments increase, others fall.

Science.gov (United States)

Nalliah, R P

2017-01-13

Background Little is known about trends in the number of malpractice payments made against dentists and other health professionals. Knowledge of these trends will inform the work of our professional organisations.Methods The National Practitioner Data Bank (NPDB) in the United States was utilised. Data about malpractice payments against dentists, hygienists, nurses, optometrists, pharmacists, physicians (DO and MD), physicians' assistants, podiatrists, psychologists, therapists and counsellors during 2004-14 were studied. Variables include type of healthcare provider, year malpractice payment was made and range of payment amount.Results In 2004 there were 17,532 malpractice payments against the studied health professions. In 2014 there were 11,650. In 2004, the number of malpractice payments against dentists represented 10.3% of all payments and in 2014 it represented 13.4%. Number of malpractice payments against dentists in 2012-2014 increased from 1,388 to 1,555.Conclusions There is an upward pressure on the number of dental malpractice payments over the last 3 years. Concurrently, there is a downward pressure on the number of combined non-dentist healthcare professional malpractice payments.

20 CFR 411.545 - How are the outcome payments calculated under the outcome-milestone payment system?

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false How are the outcome payments calculated under the outcome-milestone payment system? 411.545 Section 411.545 Employees' Benefits SOCIAL SECURITY... are the outcome payments calculated under the outcome-milestone payment system? The amount of each...

The role of hospital payments in the adoption of new medical technologies: an international survey of current practice.

Science.gov (United States)

Sorenson, Corinna; Drummond, Michael; Torbica, Aleksandra; Callea, Giuditta; Mateus, Ceu

2015-04-01

This study examined the role of prospective payment systems in the adoption of new medical technologies across different countries. A literature review was conducted to provide background for the study and guide development of a survey instrument. The survey was disseminated to hospital payment systems experts in 15 jurisdictions. Fifty-one surveys were disseminated, with 34 returned. The surveys returned covered 14 of the 15 jurisdictions invited to participate. The majority (71%) of countries update the patient classification system and/or payment tariffs on an annual basis to try to account for new technologies. Use of short-term separate or supplementary payments for new technologies occurs in 79% of countries to ensure adequate funding and facilitate adoption. A minority (43%) of countries use evidence of therapeutic benefit and/or costs to determine or update payment tariffs, although it is somewhat more common in establishing short-term payments. The main barrier to using evidence is uncertain or unavailable clinical evidence. Almost three-fourths of respondents believed diagnosis-related group systems incentivize or deter technology adoption, depending on the particular circumstances. Improvements are needed, such as enhanced strategies for evidence generation and linking evidence of value to payments, national and international collaboration and training to improve existing practice, and flexible timelines for short-term payments. Importantly, additional research is needed to understand how different payment policies impact technology uptake as well as quality of care and costs.

Micro-economic analysis of alternative policies for Dutch dairy farming

OpenAIRE

Boots, M.

1999-01-01

The dairy sector is to a large extent influenced and restricted by environmental and agricultural policies. These policies are often very detailed in nature and oriented at the farm level. That is, policy measures and regulations, such as taxes and support payments often depend on local farm circumstances and farm management. Dairy farmers constantly face minor and major policy changes, causing farm-specific uncertainties and adjustments in production. This thesis aims to quantify th...

Criticisms and defences of the balance-of-payments constrained growth model: some old, some new

Directory of Open Access Journals (Sweden)

John S.L. McCombie

2011-12-01

Full Text Available This paper assesses various critiques that have been levelled over the years against Thirlwall’s Law and the balance-of-payments constrained growth model. It starts by assessing the criticisms that the law is largely capturing an identity; that the law of one price renders the model incoherent; and that statistical testing using cross-country data rejects the hypothesis that the actual and the balance-of-payments equilibrium growth rates are the same. It goes on to consider the argument that calculations of the “constant-market-shares” income elasticities of demand for exports demonstrate that the UK (and by implication other advanced countries could not have been balance-of-payments constrained in the early postwar period. Next Krugman’s interpretation of the law (or what he terms the “45-degree rule”, which is at variance with the usual demand-oriented explanation, is examined. The paper next assesses attempts to reconcile the demand and supply side of the model and examines whether or not the balance-of-payments constrained growth model is subject to the fallacy of composition. It concludes that none of these criticisms invalidate the model, which remains a powerful explanation of why growth rates differ.

Financial catastrophe and poverty impacts of out-of-pocket health payments in Turkey.

Science.gov (United States)

Özgen Narcı, Hacer; Şahin, İsmet; Yıldırım, Hasan Hüseyin

2015-04-01

To determine the prevalence of catastrophic health payments, examine the determinants of catastrophic expenditures, and assess the poverty impact of out-of-pocket (OOP) payments. Data came from the 2004 to 2010 Household Budget Survey. Catastrophic health spending was defined by health payments as percentage of household consumption expenditures and capacity to pay at a set of thresholds. The poverty impact was evaluated by poverty head counts and poverty gaps before and after OOP health payments. The percentage of households that catastrophically spent their consumption expenditure and capacity to pay increased from 2004 to 2010, regardless of the threshold used. Households with a share of more than 40% health spending in both consumption expenditure and capacity to pay accounted for less than 1% across years. However, when a series of potential confounders were taken into account, the study found statistically significantly increased risk for the lowest threshold and decreased risk for the highest threshold in 2010 relative to the base year. Household income, size, education, senior and under 5-year-old members, health insurance, disabled members, payment for inpatient care and settlement were also statistically significant predictors of catastrophic health spending. Overall, poverty head counts were below 1%. Poverty gaps reached a maximum of 0.098%, with an overall increase in 2010 compared to 2004. Catastrophe and poverty increased from 2004 to 2010. However, given that the realization of some recent policies will affect the financial burden of OOP payments on households, the findings of this study need to be replicated.

Mathematical Modelling for EOQ Inventory System with Advance Payment and Fuzzy Parameters

Directory of Open Access Journals (Sweden)

S Priyan

2014-11-01

Full Text Available This study considers an EOQ inventory model with advance payment policy in a fuzzy situation by employing two types of fuzzy numbers that are trapezoidal and triangular. Two fuzzy models are developed here. In the first model the cost parameters are fuzzified, but the demand rate is treated as crisp constant. In the second model, the demand rate is fuzzified but the cost parameters are treated as crisp constants. For each fuzzy model, we use signed distance method to defuzzify the fuzzy total cost and obtain an estimate of the total cost in the fuzzy sense. Numerical example is provided to ascertain the sensitiveness in the decision variables about fuzziness in the components. In practical situations, costs may be dependent on some foreign monetary unit. In such a case, due to a change in the exchange rates, the costs are often not known precisely. The first model can be used in this situation. In actual applications, demand is uncertain and must be predicted. Accordingly, the decision maker faces a fuzzy environment rather than a stochastic one in these cases. The second model can be used in this situation. Moreover, the proposed models can be expended for imperfect production process.

Optimal transfer, ordering and payment policies for joint supplier-buyer inventory model with price-sensitive trapezoidal demand and net credit

Science.gov (United States)

Shah, Nita H.; Shah, Digeshkumar B.; Patel, Dushyantkumar G.

2015-07-01

This study aims at formulating an integrated supplier-buyer inventory model when market demand is variable price-sensitive trapezoidal and the supplier offers a choice between discount in unit price and permissible delay period for settling the accounts due against the purchases made. This type of trade credit is termed as 'net credit'. In this policy, if the buyer pays within offered time M1, then the buyer is entitled for a cash discount; otherwise the full account must be settled by the time M2; where M2 > M1 ⩾ 0. The goal is to determine the optimal selling price, procurement quantity, number of transfers from the supplier to the buyer and payment time to maximise the joint profit per unit time. An algorithm is worked out to obtain the optimal solution. A numerical example is given to validate the proposed model. The managerial insights based on sensitivity analysis are deduced.

20 CFR 411.536 - Under what circumstances can we make a reconciliation payment under the outcome-milestone payment...

Science.gov (United States)

2010-04-01

... reconciliation payment under the outcome-milestone payment system? 411.536 Section 411.536 Employees' Benefits... Systems § 411.536 Under what circumstances can we make a reconciliation payment under the outcome-milestone payment system? When the beneficiary's outcome payment period begins before the beneficiary has...

48 CFR 32.1007 - Administration and payment of performance-based payments.

Science.gov (United States)

2010-10-01

... contractor's experience, performance record, reliability, financial strength, and the adequacy of controls... of performance-based payments. 32.1007 Section 32.1007 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS CONTRACT FINANCING Performance-Based Payments 32.1007...

CAP DIRECT PAYMENTS AS THE MAIN TOOL TO SUPPORT THE EU FARMERS: AN ANALYSIS OF THEIR IMPLEMENTATION BASED ON SPAIN EXPERIENCE

Directory of Open Access Journals (Sweden)

Liliana CIMPOIES

2016-01-01

Full Text Available Direct payments are the main tool of the EU Common Agricultural Policy (CAP and the main objective is to support EU farmers incomes. They benefit from a particular attention during the new 2014-2020 reform. For the first time direct payments were introduced in 1992 after MacSharry reform and known as coupled payments (payments per hectare and animal head. In 2003 were introduced the decoupled payments focused at encouraging farmers and enhancing the competitiveness and sustainability of the EU agriculture. The aim of this paper is to analyze the application of direct payments as main support instrument to the EU farmers based on Spain experience. In Spain the new changes in the Single Payment Scheme (SPS were first introduced in 2006, beginning with the regime of partial decoupling, until 2012, when the coupled payments disappeared, being integrated under the SPS or transformed into additional payment. In this analysis, secondary data provided by the Spanish Agrarian Guarantee Fund (FEGA, Ministry of Agriculture, Food and Environment of Spain (MAGRAMA and Farm Accountancy Data Network (FADN. The analyzed data refers to the amount of allocated direct payments in Spain and EU countries, number of beneficiaries and its distribution on territorial aspect. So far, the distribution of direct payments in Spain, similar to other EU member states, is unequal, as a result of various factors, as the CAP development and diversity of production, the use of historical references to fix the decoupled payments per farm and others.

ACCOUNTING OF REACTIVE POWER COMPENSATION LEVEL AT PAYMENT CALCULATION OF TECHNOLOGICAL CONSUMPTION (LOSSES OF ELECTRIC POWER FOR ITS TRANSMISSION IN POWER NETWORK

Directory of Open Access Journals (Sweden)

E. P. Zabello

2005-01-01

Full Text Available The method is proposed to make a correction in payment for consumption of reactive energy and power which is attributed to deviation of actual activation energy losses for reactive power compensation from their standard value. It is recommended to calculate standard loss values for every voltage level and actual loss values are to be determined with the help of application of remote electronic accounting means in the current mode of power consumption.

Retail payments and the real economy

OpenAIRE

Hasan, Iftekhar; De Renzis, Tania; Schmiedel, Heiko

2013-01-01

This paper examines the fundamental relationship between retail payments and the real economy. Using data from across 27 European markets over the period 1995-2009, the results confirm that migration to efficient electronic retail payments stimulates the overall economy, consumption and trade. Among different payment instruments, this relationship is strongest for card payments, followed by credit transfers. Cheque payments are found to have a relatively low macroeconomic impact. Retail payme...

Paying for Payments

DEFF Research Database (Denmark)

Korsgaard, Søren

depends only on the relative costs of producing cash and card payments and can be used by regulators to assess privately set interchange fees. When calibrated to cost data, the model implies an optimal fee that is low and may even be negative. The findings are consistent with empirical evidence of high......Do consumers and merchants use the most efficient payment instruments? I examine how interchange fees, which are fees paid from merchants' banks to consumers' banks when card transactions take place, influence the choice between cash and payment cards. I show that when consumers do not pay...... transaction fees to banks - a common feature in bank contracts - card use is declining in interchange fees, and surcharging does not neutralize interchange fees. According to my model, banks set interchange fees at too high a level, resulting in too few card payments. I derive an optimal interchange fee which...

Deforestation, Leakage and Avoided Deforestation Policies: A Spatial Analysis

OpenAIRE

Philippe Delacote; Elizabeth J. Z. Robinson; Sébastien Roussel

2015-01-01

This paper analyses the impact of several avoided deforestation policies within a patchy forested landscape. Central is the idea that one neighbour's deforestation actions may impact the returns to deforestation in nearby patches. We determine the impact of each policy in terms of avoided deforestation and leakage levels at the landscape scale through modelling and simulations. Avoided deforestation policies at a landscape level are respectively: two Payment for Environmental Services (PES) p...

32 CFR 750.9 - Claims: Payments.

Science.gov (United States)

2010-07-01

... requires submission of the payment voucher to the General Accounting Office. All other field authorized payment vouchers are submitted directly to the servicing disbursing office for payment. ... 32 National Defense 5 2010-07-01 2010-07-01 false Claims: Payments. 750.9 Section 750.9 National...

20 CFR 411.566 - May an EN use outcome or milestone payments to make payments to the beneficiary?

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false May an EN use outcome or milestone payments... an EN use outcome or milestone payments to make payments to the beneficiary? Yes, an EN may use milestone or outcome payments to make payments to a beneficiary. [73 FR 29350, May 20, 2008] ...

48 CFR 32.207 - Administration and payment of commercial financing payments.

Science.gov (United States)

2010-10-01

... contractual information, and the account(s) (see 32.206(d)) to be charged for the payment. (c) Management of... of commercial financing payments. 32.207 Section 32.207 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS CONTRACT FINANCING Commercial Item...

Using contingent valuation to explore willingness to pay for renewable energy: A comparison of collective and voluntary payment vehicles

Energy Technology Data Exchange (ETDEWEB)

Wiser, Ryan H.

2002-07-28

projects. (4) A mandatory increase in the electricity bills of all customers, the funds from which are collected and spent by electricity suppliers on renewable energy projects. These payment and provision scenarios are consistent with contemporary forms of support for renewable energy. The first scenario--mandatory payments and government provision--is consistent with a system-benefits charge policy, a policy that has been adopted in 15 U.S. states. The third scenario--voluntary payments to an electricity supplier--is consistent with competitive green power marketing. The fourth scenario--mandatory payments through electricity suppliers--is consistent with a renewables portfolio standard, a policy adopted in thirteen U.S. states as of mid 2003. The second scenario--voluntary payments and government provision--has only been used in a limited fashion in the United States. In addition to having contemporary policy relevance, these four contingent valuation scenarios allow one to distinguish differences in stated WTP based on: (1) the payment method--is WTP affected by whether payments are to be made collectively or voluntarily? and (2) the provision arrangement--does the manner in which a good is provided, in this case through the government or the private sector, affect stated WTP? A split-sample, dichotomous choice contingent valuation survey of 1,574 U.S. residents was developed and implemented to test the sensitivity of stated WTP to these variables at three different payment levels, or bid points. Three secondary objectives also influenced research design, and are discussed in this report. First, this study indirectly and tentatively evaluates the importance of ''participation expectations'' in contingent valuation surveys: specifically, are individuals who state a WTP for renewable energy more likely to think that others will also contribute? Such relationships are commonly discussed in the sociology, social psychology, and marketing literatures

Adoption of Mobile Payment Platforms

DEFF Research Database (Denmark)

Staykova, Kalina Stefanova; Damsgaard, Jan

2016-01-01

Numerous mobile payment solutions, which rely on new disruptive technologies, have been launched on the payment market in recent years. But despite the growing number of mobile payment apps, very few solutions have turned to be successful as the majority of them fail to gain a critical mass...... of users. In this paper, we investigate successful platform adoption strategies by using the Reach and Range Framework for Multi-Sided Platforms as a strategic tool to which mobile payment providers can adhere in order to tackle some of the main challenges they face throughout the evolution...... of their platforms. The analysis indicates that successful mobile payment solutions tend to be launched as one-sided platforms and then gradually be expanded into being two-sided. Our study showcases that the success of mobile payment platforms lies with the ability of the platform to balance the reach (number...

Kuveyt Türk payment systems technology roadmap

OpenAIRE

Turan, Ayşe

2014-01-01

ACKNOWLEDGEMENTS, iii -- ABSTRACT, iv -- ÖZET, v -- LIST OF FIGURES, x -- LIST OF TABLES, xi -- LIST OF ABBREVIATIONS, xii -- 1. INTRODUCTION, 1 -- 1.1 Participants in a Payment System, 2 -- 1.2 Types of Payment Systems, 2 -- 1.2.1 Large-value Payment Systems (LVPS), 2 -- 1.2.2 Retail Payments, 3 -- 1.2.3 Retail Payment Instruments, 3 -- 1.2.3.1.1 Cash payments, 3 -- 1.2.3.1.2 Non-cash payments, 4 -- 1.2.3.1.2.1 Payment Cards, 4 -- 1.2.3.1.2.1.1 Credit Cards, 5 -- 1.2.3.1.2.1.2 Prepaid Cards,...

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

Science.gov (United States)

2010-10-01

... facility prospective payment system. 412.432 Section 412.432 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Inpatient Hospital Services of Inpatient...

AMCP Guide to Pharmaceutical Payment Methods, 2009 Update (Version 2.0).

Science.gov (United States)

2009-08-01

The methods by which the U.S. health care system pays for prescription drugs have faced increasing scrutiny in recent years. Two key developments have emerged: (a) congressional enactment of important changes in the basis for payments for prescription drugs in the Medicare and Medicaid programs; and (b) a March 2009 decision in a federal class action lawsuit that alleged fraudulent manipulation of the dominant pricing benchmark (average wholesale price, AWP), used primarily as the basis for payment for brand-name prescription drugs. The debate about prescription drug payment methods centers on determining the most appropriate basis for calculating how payers, including patients, government agencies, employers, and health plans, should pay pharmacies and other providers for drugs. Historically, payment for prescription drugs has been based on published prices that do not necessarily reflect the actual acquisition costs paid by providers, primarily pharmacies, physicians, and hospitals. This has led policymakers to believe that Medicare and Medicaid programs have paid more than is necessary for prescription drugs. Thus, in an effort to reform the payment system and reduce drug expenditures, policymakers have made significant changes to the benchmarks used by public programs to pay for drugs, and in some instances have created new benchmarks. Private payers have followed the government's lead and begun to change their own payment methods and benchmarks. They can be expected to accelerate the change as a result of the settlement agreement approved in the March 2009 federal court decision. The settlement will result in the lowering of the AWP for more than 400 generic and brand-name drugs. In addition - and technically unrelated to the litigation and any appeals that may be taken - 2 major price data reporting companies, First DataBank and Medi-Span, announced their intent to discontinue publication of AWP within 2 years of September 26, 2009. (At the time this report

Choice of reserve capacity by hospitals: a problem for prospective payment.

Science.gov (United States)

Widmer, Philippe K; Trottmann, Maria; Zweifel, Peter

2018-06-01

This contribution analyzes the impact of prospective payment on hospital decisions with regard to reserve capacity, using Swiss hospital data covering the years 2004-2009. This data set is unique because it permits distinguishing of institutional characteristics (e.g., ownership status) from the mode of payment as determinants of hospital efficiency, due to the fact that some Swiss cantons introduced prospective payment early while others waited for federal legislation to be enacted in 2012. Since a hospital's choice of reserve capacity depends also on the risk preferences of management while affecting the cost function, heterogeneity is predicted even in the presence of identical technology and factor prices. For estimating hospitals' marginal costs, we employ the flexible representation of risk preferences by Pope and Chavas [Am J Agric Econ 76, 196-204 (1994)]. Production uncertainty is measured as the difference between actual admissions and admissions predicted by an autoregressive moving average model. Its effect on hospital cost is analyzed using a multilevel stochastic cost frontier model with random coefficients reflecting unobserved differences in technology. Public hospitals are found to opt for a higher probability of meeting unexpected demand, as predicted. Their operating cost is 1.1% higher than for private hospitals and even 1.9% higher than for teaching hospitals, creating an incentive to turn away patients or to keep them waiting for treatment.

Standardization of Type 2 Diabetes Outpatient Expenditure with Bundled Payment Method in China.

Science.gov (United States)

Xu, Guo-Chao; Luo, Yun; Li, Qian; Wu, Meng-Fan; Zhou, Zi-Jun

2016-04-20

In recent years, the prevalence of type 2 diabetes among Chinese population has been increasing by years, directly leading to an average annual growth rate of 19.90% of medical expenditure. Therefore, it is urgent to work on strategies to control the growth of medical expenditure on type 2 diabetes on the basis of the reality of China. Therefore, in this study, we explored the feasibility of implementing bundled payment in China through analyzing bundled payment standards of type 2 diabetes outpatient services. This study analyzed the outpatient expenditure on type 2 diabetes with Beijing Urban Employee's Basic Medical Insurance from 2010 to 2012. Based on the analysis of outpatient expenditure and its influential factors, we adopted decision tree approach to conduct a case-mix analysis. In the end, we built a case-mix model to calculate the standard expenditure and the upper limit of each combination. We found that age, job status, and whether with complication were significant factors that influence outpatient expenditure for type 2 diabetes. Through the analysis of the decision tree, we used six variables (complication, age, diabetic foot, diabetic nephropathy, cardiac-cerebrovascular disease, and neuropathy) to group the cases, and obtained 11 case-mix groups. We argued that it is feasible to implement bundled payment on type 2 diabetes outpatient services. Bundled payment is effective to control the increase of outpatient expenditure. Further improvements are needed for the implementation of bundled payment reimbursement standards, together with relevant policies and measures.

The Subject Analysis of Payment Systems Characteristics

Directory of Open Access Journals (Sweden)

Korobeynikova Olga Mikhaylovna

2015-09-01

Full Text Available The article deals with the analysis of payment systems aimed at identifying the categorical terminological apparatus, proving their specific features and revealing the impact of payment systems on the state of money turnover. On the basis of the subject analysis, the author formulates the definitions of a payment system (characterized by increasing speed of effecting payments, by the reduction of costs, by high degree of payments convenience for subjects of transactions, by security of payments, by acceptable level of risks and by social efficiency, a national payment system, and a local payment system (characterized by the growth of economic and social efficiency of systems participants, by the process of money turnover optimization on the basis of saving transaction costs and increasing speed of money flows within the local payment systems. According to the economic levels, the payment systems are divided to macrosystems (national payment systems, mezosystems (payment systems localized on the operational and territorial basis, microsystems (payments by individual economic subjects. The establishment of qualitative features of payment systems, which is a basis of the author’s terminological interpretation, gave a possibility to reveal the cause-effect relations of payment systems influence on the state of money turnover in the involved subjects, and on the economy as a whole. The result of the present research consists in revealing the payment systems influence on the state of money turnover which is significant: at the state and regional level – in the optimization of budget and inter-budgetary relations, in acceleration of the money turnover, in deceleration of the money supply and inflation rate, in reduced need in money emission; at the level of economic entities – in accelerating the money turnover and accounts receivable, in the reduction of debit and credit loans, in the growth of profit (turnover; at the household level – in

Un-bundling payments for radioisotopes from radiopharmaceuticals and from diagnostic procedures: A tool to support the implementation of full-cost recovery - NEA discussion document

International Nuclear Information System (INIS)

2012-09-01

The objective of the NEA's HLG-MR policy approach is to ensure a long-term secure supply. The HLG-MR has determined that to attain that objective, a necessary (but not sufficient) requirement is that irradiation services in the 99 Mo/' 99m Tc supply chain must be provided on a full-cost recovery (FCR) basis (OECD-NEA, 2011). The HLG-MR policy approach also recommended that supply chain participants should implement payment reforms that promote full-cost recovery within their reimbursement systems. Reforms might include separate radioisotope pricing or auditing, separate radioisotope payment, differential radioisotope payment for FCR, or other approaches to promote a complete transition to full-cost recovery. This paper is written to provide a basis for further discussion on the use of separate reimbursement to encourage the move to full-cost recovery. Separate reimbursement is one tool that could be used by public and private health insurance to support the move to ensuring sufficient reimbursement rates (or payments) for 99 Mo/' 99m Tc while the industry moves to full-cost recovery for irradiation services, paying for outage reserve capacity and transitioning to using LEU targets. Other tools are available (such as differential payments, separate radioisotope payments, auditing) that could lead to similar outcomes that support the changes necessary in the 99 Mo/' 99m Tc supply chain to ensure a long-term reliable supply of these important medical isotopes

75 FR 78806 - Agency Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA...

Science.gov (United States)

2010-12-16

... Payment Request for the VA Funding Fee Payment System (VA FFPS); a Computer Generated Funding Fee Receipt.... 2900-0474.'' SUPPLEMENTARY INFORMATION: Title: Create Payment Request for the VA Funding Fee Payment System (VA FFPS); a Computer Generated Funding Fee Receipt, VA Form 26-8986. OMB Control Number: 2900...

78 FR 59771 - Proposed Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA...

Science.gov (United States)

2013-09-27

... Payment Request for the VA Funding Fee Payment System (VA FFPS); a Computer Generated Funding Fee Receipt.... Title: Create Payment Request for the VA Funding Fee Payment System (VA FFPS); A Computer Generated... through the Federal Docket Management System (FDMS) at www.Regulations.gov or to Nancy J. Kessinger...

42 CFR 413.210 - Conditions for payment under the end-stage renal disease (ESRD) prospective payment system.

Science.gov (United States)

2010-10-01

... disease (ESRD) prospective payment system. 413.210 Section 413.210 Public Health CENTERS FOR MEDICARE... § 413.210 Conditions for payment under the end-stage renal disease (ESRD) prospective payment system... prospective payment system described in § 413.215 through § 413.235 of this part. (a) Qualifications for...

20 CFR 435.22 - Payment.

Science.gov (United States)

2010-04-01

...-Award Requirements Financial and Program Management § 435.22 Payment. (a) Introduction. Payment methods..., and (ii) Financial management systems that meet the standards for fund control and accountability as..., Payment Management System, Rockville, MD 20852. Interest amounts up to $250 per year may be retained by...

32 CFR 751.13 - Partial payments.

Science.gov (United States)

2010-07-01

... voucher and all other information related to the partial payment shall be placed in the claim file. Action... 32 National Defense 5 2010-07-01 2010-07-01 false Partial payments. 751.13 Section 751.13 National... Claims Against the United States § 751.13 Partial payments. (a) Partial payments when hardship exists...

10 CFR 603.805 - Payment methods.

Science.gov (United States)

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Payment methods. 603.805 Section 603.805 Energy DEPARTMENT... Other Administrative Matters Payments § 603.805 Payment methods. A TIA may provide for: (a... progress. A fixed-support TIA must use this payment method (this does not preclude use of an initial...

Study on payments through mobile phones

Directory of Open Access Journals (Sweden)

Anca Ioana ANDREESCU

2006-01-01

Full Text Available The evolution of information and communications technology, together with the increasing use of electronic commerce, phones and mobile applications, have facilitated mobile payments to become an alternative payment method for buyers and vendors. Mobile payments offer various opportunities to business environment and became a starting point in the transition from electronic to mobile. This paper aims to analyze the present situation of the mobile payment methods and to identify the effects that mobile payment systems have on electronic commerce.

31 CFR 203.10 - Electronic payment methods.

Science.gov (United States)

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Electronic payment methods. 203.10... TAX AND LOAN PROGRAM Electronic Federal Tax Payments § 203.10 Electronic payment methods. (a) General. Electronic payment methods for Federal tax payments available under this subpart include ACH debit entries...

How do supply-side factors influence informal payments for healthcare? The case of HIV patients in Cameroon.

Science.gov (United States)

Kankeu, Hyacinthe Tchewonpi; Boyer, Sylvie; Fodjo Toukam, Raoul; Abu-Zaineh, Mohammad

2016-01-01

Direct out-of-pocket payments for healthcare continue to be a major source of health financing in low-income and middle-income countries. Some of these direct payments take the form of informal charges paid by patients to access the needed healthcare services. Remarkably, however, little is known about the extent to which these payments are exercised and their determinants in the context of Sub-Saharan Africa. This study attempts therefore to shed light on the role of supply-side factors in the occurrence of informal payments while accounting for the demand-side factors. The study relies on data taken from a nationally representative survey conducted among people living with HIV/AIDS in Cameroon. A multilevel mixed-effect logistic model is employed to identify the factors associated with the incidence of informal payments. Results reveal that circa 3.05% of the surveyed patients incurred informal payments for the consultations made on the day of the survey. The amount paid informally represents up to four times the official tariff. Factors related to the following: (i) human resource management of the health facilities (e.g., task shifting); (ii) health professionals' perceptions vis-à-vis the remunerations of HIV care provision; and (iii) reception of patients (e.g., waiting time) significantly influence the probability of incurring informal payments. Also of note, the type of healthcare facilities is found to play a role: informal payments appear to be significantly lower in private non-profit facilities compared with those belonging to public sector. Our findings allude to some policy recommendations that can help reduce the incidence of informal payments. Copyright © 2014 John Wiley & Sons, Ltd.

Social equity issues in the distribution of feed-in tariff policy benefits: A cross sectional analysis from England and Wales using spatial census and policy data

International Nuclear Information System (INIS)

Grover, David; Daniels, Benjamin

2017-01-01

The feed-in tariff has become a popular policy instrument globally for deploying clean energy, often involving substantial public spending commitments. Yet relatively little attention has been paid to how payments made under this policy type get distributed across socioeconomic groups. This paper links information on individual domestic photovoltaic (PV) installations registered under the feed-in tariff for England and Wales, to spatially-organised census data. This makes it possible to observe which socioeconomic groups are benefitting most and least under the policy. Comparing the observed benefit distribution to a counterfactual distribution of perfect equality, a moderate to high level of inequality is found. Cross-sectional regressions suggest that settlement density, home ownership status, physical dwelling type, local information spillovers, and household social class shaped this outcome. Greater sensitivity to these factors in policy design could improve distributional outcomes under feed-in tariff policies in England and Wales, and beyond. - Highlights: • Feed-in tariffs are subsidies involving substantial public spending commitments. • Payment distribution under the feed-in tariff in England and Wales has been substantially unequal. • Linking policy data to spatial census data can measure the degree of inequality. • Policy design that is more sensitive to participants’ socioeconomic characteristics can improve distributional outcomes.

42 CFR 412.632 - Method of payment under the inpatient rehabilitation facility prospective payment system.

Science.gov (United States)

2010-10-01

... rehabilitation facility receives payment under this subpart for inpatient operating costs and capital-related... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR... and for costs of an approved education program and other costs paid outside the prospective payment...

Understanding informal payments in health care: motivation of health workers in Tanzania.

Science.gov (United States)

Stringhini, Silvia; Thomas, Steve; Bidwell, Posy; Mtui, Tina; Mwisongo, Aziza

2009-06-30

There is growing evidence that informal payments for health care are fairly common in many low- and middle-income countries. Informal payments are reported to have a negative consequence on equity and quality of care; it has been suggested, however, that they may contribute to health worker motivation and retention. Given the significance of motivation and retention issues in human resources for health, a better understanding of the relationships between the two phenomena is needed. This study attempts to assess whether and in what ways informal payments occur in Kibaha, Tanzania. Moreover, it aims to assess how informal earnings might help boost health worker motivation and retention. Nine focus groups were conducted in three health facilities of different levels in the health system. In total, 64 health workers participated in the focus group discussions (81% female, 19% male) and where possible, focus groups were divided by cadre. All data were processed and analysed by means of the NVivo software package. The use of informal payments in the study area was confirmed by this study. Furthermore, a negative relationship between informal payments and job satisfaction and better motivation is suggested. Participants mentioned that they felt enslaved by patients as a result of being bribed and this resulted in loss of self-esteem. Furthermore, fear of detection was a main demotivating factor. These factors seem to counterbalance the positive effect of financial incentives. Moreover, informal payments were not found to be related to retention of health workers in the public health system. Other factors such as job security seemed to be more relevant for retention. This study suggests that the practice of informal payments contributes to the general demotivation of health workers and negatively affects access to health care services and quality of the health system. Policy action is needed that not only provides better financial incentives for individuals but also

Understanding informal payments in health care: motivation of health workers in Tanzania

Directory of Open Access Journals (Sweden)

Bidwell Posy

2009-06-01

Full Text Available Abstract Background There is growing evidence that informal payments for health care are fairly common in many low- and middle-income countries. Informal payments are reported to have a negative consequence on equity and quality of care; it has been suggested, however, that they may contribute to health worker motivation and retention. Given the significance of motivation and retention issues in human resources for health, a better understanding of the relationships between the two phenomena is needed. This study attempts to assess whether and in what ways informal payments occur in Kibaha, Tanzania. Moreover, it aims to assess how informal earnings might help boost health worker motivation and retention. Methods Nine focus groups were conducted in three health facilities of different levels in the health system. In total, 64 health workers participated in the focus group discussions (81% female, 19% male and where possible, focus groups were divided by cadre. All data were processed and analysed by means of the NVivo software package. Results The use of informal payments in the study area was confirmed by this study. Furthermore, a negative relationship between informal payments and job satisfaction and better motivation is suggested. Participants mentioned that they felt enslaved by patients as a result of being bribed and this resulted in loss of self-esteem. Furthermore, fear of detection was a main demotivating factor. These factors seem to counterbalance the positive effect of financial incentives. Moreover, informal payments were not found to be related to retention of health workers in the public health system. Other factors such as job security seemed to be more relevant for retention. Conclusion This study suggests that the practice of informal payments contributes to the general demotivation of health workers and negatively affects access to health care services and quality of the health system. Policy action is needed that not only

75 FR 61252 - Proposed Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA...

Science.gov (United States)

2010-10-04

... Payment Request for the VA Funding Fee Payment System (VA FFPS); A Computer Generated Funding Fee Receipt... Payment Request for the VA Funding Fee Payment System (VA FFPS); A Computer Generated Funding Fee Receipt... information through the Federal Docket Management System (FDMS) at http://www.Regulations.gov or to Nancy J...

75 FR 61859 - Proposed Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA...

Science.gov (United States)

2010-10-06

... Payment Request for the VA Funding Fee Payment System (VA FFPS); A Computer Generated Funding Fee Receipt... Payment Request for the VA Funding Fee Payment System (VA FFPS); A Computer Generated Funding Fee Receipt... information through the Federal Docket Management System (FDMS) at http://www.Regulations.gov or to Nancy J...

5 CFR 9701.361 - Special skills payments.

Science.gov (United States)

2010-01-01

... RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Special Payments § 9701.361 Special skills payments... at the same time as basic pay or in periodic lump-sum payments. Special skills payments are not basic... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Special skills payments. 9701.361 Section...

Managerial accounting in the system of payments with enterprise buyers

Directory of Open Access Journals (Sweden)

Tsegel'nik N.I.

2017-12-01

Full Text Available Today, in the period of global changes in different spheres of social activity, the issue of managerial accounting in the system of payments with buyers is actual enough as the efficiency of management of enterprise economic activity to a great extent depends exactly on the information resources of managerial accounting. The managerial accounting in the system of payments with buyers is adjusted on the implementation of enterprise strategies, that is the construction of administrative accounting depends on the strategy of market scope. There is a necessity to make the decision about how many places for selling products should be opened on a certain geographical territory to satisfy the necessities of present and potential clients of a special purpose group in products, commodities and services. The system of tasks of administrative accounting in the system of payments with buyers is formulated, that allows to unite all the information about the products sold, will do the information integral and will enable users, in particular, the leader of an enterprise, to a great extent to take the opportunity to get the complete information on the state of calculations with buyers and to make administrative decisions correctly in order to avoid complicated and contradictory situations with buyers. The paper determines the directions for further researches in relation to the development of issues, which have direct regard to the buyers of purchase-sale contractual relations.

12 CFR 412.11 - Payment guidelines.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Payment guidelines. 412.11 Section 412.11 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES ACCEPTANCE OF PAYMENT FROM A NON-FEDERAL SOURCE FOR TRAVEL EXPENSES § 412.11 Payment guidelines. (a) Payments from a non-Federal source, other than...

Incentives and provider payment methods.

Science.gov (United States)

Barnum, H; Kutzin, J; Saxenian, H

1995-01-01

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

Payments-Equal-To-Taxes (PETT): An interpretation of Sections 116(c) (3) and 118(b) (4) of the Nuclear Waste Policy Act of 1982, as amended

International Nuclear Information System (INIS)

Benson, A.; Moore, W.E.; Lesko, R.

1991-01-01

The Payments-Equal-To-Taxes (PETT) program breaks new ground in government interaction by creating a tax-like transfer of funds from the federal government to states and local government. The PETT program is one of the financial assistance provisions of the Nuclear Waste Policy Act of 1982, as amended [42 U.S.C. 10101, et seq.] (NWPAA). The NWPAA charges the US DOE with, among other things, the responsibility for investigation of potential sites and for licensing, constructing, and operating a repository for high-level radioactive waste and spent fuel and an MRS facility. The NWPAA also called for financial assistance to the jurisdictions in which the repository and MRS facility are to be located. One of the financial impacts to the jurisdictions would be loss of tax revenue since the Supremacy clause of the Constitution prohibits jurisdictions from taxing the federal government. The objective of the PETT program is to provide payments that will offset this loss. Since the NWPAA authorizes continued site characterization activities only in the state of Nevada, the focus of this paper will be on the PETT program in Nevada. However, the information presented here generally applied to implementation of the program in other states where site characterization activities have been conducted

Federal policies for renewable electricity: Impacts and interactions

International Nuclear Information System (INIS)

Palmer, Karen; Paul, Anthony; Woerman, Matt; Steinberg, Daniel C.

2011-01-01

Three types of policies that are prominent in the federal debate over addressing greenhouse gas emissions in the United States are a cap-and-trade program (CTP) on emissions, a renewable portfolio standard (RPS) for electricity production, and tax credits for renewable electricity producers. Each of these policies would have different consequences, and combinations of these policies could induce interactions yielding a whole that is not the sum of its parts. This paper utilizes the Haiku electricity market model to evaluate the economic and technology outcomes, climate benefits, and cost-effectiveness of three such policies and all possible combinations of the policies. A central finding is that the carbon dioxide (CO 2 ) emissions reductions from CTP can be significantly greater than those from the other policies, even for similar levels of renewable electricity production, since of the three policies, CTP is the only one that distinguishes electricity generated by coal and natural gas. It follows that CTP is the most cost-effective among these approaches at reducing CO 2 emissions. An alternative compliance payment mechanism in an RPS program could substantially affect renewables penetration, and the electricity price effects of the policies hinge partly on the regulatory structure of electricity markets, which varies across the country. - Research highlights: → Climate benefits of cap-and-trade are greater than of tax credits or RPS. → Cap-and-trade is more cost-effective at reducing emissions than tax credits or RPS. → Tax credits are a subsidy to production that raises electricity consumption. → Alternative compliance payment can substantially affect the outcome of RPS.

42 CFR 484.205 - Basis of payment.

Science.gov (United States)

2010-10-01

... episode payment is subject to the following adjustments and additional payments: (1) A low-utilization... 5, 1997 unless the national 60-day episode payment is subject to a low-utilization payment... payment for initial episodes is paid to an HHA at 60 percent of the case-mix and wage adjusted 60-day...

Capital flight and the uncertainty of government policies

NARCIS (Netherlands)

Hermes, N.; Lensink, R.

2000-01-01

This paper shows that policy uncertainty, measured by the uncertainty of budget deficits, tax payments, government consumption and the inflation rate, has a statistically significant positive impact on capital flight. This result remains robust after having applied stability tests.

Does User Fee Removal Policy Provide Financial Protection from Catastrophic Health Care Payments? Evidence from Zambia.

Directory of Open Access Journals (Sweden)

Felix Masiye

Full Text Available Out-of-pocket payments in health care have been shown to impose significant burden on households in Sub-Saharan Africa, leading to constrained access to health care and impoverishment. In an effort to reduce the financial burden imposed on households by user fees, some countries in Sub-Saharan Africa have abolished user fees in the health sector. Zambia is one of few countries in Sub-Saharan Africa to abolish user fees in primary health care facilities with a view to alleviating financial burden of out-of-pocket payments among the poor. The main aim of this paper was to examine the extent and patterns of financial protection from fees following the decision to abolish user fees in public primary health facilities.Our analysis is based on a nationally representative health expenditure and utilization survey conducted in 2014. We calculated the incidence and intensity of catastrophic health expenditure based on households' out-of-pocket payments during a visit as a percentage of total household consumption expenditure. We further show the intensity of the problem of catastrophic health expenditure (CHE experienced by households.Our analysis show that following the removal of user fees, a majority of patients who visited public health facilities benefitted from free care at the point of use. Further, seeking care at public primary health facilities is associated with a reduced likelihood of incurring CHE after controlling for economic wellbeing and other covariates. However, 10% of households are shown to suffer financial catastrophe as a result of out-of-pocket payments. Further, there is considerable inequality in the incidence of CHE whereby the poorest expenditure quintile experienced a much higher incidence.Despite the removal of user fees at primary health care level, CHE is high among the poorest sections of the population. This study also shows that cost of transportation is mainly responsible for limiting the protective effectiveness of

Forecasting the future reimbursement system of Korean National Health Insurance: a contemplation focusing on global budget and Neo-KDRG-based payment systems.

Science.gov (United States)

Kim, Yang-Kyun

2012-05-01

With the adoption of national health insurance in 1977, Korea has been utilizing fee-for-service payment with contract-based healthcare reimbursement system in 2000. Under the system, fee-for-service reimbursement has been accused of augmenting national healthcare expenditure by excessively increasing service volume. The researcher examined in this paper two major alternatives including diagnosis related group-based payment and global budget to contemplate the future of reimbursement system of Korean national health insurance. Various literature and preceding studies on pilot project and actual implementation of Neo-KDRG were reviewed. As a result, DRG-based payment was effective for healthcare cost control but low in administrative efficiency. Global budget may be adequate for cost control and improving the quality of healthcare and administrative efficiency. However, many healthcare providers disagree that excess care arising from fee-for-service payment alone has led to financial deterioration of national health insurance and healthcare institutions should take responsibility with global budget payment as an appropriate solution. Dissimilar payment systems may be applied to different types of institutions to reflect their unique attributes, and this process can be achieved step-by-step. Developing public sphere among the stakeholders and striving for consensus shall be kept as collateral to attain the desirable reimbursement system in the future.

[From passive to active: policies for Latin American emigrants].

Science.gov (United States)

Maletta, H

1988-12-01

The conventional view of emigration holds that it represents a loss of resources from a country and that the only possible policy response is to discourage new emigration while promoting return of those who have left. A new policy is needed based on a fuller understanding of the potential benefits of emigration for the country of origin. The cost of emigration is usually counted as the loss of educational investment, the loss of labor force, and the loss of the contributions to development that would have been made by talented emigrants. But such views usually do not include a serious treatment of the economic problems of labor supply and demand in general or of skilled labor in particular. Underemployment or unemployment of highly educated persons and overproduction of educated persons are problems throughout Latin America and much of the developing world. A truer evaluation of the costs of education which considered decreasing marginal costs rather than average costs per student, nominally variable costs that actually behave as fixed costs, and an adequate assignment of costs for students leaving school before graduating would lead to much lower estimates of average cost per university student in Latin America. Significant emigration may actually result indirectly in an increase in national income by reducing pressure on the labor market and allowing wages to rise for remaining workers. Remittances for emigrants and repatriation of savings may contribute significantly to national income and balance of payments, and may compensate for or even exceed the economic losses of emigration. National policy for emigrants should aim at maximizing the economic benefits of emigration by providing incentives for the accumulation of capital obtained abroad and its transfer to the country of origin. The 1st major goal of emigration policy should be to maintain affective and social ties between the emigrant and the country of origin as a necessary condition for channeling

Willingness-to-pay and policy-instrument choice for climate-change policy in the United States

International Nuclear Information System (INIS)

Kotchen, Matthew J.; Boyle, Kevin J.; Leiserowitz, Anthony A.

2013-01-01

This paper provides the first willingness-to-pay (WTP) estimates in support of a national climate-change policy that are comparable with the costs of actual legislative efforts in the U.S. Congress. Based on a survey of 2034 American adults, we find that households are, on average, willing to pay between $79 and $89 per year in support of reducing domestic greenhouse-gas (GHG) emissions 17% by 2020. Even very conservative estimates yield an average WTP at or above $60 per year. Taking advantage of randomized treatments within the survey valuation question, we find that mean WTP does not vary substantially among the policy instruments of a cap-and-trade program, a carbon tax, or a GHG regulation. But there are differences in the sociodemographic characteristics of those willing to pay across policy instruments. Greater education always increases WTP. Older individuals have a lower WTP for a carbon tax and a GHG regulation, while greater household income increases WTP for these same two policy instruments. Republicans, along with those indicating no political party affiliation, have a significantly lower WTP regardless of the policy instrument. But many of these differences are no longer evident after controlling for respondent opinions about whether global warming is actually happening. - Highlights: ► First willingness-to-pay (WTP) estimates for actual national climate-change policy in the U.S. ► WTP does not vary among the instruments of a cap-and-trade program, a carbon tax, or a GHG regulation. ► There are differences in the characteristics of those willing to pay across policy instruments. ► No differences after controlling for opinions about whether global warming is actually happening

Potential dividends and actual cash flows in equity valuation. A critical analysis1

Directory of Open Access Journals (Sweden)

Ignacio Vélez-Pareja

2009-10-01

Full Text Available Practitioners and most academics in valuation include changes in liquid assets (potential dividends in the cash flows. This widespread and wrong practice is inconsistent with basic finance theory. We present economic, theoretical, and empirical arguments to support the thesis. Economic arguments underline that only flows of cash should be considered for valuation; theoretical arguments show how potential dividends lead to contradiction and to arbitrage losses. Empirical arguments, from recent studies, suggest that investors discount potential dividends with high discount rates, which means that changes in liquid assets are not value drivers. Hence, when valuing cash flows, we should consider only actual payments.

DEVOLUTION IN ITALIAN CULTURAL POLICIES MICRO VIEW AND ACTUAL IMPACTS

Directory of Open Access Journals (Sweden)

Stefano Monti

2012-04-01

Full Text Available

Devolution has definitely become a ‘flagship’ in the Italian political debate. It has affected any aspect of public policy over the last 17 years and the cultural sector has not been spared. Its key aim is to decentralise legal and administration powers in a way that could reduce the burden of State offices work and set up a more efficient and effective administration able to meet citizens’ needs. After a long tradition of centralized policies and administration, long, costly and often in efficient procedures required a profound change. The reforms were so ledby the ideal to implement public policies closest to citizens’ needs, to provide direct responses and increase their participation to local governments’ actions (democratization and participative policy, to deliver more effective services (better performance and distribute more equally the burden of administrative work of State offices (decentralisation of day-to-day administration.

La Devolution e la politica culturale italiana

La Devolution riveste un punto centrale nel dibattito politico italiano: ha riguardato ogni aspetto della politica pubblica negli ultimi 17 anni, e il settore culturale non ne è stato risparmiato. L'obbiettivo principale è quello di decentralizzare i poteri giuridici e amministrativi in modo da ridurre il peso del lavoro degli uffici pubblici statali, e di organizzare un'amministrazione più efficiente ed efficace in grado di soddisfare le necessità dei cittadini. Dopo una lunga tradizione basata su politica e amministrazione centralizzate, procedure lunghe, costose e spesso inefficienti richiedevano un profondo cambiamento. Le riforme sono state quindi indirizzate all'implemento di politiche pubbliche più vicine ai cittadini, a incrementare la loro partecipazione nelle azioni di governo locali (politica di democratizzazione e partecipativa, a fornire servizi più efficienti (migliori prestazioni e a distribuire

7 CFR 1599.6 - Payments.

Science.gov (United States)

2010-01-01

... AGRICULTURE McGOVERN-DOLE INTERNATIONAL FOOD FOR EDUCATION AND CHILD NUTRITION PROGRAM § 1599.6 Payments. (a... payment; the bank ABA number to which payment is to be made; the account number for the deposit at the bank; the participant's taxpayer identification number; and the type of the account into which the...

7 CFR 1499.6 - Payments.

Science.gov (United States)

2010-01-01

... AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS FOOD FOR PROGRESS PROGRAM § 1499.6 Payments. (a) If the... payment; the bank ABA number to which payment is to be made; the account number for the deposit at the bank; the participant's taxpayer identification number; and the type of the account into which the...

Capital flight and the uncertainty of government policies

NARCIS (Netherlands)

Hermes, C.L.M.; Lensink, B.W.

This paper shows that policy uncertainty, measured by the uncertainty of budget deficits, tart payments, government consumption and the inflation rate, has a statistically significant positive impact on capital flight. This result remains robust after having applied stability tests. (C) 2001

31 CFR 544.504 - Payments and transfers to blocked accounts in U.S. financial institutions.

Science.gov (United States)

2010-07-01

... accounts in U.S. financial institutions. 544.504 Section 544.504 Money and Finance: Treasury Regulations... Licensing Policy § 544.504 Payments and transfers to blocked accounts in U.S. financial institutions. Any.... financial institution must be blocked in an account on the books of that financial institution. A transfer...

31 CFR 585.503 - Payments and transfers to blocked accounts in U.S. financial institutions.

Science.gov (United States)

2010-07-01

... accounts in U.S. financial institutions. 585.503 Section 585.503 Money and Finance: Treasury Regulations... Policy § 585.503 Payments and transfers to blocked accounts in U.S. financial institutions. (a) Any... account in a U.S. financial institution is authorized, provided that a transfer from a blocked account...

31 CFR 597.503 - Payments and transfers to blocked accounts in U.S. financial institutions.

Science.gov (United States)

2010-07-01

... accounts in U.S. financial institutions. 597.503 Section 597.503 Money and Finance: Treasury Regulations... Licensing Policy § 597.503 Payments and transfers to blocked accounts in U.S. financial institutions. (a... financial institution into a blocked account in a U.S. financial institution is authorized, provided that a...

31 CFR 593.504 - Payments and transfers to blocked accounts in U.S. financial institutions.

Science.gov (United States)

2010-07-01

... accounts in U.S. financial institutions. 593.504 Section 593.504 Money and Finance: Treasury Regulations... Licensing Policy § 593.504 Payments and transfers to blocked accounts in U.S. financial institutions. Any.... financial institution must be blocked in an account on the books of that financial institution. A transfer...

7 CFR 1726.253 - Prior approved contract modification related to alternative bid provision for payment to...

Science.gov (United States)

2010-01-01

... alternative bid provision for payment to contractor for bulk purchase of materials. 1726.253 Section 1726.253... contractor for bulk purchase of materials. When construction is to be performed over an extended period of... AGRICULTURE ELECTRIC SYSTEM CONSTRUCTION POLICIES AND PROCEDURES Modifications to RUS Standard Contract Forms...

Financing and funding health care: Optimal policy and political implementability.

Science.gov (United States)

Nuscheler, Robert; Roeder, Kerstin

2015-07-01

Health care financing and funding are usually analyzed in isolation. This paper combines the corresponding strands of the literature and thereby advances our understanding of the important interaction between them. We investigate the impact of three modes of health care financing, namely, optimal income taxation, proportional income taxation, and insurance premiums, on optimal provider payment and on the political implementability of optimal policies under majority voting. Considering a standard multi-task agency framework we show that optimal health care policies will generally differ across financing regimes when the health authority has redistributive concerns. We show that health care financing also has a bearing on the political implementability of optimal health care policies. Our results demonstrate that an isolated analysis of (optimal) provider payment rests on very strong assumptions regarding both the financing of health care and the redistributive preferences of the health authority. Copyright © 2015 Elsevier B.V. All rights reserved.

Abrechnung mobiler Dienste im Mobile-Payment-Referenzmodell

OpenAIRE

Pousttchi, Key; Wiedemann, Dietmar Georg

2005-01-01

The purpose of the paper is to analyze mobile payments in the mobile commerce scenario. Therefore, we first classify the mobile payment in the mobile commerce scenario by explaining general offer models, charging concepts, and intermediaries. Second, we describe the mobile payment reference model, especially, the mobile payment reference organization model and different mobile payment standard types. Finally, we conclude our findings.

Under Pressure: Financial Effect of the Hospital-Acquired Conditions Initiative-A Statewide Analysis of Pressure Ulcer Development and Payment.

Science.gov (United States)

Meddings, Jennifer; Reichert, Heidi; Rogers, Mary A M; Hofer, Timothy P; McMahon, Laurence F; Grazier, Kyle L

2015-07-01

To assess the financial effect of the 2008 Hospital-Acquired Conditions Initiative (HACI) pressure ulcer payment changes on Medicare, other payers, and hospitals. Retrospective before-and-after study of all-payer statewide administrative data for more than 2.4 million annual adult discharges in 2007 and 2009 using the Healthcare Cost and Utilization Project State Inpatient Datasets for California. How often and by how much the 2008 payment changes for pressure ulcers affected hospital payment was assessed. Nonfederal acute care California hospitals (N = 311). Adults discharged from acute-care hospitals. Pressure ulcer rates and hospital payment changes. Hospital-acquired pressure ulcer rates were low in 2007 (0.28%) and 2009 (0.27%); present-on-admission pressure ulcer rates increased from 2.3% in 2007 to 3.0% in 2009. According to clinical stage of pressure ulcer (available in 2009), hospital-acquired Stage III and IV ulcers occurred in 603 discharges (0.02%); 60,244 discharges (2.42%) contained other pressure ulcer diagnoses. Payment removal for Stage III and IV hospital-acquired ulcers reduced payment in 75 (0.003%) discharges, for a statewide payment decrease of $310,444 (0.001%) for all payers and $199,238 (0.001%) for Medicare. For all other pressure ulcers, the Hospital-Acquired Conditions Initiative reduced hospital payment in 20,246 (0.81%) cases (including 18,953 cases with present-on-admission ulcers), reducing statewide payment by $62,538,586 (0.21%) for all payers and $47,237,984 (0.32%) for Medicare. The total financial effect of the 2008 payment changes for pressure ulcers was negligible. Most payment decreases occurred by removal of comorbidity payments for present-on-admission pressure ulcers other than Stages III and IV. The removal of payment for hospital-acquired Stage III and IV ulcers by implementation of the HACI policy was 1/200th that of the removal of payment for other types of pressure ulcers that occurred in implementation of the

Paying for payments: free payments and optimal interchange fees

OpenAIRE

Korsgaard, Søren

2014-01-01

Do consumers and merchants use the most efficient payment instruments? I examine how inter- change fees, which are fees paid from merchants' banks to consumers' banks when card transactions take place, influence the choice between cash and payment cards. I show that when consumers do not pay transaction fees to banks - a common feature in bank contracts - card use is declining in interchange fees, and surcharging does not neutralize interchange fees. According to my model, banks set interchan...

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

Science.gov (United States)

2013-12-10

... MFP Multi-Factor Productivity MGMA Medical Group Management Association MIEA-TRHCA The Medicare... 69624), we revised the methodology for calculating direct PE RVUs from the top- down to the bottom-up... Based on RVUs To calculate the payment for each physicians' service, the components of the fee schedule...

Heart Attack Payment - Hospital

Data.gov (United States)

U.S. Department of Health & Human Services — Payment for heart attack patients measure – provider data. This data set includes provider data for payments associated with a 30-day episode of care for heart...

20 CFR 411.597 - Will SSA periodically review the outcome payment system and the outcome-milestone payment system...

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Will SSA periodically review the outcome payment system and the outcome-milestone payment system for possible modifications? 411.597 Section 411... Employment Network Payment Systems § 411.597 Will SSA periodically review the outcome payment system and the...

Bundled payment fails to gain a foothold In California: the experience of the IHA bundled payment demonstration.

Science.gov (United States)

Ridgely, M Susan; de Vries, David; Bozic, Kevin J; Hussey, Peter S

2014-08-01

To determine whether bundled payment could be an effective payment model for California, the Integrated Healthcare Association convened a group of stakeholders (health plans, hospitals, ambulatory surgery centers, physician organizations, and vendors) to develop, through a consensus process, the methods and means of implementing bundled payment. In spite of a high level of enthusiasm and effort, the pilot did not succeed in its goal to implement bundled payment for orthopedic procedures across multiple payers and hospital-physician partners. An evaluation of the pilot documented a number of barriers, such as administrative burden, state regulatory uncertainty, and disagreements about bundle definition and assumption of risk. Ultimately, few contracts were signed, which resulted in insufficient volume to test hypotheses about the impact of bundled payment on quality and costs. Although bundled payment failed to gain a foothold in California, the evaluation provides lessons for future bundled payment initiatives. Project HOPE—The People-to-People Health Foundation, Inc.

Drivers behind widespread informal payments in the Romanian public health care system: From tolerance to corruption to socio-economic and spatial patterns.

Science.gov (United States)

Horodnic, Adrian V; Mazilu, Sorin; Oprea, Liviu

2018-03-15

In order to explain informal payments in public health care services in Romania, this paper evaluates the relationship between extra payments or valuable gifts (apart from official fees) and the level of tolerance to corruption, as well as the socio-economic and spatial patterns across those individuals offering informal payments. To evaluate this, a survey undertaken in 2013 is reported. Using logistic regression analysis, the findings are that patients with a high tolerance to corruption, high socio-economic risk (those divorced, separated, or with other form of marital status, and those not working), and located in rural or less affluent areas are more likely to offer (apart from official fees) extra payments or valuable gifts for health care services. The paper concludes by discussing the health policy implications. Copyright © 2018 John Wiley & Sons, Ltd.

Heart Attack Payment - National

Data.gov (United States)

U.S. Department of Health & Human Services — Payment for heart attack patients measure – national data. This data set includes national-level data for payments associated with a 30-day episode of care for heart...

Heart Attack Payment - State

Data.gov (United States)

U.S. Department of Health & Human Services — Payment for heart attack patients measure – state data. This data set includes state-level data for payments associated with a 30-day episode of care for heart...

Agency Ownership, Patient Payment Source, and Length of Service in Home Care, 1992-2000

Science.gov (United States)

Han, Beth; McAuley, William J.; Remsburg, Robin E.

2007-01-01

Purpose: Little is known about whether an association exists between agency ownership and length of service among home care patients with different payment sources. This study investigated how for-profit and not-for-profit agencies responded to policy changes in the 1990s with respect to length of service. Design and Methods: We examined length of…

A simple simulation model as a tool to assess alternative health care provider payment reform options in Vietnam.

Science.gov (United States)

Cashin, Cheryl; Phuong, Nguyen Khanh; Shain, Ryan; Oanh, Tran Thi Mai; Thuy, Nguyen Thi

2015-01-01

Vietnam is currently considering a revision of its 2008 Health Insurance Law, including the regulation of provider payment methods. This study uses a simple spreadsheet-based, micro-simulation model to analyse the potential impacts of different provider payment reform scenarios on resource allocation across health care providers in three provinces in Vietnam, as well as on the total expenditure of the provincial branches of the public health insurance agency (Provincial Social Security [PSS]). The results show that currently more than 50% of PSS spending is concentrated at the provincial level with less than half at the district level. There is also a high degree of financial risk on district hospitals with the current fund-holding arrangement. Results of the simulation model show that several alternative scenarios for provider payment reform could improve the current payment system by reducing the high financial risk currently borne by district hospitals without dramatically shifting the current level and distribution of PSS expenditure. The results of the simulation analysis provided an empirical basis for health policy-makers in Vietnam to assess different provider payment reform options and make decisions about new models to support health system objectives.

Medicare payments to the neurology workforce in 2012.

Science.gov (United States)

Skolarus, Lesli E; Burke, James F; Callaghan, Brian C; Becker, Amanda; Kerber, Kevin A

2015-04-28

Little is known about how neurology payments vary by service type (i.e., evaluation and management [E/M] vs tests/treatments) and compare to other specialties, yet this information is necessary to help neurology define its position on proposed payment reform. Medicare Provider Utilization and Payment Data from 2012 were used. These data included all direct payments to providers who care for fee-for-service Medicare recipients. Total payment was determined by medical specialty and for various services (e.g., E/M, EEG, electromyography/nerve conduction studies, polysomnography) within neurology. Payment and proportion of services were then calculated across neurologists' payment categories. Neurologists comprised 1.5% (12,317) of individual providers who received Medicare payments and were paid $1.15 billion by Medicare in 2012. Sixty percent ($686 million) of the Medicare payment to neurologists was for E/M, which was a lower proportion than primary providers (approximately 85%) and higher than surgical subspecialties (range 9%-51%). The median neurologist received nearly 75% of their payments from E/M. Two-thirds of neurologists received 60% or more of their payment from E/M services and over 20% received all of their payment from E/M services. Neurologists in the highest payment category performed more services, of which a lower proportion were E/M, and performed at a facility, compared to neurologists in lower payment categories. E/M is the dominant source of payment to the majority of neurologists and should be prioritized by neurology in payment restructuring efforts. © 2015 American Academy of Neurology.

Out of pocket payments and social health insurance for private hospital care: Evidence from Greece.

Science.gov (United States)

Grigorakis, Nikolaos; Floros, Christos; Tsangari, Haritini; Tsoukatos, Evangelos

2016-08-01

The Greek state has reduced their funding on health as part of broader efforts to limit the large fiscal deficits and rising debt ratios to GDP. Benefits cuts and limitations of Social Health Insurance (SHI) reimbursements result in substantial Out of Pocket (OOP) payments in the Greek population. In this paper, we examine social health insurance's risk pooling mechanisms and the catastrophic impact that OOP payments may have on insured's income and well-being. Using data collected from a cross sectional survey in Greece, we find that the OOP payments for inpatient care in private hospitals have a positive relationship with SHI funding. Moreover, we show that the SHI funding is inadequate to total inpatient financing. We argue that the Greek health policy makers have to give serious consideration to the perspective of a SHI system which should be supplemented by the Private Health Insurance (PHI) sector. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Connecting Payments for Ecosystem Services and Agri-Environment Regulation: An Analysis of the Welsh Glastir Scheme

Science.gov (United States)

Wynne-Jones, Sophie

2013-01-01

Policy debates in the European Union have increasingly emphasised "Payments for Ecosystem Services" (PES) as a model for delivering agri-environmental objectives. This paper examines the Glastir scheme, introduced in Wales in 2009, as a notable attempt to move between long standing models of European agri-environment regulation and…

Wide variation in hospital and physician payment rates evidence of provider market power.

Science.gov (United States)

Ginsburg, Paul B

2010-11-01

Wide variation in private insurer payment rates to hospitals and physicians across and within local markets suggests that some providers, particularly hospitals, have significant market power to negotiate higher-than-competitive prices, according to a new study by the Center for Studying Health System Change (HSC). Looking across eight health care markets--Cleveland; Indianapolis; Los Angeles; Miami; Milwaukee; Richmond, Va.; San Francisco; and rural Wisconsin--average inpatient hospital payment rates of four large national insurers ranged from 147 percent of Medicare in Miami to 210 percent in San Francisco. In extreme cases, some hospitals command almost five times what Medicare pays for inpatient services and more than seven times what Medicare pays for outpatient care. Variation within markets was just as dramatic. For example, the hospital with prices at the 25th percentile of Los Angeles hospitals received 84 percent of Medicare rates for inpatient care, while the hospital with prices at the 75th percentile received 184 percent of Medicare rates. The highest-priced Los Angeles hospital with substantial inpatient claims volume received 418 percent of Medicare. While not as pronounced, significant variation in physician payment rates also exists across and within markets and by specialty. Few would characterize the variation in hospital and physician payment rates found in this study to be consistent with a highly competitive market. Purchasers and public policy makers can address provider market power, or the ability to negotiate higher-than-competitive prices, through two distinct approaches. One is to pursue market approaches to strengthen competitive forces, while the other is to constrain payment rates through regulation.

Does a global budget superimposed on fee-for-service payments mitigate hospitals' medical claims in Taiwan?

Science.gov (United States)

Hsu, Pi-Fem

2014-12-01

Taiwan's global budgeting for hospital health care, in comparison to other countries, assigns a regional budget cap for hospitals' medical benefits claimed on the basis of fee-for-service (FFS) payments. This study uses a stays-hospitals-years database comprising acute myocardial infarction inpatients to examine whether the reimbursement policy mitigates the medical benefits claimed to a third-payer party during 2000-2008. The estimated results of a nested random-effects model showed that hospitals attempted to increase their medical benefit claims under the influence of initial implementation of global budgeting. The magnitudes of hospitals' responses to global budgeting were significantly attributed to hospital ownership, accreditation status, and market competitiveness of a region. The results imply that the regional budget cap superimposed on FFS payments provides only blunt incentive to the hospitals to cooperate to contain medical resource utilization, unless a monitoring mechanism attached with the payment system.

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

Science.gov (United States)

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

2011-05-01

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

7 CFR 760.209 - Livestock payment calculations.

Science.gov (United States)

2010-01-01

... 7 Agriculture 7 2010-01-01 2010-01-01 false Livestock payment calculations. 760.209 Section 760..., DEPARTMENT OF AGRICULTURE SPECIAL PROGRAMS INDEMNITY PAYMENT PROGRAMS Emergency Assistance for Livestock, Honeybees, and Farm-Raised Fish Program § 760.209 Livestock payment calculations. (a) Payments for an...

Actuality of assortment policy in the modern management of retail business enterprise

Directory of Open Access Journals (Sweden)

Yefimova Yevheniia

2016-07-01

Full Text Available In the result of research it has been found, that the assortment policy defines the course of actions for managing a point-of-sale assortment which foresees clarification and specification of strategic purpose and current tasks; development and grounding of facilities, methods and forms of activity for their achievement; determination of the real resources providing the realization of the plan. The constituents of assortment policy of enterprise of retail business are identified. It is well-proved that with the help of assortment policy achievement of ultimate goals of an enterprise is provided, the constituents of commercial strategy associate together and the possibility of the most effective usage of resources has arrived.

Survey of electronic payment methods and systems

NARCIS (Netherlands)

Havinga, Paul J.M.; Smit, Gerardus Johannes Maria; Helme, A.; Verbraeck, A.

1996-01-01

In this paper an overview of electronic payment methods and systems is given. This survey is done as part of the Moby Dick project. Electronic payment systems can be grouped into three broad classes: traditional money transactions, digital currency and creditdebit payments. Such payment systems have

Emerging lessons from regional and state innovation in value-based payment reform: balancing collaboration and disruptive innovation.

Science.gov (United States)

Conrad, Douglas A; Grembowski, David; Hernandez, Susan E; Lau, Bernard; Marcus-Smith, Miriam

2014-09-01

In recent decades, practitioners and policymakers have turned to value-based payment initiatives to help contain spending on health care and to improve the quality of care. The Robert Wood Johnson Foundation funded 7 grantees across the country to design and implement value-based, multistakeholder payment reform projects in 6 states and 3 regions of the United States. As the external evaluator of these projects, we reviewed documents, conducted Internet searches, interviewed key stakeholders, cross-validated factual and narrative interpretation, and performed qualitative analyses to derive cross-site themes and implications for policy and practice. The nature of payment reform and its momentum closely reflects the environmental context of each project. Federal legislation such as the Patient Protection and Affordable Care Act and federal and state support for the development of the patient-centered medical home and accountable care organizations encourage value-based payment innovation, as do local market conditions for payers and providers that combine a history of collaboration with independent innovation and experimentation by individual organizations. Multistakeholder coalitions offer a useful facilitating structure for galvanizing payment reform. But to achieve the objectives of reduced cost and improved quality, multistakeholder payment innovation must overcome such barriers as incompatible information systems, the technical difficulties and transaction costs of altering existing billing and payment systems, competing stakeholder priorities, insufficient scale to bear population health risk, providers' limited experience with risk-bearing payment models, and the failure to align care delivery models with the form of payment. From the evidence adduced in this article, multistakeholder, value-based payment reform requires a trusted, widely respected "honest broker" that can convene and maintain the ongoing commitment of health plans, providers, and purchasers

Proof of payment for all reimbursement claims

CERN Multimedia

HR Department

2006-01-01

Members of the personnel are kindly requested to note that only documents proving that a payment has been made are accepted as proof of payment for any claims for reimbursement, including specifically the reimbursement of education fees. In particular, the following will be accepted as proof of payment: bank or post office bank statements indicating the name of the institution to which the payment was made; photocopies of cheques made out to the institution to which the payments were made together with bank statements showing the numbers of the relevant cheques; proof of payment in the form of discharged payment slips; invoices with acknowledgement of settlement, receipts, bank statements detailing operations crediting another account or similar documents. As a result, the following documents in particular will no longer be accepted as proof of payment: photocopies of cheques that are not submitted together with bank or post office bank statements showing the numbers of the relevant cheques; details of ...

9 CFR 201.55 - Purchases, sales, acquisitions, payments and settlements to be made on actual weights.

Science.gov (United States)

2010-01-01

... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Purchases, sales, acquisitions... AGRICULTURE REGULATIONS UNDER THE PACKERS AND STOCKYARDS ACT Trade Practices § 201.55 Purchases, sales... ticket. If the actual weight used is not obtained on the date and at the place of transfer of possession...

Hospital non-price competition under the Global Budget Payment and Prospective Payment Systems.

Science.gov (United States)

Chen, Wen-Yi; Lin, Yu-Hui

2008-06-01

This paper provides theoretical analyses of two alternative hospital payment systems for controlling medical cost: the Global Budget Payment System (GBPS) and the Prospective Payment System (PPS). The former method assigns a fixed total budget for all healthcare services over a given period with hospitals being paid on a fee-for-service basis. The latter method is usually connected with a fixed payment to hospitals within a Diagnosis-Related Group. Our results demonstrate that, given the same expenditure, the GBPS would approach optimal levels of quality and efficiency as well as the level of social welfare provided by the PPS, as long as market competition is sufficiently high; our results also demonstrate that the treadmill effect, modeling an inverse relationship between price and quantity under the GBPS, would be a quality-enhancing and efficiency-improving outcome due to market competition.

Effects of payments for ecosystem services on wildlife habitat recovery.

Science.gov (United States)

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

2016-08-01

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

Third-party online payment solutions in China

OpenAIRE

Yang, Qian

2017-01-01

The topic of this paper is third-party online payment solutions in China and the main purpose of this paper is to figure out the research question: What are the impacts of third-party online payment solutions on China? Generally speaking, the third-party online payment solutions, including mobile payments, usually used by customer who purchase online and usually used in transaction platform. However, in China, people can use third-party payment solutions in different platfor...

77 FR 66554 - Federal Travel Regulation (FTR); Payment of Expenses Connected With the Death of Certain Employees

Science.gov (United States)

2012-11-06

... agency. DATES: Effective date: November 6, 2012. Applicability date: This final rule applies to travel...; Docket Number 2011-0022, Sequence 1] RIN 3090-AJ21 Federal Travel Regulation (FTR); Payment of Expenses Connected With the Death of Certain Employees AGENCY: Office of Government-wide Policy, General Services...

Specialty Payment Model Opportunities and Assessment

Science.gov (United States)

Mulcahy, Andrew W.; Chan, Chris; Hirshman, Samuel; Huckfeldt, Peter J.; Kofner, Aaron; Liu, Jodi L.; Lovejoy, Susan L.; Popescu, Ioana; Timbie, Justin W.; Hussey, Peter S.

2015-01-01

Abstract Gastroenterology and cardiology services are common and costly among Medicare beneficiaries. Episode-based payment, which aims to create incentives for high-quality, low-cost care, has been identified as a promising alternative payment model. This article describes research related to the design of episode-based payment models for ambulatory gastroenterology and cardiology services for possible testing by the Center for Medicare and Medicaid Innovation at the Centers for Medicare and Medicaid Services (CMS). The authors analyzed Medicare claims data to describe the frequency and characteristics of gastroenterology and cardiology index procedures, the practices that delivered index procedures, and the patients that received index procedures. The results of these analyses can help inform CMS decisions about the definition of episodes in an episode-based payment model; payment adjustments for service setting, multiple procedures, or other factors; and eligibility for the payment model. PMID:28083363

28 CFR 74.12 - Order of payment.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Order of payment. 74.12 Section 74.12 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) CIVIL LIBERTIES ACT REDRESS PROVISION Notification and Payment § 74.12 Order of payment. Payment will be made in the order of date of birth pursuant...

Model Checking a Client-Side Micro Payment Protocol

NARCIS (Netherlands)

Chaudhary, Kaylash; Fehnker, Ansgar

2016-01-01

Virtual payment systems overcome the drawbacks such as processing and operational cost of the traditional payment system. The main aim of the virtual payment system is to provide efficient services in terms of cost. Online payment using credit card is one of the most expensive of all payment means.

Tropical wetlands and REDD+: Three unique scientific challenges for policy

Directory of Open Access Journals (Sweden)

Daniel A Friess

2013-07-01

Full Text Available The carbon sequestration and storage value of terrestrial habitats is now increasingly appreciated, and is the basis for Payment for Ecosystem Service (PES policies such as REDD+. Tropical wetlands may be suitable for inclusion in such schemes because of the disproportionately large volume of carbon they are able to store. However, tropical wetlands offer a number of unique challenges for carbon management and policy compared to terrestrial forest systems: 1 Tropical wetlands are dynamic and subject to a wide range of physical and ecological processes that affect their long-term carbon storage potential – thus, such systems can quickly become a carbon source instead of a sink; 2 Carbon dynamics in tropical wetlands often operate over longer time-scales than are currently covered by REDD+ payments; and 3 Much of the carbon in a tropical wetland is stored in the soil, so monitoring, reporting and verification (MRV needs to adequately encapsulate the entire ecosystem and not just the vegetative component. This paper discusses these physical and biological concepts, and highlights key legal, management and policy questions that must be considered when constructing a policy framework to conserve these crucial ecosystems.

Assessing the impoverishing effects, and factors associated with the incidence of catastrophic health care payments in Kenya.

Science.gov (United States)

Barasa, Edwine W; Maina, Thomas; Ravishankar, Nirmala

2017-02-06

Monitoring the incidence and intensity of catastrophic health expenditure, as well as the impoverishing effects of out of pocket costs to access healthcare, is a key part of benchmarking Kenya's progress towards reducing the financial burden that households experience when accessing healthcare. The study relies on data from the nationally-representative Kenya Household Expenditure and Utilization Survey conducted in 2013 (n =33,675). We undertook health equity analysis to estimate the incidence and intensity of catastrophic expenditure. Households were considered to have incurred catastrophic expenditures if their annual out of-pocket health expenditures exceeded 40% of their annual non-food expenditure. We assessed the impoverishing effects of out of pocket payments using the Kenya national poverty line. We distinguished between direct payments for healthcare such as payments for consultation, medicines, medical procedures, and total healthcare expenditure that includes direct healthcare payments and the cost of transportation to and from health facilities. We used logistic regression analysis to explore the factors associated with the incidence of catastrophic expenditures. When only direct payments to healthcare providers were considered, the incidence of catastrophic expenditures was 4.52%. When transport costs are included, the incidence of catastrophic expenditure increased to 6.58%. 453,470 Kenyans are pushed into poverty annually as a result of direct payments for healthcare. When the cost of transport is included, that number increases by more than one third to 619,541. Unemployment of the household head, presence of an elderly person, a person with a chronic ailment, a large household size, lower household social-economic status, and residence in marginalized regions of the country are significantly associated with increased odds of incurring catastrophic expenditures. Kenyan policy makers should prioritize extending pre-payment mechanisms to more

46 CFR 282.30 - Payment of subsidy.

Science.gov (United States)

2010-10-01

... include for payment in such voucher the amount of ODS accrued for the voyages terminated during the period. ... 46 Shipping 8 2010-10-01 2010-10-01 false Payment of subsidy. 282.30 Section 282.30 Shipping... COMMERCE OF THE UNITED STATES Subsidy Payment and Billing Procedures § 282.30 Payment of subsidy...

46 CFR 252.40 - Payment of subsidy.

Science.gov (United States)

2010-10-01

... Payment and Billing Procedures § 252.40 Payment of subsidy. (a) Submission of voucher. At the close of each calendar month, the subsidized operator may submit a voucher, and include for payment in such... submit an initial voucher and include for payment in such voucher a percentage of the ODS payable for the...

Bundled payment and enhanced recovery after surgery.

Science.gov (United States)

Huang, Jeffrey

2015-01-01

Medicare's fee-for-service (FFS) payment model may contribute to unsustainable spending growth. Payers are turning to alternative payment methods. The leading alternative payment model to the FFS problem is bundled payment. The Centers for Medicare & Medicaid Services (CMS) is taking another step to improve healthcare quality at lower cost. The CMS's Center for Medicare and Medicaid Innovation developed four models of bundled payments and 48 discrete clinical condition episodes. Many surgical care procedures are included in the 48 different clinical condition episodes.

Payments to the Lab

Science.gov (United States)

Goals Recycling Green Purchasing Pollution Prevention Reusing Water Resources Environmental Management the Lab Make payments for event registrations, sponsorships, insurance, travel, other fees. Contact Treasury Team (505) 667-4090 Email If you need to make a payment to the Lab for an event registration

Variation in payments for spine surgery episodes of care: implications for episode-based bundled payment.

Science.gov (United States)

Kahn, Elyne N; Ellimoottil, Chandy; Dupree, James M; Park, Paul; Ryan, Andrew M

2018-05-25

OBJECTIVE Spine surgery is expensive and marked by high variation across regions and providers. Bundled payments have potential to reduce unwarranted spending associated with spine surgery. This study is a cross-sectional analysis of commercial and Medicare claims data from January 2012 through March 2015 in the state of Michigan. The objective was to quantify variation in payments for spine surgery in adult patients, document sources of variation, and determine influence of patient-level, surgeon-level, and hospital-level factors. METHODS Hierarchical regression models were used to analyze contributions of patient-level covariates and influence of individual surgeons and hospitals. The primary outcome was price-standardized 90-day episode payments. Intraclass correlation coefficients-measures of variability accounted for by each level of a hierarchical model-were used to quantify sources of spending variation. RESULTS The authors analyzed 17,436 spine surgery episodes performed by 195 surgeons at 50 hospitals. Mean price-standardized 90-day episode payments in the highest spending quintile exceeded mean payments for episodes in the lowest cost quintile by $42,953 (p accounting for patient-level covariates, the remaining hospital-level and surgeon-level effects accounted for 2.0% (95% CI 1.1%-3.8%) and 4.0% (95% CI 2.9%-5.6%) of total variation, respectively. CONCLUSIONS Significant variation exists in total episode payments for spine surgery, driven mostly by variation in post-discharge and facility payments. Hospital and surgeon effects account for relatively little of the observed variation.

Rehabilitation of compensable workplace injuries: effective payment models for quality vocational rehabilitation outcomes in a changing social landscape.

Science.gov (United States)

Matthews, Lynda R; Hanley, Francine; Lewis, Virginia; Howe, Caroline

2015-01-01

With social and economic costs of workplace injury on the increase, efficient payment models that deliver quality rehabilitation outcomes are of increasing interest. This paper provides a perspective on the issue informed by both refereed literature and published research material not available commercially (gray literature). A review of payment models, workers' compensation and compensable injury identified relevant peer-reviewed and gray literature that informed our discussion. Fee-for-service and performance-based payment models dominate the health and rehabilitation literature, each described as having benefits and challenges to achieving quality outcomes for consumers. There appears to be a movement toward performance-based payments in compensable workplace injury settings as they are perceived to promote time-efficient services and support innovation in rehabilitation practice. However, it appears that the challenges that arise for workplace-based rehabilitation providers and professionals when working under the various payment models, such as staff retention and quality of client-practitioner relationship, are absent from the literature and this could lead to flawed policy decisions. Robust evidence of the benefits and costs associated with different payment models - from the perspectives of clients/consumers, funders and service providers - is needed to inform best practice in rehabilitation of compensable workplace injuries. Available but limited evidence suggests that payment models providing financial incentives for stakeholder-agreed vocational rehabilitation outcomes tend to improve service effectiveness in workers' compensation settings, although there is little evidence of service quality or client satisfaction. Working in a system that identifies payments for stakeholder-agreed outcomes may be more satisfying for rehabilitation practitioners in workers' compensation settings by allowing more clinical autonomy and innovative practice. Researchers

Definition of a prospective payment system to reimburse emergency departments.

Science.gov (United States)

Levaggi, Rosella; Montefiori, Marcello

2013-10-11

Payers are increasingly turning to Prospective Payment Systems (PPSs) because they incentivize efficiency, but their application to emergency departments (EDs) is difficult because of the high level of uncertainty and variability in the cost of treating each patient.To the best of our knowledge, our work represents the first attempt at defining a PPS for this part of hospital activity. Data were specifically collected for this study and relate to 1011 patients who were triaged at an ED of a major Italian hospital, during 1 week in December 2010.The cost for each patient was analytically estimated by adding up several components: 1) physician and other staff costs that were imputed on the basis of the time each physician claimed to have spent treating the patient; 2) the cost for each test/treatment each patient actually underwent; 3) overhead costs, shared among patients using the time elapsed between first examination and discharge from the ED. The distribution of costs by triage code shows that, although the average cost increases across the four triage groups, the variance within each code is quite high. The maximum cost for a yellow code is €1074.7, compared with €680 for red, the most serious code. Using cluster analysis, the red code cluster is enveloped by yellow, and their costs are therefore indistinguishable, while green codes span all cost groups. This suggests that triage code alone is not a good proxy for the patient cost, and that other cost drivers need to be included. Crude triage codes cannot be used to define PPSs because they are not sufficiently correlated with costs and are characterized by large variances. However, if combined with other information, such as the number of laboratory and non-laboratory tests/examinations, it is possible to define cost groups that are sufficiently homogeneous to be reimbursed prospectively. This should discourage strategic behavior and allow the ED to break even or create profits, which can be reinvested to

42 CFR 408.65 - Payment options.

Science.gov (United States)

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Payment options. 408.65 Section 408.65 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PREMIUMS FOR SUPPLEMENTARY MEDICAL INSURANCE Direct Remittance: Individual Payment § 408.65 Payment options...

47 CFR 27.1186 - Payment issues.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Payment issues. 27.1186 Section 27.1186 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS... Broadband Radio Service Relocation from the 2150-2160/62 Mhz Band § 27.1186 Payment issues. Payment of cost...

E-commerce settles for established payment systems: Limited market potential for innovative payment systems

OpenAIRE

Heng, Stefan

2007-01-01

Established payment systems play a dominant role also in B2C e-commerce. Innovative payment systems can only be a success here if they pay attention to the particular features of e-commerce, convey the worth of their value-adding unique selling proposition and enjoy the support of established e-shops or financial service providers. However, apart from rare cases the conventional payment systems leave little room for the innovative systems. This holds all the more since the conventional paymen...

Assessing impacts of payments for watershed services on sustainability in coupled human and natural systems

Science.gov (United States)

Heidi Asbjornsen; Alex S. Mayer; Kelly W. Jones; Theresa Selfa; Leonardo Saenz; Randall K. Kolka; Kathleen E. Halvorsen

2015-01-01

Payments for watershed services (PWS) as a policy tool for enhancing water quality and supply have gained momentum in recent years, but their ability to lead to sustainable watershed outcomes is uncertain. Consequently, the demand for effective monitoring and evaluation (M&E) of PWS impacts on coupled human and natural systems (CHANS) and their implications for...

Combining DRGs and per diem payments in the private sector: the Equitable Payment Model.

Science.gov (United States)

Hanning, Brian W T

2005-02-01

The many types of payment models used in the Australian private sector are reviewed. Their features are compared and contrasted to those desirable in an optimal private sector payment model. The EPM(TM) (Equitable Payment Model) is discussed and its consistency with the desirable features of an optimal private sector payment model outlined. These include being based on a robust classification system, nationally benchmarked length of stay (LOS) results, nationally benchmarked relative cost and encouraging continual improvement in efficiency to the benefit of both health funds and private hospitals. The advantages in the context of the private sector of EPM(TM) being a per diem model, albeit very different to current per diem models, are discussed. The advantages of EPM(TM) for hospitals and health funds are outlined.

42 CFR 460.182 - Medicaid payment.

Science.gov (United States)

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Medicaid payment. 460.182 Section 460.182 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...) Payment § 460.182 Medicaid payment. (a) Under a PACE program agreement, the State administering agency...

5 CFR 1655.14 - Loan payments.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Loan payments. 1655.14 Section 1655.14 Administrative Personnel FEDERAL RETIREMENT THRIFT INVESTMENT BOARD LOAN PROGRAM § 1655.14 Loan payments. (a) Loan payments must be made through payroll deduction in accordance with the loan agreement. Once loan...

Has the Copayment Ceiling Improved Financial Protection in the Korean National Health Insurance System? Evidence From the 2009 Policy Change.

Science.gov (United States)

Lee, Tae-Jin; Cheong, Chelim

2017-11-01

To relieve the financial burden faced by households, the Korean National Health Insurance (NHI) system introduced a "copayment ceiling," which evolved into a differential ceiling in 2009, with the copayment ceiling depending on patients' income. This study aimed to examine the effect of the differential copayment ceiling on financial protection and healthcare utilization, particularly focusing on whether its effects varied across different income groups. This study obtained data from the Korea Health Panel. The number of households included in the analysis was 6555 in 2008, 5859 in 2009, 5539 in 2010, and 5372 in 2011. To assess the effects of the differential copayment ceiling on utilization, out-of-pocket (OOP) payments, and catastrophic payments, various random-effects models were applied. Utilization was measured as treatment days, while catastrophic payments were defined as OOP payments exceeding 10% of household income. Among the right-hand side variables were the interaction terms of the new policy with income levels, as well as a set of household characteristics. The differential copayment ceiling contributed to increased utilization regardless of income levels both in all patients and in cancer patients. However, the new policy did not seem to reduce significantly the incidence of catastrophic payments among cancer patients, and even increased the incidence among all patients. The limited effect of the differential ceiling can be attributed to a high proportion of direct payments for services not covered by the NHI, as well as the relatively small number of households benefiting from the differential ceilings; these considerations warrant a better policy design.

Characteristics of Mobile Payment Procedures

OpenAIRE

Kreyer, Nina; Pousttchi, Key; Turowski, Klaus

2002-01-01

Companies are not going to invest into the development of innovative applications or services unless these can be charged for appropriately. Thus, the existence of standardized and widely accepted mobile payment procedures is crucial for successful business-to-customer mobile commerce. The acceptance of mobile payment procedures depends on costs, security and convenience issues. For the latter, it is important that a procedure can be used over the different payment scenarios mobile commerce, ...

42 CFR 412.505 - Conditions for payment under the prospective payment system for long-term care hospitals.

Science.gov (United States)

2010-10-01

... payment system for long-term care hospitals. 412.505 Section 412.505 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Long-Term Care Hospitals § 412.505 Conditions for...

[Provide comprehensive service for state policy].

Science.gov (United States)

Wu, X

1991-04-01

In recent years, Chinese insurance companies introduced family planning (FP) insurance series. These schemes originated from the "one child" and life insurance and accident insurance of the early 1980s, which were established in response to the need that came with the "one child" policy. In order to help relieve the difficulties of rural FP work, the People's Insurance Corporation extended these programs to a series of schemes. These schemes included e.g., and old age security program for the families with 1 daughter only, old age security for families with an only child, and the program for FP workers' personal safety. The purpose of these schemes was to guarantee security in old age for families with few children, to ensure compensation if accident occurs during delivery or as a result of birth control operations; and compensation for FP workers for physical assaults they encountered. As FP organizations have been directly involved in advertising the insurance programs, there has been support from local governments with human and financial resources, and these insurance programs have been expanding every year. The payment of the policy has been either entirely or partially borne by the employers of the insured. In the process of the development of the insurance program, some problems have occurred. 1st, competition between FP organizations and insurance companies have evolved in sponsoring the program for its profit. 2nd, some media reports have confused the payment of premiums with the compulsory levy of undue fees, which in a way, hindered the expansion of program enrollment. 3rd, some local administrations are short of funds to pay for the insurance premiums. 4th, the accrued income from the premiums is lower than the expected sum of the principle and interest if the same funds were deposited in a bank at current interest rate. Therefore, some schemes lack appeal. FP series insurance is a longer term program which will have an important impact on the

PAYING UP THE FISCAL DEBTS IN ROMANIA THROUGH EXCEPTIONAL VEHICLES – DATIO IN SOLUTUM/ UNRESTRAINED PAYMENT

Directory of Open Access Journals (Sweden)

POPEANGĂ VASILE NICOLAE

2014-06-01

Full Text Available In accordance with the legal norm incidents in tax procedures, in Romania the tax debts can pay off through commissioning. Fighting procedure of tax receivables by placing in payment by the taxpayer begins by formulating the debtor, owner of real estate, a request to this effect, which addresses the tax authority that administers the claims. The debtor's right to appeal to this method is practically unlimited. Extinguishing procedure of tax receivables by placing in payment by the taxpayer begins by formulating the debtor, owner of real estate, a request to this effect, which addresses the tax authority that administers the claims. The debtor's right to appeal this way is practically unlimited. It actually arises from the time the claim becomes due and remain until its extinction, as long as the taxpayer has an active fiscal condition.

Medicare physician payment systems: impact of 2011 schedule on interventional pain management.

Science.gov (United States)

Manchikanti, Laxmaiah; Singh, Vijay; Caraway, David L; Benyamin, Ramsin M; Hirsch, Joshua A

2011-01-01

Physicians in the United States have been affected by significant changes in the patterns of medical practice evolving over the last several decades. The recently passed affordable health care law, termed the Patient Protection and Affordable Care Act of 2010 (the ACA, for short) affects physicians more than any other law. Physician services are an integral part of health care. Physicians are paid in the United States for their personal services. This payment also includes the overhead expenses for maintaining an office and providing services. The payment system is highly variable in the private insurance market; however, governmental systems have a formula-based payment, mostly based on the Medicare payment system. Physician services are billed under Part B. Since the inception of the Medicare program in 1965, several methods have been used to determine the amounts paid to physicians for each covered service. Initially, the payment systems compensated physicians on the basis of their charges. In 1975, just over 10 years after the inception of the Medicare program, payments changed so as not to exceed the increase in the Medical Economic Index (MEI). Nevertheless, the policy failed to curb increases in costs, leading to the determination of a yearly change in fees by legislation from 1984 to 1991. In 1992, the fee schedule essentially replaced the prior payment system that was based on the physician's charges, which also failed to live up to expectations for operational success. Then, in 1998, the sustainable growth rate (SGR) system was introduced. In 2009, multiple attempts were made by Congress to repeal the formula - rather unsuccessfully. Consequently, the SGR formula continues to hamper physician payments. The mechanism of the SGR includes 3 components that are incorporated into a statutory formula: expenditure targets, growth rate period, and annual adjustments of payment rates for physician services. Further, the relative value of a physician fee schedule

Cash and Payments Management Data

Data.gov (United States)

General Services Administration — The Prompt Payment Act, along with the Debt Collection Improvement Act of 1996, requires the timely payment of commercial obligations for supplies and services using...

Study of Mobile Payment Services in India : Distribution of the roles, responsibilities and attitudes amongst actors of the payment systems

OpenAIRE

Singh Sambhy, Gurpreet

2014-01-01

Information technology and payment systems have witnessed the introduction, acceptance and wide scale deployment of electronic payment systems. The payment system ecosystem has now witnessed the introduction of mobile payment systems and their associated services. Major actors involved in mobile payment systems include telecom operators, banks, merchants and consumers. They need to aggregate their resources and develop a coherent ecosystem which would help the individual actors while also ben...

41 CFR 51-5.7 - Payments.

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Payments. 51-5.7 Section... Payments. Payments for products or services of persons who are blind or have other severe disabilities shall be made within 30 days after shipment or receipt of a proper invoice or voucher. ...

20 CFR 410.501 - Payment periods.

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Payment periods. 410.501 Section 410.501 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Payment of Benefits § 410.501 Payment periods. Benefits are paid to...

5 CFR 1620.35 - Loan payments.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Loan payments. 1620.35 Section 1620.35... Nonappropriated Fund Employees § 1620.35 Loan payments. NAF instrumentalities must deduct and transmit TSP loan... CFR part 1655 and Board procedures. Loan payments may not be deducted and transmitted for employees...

Medicare Provider Payment Data - Home Health Agencies

Data.gov (United States)

U.S. Department of Health & Human Services — The Home Health Agency PUF contains information on utilization, payment (Medicare payment and standard payment), and submitted charges organized by CMS Certification...

An Investigation of Digital Payment Platform Designs

DEFF Research Database (Denmark)

Kazan, Erol; Damsgaard, Jan

2014-01-01

This paper focuses on the triumph march of mobile phones that currently are annexing music players, navigation devices, and cameras as separate physical objects. The next target is set on payment. Through synthesizing available literature, we construct a framework for studying digital payment...... platforms that combines platform, technology and business design aspects. The framework is applied to conduct a comparative case study of digital payment platforms. Four types of market actors are considered: banks, mobile network operators, merchants, and startups, which are incumbents and disrupters....... By hosting third-party services, payment instruments are evolving from single-purpose to multi-functional ones. Our research extends existing payment literature from the MSP perspective to emphasize certain digital payment platform components, which impact strategies and complementary products....

Security Safeguards on E-Payment Systems in Malaysia: Analysis on the Payment Systems Act 2003

OpenAIRE

Zulhuda, Sonny; Azmi, Ida Madieha bt. Abdul Ghani

2011-01-01

Central to the infrastructure of electronic commerce activities is the electronic payment system. This encompasses not only the issues of technical sophistication but also legal readiness. In the context of electronic commerce environment in Malaysia, this paper seeks to highlight and examine the Malaysian legal readiness in the aspect of electronic payment system, focusing on its Payment Systems Act 2003. The discussion is limited to the issue of electronic security measures embodied in the ...

Fairly efficient or efficiently fair: success factors and constraints of payment and reward schemes for environmental services in Asia

NARCIS (Netherlands)

Beria, L.

2011-01-01

Payment for environmental service (PES) is strictly defined as a market-based environmental policy instrument to achieve environmental protection in the most efficient way. However, an increasing body of literature shows that the prescriptive conceptualization of PES cannot be easily generalized

45 CFR 34.7 - Payment procedures.

Science.gov (United States)

2010-10-01

... whole or part, the claims officer shall prepare and mail a payment voucher to the claimant. (b) This... payment voucher, the claims officer shall sign and forward the signed voucher to the office where the claimant is or was employed for processing. (d) Upon receipt of the signed payment voucher, the office in...

7 CFR 920.112 - Late payments.

Science.gov (United States)

2010-01-01

... Miscellaneous Provisions § 920.112 Late payments. Pursuant to § 920.41(a), interest will be charged at a 1.5 percent monthly simple interest rate. Assessments for kiwifruit shall be deemed late if not received... late charge will be assessed when payment becomes 30 days late. Interest and late payment charges shall...

Medicaid Disproportionate Share Hospital Payments

Data.gov (United States)

U.S. Department of Health & Human Services — Medicaid Disproportionate Share Hospital (DSH) Payments This link provides you with information about Medicaid DSH Payments. You can find information on DSH Audit...

CMS announces new payment model

Directory of Open Access Journals (Sweden)

Robbins RA

2018-01-01

Full Text Available No abstract available. Article truncated after 150 words. On Tuesday, 1/9/18, the Centers for Medicare and Medicaid (CMS announced a new voluntary bundled-payment model that will be considered an advanced alternative payment model under Medicare Access and CHIP Reauthorization Act of 2015 (MACRA (1. The new model is the first advanced Alternative Payment Model (APM to be introduced by the Trump administration. The Trump administration has been a vocal advocate of reducing administrative burden for clinicians and has touted voluntary models as a solution (2. The new, voluntary model comes less than two months after the CMS officially decided to eliminate two mandatory bundled-payment models created during the Obama administration. Under the model, clinician payment will be based on quality measures during a 90-day episode of care. Participants must select at least one of the 32 clinical episodes to apply to the model. The inpatient clinical episodes are listed in Table 1 (3. Table 1. Clinical inpatient episodes under …

Medical ethics: enhanced or undermined by modes of payment?

Science.gov (United States)

Zweifel, Peter; Janus, Katharina

2017-01-01

coming from the case studies. As to physicians working in hospital or group practice, the prediction is again that a transition in hospital payment from FFS to PP weakens their ethical orientation. However, this prediction could not be tested because the one hospital study found relates to a transition to P4P, suggesting that this mode of payment may actually enhance medical ethics of healthcare providers working in a hospital or group practice. The claim that moving away from FFS undermines medical ethics is far too sweeping. It can only in part be justified by observed relationships, which even may suggest that a transition to P4P strengthens medical ethics.

The Actual Problems of Modern Spain

Directory of Open Access Journals (Sweden)

Natalya E. Anikeeva

2014-01-01

Full Text Available The important aim of national and Spanish historiography and political science is to study history and foreign policy of modern Spain. The author studied articles and monographies of spanish politicians and researchers ( M. Rahoy, I. Aries, A. Rubalcaba, I. Molina for the preparation of this article during the scientific trip to Madrid (Complutense University, Faculty of Political Science and Sociology, which was held in the framework of cooperation between the Bank Santander and MGIMO (University. The paper analyzes the political and economic aspects of life in Spain, and its foreign policy of the period of government of Mariano Rajoy (from 2011 to the present time. The article is dedicated to actual problems of modern Spain: the economy and the priorities of the government of M.Rajoy, the problem of separatism and political system of the country. Modern Spain is still recovering economically from the euro debt crisis and continues to struggle with near-record unemployment. Domestic economic recovery of Spain and the country's foreign position are closely linked. The European integration process still remains the main strategic task of the spanish foreign policy. Spain increases its role in world politics and obtains a non-permanent UN's Security Council seat for the 2015-2016 term.

Effect of payments for health care on poverty estimates in 11 countries in Asia: an analysis of household survey data.

Science.gov (United States)

van Doorslaer, Eddy; O'Donnell, Owen; Rannan-Eliya, Ravi P; Somanathan, Aparnaa; Adhikari, Shiva Raj; Garg, Charu C; Harbianto, Deni; Herrin, Alejandro N; Huq, Mohammed Nazmul; Ibragimova, Shamsia; Karan, Anup; Ng, Chiu Wan; Pande, Badri Raj; Racelis, Rachel; Tao, Sihai; Tin, Keith; Tisayaticom, Kanjana; Trisnantoro, Laksono; Vasavid, Chitpranee; Zhao, Yuxin

2006-10-14

Conventional estimates of poverty do not take account of out-of-pocket payments to finance health care. We aimed to reassess measures of poverty in 11 low-to-middle income countries in Asia by calculating total household resources both with and without out-of-pocket payments for health care. We obtained data on payments for health care from nationally representative surveys, and subtracted these payments from total household resources. We then calculated the number of individuals with less than the internationally accepted threshold of absolute poverty (US1 dollar per head per day) after making health payments. We also assessed the effect of health-care payments on the poverty gap--the amount by which household resources fell short of the 1 dollar poverty line in these countries. Our estimate of the overall prevalence of absolute poverty in these countries was 14% higher than conventional estimates that do not take account of out-of-pocket payments for health care. We calculated that an additional 2.7% of the population under study (78 million people) ended up with less than 1 dollar per day after they had paid for health care. In Bangladesh, China, India, Nepal, and Vietnam, where more than 60% of health-care costs are paid out-of-pocket by households, our estimates of poverty were much higher than conventional figures, ranging from an additional 1.2% of the population in Vietnam to 3.8% in Bangladesh. Out-of-pocket health payments exacerbate poverty. Policies to reduce the number of Asians living on less than 1 dollar per day need to include measures to reduce such payments.

Carbon rentals and silvicultural subsidies for private forests as climate policy instruments

International Nuclear Information System (INIS)

Uusivuori, J.; Laturi, J.

2007-01-01

The impacts of potential climate policy instruments on the carbon production of privately owned and operated forests were investigated. A forest model with an endogenous growth description and age-class structure was used to describe both the output supply and input demand decisions of a private non-industrial landowner with optimized consumption flow, harvest timing, and an intertemporal allocation of forest investments. Two scenarios were examined, notably (1) a scenario in which the landowner was granted periodic carbon rental payments; and (2) a scenario in which the government subsidized the costs of silvicultural investments. The intended and unintended effects of the policies were examined. Models were used to demonstrate that the effectiveness of the instruments was significantly influenced by the age-class structure of forests when future carbon benefits were discounted. It was concluded that carbon rental payments were a more effective policy for older age-class structured forests. Silvicultural subsidies were more beneficial for forests with younger age-class structures. 21 refs., 6 figs

Genesis and Evolution of Digital Payment Platforms

DEFF Research Database (Denmark)

Hjelholt, Morten; Damsgaard, Jan

2012-01-01

Payment transactions through the use of physical coins, bank notes or credit cards have for centuries been the standard formats of exchanging money. Recently online and mobile digital payment platforms has entered the stage as contenders to this position and possibly could penetrate societies...... thoroughly and substitute current payment standards in the decades to come. This paper portrays how digital payment paltforms evolve in socio-technical niches and how various technological platforms aim for institutional attention in their attempt to challenge earlier platforms and standards. The paper...... applies a co-evolutionary multilevel perspective to model the interplay and processes between technology and society wherein digital payment platforms potentially will substitute other payment platforms just like the credit card negated the check. On this basis this paper formulate a multilevel conceptual...

24 CFR 2002.15 - Advance payments.

Science.gov (United States)

2010-04-01

... where the requester has a history of prompt payment of FOIA fees, or require an advance payment of an amount up to the full estimated charges in the case of requesters with no history of payment; or (2) Where a requester has previously failed to pay a fee charged in a timely fashion (i.e., within 30 days...

14 CFR 1206.704 - Advance payments.

Science.gov (United States)

2010-01-01

... where the requester has a history of prompt payment of FOIA fees, or require an advance payment of an amount up to the full estimated charges in the case of requesters with no history of payment; or (2) A requester has previously failed to pay a fee in a timely fashion (within 30 days of billing), then NASA may...

32 CFR 756.7 - Payment.

Science.gov (United States)

2010-07-01

... payment is possible under another statute. In some cases, neither the NAFI nor its insurer may be legally responsible. In those instances when there is no negligence, and payment is authorized under some other...

Why 'Optimal' Payment for Healthcare Providers Can Never be Optimal Under Community Rating.

Science.gov (United States)

Zweifel, Peter; Frech, H E

2016-02-01

This article extends the existing literature on optimal provider payment by accounting for consumer heterogeneity in preferences for health insurance and healthcare. This heterogeneity breaks down the separation of the relationship between providers and the health insurer and the relationship between consumers and the insurer. Both experimental and market evidence for a high degree of heterogeneity are presented. Given heterogeneity, a uniform policy fails to effectively control moral hazard, while incentives for risk selection created by community rating cannot be neutralized through risk adjustment. Consumer heterogeneity spills over into relationships with providers, such that a uniform contract with providers also cannot be optimal. The decisive condition for ensuring optimality of provider payment is to replace community rating (which violates the principle of marginal cost pricing) with risk rating of contributions combined with subsidization targeted at high risks with low incomes.

20 CFR 411.582 - Can a State VR agency receive payment under the cost reimbursement payment system if a continuous...

Science.gov (United States)

2010-04-01

... the cost reimbursement payment system if a continuous 9-month period of substantial gainful activity... Systems § 411.582 Can a State VR agency receive payment under the cost reimbursement payment system if a... under the cost reimbursement payment system under subpart V of part 404 (or subpart V of part 416) of...

Are soil pollution risks established by governments the same as actual risks?

NARCIS (Netherlands)

Reijnders, L.

2009-01-01

Though soil pollution policies in North America and the European Union increasingly use risk-based standards, the construction and application of such standards are often deficient in taking account of actual risks. Standards refer to total concentrations of substances and not to the biologically

The obstacles of NFC mobile payment development in Finland : security issues of NFC mobile payment

OpenAIRE

Yang, Ning

2016-01-01

In the recent years, with the rapid development of science and technology in the consumer markets, payment terms are being promoted much faster than ever. It is considered that NFC Mobile payment will enjoy a great prospect. NFC Mobile payment technique, which is based on the RFID technology, has been growing popularity. Near Field Communication (NFC) is the proximity standard for the proximity cards that can be modified to allow integration of the technology into a cellular phone. NFC tec...

75 FR 71799 - Medicare Program: Hospital Outpatient Prospective Payment System and CY 2011 Payment Rates...

Science.gov (United States)

2010-11-24

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

Out-of-Pocket Payments and Subjective Unmet Need of Healthcare.

Science.gov (United States)

Schokkaert, Erik; Steel, Jonas; Van de Voorde, Carine

2017-10-01

We present a critical review of the literature that discusses the link between the level of out-of-pocket payments in developed countries and the share of people in these countries reporting that they postpone or forgo healthcare for financial reasons. We discuss the pros and cons of measuring access problems with this subjective variable. Whereas the quantitative findings in terms of numbers of people postponing care must be interpreted with utmost caution, the picture for the vulnerable groups in society is reasonably robust and unsurprising: people with low incomes and high morbidity and incomplete (or non-existent) insurance coverage are most likely to postpone or forgo healthcare for financial reasons. It is more surprising that people with high incomes and generous insurance coverage also report that they postpone care. We focus on some policy-relevant issues that call for further research: the subtle interactions between financial and non-financial factors, the possibility of differentiation of out-of-pocket payments between patients and between healthcare services, and the normative debate around accessibility and affordability.

Financial Technologies: A Note on Mobile Payment

Directory of Open Access Journals (Sweden)

Song Yee Leng

2018-02-01

Full Text Available The financial market is currently disrupted by the rise of new technologies "FinTech” a short form for financial technology, which profoundly reshapes the financial intermediary structure and makes financial services more efficient. Mobile technology with Internet-enabled devices are the next logical phase of the World Wide Web campaign such as mobile phone taking over the mass market and will fundamentally change the way products are buy and sell as well as financial services especially the mobile payment system. This research examines changes payment method in financial services, particularly those involving mobile payments that can create new channels for consumers to purchase goods and services using mobile phone. Mobile payment application is ready to replace traditional cash, checks, credit and debit card throughout the country. In this stage of development, the current situation of mobile payment market, review the previous literature on mobile payment services, analysis use of mobile payment worldwide and various initiatives use mobile phones to offer financial services for those ‘unbanked’.

Financial Technologies: A Note on Mobile Payment

Directory of Open Access Journals (Sweden)

Song Yee Leng

2018-02-01

Full Text Available The financial market is currently disrupted by the rise of new technologies “FinTech” a short form of financial technology, which profoundly reshapes the financial intermediary structure and makes financial services more efficient. Mobile technology with Internet-enabled devices are the next logical phase of the World Wide Web a campaign such as mobile phone taking over the mass market and will fundamentally change the way products are bought and sold as well as financial services especially the mobile payment system. This research examines changes payment method in financial services, particularly those involving mobile payments that can create new channels for consumers to purchase goods and services using a mobile phone. Mobile payment application is ready to replace traditional cash, checks, credit and debit card throughout the country. In this stage of development, the current situation of mobile payment market, review the previous literature on mobile payment services, analysis use of mobile payment worldwide and various initiatives use mobile phones to offer financial services for those ‘unbanked’.

Retail payments in the Netherlands : Facts and theory

NARCIS (Netherlands)

Bolt, Wilko

Over the last decade, the Netherlands observed a rapid shift from cash and paper-based payment instruments toward electronic payment instruments. Banks are well aware that transaction pricing can speed up the shift to low-cost electronic payments. But payment pricing is a complex matter, due to

When Regional Innovation Policies Meet Policy Rationales and Evidence:

DEFF Research Database (Denmark)

Borrás, Susana; Jordana, Jacint

regions, and to understand how rationales and evidence can be translated into policy-making. To this purpose, this paper develops a framework to study the extent to which regional innovation policies have changed during the past few years. Since the mid-2000s there has been an important development......In spite of recent advancements regarding regional innovation policy rationales and evidence, there are few analyses about the actual features of existing regional innovation policies. Nevertheless, a policy analysis perspective is important in order to recognise their distinctive patterns across...... of innovation policy rationales, advocating for more specialisation; likewise, greater data availability at the regional level has allowed more sophisticated assessment of innovation performance. Finally, the crisis since 2008 has had ravaging effects in some regions, with job losses and severe economic...

When Regional Innovation Policies Meet Policy Rationales and Evidence

DEFF Research Database (Denmark)

Borrás, Susana; Jordana, Jacint

2016-01-01

regions, and to understand how rationales and evidence can be translated into policy-making. To this purpose, this paper develops a framework to study the extent to which regional innovation policies have changed during the past few years. Since the mid-2000s, there has been an important development......In spite of recent advancements regarding regional innovation policy rationales and evidence, there are few analyses about the actual features of existing regional innovation policies. Nevertheless, a policy analysis perspective is important in order to recognize their distinctive patterns across...... of innovation policy rationales, advocating for more specialization; likewise, greater data availability at the regional level has allowed more sophisticated assessment of innovation performance. Finally, the crisis since 2008 has had ravaging effects in some regions, with job losses and severe economic...

Evaluación de las políticas educativas desde la Informed-Policy: Consideraciones teórico-metodológicas y retos actuales

Directory of Open Access Journals (Sweden)

José Sánchez-Santamaría

2015-07-01

Full Text Available La evaluación de las políticas educativas es una prioridad política, científica y social. Ello se debe a la existencia de una preocupación política por avanzar en el diseño e implementación de políticas de impacto, unido al interés de la comunidad científica por conocer mejor su sentido y función en la mejora de la calidad de los sistemas educativos en sociedades democráticas. Por todo ello, en este artículo se realiza una revisión sobre el estado de la evaluación de las políticas educativas de modo que nos permita establecer las perspectivas teóricas con mayor tradición y las emergentes, las cuestiones metodológicas referidas al desarrollo de sistemas de indicadores e índices de evaluación y los retos actuales planteados desde el movimiento de la Informed-Policy. Se apuesta por una aproximación descriptivo-exploratoria tomando como referencia fuentes de información y de datos primarios. Se aprecia una tendencia a establecer vínculos entre evidencias y políticas educativas, así como una preocupación creciente a que las evaluaciones de las políticas educativas informen sobre sus contribuciones a la equidad educativa.Cómo referenciar este artículoSánchez-Santamaría, J., & Espinoza, O. (2015. Evaluación de las políticas educativas desde la Informed-Policy: Consideraciones teórico-metodológicas y retos actuales. Foro de Educación, 13(19, 381-405. doi: http://dx.doi.org/10.14516/fde.2015.013.019.017

The Independent Payment Advisory Board.

Science.gov (United States)

Manchikanti, Laxmaiah; Falco, Frank J E; Singh, Vijay; Benyamin, Ramsin M; Hirsch, Joshua A

2011-01-01

The Independent Payment Advisory Board (IPAB) is a vastly powerful component of the president's health care reform law, with authority to issue recommendations to reduce the growth in Medicare spending, providing recommendations to be considered by Congress and implemented by the administration on a fast track basis. Ever since its inception, IPAB has been one of the most controversial issues of the Patient Protection and Affordable Care Act (ACA), even though the powers of IPAB are restricted and multiple sectors of health care have been protected in the law. IPAB works by recommending policies to Congress to help Medicare provide better care at a lower cost, which would include ideas on coordinating care, getting rid of waste in the system, providing incentives for best practices, and prioritizing primary care. Congress then has the power to accept or reject these recommendations. However, Congress faces extreme limitations, either to enact policies that achieve equivalent savings, or let the Secretary of Health and Human Services (HHS) follow IPAB's recommendations. IPAB has strong supporters and opponents, leading to arguments in favor of or against to the extreme of introducing legislation to repeal IPAB. The origins of IPAB are found in the ideology of the National Institute for Health and Clinical Excellence (NICE) and the impetus of exploring health care costs, even though IPAB's authority seems to be limited to Medicare only. The structure and operation of IPAB differs from Medicare and has been called the Medicare Payment Advisory Commission (MedPAC) on steroids. The board membership consists of 15 full-time members appointed by the president and confirmed by the Senate with options for recess appointments. The IPAB statute sets target growth rates for Medicare spending. The applicable percent for maximum savings appears to be 0.5% for year 2015, 1% for 2016, 1.25% for 2017, and 1.5% for 2018 and later. The IPAB Medicare proposal process involves

Connecting reason to power : Assessments, learning, and environmental policy integration in Swedish energy policy

NARCIS (Netherlands)

Nilsson, M.A.

2005-01-01

The purpose of this thesis is to contribute to understanding what makes a policymaking system better at integrating sustainability concerns into its processes. Three questions are in focus. First, how can policy integration be understood analytically and what is its actual status in sector policy?

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

Science.gov (United States)

2017-08-04

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

76 FR 33780 - Assessments for Mismatched Payments or Inadequate Payment Information for Geothermal, Solid...

Science.gov (United States)

2011-06-09

...] Assessments for Mismatched Payments or Inadequate Payment Information for Geothermal, Solid Minerals, and...: Regulations for geothermal, solid minerals, and Indian oil and gas leases authorize the Office of Natural..., Office of Natural Resources Revenue, P.O. Box 25165, MS 61211B, Denver, Colorado 80225-0165...

Has the Copayment Ceiling Improved Financial Protection in the Korean National Health Insurance System? Evidence From the 2009 Policy Change

Directory of Open Access Journals (Sweden)

Tae-Jin Lee

2017-11-01

Full Text Available Objectives To relieve the financial burden faced by households, the Korean National Health Insurance (NHI system introduced a “copayment ceiling,” which evolved into a differential ceiling in 2009, with the copayment ceiling depending on patients’ income. This study aimed to examine the effect of the differential copayment ceiling on financial protection and healthcare utilization, particularly focusing on whether its effects varied across different income groups. Methods This study obtained data from the Korea Health Panel. The number of households included in the analysis was 6555 in 2008, 5859 in 2009, 5539 in 2010, and 5372 in 2011. To assess the effects of the differential copayment ceiling on utilization, out-of-pocket (OOP payments, and catastrophic payments, various random-effects models were applied. Utilization was measured as treatment days, while catastrophic payments were defined as OOP payments exceeding 10% of household income. Among the right-hand side variables were the interaction terms of the new policy with income levels, as well as a set of household characteristics. Results The differential copayment ceiling contributed to increased utilization regardless of income levels both in all patients and in cancer patients. However, the new policy did not seem to reduce significantly the incidence of catastrophic payments among cancer patients, and even increased the incidence among all patients. Conclusions The limited effect of the differential ceiling can be attributed to a high proportion of direct payments for services not covered by the NHI, as well as the relatively small number of households benefiting from the differential ceilings; these considerations warrant a better policy design.

The balance-of-payments constraint:from balanced trade to sustainable debt

Directory of Open Access Journals (Sweden)

Nelson H. Barbosa-Filho

2001-12-01

Full Text Available This paper extends the balance-of-payments constraint on growth known as Thirlwall's law to incorporate unbalanced trade and debt accumulation. Assuming that small open economies face a liquidity constraint, the text shows the growth and real-exchange-rate policy rules consistent with a stable ratio of net exports to income. Given such rules, the text shows how the trade balance of a small open economy is residually determined by the ratio of foreign debt to income allowed by international conditions.

Dynamic Rule Encryption for Mobile Payment

Directory of Open Access Journals (Sweden)

Emir Husni

2017-01-01

Full Text Available The trend of financial transactions by using a mobile phone or mobile payment increases. By using the mobile payment service, users can save money on mobile phone (handset and separate from the pulse. For protecting users, mobile payment service providers must complete the mobile payment service with the transaction security. One way to provide transaction security is to utilize a secure mobile payment application. This research provides a safety feature used for an Android-based mobile payment application. This security feature is making encryption rules dynamically named Dynamic Rule Encryption (DRE. DRE has the ability to protect data by means of encrypting data with dynamic rules, and DRE also has a token function for an authentication. DRE token raised with dynamic time-based rules. Here, the time is used as a reference with the order of the day in the year (day of the year. The processes of the DRE’s encryption, decryption, and the DRE’s functionality as the token are discussed in this paper. Here, the Hamming distance metric is employed for having maximum differences between plaintext and ciphertext.

ELECTRONIC PAYMENT SYSTEM AND ITS PROTECTION

Directory of Open Access Journals (Sweden)

Miroslav Milutinovic

2015-01-01

Full Text Available All developed countries are in transition from the IT economy to a web economy - the biggest technological innovation that will have a long-term positive effect on the formation of the economic growth rate, the major structural changes and on the differentiated effects on the economic areas that are, at a faster or a slower rate, being included in this technological change. The electronic commerce or e-commerce has a huge potential for development. The electronic commerce between the companies (B-2-B is significantly greater compared to retail electronic commerce (B-2-C. In both spheres of trade, the Internet is used as a platform for the transfer of information and for concluding business deals. Market economy requires Accelerated Payment Processing which is achieved by introducing and improving the electronic payment procedures. There is an emphasized dichotomy between the two spheres of the payment system: large-value and small-value payments. The large value payment systems can be described as the arteries of the payment system, and the small-value transfer systems as a complex network of veins that bind the entire economy.

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.

Congestion and cascades in payment systems

Science.gov (United States)

Beyeler, Walter E.; Glass, Robert J.; Bech, Morten L.; Soramäki, Kimmo

2007-10-01

We develop a parsimonious model of the interbank payment system. The model incorporates an endogenous instruction arrival process, a scale-free topology of payments between banks, a fixed total liquidity which limits banks’ capacity to process arriving instructions, and a global market that distributes liquidity. We find that at low liquidity the system becomes congested and payment settlement loses correlation with payment instruction arrival, becoming coupled across the network. The onset of congestion is evidently related to the relative values of three characteristic times: the time for banks’ net position to return to 0, the time for a bank to exhaust its liquidity endowment, and the liquidity market relaxation time. In the congested regime settlement takes place in cascades having a characteristic length scale. A global liquidity market substantially attenuates congestion, requiring only a small fraction of the payment-induced liquidity flow to achieve strong beneficial effects.

38 CFR 10.51 - Payments to minor child.

Science.gov (United States)

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Payments to minor child. 10.51 Section 10.51 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS ADJUSTED COMPENSATION Payments § 10.51 Payments to minor child. Payments to minor child through legal guardian, natural...

M-Payments Issues and Concepts

Directory of Open Access Journals (Sweden)

Cristian TOMA

2012-01-01

Full Text Available The paper has four sections. First section has an intro for the mobile payments requirements for a reliable service. Second section shows types and models of mobile payment service but not taking into account the service patterns and the electronic money systems. In section three as a case study is shown an author solution may be improved taking into account the security and ergonomic issues presented in the first two sections. The last section presents a summary of technologies available for improvement of the mobile payment services.

45 CFR 35.7 - Payment of approved claims.

Science.gov (United States)

2010-10-01

... duly authorized agent shall sign the voucher for payment, Standard Form 1145, before payment is made. (b) When the claimant is represented by an attorney, the voucher for payment (SF 1145) shall... 45 Public Welfare 1 2010-10-01 2010-10-01 false Payment of approved claims. 35.7 Section 35.7...

40 CFR 10.7 - Payment of approved claim.

Science.gov (United States)

2010-07-01

..., claimant or his duly authorized agent shall sign the voucher for payment, Standard Form 1145, before payment is made. (b) When the claimant is represented by an attorney, the voucher for payment (SF 1145... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Payment of approved claim. 10.7 Section...

24 CFR 206.26 - Change in payment option.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Change in payment option. 206.26... in payment option. (a) General. The payment option may be changed as provided in this section. (b... credit payment option. Until the repairs are completed, the mortgagee shall make no line of credit...

42 CFR 102.83 - Payment of all benefits.

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Payment of all benefits. 102.83 Section 102.83... COMPENSATION PROGRAM Calculation and Payment of Benefits § 102.83 Payment of all benefits. (a) The Secretary may pay any benefits under this Program through lump-sum payments. If the Secretary determines that...

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

Science.gov (United States)

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

2016-01-01

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

31 CFR 545.519 - Payments and transfers authorized for goods and services exported to the territory of Afghanistan...

Science.gov (United States)

2010-07-01

...) SANCTIONS REGULATIONS Licenses, Authorizations and Statements of Licensing Policy § 545.519 Payments and... Taliban prior to the effective date. (a) Specific licenses may be issued on a case-by-case basis to permit... for the benefit of a person with respect to goods, software, technology, or services exported prior to...

Radioactive waste management policy

International Nuclear Information System (INIS)

Morrison, R.W.

1983-06-01

The speaker discusses the development of government policy regarding radioactive waste disposal in Canada, indicates overall policy objectives, and surveys the actual situation with respect to radioactive wastes in Canada. He also looks at the public perceptions of the waste management situation and how they relate to the views of governmental decision makers

The Central American Regional Payment System: Reasons for its Failure and Reconversion (1989-1993

Directory of Open Access Journals (Sweden)

Rafael de Juan Peñalosa

1995-11-01

Full Text Available This article, entitled “The Central American regional payment system: focusses and its reconversion”, is placed in the context of the recent strengthening of those mechanisms responsible for the reactivation of the Central American process of regional economic integration. With the aim of starting up a Central American regional payment system within the framework of the evolution and development of the regional integration of the Central American isthmus, the member countries of the Central American Common Market asked the European Community for technical assistance regarding its creationand application. After careful study by the EC this petition met with a positive response fitting as it did within the context of the policy of cooperation between the European Union and the countries of the Central American region. This in turn led to the signing of the Central American Payment System Financing Treaty in the Irish capital, Dublin, coinciding as it did with the San Jose VI Conference (9/10 March, 1990 which subsequently enjoyed diplomatic as well as financial and technical support as well as an intense development throughout the latter years of the Nineties.

34 CFR 35.7 - Payment of approved claims.

Science.gov (United States)

2010-07-01

... sign the voucher for payment, Standard Form 1145, before payment is made. (b) When the claimant is represented by an attorney, the voucher for payment (SF 1145) shall designate both the claimant and his... 34 Education 1 2010-07-01 2010-07-01 false Payment of approved claims. 35.7 Section 35.7 Education...

12 CFR 793.7 - Payment of approved claims.

Science.gov (United States)

2010-01-01

... voucher for payment, Standard Form 1145, before payment is made. (b) When the claimant is represented by an attorney, the voucher for payment (S.F. 1145) shall designate both the claimant and his attorney... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Payment of approved claims. 793.7 Section 793.7...

34 CFR 5.62 - Advance payment of fees.

Science.gov (United States)

2010-07-01

... anticipated cost and obtains satisfactory assurance of full payment if the requester has a history of prompt payment of FOIA fees; or (2) Requires an advance payment if the requester has no history of payment. (b) If a requester has previously failed to pay a fee in a timely fashion, the FOI Officer does not...

20 CFR 404.1055 - Payments for agricultural labor.

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Payments for agricultural labor. 404.1055... Payments for agricultural labor. (a) When cash payments are not wages. We do not include as wages your cash payments in a calendar year after 1987 from an employer for agricultural labor (see § 404.1056) if your...

Analysis of mobile pre-payment (pay in advance) and post-payment (pay later) services

NARCIS (Netherlands)

Molina-Castillo, Francisco Jose; Rodriguez-Guirao, Alicia; Lopez-Nicolas, Carolina; Bouwman, W.A.G.A.

2016-01-01

The diffusion of mobile payments (M-payments) is still in its early stages and further research is needed to understand what motivates or restricts people's behaviour when using mobile services. Based on a sample of Dutch mobile service users, this study analyses the antecedents of two types of

Build Your Own Payment Model.

Science.gov (United States)

Berlin, Joey

2017-07-01

Physicians participating in MACRA have a unique opportunity to create and submit their own alternative payment models to the government and take command of their own future payments. At least one Texas physician is taking a crack at developing his own model.

28 CFR 70.22 - Payment.

Science.gov (United States)

2010-07-01

... (INCLUDING SUBAWARDS) WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial and Program Management § 70.22 Payment. (a) Payment methods must... transfer of funds and disbursement by the recipient, and financial management systems that meet the...

15 CFR 14.22 - Payment.

Science.gov (United States)

2010-01-01

... AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, OTHER NON-PROFIT, AND COMMERCIAL ORGANIZATIONS Post-Award Requirements Financial and Program Management § 14.22 Payment. (a) Payment methods... transfer of funds and disbursement by the recipient, and financial management systems that meet the...

Do Economic Policy Decisions affect Stock Market Development in ...

African Journals Online (AJOL)

IMF (2006) firms this up by reporting that out of the world's GDP of $41.3 trillion in ... implications on stock returns. He therefore ... Laopodis (2006) theoretically explain that the outcomes of fiscal policy actions (budget deficits ... issues, political stability, international relations, balance-of-payment situation and others and.

48 CFR 32.007 - Contract financing payments.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Contract financing... GENERAL CONTRACTING REQUIREMENTS CONTRACT FINANCING 32.007 Contract financing payments. (a)(1) Unless... section, the due date for making contract financing payments by the designated payment office is the 30th...

Payment Procedures for Electronic Government Services

OpenAIRE

Pousttchi, Key; Wiedemann, Dietmar Georg

2005-01-01

In this paper, we analyse payment procedures for their suitability for electronic government. We provide an overview of the payment procedures currently available on the market, compare the situation in electronic government with the situation in electronic commerce and analyze what we can transfer. Based on functional requirements we propose a scheme that allows public agencies to examine the appropriateness of any given payment procedure for electronic government.

7 CFR 760.3 - Indemnity payments on milk.

Science.gov (United States)

2010-01-01

... 7 Agriculture 7 2010-01-01 2010-01-01 false Indemnity payments on milk. 760.3 Section 760.3... Farmers for Milk § 760.3 Indemnity payments on milk. An indemnity payment for milk may be made to an... whole milk marketed during the applications period, and (b) any payment not subject to refund which he...

Chief nursing officers’ perspectives on Medicare’s hospital-acquired conditions non-payment policy: implications for policy design and implementation

Directory of Open Access Journals (Sweden)

Wald Heidi

2012-08-01

Full Text Available Abstract Background Preventable adverse events from hospital care are a common patient safety problem, often resulting in medical complications and additional costs. In 2008, Center for Medicare and Medicaid Services (CMS implemented a policy, mandated by the Deficit Reduction Act of 2005, targeting a list of these ‘reasonably’ preventable hospital-acquired conditions (HACs for reduced reimbursement. Extensive debate ensued about the potential adverse effects of the policy, but there was little discussion of its impact on hospitals’ quality improvement (QI activities. This study’s goals were to understand organizational responses to the HAC policy, including internal and external influences that moderated the success or failure of QI efforts. Methods We employed a qualitative descriptive design. Representatives from 14 Nurses Improving Care of Health System Elders (NICHE hospitals participated in semi-structured interviews addressing the impact of the HAC policy generally, and for two indicator conditions: central-line associated bloodstream infection (CLABSI and catheter-associated urinary tract infection (CAUTI. Within-case analysis identified the key components of each institution’s response to the policy; across-case analysis identified themes. Exemplar cases were used to explicate findings. Results Interviewees reported that the HAC policy is one of many internal and external factors motivating hospitals to address HACs. They agreed the policy focused attention on prevention of HACs that had previously received fewer dedicated resources. The impact of the policy on prevention activities, barriers, and facilitators was condition-specific. CLABSI efforts were in place prior to the policy, whereas CAUTI efforts were less mature. Nearly all respondents noted that pressure ulcer detection and documentation became a larger focus stemming from the policy change. A major challenge was the determination of which conditions were �

Electronic Payments Profitability Extent Model

Directory of Open Access Journals (Sweden)

Rudolf Vohnout

2016-12-01

Full Text Available Cashless payments are recent phenomena, which even increased with the introduction of contactless means like NFC, PayPass or payWave. Such new methods speed-up the entire payment process and in comparison to cash transactions are much simpler and faster. But on the other hand the key question for merchant is if it is worth to have such device, which accept these new payment means or not to have the terminal at all. What is the amount of cash flow, which delimits the cash holdings to be still profitable? This paper tries to give answers to such question by presenting general profitability model, which will address defining the cash threshold amount. The aim is to show that cash holdings could be profitable up to certain amount, but after the threshold is met, cashless payment methods are fairly superior despite their additional costs.

31 CFR 500.520 - Payments from accounts of United States citizens in employ of United States in foreign countries...

Science.gov (United States)

2010-07-01

... States citizens in employ of United States in foreign countries and certain other persons. 500.520..., Authorizations and Statements of Licensing Policy § 500.520 Payments from accounts of United States citizens in employ of United States in foreign countries and certain other persons. (a) Banking institutions within...

31 CFR 515.520 - Payments from accounts of United States citizens in employ of United States in foreign countries...

Science.gov (United States)

2010-07-01

... States citizens in employ of United States in foreign countries and certain other persons. 515.520..., Authorizations, and Statements of Licensing Policy § 515.520 Payments from accounts of United States citizens in employ of United States in foreign countries and certain other persons. (a) Banking institutions within...

7 CFR 714.46 - Certification for payment.

Science.gov (United States)

2010-01-01

... ERRONEOUSLY, ILLEGALLY, OR WRONGFULLY COLLECTED § 714.46 Certification for payment. An officer or employee of the Department of Agriculture authorized to certify public vouchers for payment shall, for and on... 7 Agriculture 7 2010-01-01 2010-01-01 false Certification for payment. 714.46 Section 714.46...

48 CFR 49.112-2 - Final payment.

Science.gov (United States)

2010-10-01

... voucher or invoice and forward the documents to the disbursing officer for payment. (b) Settlement by...) Construction contracts. In the case of construction contracts, before forwarding the final payment voucher, the... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Final payment. 49.112-2...

The Race to Dominate the Mobile Payments Platform

DEFF Research Database (Denmark)

Staykova, Kalina Stefanova; Damsgaard, Jan

2015-01-01

The payment market has been stable for a number of decades with well-defined roles (acquirers and issuers), profitable business models (the card schemes) and a dominant design in which the merchants absorb the costs associated with payments. However, numerous digital payment solutions, which rely...... on new disruptive technologies, are emerging on the payment market, transforming the payment area from being established into a state of flux. In this article, we investigate the various factors that determine the success of a given solution. To this end, we build a framework to analyze the entry...

45 CFR 2543.22 - Payment.

Science.gov (United States)

2010-10-01

... AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial and Program Management § 2543.22 Payment. (a) Payment methods shall minimize the time... and disbursement by the recipient, and (2) Financial management systems that meet the standards for...

Actual versus perceived central bank transparency: the case of the European Central Bank

NARCIS (Netherlands)

van der Cruijsen, C.; Eijffinger, S.

2008-01-01

Central banks have become more and more transparent about their monetary policy making process. In the central bank transparency literature the distinction between actual and perceived transparency is often lacking. However, as perceptions are crucial for the actions of economic agents this

Charging of mobile services by mobile payment reference model

OpenAIRE

Pousttchi, Key; Wiedemann, Dietmar Georg

2005-01-01

The purpose of the paper is to analyze mobile payments in the mobile commerce scenario. Therefore, we first classify the mobile payment in the mobile commerce scenario by explaining general offer models, charging concepts, and intermediaries. Second, we describe the mobile payment reference model, especially, the mobile payment reference organization model and different mobile payment standard types. Finally, we conclude our findings.

Design and implementation of Bluetooth beacon in mobile payment system

Science.gov (United States)

Han, Tiantian; Ding, Lei

2017-08-01

The current line of payment means, mainly in the following ways, cash payment, credit card payment, WeChat Alipay sweep payment. There are many inconvenience in Cash payment, large amounts of cash inconvenience to carry, count the money to spend time and effort, true and false banknotes difficult to distinguish, ticket settlement easy to go wrong. Credit card payment is relatively time-consuming, and WeChat Alipay sweep payment need to sweep. Therefore, the design of a convenient, fast payment to meet the line to pay the demand is particularly important. Based on the characteristics of BLE Bluetooth wireless communication technology, this paper designs a kind of payment method based on Bluetooth beacon. Through the Bluetooth beacon broadcast consumption, consumers only need to open the relevant APP in the Android client, and you can get Bluetooth via mobile phone Bluetooth the amount of consumption of the standard broadcast, in accordance with the corresponding payment platform to complete the payment process, which pay less time to improve the efficiency of payment.

Towards A Framework of Digital Payment Platform Design

DEFF Research Database (Denmark)

Kazan, Erol; Damsgaard, Jan

This paper focuses on the triumph march of mobile phones that currently are annexing music players, navigation devices, and cameras as separate physical objects. The next target is set on payment. Through synthesizing available literature, we construct a framework for studying digital payment...... platforms that combines platform, technology and business design aspects. The framework is applied to conduct a comparative case study of digital payment platforms. Four types of market actors are considered: banks, mobile network operators, merchants, and startups, which are incumbents and disrupters....... By hosting third-party services, payment instruments are evolving from single-purpose to multi-functional ones. Our research extends existing payment literature from the MSP perspective to emphasize certain digital payment platform components, which impact strategies and complementary products....

40 CFR 66.74 - Payment or reimbursement.

Science.gov (United States)

2010-07-01

....74 Payment or reimbursement. (a) Within thirty days after any adjustment of a noncompliance penalty... timely payment of a deficiency shall pay a nonpayment penalty. The nonpayment penalty shall be calculated as of the due date of the deficiency payment and shall be equal to 20% of the deficiency not paid...

Agency ownership, patient payment source, and length of service in home care, 1992 2000.

Science.gov (United States)

Han, Beth; McAuley, William J; Remsburg, Robin E

2007-08-01

Little is known about whether an association exists between agency ownership and length of service among home care patients with different payment sources. This study investigated how for-profit and not-for-profit agencies responded to policy changes in the 1990s with respect to length of service. We examined length of service among 37,364 home care patients using the 1992, 1994, 1996, 1998, and 2000 National Home and Hospice Care Surveys. We used Kaplan-Meier methods and Cox regression models. After we adjusted for patient and agency characteristics, our results revealed that agency ownership was not associated with length of service for patients with private insurance, Medicare, Medicaid, Medicare plus Medicaid, or Medicare plus private insurance. This finding was consistent from 1992 through 2000. Length of service among patients with Medicare decreased significantly from 1998 through 2000, but length of service among patients with Medicaid did not change significantly from 1992 through 2000. Agency ownership is not associated with patient length of service in home care. Regardless of the policy changes in the home care arena in the 1990s, for-profit and not-for-profit home health agencies behaved similarly with regard to length of service among patients within differently structured payment systems.

Equal Access to Justice Act Payments

Data.gov (United States)

Social Security Administration — A dataset containing payment amounts made by the Social Security Administration for court-approved Equal Access to Justice Act (EAJA) payments for fiscal year 2010...

7 CFR 3430.51 - Payment.

Science.gov (United States)

2010-01-01

... Regulations of the Department of Agriculture (Continued) COOPERATIVE STATE RESEARCH, EDUCATION, AND EXTENSION... payments will be made in advance unless a deviation is accepted (see § 3430.3) or as specified in paragraph... Standard Application for Payments (ASAP) system, or another electronic funds transfer (EFT) method, except...

Empirical Studies on Cash Payments

NARCIS (Netherlands)

J. Kippers (Jeanine)

2004-01-01

textabstractCash is still the most common means of daily payments. The large number of cash payments is supported by a costly distribution system in which retailers, banks and central banks participate. Currency is issued in a range of bank note and coin denominations to facilitate efficiency

42 CFR 413.172 - Principles of prospective payment.

Science.gov (United States)

2010-10-01

... SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Payment for End... methodology used to establish payment rates and the changes specified in § 413.196(b) in the Federal Register...

Better Patient Care At High-Quality Hospitals May Save Medicare Money And Bolster Episode-Based Payment Models.

Science.gov (United States)

Tsai, Thomas C; Greaves, Felix; Zheng, Jie; Orav, E John; Zinner, Michael J; Jha, Ashish K

2016-09-01

US policy makers are making efforts to simultaneously improve the quality of and reduce spending on health care through alternative payment models such as bundled payment. Bundled payment models are predicated on the theory that aligning financial incentives for all providers across an episode of care will lower health care spending while improving quality. Whether this is true remains unknown. Using national Medicare fee-for-service claims for the period 2011-12 and data on hospital quality, we evaluated how thirty- and ninety-day episode-based spending were related to two validated measures of surgical quality-patient satisfaction and surgical mortality. We found that patients who had major surgery at high-quality hospitals cost Medicare less than those who had surgery at low-quality institutions, for both thirty- and ninety-day periods. The difference in Medicare spending between low- and high-quality hospitals was driven primarily by postacute care, which accounted for 59.5 percent of the difference in thirty-day episode spending, and readmissions, which accounted for 19.9 percent. These findings suggest that efforts to achieve value through bundled payment should focus on improving care at low-quality hospitals and reducing unnecessary use of postacute care. Project HOPE—The People-to-People Health Foundation, Inc.

7 CFR 634.27 - Cost-share payment.

Science.gov (United States)

2010-01-01

... essential for meeting the water quality objectives in the project area. (c) Basis for cost-share payment. (1... administering agency for each project using cost data from the local area. These costs should be reviewed by the... responsibility to apply for payments. (f) Authorizations for payments to suppliers. (1) The contract may...

32 CFR 701.49 - Payment of fees.

Science.gov (United States)

2010-07-01

... documents, particularly for those requesters who have no payment history, or for those requesters who have failed previously to pay a fee in a timely fashion (i.e., within 30 calendar days from the date of the... and obtain satisfactory assurance of full payment where the requester has a history of prompt payments...

42 CFR 417.536 - Cost payment principles.

Science.gov (United States)

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Cost payment principles. 417.536 Section 417.536... PREPAYMENT PLANS Medicare Payment: Cost Basis § 417.536 Cost payment principles. (a) Applicability. Unless otherwise specified in this subpart, the principles set forth in parts 412 and 413 of this chapter are...