WorldWideScience

Sample records for providing financial incentives

  1. The influence of provider characteristics and market forces on response to financial incentives.

    Science.gov (United States)

    O'Neil, Brock; Tyson, Mark; Graves, Amy J; Barocas, Daniel A; Chang, Sam S; Penson, David F; Resnick, Matthew J

    2017-11-01

    Alternative payment models, such as accountable care organizations, use financial incentives as levers for change to facilitate the transition from volume to value. However, implementation raises concerns about adverse changes in market competition and the resultant physician response. We sought to identify physician characteristics and market-level factors associated with variation in response to financial incentives for cancer care that may ultimately be leveraged in risk-shared payment models. Retrospective cohort study of physicians providing minimally invasive bladder cancer procedures to fee-for-service Medicare beneficiaries. We examined the relationship of between-group differences in market-level factors (competition [Herfindahl-Hirschman Index (HHI)] and provider density) and physician-level factors (use of unique billing codes, number of billing codes per patient, and competing financial interest) to responsiveness to financial incentives. Incentive-responsive providers had increased odds (odds ratio [OR], 1.19; 95% CI, 1.04-1.35) of practicing in markets with the highest quartile of provider density but not HHI (OR, 0.96; 95% CI, 0.87-1.05). Incentive-responsive providers were more likely to bill in the highest quartile for unique codes (OR, 1.49; 95% CI, 1.32-1.69) and codes per patient (OR, 1.18; 95% CI, 1.11-1.25) and less likely to have a competing financial interest (OR, 0.76; 95% CI, 0.72-0.81). Responsiveness to financial incentives in cancer care is associated with high market provider density, profit-maximizing billing behavior, and lack of competing financial ownership interests. Identifying physicians and markets responsive to financial incentives may ultimately promote the successful implementation of alternative payment models in cancer care.

  2. Effectiveness of UK provider financial incentives on quality of care: a systematic review.

    Science.gov (United States)

    Mandavia, Rishi; Mehta, Nishchay; Schilder, Anne; Mossialos, Elias

    2017-11-01

    Provider financial incentives are being increasingly adopted to help improve standards of care while promoting efficiency. To review the UK evidence on whether provider financial incentives are an effective way of improving the quality of health care. Systematic review of UK evidence, undertaken in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. MEDLINE and Embase databases were searched in August 2016. Original articles that assessed the relationship between UK provider financial incentives and a quantitative measure of quality of health care were included. Studies showing improvement for all measures of quality of care were defined as 'positive', those that were 'intermediate' showed improvement in some measures, and those classified as 'negative' showed a worsening of measures. Studies showing no effect were documented as such. Quality was assessed using the Downs and Black quality checklist. Of the 232 published articles identified by the systematic search, 28 were included. Of these, nine reported positive effects of incentives on quality of care, 16 reported intermediate effects, two reported no effect, and one reported a negative effect. Quality assessment scores for included articles ranged from 15 to 19, out of a maximum of 22 points. The effects of UK provider financial incentives on healthcare quality are unclear. Owing to this uncertainty and their significant costs, use of them may be counterproductive to their goal of improving healthcare quality and efficiency. UK policymakers should be cautious when implementing these incentives - if used, they should be subject to careful long-term monitoring and evaluation. Further research is needed to assess whether provider financial incentives represent a cost-effective intervention to improve the quality of care delivered in the UK. © British Journal of General Practice 2017.

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

    Science.gov (United States)

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

    2012-01-01

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

  4. Financial assistance for investments in wind power in Germany. Business incentives provided by the Deutsche Ausgleichsbank

    Energy Technology Data Exchange (ETDEWEB)

    Koch, M [Deutsche Ausgleichsbank, Bonn (Germany)

    1996-12-31

    Within a generous financial framework investments in wind energy power have rapidly increased in Germany since the late 1980`s. In addition to direct subsidies or incentive stipulated by statutory provisions the DtA has encouraged investments in wind energy projects by loans at preferential interest rates with tremendous success and it will continue to do so. At present especially new ways of supporting environmental investments are being seek which have a cross-border environmental impact. The goal is to provide financial assistance both to domestic and foreign companies willing to invest in transboundary projects which may be located in East European Countries

  5. Financial assistance for investments in wind power in Germany. Business incentives provided by the Deutsche Ausgleichsbank

    Energy Technology Data Exchange (ETDEWEB)

    Koch, M. [Deutsche Ausgleichsbank, Bonn (Germany)

    1995-12-31

    Within a generous financial framework investments in wind energy power have rapidly increased in Germany since the late 1980`s. In addition to direct subsidies or incentive stipulated by statutory provisions the DtA has encouraged investments in wind energy projects by loans at preferential interest rates with tremendous success and it will continue to do so. At present especially new ways of supporting environmental investments are being seek which have a cross-border environmental impact. The goal is to provide financial assistance both to domestic and foreign companies willing to invest in transboundary projects which may be located in East European Countries

  6. Financial assistance for investments in wind power in Germany. Business incentives provided by the Deutsche Ausgleichsbank

    International Nuclear Information System (INIS)

    Koch, M.

    1995-01-01

    Within a generous financial framework investments in wind energy power have rapidly increased in Germany since the late 1980's. In addition to direct subsidies or incentive stipulated by statutory provisions the DtA has encouraged investments in wind energy projects by loans at preferential interest rates with tremendous success and it will continue to do so. At present especially new ways of supporting environmental investments are being seek which have a cross-border environmental impact. The goal is to provide financial assistance both to domestic and foreign companies willing to invest in transboundary projects which may be located in East European Countries

  7. The effect of financial incentives on the quality of health care provided by primary care physicians.

    Science.gov (United States)

    Scott, Anthony; Sivey, Peter; Ait Ouakrim, Driss; Willenberg, Lisa; Naccarella, Lucio; Furler, John; Young, Doris

    2011-09-07

    The use of blended payment schemes in primary care, including the use of financial incentives to directly reward 'performance' and 'quality' is increasing in a number of countries. There are many examples in the US, and the Quality and Outcomes Framework (QoF) for general practitioners (GPs) in the UK is an example of a major system-wide reform. Despite the popularity of these schemes, there is currently little rigorous evidence of their success in improving the quality of primary health care, or of whether such an approach is cost-effective relative to other ways to improve the quality of care. The aim of this review is to examine the effect of changes in the method and level of payment on the quality of care provided by primary care physicians (PCPs) and to identify:i) the different types of financial incentives that have improved quality;ii) the characteristics of patient populations for whom quality of care has been improved by financial incentives; andiii) the characteristics of PCPs who have responded to financial incentives. We searched the Cochrane Effective Practice and Organisation of Care (EPOC) Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL) and Cochrane Database of Systematic Reviews (CDSR) (The Cochrane Library), MEDLINE, HealthSTAR, EMBASE, CINAHL, PsychLIT, and ECONLIT. Searches of Internet-based economics and health economics working paper collections were also conducted. Finally, studies were identified through the reference lists of retrieved articles, websites of key organisations, and from direct contact with key authors in the field. Articles were included if they were published from 2000 to August 2009. Randomised controlled trials (RCT), controlled before and after studies (CBA), and interrupted time series analyses (ITS) evaluating the impact of different financial interventions on the quality of care delivered by primary healthcare physicians (PCPs). Quality of care was defined as patient reported outcome

  8. Financial incentive approaches for reducing peak electricity demand, experience from pilot trials with a UK energy provider

    International Nuclear Information System (INIS)

    Bradley, Peter; Coke, Alexia; Leach, Matthew

    2016-01-01

    Whilst tariff-based approaches to load-shifting are common in the residential sector, incentive-based approaches are rare. This is so, even though providing customers incentives to shape their power consumption patterns has substantial potential. This paper presents findings from an exploratory UK pilot study that trials financial payments and detailed energy feedback to incentivise load-shifting of residential electricity consumption. An intervention study was implemented measuring actual energy use by individual households as well as conducting surveys and interviews. From the trials it was found that the approaches resulted in reductions in peak time energy use. Evidence from the study found that the incentives-based approaches were able to overcome some of the barriers to response experienced in Time-of-Use studies, though less good on others. Interestingly, the height of the barriers varied by the electricity-using practice and the incentivising approach applied. The height of the barriers also varied by participant. The study concludes by identifying that broad participation in demand response is likely to require a suite of incentivising approaches that appeal to different people, a key policy finding of interest to international agencies, government, public and private sector entities. - Highlights: • Novel study of financial incentive approaches for shifting residential energy. • First academic paper comprehensively identifying barriers to time of use tariffs. • First study reporting barriers to financial incentive approaches for demand response. • Incentive study design can be applied by government and energy companies.

  9. The cost-effectiveness of using financial incentives to improve provider quality: a framework and application

    DEFF Research Database (Denmark)

    Meacock, R.; Kristensen, Søren Rud; Sutton, M.

    2014-01-01

    Despite growing adoption of pay-for-performance (P4P) programmes in health care, there is remarkably little evidence on the cost-effectiveness of such schemes. We review the limited number of previous studies and critique the frameworks adopted and the narrow range of costs and outcomes considered......, and whether performance improvement is a transitory or investment activity. Our application to the Advancing Quality initiative demonstrates that the incentive payments represented less than half of the 13m pound total programme costs. By generating approximately 5200 quality-adjusted life years and 4.4m...

  10. Financial versus Non-Financial Incentives for Improving Patient Experience.

    Science.gov (United States)

    Lee, Thomas H

    2015-05-01

    Delivering compassionate and coordinated care is a goal for all health care providers. Humans are not always consistent, though, both individually and collectively, and this is why everyone needs incentives to be at their best and to try to always be improving. The endlessly interesting question in patient experience is, what should those incentives look like? Should they be financial or nonfinancial? Dr. Thomas H. Lee explores what is most effective in regard to engaging and motivating physicians. While different approaches will work in different organizational cultures, financial incentives have their role in performance improvement. Compassionate coordinated care should be a social norm and be pursued by all health care organizations.

  11. 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.

  12. Financial Incentives to Promote Active Travel

    OpenAIRE

    Martin, Adam; Suhrcke, Marc; Ogilvie, David

    2012-01-01

    Context Financial incentives, including taxes and subsidies, can be used to encourage behavior change. They are common in transport policy for tackling externalities associated with use of motor vehicles, and in public health for influencing alcohol consumption and smoking behaviors. Financial incentives also offer policymakers a compromise between ?nudging,? which may be insufficient for changing habitual behavior, and regulations that restrict individual choice. Evidence acquisition The lit...

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

    Science.gov (United States)

    Ananthapavan, J; Peterson, A; Sacks, G

    2018-05-01

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

  14. Using financial incentives to improve value in orthopaedics.

    Science.gov (United States)

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

    2012-04-01

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

  15. Financial Incentives to Enable Clean Energy Deployment: Policy Overview and Good Practices

    Energy Technology Data Exchange (ETDEWEB)

    Cox, Sadie [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2016-02-24

    Financial incentives have been widely implemented by governments around the world to support scaled up deployment of renewable energy and energy efficiency technologies and practices. As of 2015, at least 48 countries have adopted financial incentives to support renewable energy and energy efficiency deployment. Broader clean energy strategies and plans provide a crucial foundation for financial incentives that often complement regulatory policies such as renewable energy targets, standards, and other mandates. This policy brief provides a primer on key financial incentive design elements, lessons from different country experiences, and curated support resources for more detailed and country-specific financial incentive design information.

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

    Science.gov (United States)

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

    2015-10-01

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

  17. Financial Incentives to Promote Active Travel

    Science.gov (United States)

    Martin, Adam; Suhrcke, Marc; Ogilvie, David

    2012-01-01

    Context Financial incentives, including taxes and subsidies, can be used to encourage behavior change. They are common in transport policy for tackling externalities associated with use of motor vehicles, and in public health for influencing alcohol consumption and smoking behaviors. Financial incentives also offer policymakers a compromise between “nudging,” which may be insufficient for changing habitual behavior, and regulations that restrict individual choice. Evidence acquisition The literature review identified studies published between January 1997 and January 2012 of financial incentives relating to any mode of travel in which the impact on active travel, physical activity, or obesity levels was reported. It encompassed macroenvironmental schemes, such as gasoline taxes, and microenvironmental schemes, such as employer-subsidized bicycles. Five relevant reviews and 20 primary studies (of which nine were not included in the reviews) were identified. Evidence synthesis The results show that more-robust evidence is required if policymakers are to maximize the health impact of fiscal policy relating to transport schemes of this kind. Conclusions Drawing on a literature review and insights from the SLOTH (sleep, leisure, occupation, transportation, and home-based activities) time-budget model, this paper argues that financial incentives may have a larger role in promoting walking and cycling than is acknowledged generally. PMID:23159264

  18. Improving the cost effectiveness of financial incentives in managing travel demand management (TDM).

    Science.gov (United States)

    2013-10-01

    Providing financial incentives to commuters to use alternative modes is a common element of managing transportation demand. Although these incentives have become common during the past two decades as elements of transportation demand management (TDM)...

  19. Wellness Programs With Financial Incentives Through Disparities Lens.

    Science.gov (United States)

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

    2018-02-01

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

  20. Financial incentives enhance adaptation to a sensorimotor transformation.

    Science.gov (United States)

    Gajda, Kathrin; Sülzenbrück, Sandra; Heuer, Herbert

    2016-10-01

    Adaptation to sensorimotor transformations has received much attention in recent years. However, the role of motivation and its relation to the implicit and explicit processes underlying adaptation has been neglected thus far. Here, we examine the influence of extrinsic motivation on adaptation to a visuomotor rotation by way of providing financial incentives for accurate movements. Participants in the experimental group "bonus" received a defined amount of money for high end-point accuracy in a visuomotor rotation task; participants in the control group "no bonus" did not receive a financial incentive. Results showed better overall adaptation to the visuomotor transformation in participants who were extrinsically motivated. However, there was no beneficial effect of financial incentives on the implicit component, as assessed by the after-effects, and on separately assessed explicit knowledge. These findings suggest that the positive influence of financial incentives on adaptation is due to a component which cannot be measured by after-effects or by our test of explicit knowledge. A likely candidate is model-free learning based on reward-prediction errors, which could be enhanced by the financial bonuses.

  1. Perspectives on financial incentives to health service providers for increasing breast feeding and smoking quit rates during pregnancy: a mixed methods study.

    Science.gov (United States)

    Hoddinott, Pat; Thomson, Gill; Morgan, Heather; Crossland, Nicola; MacLennan, Graeme; Dykes, Fiona; Stewart, Fiona; Bauld, Linda; Campbell, Marion K

    2015-11-13

    To explore the acceptability, mechanisms and consequences of provider incentives for smoking cessation and breast feeding as part of the Benefits of Incentives for Breastfeeding and Smoking cessation in pregnancy (BIBS) study. Cross-sectional survey and qualitative interviews. Scotland and North West England. Early years professionals: 497 survey respondents included 156 doctors; 197 health visitors/maternity staff; 144 other health staff. Qualitative interviews or focus groups were conducted with 68 pregnant/postnatal women/family members; 32 service providers; 22 experts/decision-makers; 63 conference attendees. Early years professionals were surveyed via email about the acceptability of payments to local health services for reaching smoking cessation in pregnancy and breastfeeding targets. Agreement was measured on a 5-point scale using multivariable ordered logit models. A framework approach was used to analyse free-text survey responses and qualitative data. Health professional net agreement for provider incentives for smoking cessation targets was 52.9% (263/497); net disagreement was 28.6% (142/497). Health visitors/maternity staff were more likely than doctors to agree: OR 2.35 (95% CI 1.51 to 3.64; pgaming, box-ticking bureaucracies and health inequalities were counterbalances to potential benefits. Provider incentives are favoured by non-medical staff. Solutions which increase trust and collaboration towards shared goals, without negatively impacting on relationships or increasing bureaucracy are required. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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

    Science.gov (United States)

    Mathews, Maria; Ryan, Dana

    2015-03-01

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

  3. Acceptability of financial incentives and penalties for encouraging uptake of healthy behaviours: focus groups.

    Science.gov (United States)

    Giles, Emma L; Sniehotta, Falko F; McColl, Elaine; Adams, Jean

    2015-01-31

    There is evidence that financial incentive interventions, which include both financial rewards and also penalties, are effective in encouraging healthy behaviours. However, concerns about the acceptability of such interventions remain. We report on focus groups with a cross-section of adults from North East England exploring their acceptance of financial incentive interventions for encouraging healthy behaviours amongst adults. Such information should help guide the design and development of acceptable, and effective, financial incentive interventions. Eight focus groups with a total of 74 adults were conducted between November 2013 and January 2014 in Newcastle upon Tyne, UK. Focus groups lasted approximately 60 minutes and explored factors that made financial incentives acceptable and unacceptable to participants, together with discussions on preferred formats for financial incentives. Verbatim transcripts were thematically coded and analysed in Nvivo 10. Participants largely distrusted health promoting financial incentives, with a concern that individuals may abuse such schemes. There was, however, evidence that health promoting financial incentives may be more acceptable if they are fair to all recipients and members of the public; if they are closely monitored and evaluated; if they are shown to be effective and cost-effective; and if clear health education is provided alongside health promoting financial incentives. There was also a preference for positive rewards rather than negative penalties, and for shopping vouchers rather than cash incentives. This qualitative empirical research has highlighted clear suggestions on how to design health promoting financial incentives to maximise acceptability to the general public. It will also be important to determine the acceptability of health promoting financial incentives in a range of stakeholders, and in particular, those who fund such schemes, and policy-makers who are likely to be involved with the design

  4. Financial Incentives for Steering Education and Training. Getting Skills Right

    Science.gov (United States)

    OECD Publishing, 2017

    2017-01-01

    This report examines how governments use financial incentives to promote a better alignment between labour market needs, on the one hand, and the supply of skills, on the other. In doing so, it identifies: (1) innovative models that countries may be interested in learning from; (2) best practice in the design and use of financial incentives; (3)…

  5. Nudging for health: do we need financial incentives?

    Science.gov (United States)

    Goel, Vivek

    2012-01-01

    Nudges, creating simple processes or structures that guide people toward a particular behaviour choice, are potentially a powerful tool for health promotion. User financial incentives could be a monetary form of such nudges. Given the challenges of chronic disease prevention, interventions such as nudges should be explored further. However, there would appear to be limited rationale for pursuing financial incentives as nudges.

  6. Financial incentive schemes in primary care

    Directory of Open Access Journals (Sweden)

    Gillam S

    2015-09-01

    Full Text Available Stephen Gillam Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK Abstract: Pay-for-performance (P4P schemes have become increasingly common in primary care, and this article reviews their impact. It is based primarily on existing systematic reviews. The evidence suggests that P4P schemes can change health professionals' behavior and improve recorded disease management of those clinical processes that are incentivized. P4P may narrow inequalities in performance comparing deprived with nondeprived areas. However, such schemes have unintended consequences. Whether P4P improves the patient experience, the outcomes of care or population health is less clear. These practical uncertainties mirror the ethical concerns of many clinicians that a reductionist approach to managing markers of chronic disease runs counter to the humanitarian values of family practice. The variation in P4P schemes between countries reflects different historical and organizational contexts. With so much uncertainty regarding the effects of P4P, policy makers are well advised to proceed carefully with the implementation of such schemes until and unless clearer evidence for their cost–benefit emerges. Keywords: financial incentives, pay for performance, quality improvement, primary care

  7. The use of financial incentives in Australian general practice.

    Science.gov (United States)

    Kecmanovic, Milica; Hall, Jane P

    2015-05-18

    To examine the uptake of financial incentive payments in general practice, and identify what types of practitioners are more likely to participate in these schemes. Analysis of data on general practitioners and GP registrars from the Medicine in Australia - Balancing Employment and Life (MABEL) longitudinal panel survey of medical practitioners in Australia, from 2008 to 2011. Income received by GPs from government incentive schemes and grants and factors associated with the likelihood of claiming such incentives. Around half of GPs reported receiving income from financial incentives in 2008, and there was a small fall in this proportion by 2011. There was considerable movement into and out of the incentives schemes, with more GPs exiting than taking up grants and payments. GPs working in larger practices with greater administrative support, GPs practising in rural areas and those who were principals or partners in practices were more likely to use grants and incentive payments. Administrative support available to GPs appears to be an increasingly important predictor of incentive use, suggesting that the administrative burden of claiming incentives is large and not always worth the effort. It is, therefore, crucial to consider such costs (especially relative to the size of the payment) when designing incentive payments. As market conditions are also likely to influence participation in incentive schemes, the impact of incentives can change over time and these schemes should be reviewed regularly.

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

    Science.gov (United States)

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

    2001-05-28

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

  9. Health spending, illicit financial flows and tax incentives in Malawi.

    Science.gov (United States)

    O'Hare, B; Curtis, M

    2014-12-01

    This analysis examines the gaps in health care financing in Malawi and how foregone taxes could fill these gaps. It begins with an assessment of the disease burden and government health expenditure. Then it analyses the tax revenues foregone by the government of Malawi by two main routes: Illicit financial flows (IFF) from the country, Tax incentives. We find that there are significant financing gaps in the health sector; for example, government expenditure is United States Dollars (USD) 177 million for 2013/2014 while projected donor contribution in 2013/2014 is USD 207 million and the total cost for the minimal health package is USD 535 million. Thus the funding gap between the government budget for health and the required spending to provide the minimal package for 2013/2014 is USD 358 million. On the other hand we estimate that almost USD 400 million is lost through IFF and corporate utilization of tax incentives each year. The revenues foregone plus the current government health spending would be sufficient to cover the minimal public health package for all Malawians and would help tackle Malawi's disease burden. Every effort must be made, including improving transparency and revising laws, to curtail IFF and moderate tax incentives.

  10. Investigating financial incentives for maternal health: an introduction.

    Science.gov (United States)

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

    2013-12-01

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

  11. 42 CFR 495.310 - Medicaid provider incentive payments.

    Science.gov (United States)

    2010-10-01

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

  12. The law, policy, and ethics of employers' use of financial incentives to improve health.

    Science.gov (United States)

    Madison, Kristin M; Volpp, Kevin G; Halpern, Scott D

    2011-01-01

    The Patient Protection and Affordable Care Act (ACA) turns to a nontraditional mechanism to improve public health: employer-provided financial incentives for healthy behaviors. Critics raise questions about incentive programs' effectiveness, employer involvement, and potential discrimination. We support incentive program development despite these concerns. The ACA sets the stage for a broad-based research and implementation agenda through which we can learn to structure incentive programs to not only promote public health but also address prevalent concerns. © 2011 American Society of Law, Medicine & Ethics, Inc.

  13. [Financial incentives in improving healthcare quality. SESPAS Report 2012].

    Science.gov (United States)

    Eirea Eiras, Carlos; Ortún Rubio, Vicente

    2012-03-01

    We address the contribution of financial incentives linked to pay for performance (P4P) to improving the quality of care. The situation of P4P is analyzed internationally and in the distinct health services in Spain. The participation of P4P in wage compensation and the effects of the current economic crisis on these incentives is discussed. We review the results of recent studies to clarify the role of these incentive models and assess possible orientations and new proposals. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

  14. Reports of unintended consequences of financial incentives to improve management of hypertension.

    Directory of Open Access Journals (Sweden)

    Sylvia J Hysong

    Full Text Available Given the increase in financial-incentive programs nationwide, many physicians and physician groups are concerned about potential unintended consequences of providing financial incentives to improve quality of care. However, few studies examine whether actual unintended consequences result from providing financial incentives to physicians. We sought to document the extent to which the unintended consequences discussed in the literature were observable in a randomized clinical trial (RCT of financial incentives.We conducted a qualitative observational study nested within a larger RCT of financial incentives to improve hypertension care. We conducted 30-minute telephone interviews with primary care personnel at facilities participating in the RCT housed at12 geographically dispersed Veterans Affairs Medical Centers nationwide. Participants answered questions about unintended effects, clinic team dynamics, organizational impact on care delivery, study participation. We employed a blend of inductive and deductive qualitative techniques for analysis.Sixty-five participants were recruited from RCT enrollees and personnel not enrolled in the larger RCT, plus one primary care leader per site.Emergent themes included possible patient harm, emphasis on documentation over improving care, reduced professional morale, and positive spillover. All discussions of unintended consequences involving patient harm were only concerns, not actual events. Several unintended consequences concerned ancillary initiatives for quality improvement (e.g., practice guidelines and performance measurement systems rather than financial incentives.Many unintended consequences of financial incentives noted were either only concerns or attributable to ancillary quality-improvement initiatives. Actual unintended consequences included improved documentation of care without necessarily improving actual care, and positive unintended consequences.Clinicaltrials.gov Identifier: NCT

  15. Health spending, illicit financial flows and tax incentives in Malawi ...

    African Journals Online (AJOL)

    Health spending, illicit financial flows and tax incentives in Malawi. B O'Hare, M Curtis. Abstract. This analysis examines the gaps in health care financing in Malawi and how foregone taxes could fill these gaps. It begins with an assessment of the disease burden and government health expenditure. Then it analyses the tax ...

  16. The Effects of Financial Incentives on Retirement Decisions:

    DEFF Research Database (Denmark)

    Søgaard, Jakob Egholt; Anton Schultz, Esben; Schaarup, Jonas Zielke

    2013-01-01

    We exploit a temporary tax rebate introduced in Denmark in 2008 to estimate the effect of financial incentives on retirement decisions. The scheme offered individuals in a limited number of cohorts a tax rebate of up to 100,000 DKK (approximately $20,000) if they stayed on the labor market until...

  17. Entrepreneurship and Financial Incentives of Return, Risk, and Skew

    DEFF Research Database (Denmark)

    Berkhout, Peter; Hartog, Joop; Van Praag, Mirjam

    2016-01-01

    . The focus on earnings forgone may help to solve the lack of robust empirical support for the effect of financial incentives on the decision to become an entrepreneur. We find, consistent with standard theory, that a higher mean, lower variance, and higher skew in the relevant wage distribution reduce...

  18. Strengthening financial management, providing financial safeguard mechanism

    International Nuclear Information System (INIS)

    Sun Wumei

    2010-01-01

    This article reviewed the history of Zhong He Shanxi Uranium Enrichment Company, summarizing an efficient and systematical financial management method during both construction period and operational period of the company. It related to fundamental financial management structure building, integrated budgeting, fund management, cost management, asset management, tax planning and HR management. of financial staffs. (author)

  19. A systematic review of financial incentives given in the health care setting

    DEFF Research Database (Denmark)

    Molema, Claudia C.M.; Wendel-Vos, G.C Wanda; Pujik, Lisanne

    2016-01-01

    was to provide insight in the effectiveness of financial incentives used for promoting physical activity in the healthcare setting. Methods: A systematic literature search was performed in three databases: Medline, EMBASE and SciSearch. In total, 1395 papers published up until April 2015 were identified. Eleven......Introduction: A substantial amount of the western population is inactive according to current physical activity guidelines, which is an important risk factor for chronic conditions and mortality. Financial incentives may encourage people to become more active. The objective of this review...... of them were screened on in- and exclusion criteria based on the full-text publication. Results: Three studies were included in the review. Two studies have combined a financial incentive with nutrition classes or motivational interviewing. One of which provided a free membership to a sports facility...

  20. Financial Incentives to Increase Advance Care Planning Among Medicaid Beneficiaries: Lessons Learned From Two Pragmatic Randomized Trials.

    Science.gov (United States)

    Barnato, Amber E; Moore, Robert; Moore, Charity G; Kohatsu, Neal D; Sudore, Rebecca L

    2017-07-01

    Medicaid populations have low rates of advance care planning (ACP). Potential policy interventions include financial incentives. To test the effectiveness of patient plus provider financial incentive compared with provider financial incentive alone for increasing ACP discussions among Medicaid patients. Between April 2014 and July 2015, we conducted two sequential assessor-blinded pragmatic randomized trials in a health plan that pays primary care providers (PCPs) $100 to discuss ACP: 1) a parallel cluster trial (provider-delivered patient incentive) and 2) an individual-level trial (mail-delivered patient incentive). Control and intervention arms included encouragement to complete ACP, instructions for using an online ACP tool, and (in the intervention arm) $50 for completing the online ACP tool and a small probability of $1000 (i.e., lottery) for discussing ACP with their PCP. The primary outcome was provider-reported ACP discussion within three months. In the provider-delivered patient incentive study, 38 PCPs were randomized to the intervention (n = 18) or control (n = 20) and given 10 patient packets each to distribute. Using an intention-to-treat analysis, there were 27 of 180 ACP discussions (15%) in the intervention group and 5 of 200 (2.5%) in the control group (P = .0391). In the mail-delivered patient incentive study, there were 5 of 187 ACP discussions (2.7%) in the intervention group and 5 of 189 (2.6%) in the control group (P = .99). ACP rates were low despite an existing provider financial incentive. Adding a provider-delivered patient financial incentive, but not a mail-delivered patient incentive, modestly increased ACP discussions. PCP encouragement combined with a patient incentive may be more powerful than either encouragement or incentive alone. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2007-01-01

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

  2. Incentive schemes and female leadership in financial firms

    Directory of Open Access Journals (Sweden)

    Björn Lantz

    2013-01-01

    Full Text Available Our purpose is to explore how performance in Swedish financial companies is affected by the presence of a female chief executive officer (CEO, the presence of an incentive scheme, and the proportion of female board members. The results indicate that a female CEO is associated with a lower return on equity (ROE and a lower Tobin’s Q, but we find no significant association between the proportion of female board members and firm performance. An incentive scheme is generally associated with a lower return on assets (ROA and a higher Tobin’s Q. In particular, a share-based incentive scheme is associated with a lower ROA, a lower ROE, and a higher Tobin’s Q.

  3. Superintendents' Views on Financial and Non-Financial Incentives on Teacher Recruitment and Retention

    Science.gov (United States)

    Kelly, Paul; Tejeda-Delgado, Carmen; Slate, John R.

    2008-01-01

    In this study, the researchers investigated the perceived relationships of financial and non-financial incentives on teacher recruitment and retention among public school teachers in the State of Texas from the perspective of 98 public school superintendents. Findings revealed that school districts tended to offer teachers' salaries over the state…

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

    Science.gov (United States)

    Latham, Lesley P; Marshall, Emily Gard

    2015-02-01

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

  5. A consideration of user financial incentives to address health inequalities.

    Science.gov (United States)

    Oliver, Adam; Brown, Lawrence D

    2012-04-01

    Health inequalities and user financial incentives to encourage health-related behavior change are two topical issues in the health policy discourse, and this article attempts to combine the two; namely, we try to address whether the latter can be used to reduce the former in the contexts of the United Kingdom and the United States. Payments for some aspects of medical adherence may offer a promising way to address, to some extent, inequalities in health and health care in both countries. However, payments for more sustained behavior change, such as that associated with smoking cessation and weight loss, have thus far shown little long-term effect, although more research that tests the effectiveness of different incentive mechanism designs, informed by the findings of behavioral economics, ought to be undertaken. Many practical, political, ethical, and ideological objections can be waged against user financial incentives in health, and this article reviews a number of them, but the justifiability of and limits to these incentives require more academic and public discourse so as to gain a better understanding of the circumstances in which they can legitimately be used.

  6. Public attitudes to financial incentive models for organs

    DEFF Research Database (Denmark)

    Hoeyer, Klaus; Schicktanz, Silke; Deleuran, Ida

    2013-01-01

    Waiting lists for organs have stimulated interest in the use of financial incentives for organ donation (FIs), but the literature does not contain an adequate overview of studies of public attitudes toward this mode of procurement. We conducted a literature review of international peer......-reviewed research published between 2002 and 2012 on how members of the public position themselves toward FIs. We identified and analyzed 23 studies using MEDLINE, PsycINFO, Sociological Abstracts and cross-reference search. The search included whole organs, donation, quantitative and empirical qualitative social...... scientific studies on, public attitudes (excluding professionals and medical students). The review reveals a broad divergence of public opinions on financial incentives. However, quantitative studies showed a low overall level of acceptance of payment for organs in living donation (LD); only a slightly...

  7. Using financial incentives to improve the care of tuberculosis patients.

    Science.gov (United States)

    Lee, Cheng-Yi; Chi, Mei-Ju; Yang, Shiang-Lin; Lo, Hsiu-Yun; Cheng, Shou-Hsia

    2015-01-01

    Tuberculosis (TB) is a serious public health concern, and Taiwan has implemented a pay-for-performance (P4P) program to incentivize healthcare professionals to provide comprehensive care to TB patients. This study aims to examine the effects of the TB P4P program on treatment outcomes and related expenses. A population-based natural experimental design with intervention and comparison groups. Propensity score matching was conducted to increase the comparability between the P4P and non-P4P group. A total of 12,018 subjects were included in the analysis, with 6009 cases in each group. Generalized linear models and multinomial logistic regression were employed to examine the effects of the P4P program. The regression models indicated that patients enrolled in the P4P program had 14% more ambulatory visits than non-P4P patients (P ratio, 1.56; P financial incentives to healthcare institutions could be a feasible model for better TB control.

  8. What's good for the goose is good for the gander. Guiding principles for the use of financial incentives in health behaviour change.

    Science.gov (United States)

    Lynagh, Marita C; Sanson-Fisher, Rob W; Bonevski, Billie

    2013-03-01

    The use of financial incentives or pay-for-performance programs for health care providers has triggered emerging interest in the use of financial incentives for encouraging health behaviour change. This paper aims to identify key conditions under which the use of financial incentives for improvements in public health outcomes is most likely to be effective and appropriate. We review recent systematic reviews on their effectiveness in changing health behaviour and identify existing moral concerns concerning personal financial incentives. Current evidence indicates that incentives can be effective in driving health behaviour change under certain provisos, while a number of misgivings continue to be deliberated on. We outline a number of key principles for consideration in decisions about the potential use of incentives in leading to public health improvements. These key principles can assist policy makers in making decisions on the use of financial incentives directed at achieving improvements in public health.

  9. Social values and the corruption argument against financial incentives for healthy behaviour.

    Science.gov (United States)

    Brown, Rebecca C H

    2017-03-01

    Financial incentives may provide a way of reducing the burden of chronic diseases by motivating people to adopt healthy behaviours. While it is still uncertain how effective such incentives could be for promoting health, some argue that, even if effective, there are ethical objections that preclude their use. One such argument is made by Michael Sandel, who suggests that monetary transactions can have a corrupting effect on the norms and values that ordinarily regulate exchange and behaviour in previously non-monetised contexts. In this paper, I outline Sandel's corruption argument and consider its validity in the context of health incentives. I distinguish between two forms of corruption that are implied by Sandel's argument: efficiency corruption and value corruption While Sandel's thought-provoking discussion provides a valuable contribution to debates about health policies generally and health incentives specifically, I suggest the force of his criticism of health incentives is limited: further empirical evidence and theoretical reasoning are required to support the suggestion that health incentives are an inappropriate tool for promoting health. While I do not find Sandel's corruption argument compelling, this only constitutes a partial defence of health incentives, since other criticisms relating to their use may prove more successful. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  10. Perceptions and experiences of financial incentives: a qualitative study of dialysis care in England.

    Science.gov (United States)

    Abma, Inger; Jayanti, Anuradha; Bayer, Steffen; Mitra, Sandip; Barlow, James

    2014-02-12

    The objective of the study was to understand the extent to which financial incentives such as Payment by Results and other payment mechanisms motivate kidney centres in England to change their practices. The study followed a qualitative design. Data collection involved 32 in-depth semistructured interviews with healthcare professionals and managers, focusing on their subjective experience of payment structures. Participants were kidney healthcare professionals, clinical directors, kidney centre managers and finance managers. Healthcare commissioners from different parts of England were also interviewed. Participants worked at five kidney centres from across England. The selection was based on the prevalence of home haemodialysis, ranging from low (8%) prevalence, with at least one centre in each one of these categories at the time of selection. While the tariff for home haemodialysis is not a clear incentive for its adoption due to uncertainty about operational costs, Commissioning for Quality and Innovation (CQUIN) targets and the Best Practice Tariff for vascular access were seen by our case study centres as a motivator to change practices. The impact of financial incentives designed at a policy level is influenced by the understanding of cost and benefits at the local operational level. In a situation where costs are unclear, incentives which are based on the improvement of profit margins have a smaller impact than incentives which provide an additional direct payment, even if this extra financial support is relatively small.

  11. Shared vision and autonomous motivation vs. financial incentives driving success in corporate acquisitions

    Science.gov (United States)

    Clayton, Byron C.

    2015-01-01

    Successful corporate acquisitions require its managers to achieve substantial performance improvements in order to sufficiently cover acquisition premiums, the expected return of debt and equity investors, and the additional resources needed to capture synergies and accelerate growth. Acquirers understand that achieving the performance improvements necessary to cover these costs and create value for investors will most likely require a significant effort from mergers and acquisitions (M&A) management teams. This understanding drives the common and longstanding practice of offering hefty performance incentive packages to key managers, assuming that financial incentives will induce in-role and extra-role behaviors that drive organizational change and growth. The present study debunks the assumptions of this common M&A practice, providing quantitative evidence that shared vision and autonomous motivation are far more effective drivers of managerial performance than financial incentives. PMID:25610406

  12. Shared vision and autonomous motivation vs. financial incentives driving success in corporate acquisitions.

    Science.gov (United States)

    Clayton, Byron C

    2014-01-01

    Successful corporate acquisitions require its managers to achieve substantial performance improvements in order to sufficiently cover acquisition premiums, the expected return of debt and equity investors, and the additional resources needed to capture synergies and accelerate growth. Acquirers understand that achieving the performance improvements necessary to cover these costs and create value for investors will most likely require a significant effort from mergers and acquisitions (M&A) management teams. This understanding drives the common and longstanding practice of offering hefty performance incentive packages to key managers, assuming that financial incentives will induce in-role and extra-role behaviors that drive organizational change and growth. The present study debunks the assumptions of this common M&A practice, providing quantitative evidence that shared vision and autonomous motivation are far more effective drivers of managerial performance than financial incentives.

  13. Shared Vision and Autonomous Motivation versus Financial Incentives Driving Success in Corporate Acquisitions

    Directory of Open Access Journals (Sweden)

    Byron C Clayton

    2015-01-01

    Full Text Available Successful corporate acquisitions require its managers to achieve substantial performance improvements in order to sufficiently cover acquisition premiums, the expected return of debt and equity investors, and the additional resources needed to capture synergies and accelerate growth. Acquirers understand that achieving the performance improvements necessary to cover these costs and create value for investors will most likely require a significant effort from mergers and acquisitions (M&A management teams. This understanding drives the common and longstanding practice of offering hefty performance incentive packages to key managers, assuming that financial incentives will induce in-role and extra-role behaviors that drive organizational change and growth. The present study debunks the assumptions of this common M&A practice, providing quantitative evidence that shared vision and autonomous motivation are far more effective drivers of managerial performance than financial incentives.

  14. Financial incentives and coverage of child health interventions: a systematic review and meta-analysis.

    Science.gov (United States)

    Bassani, Diego G; Arora, Paul; Wazny, Kerri; Gaffey, Michelle F; Lenters, Lindsey; Bhutta, Zulfiqar A

    2013-01-01

    Financial incentives are widely used strategies to alleviate poverty, foster development, and improve health. Cash transfer programs, microcredit, user fee removal policies and voucher schemes that provide direct or indirect monetary incentives to households have been used for decades in Latin America, Sub-Saharan Africa, and more recently in Southeast Asia. Until now, no systematic review of the impact of financial incentives on coverage and uptake of health interventions targeting children under 5 years of age has been conducted. The objective of this review is to provide estimates on the effect of six types of financial incentive programs: (i) Unconditional cash transfers (CT), (ii) Conditional cash transfers (CCT), (iii) Microcredit (MC), (iv) Conditional Microcredit (CMC), (v) Voucher schemes (VS) and (vi) User fee removal (UFR) on the uptake and coverage of health interventions targeting children under the age of five years. We conducted systematic searches of a series of databases until September 1st, 2012, to identify relevant studies reporting on the impact of financial incentives on coverage of health interventions and behaviors targeting children under 5 years of age. The quality of the studies was assessed using the CHERG criteria. Meta-analyses were undertaken to estimate the effect when multiple studies meeting our inclusion criteria were available. Our searches resulted in 1671 titles identified 25 studies reporting on the impact of financial incentive programs on 5 groups of coverage indicators: breastfeeding practices (breastfeeding incidence, proportion of children receiving colostrum and early initiation of breastfeeding, exclusive breastfeeding for six months and duration of breastfeeding); vaccination (coverage of full immunization, partial immunization and specific antigens); health care use (seeking healthcare when child was ill, visits to health facilities for preventive reasons, visits to health facilities for any reason, visits for health

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-07-13

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

  16. Financial incentives for a healthy life style and disease prevention among older people: a systematic literature review.

    Science.gov (United States)

    Tambor, Marzena; Pavlova, Milena; Golinowska, Stanisława; Arsenijevic, Jelena; Groot, Wim

    2016-09-05

    To motivate people to lead a healthier life and to engage in disease prevention, explicit financial incentives, such as monetary rewards for attaining health-related targets (e.g. smoking cessation, weight loss or increased physical activity) or disincentives for reverting to unhealthy habits, are applied. A review focused on financial incentives for health promotion among older people is lacking. Attention to this group is necessary because older people may respond differently to financial incentives, e.g. because of differences in opportunity costs and health perceptions. To outline how explicit financial incentives for healthy lifestyle and disease prevention work among older persons, this study reviews the recent evidence on this topic. We applied the method of systematic literature review and we searched in PUBMED, ECONLIT and COCHRANE LIBRARY for studies focused on explicit financial incentives targeted at older adults to promote health and stimulate primary prevention as well as screening. The publications selected as relevant were analyzed based on directed (relational) content analysis. The results are presented in a narrative manner complemented with an appendix table that describes the study details. We assessed the design of the studies reported in the publications in a qualitative manner. We also checked the quality of our review using the PRISMA 2009 checklist. We identified 15 studies on the role of explicit financial incentives in changing health-related behavior of older people. They include both, quantitative studies on the effectiveness of financial rewards as well as qualitative studies on the acceptability of financial incentives. The quantitative studies are characterized by a great diversity of designs and provide mixed results on the effects of explicit financial incentives. The results of the qualitative studies indicate limited trust of older people in the use of explicit financial incentives for health promotion and prevention. More

  17. Privatized Returns and Socialized Risks: CEO Incentives, Securitization Accounting and the Financial Crisis

    OpenAIRE

    Fabrizi, M.; Parbonetti, A.

    2013-01-01

    The paper investigates the role of CEO’s equity and risk incentives in boosting securitization in the financial industry and in motivating executives to reduce the perceived risk while betting on it. Using a sample of US financial institutions over the period 2003-2009 we document that CEOs with high equity incentives have systematically engaged in securitization transactions to a larger extent than CEOs with low incentives. We also show that CEOs with high equity and risk-related incentives ...

  18. Incentives in Rheumatology: the Potential Contribution of Physician Responses to Financial Incentives, Public Reporting, and Treatment Guidelines to Health Care Sustainability.

    Science.gov (United States)

    Harrison, Mark; Milbers, Katherine; Mihic, Tamara; Anis, Aslam H

    2016-07-01

    Concerns about the sustainability of current health care expenditure are focusing attention on the cost, quality and value of health care provision. Financial incentives, for example pay-for-performance (P4P), seek to reward quality and value in health care provision. There has long been an expectation that P4P schemes are coming to rheumatology. We review the available evidence about the use of incentives in this setting and provide two emerging examples of P4P schemes which may shape the future of service provision in rheumatology. Currently, there is limited and equivocal evidence in rheumatology about the impact of incentive schemes. However, reporting variation in the quality and provision of rheumatology services has highlighted examples of inefficiencies in the delivery of care. If financial incentives can improve the delivery of timely and appropriate care for rheumatology patients, then they may have an important role to play in the sustainability of health care provision.

  19. 'Show me the money': financial incentives increase chlamydia screening rates among tertiary students: a pilot study.

    Science.gov (United States)

    Currie, Marian J; Schmidt, Matthias; Davis, Belinda K; Baynes, Anne M; O'Keefe, Elissa J; Bavinton, Tim P; McNiven, Michelle; Martin, Sarah J; Bowden, Francis J

    2010-03-01

    We hypothesise that text-messaging and financial incentives would increase tertiary student participation in chlamydia screening. A cross-sectional study was conducted over two phases on eight tertiary campuses during 2007. During Phase 1 (6 months) study activities were advertised through student organisations and media. Education and screening were offered during a range of student activities. During Phase 2 (4 days) education and screening were offered via text messages. Non-financial incentives were offered during Phase 1 and a $10 cash incentive was offered during Phase 2. Rates of specimens provided by students and the direct costs incurred during each phase were compared. 2786 students attended the 31 activities conducted in Phase 1. Of these, 627 students (22.5%) provided urine specimens for chlamydia testing. During Phase 2, the dissemination of 866 text messages resulted in urine specimens from 392 students (45.3%). Costs per test were AUD $175.11 in Phase 1 and AUD $27.13 in Phase 2. Compared with more labour intensive (and therefore more expensive) screening activities conducted over a 6-month period, offering a small financial incentive to tertiary students through text messaging over a 4-day period significantly increased participation in on-campus chlamydia screening. This model could readily be applied to other populations to increase participation in chlamydia screening.

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Science.gov (United States)

    Fronstin, Paul; Roebuck, M Christopher

    2015-08-01

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

  2. The impact of financial constraints and incentives on professional autonomy.

    Science.gov (United States)

    Lewis, Jenny M; Marjoribanks, Tim

    2003-01-01

    General practice has been the subject of extensive reforms over the 1990s in Australia as elsewhere. Reforms have attempted to improve quality and contain the overall cost of health care, and have often been seen as reducing the autonomy of medical professionals. This paper examines the impact of financial constraints and incentives introduced during the 1990s on Australian GPs' perceptions of autonomy. An existing seven component definition of autonomy and six themes that emerged from reviewing publications were used to construct focus group questions. A total of 25 GPs participated in four focus groups. Those who participated believe that their financial autonomy has been diminished by policy changes and consumer expectations. They also perceive that their ability to control clinical decisions, which they regard as the most important aspect of professional autonomy, has been reduced along with financial autonomy. Organized medicine in Australia sees financial accountability and clinical decision making as polar opposites, and has continued to argue that fee-for-service payment is the only appropriate method of remuneration, despite increasing evidence that this does not guarantee clinical autonomy. Major changes to the financing of general practice in Australia are required to address the concerns of GPs, governments and patients.

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

    Science.gov (United States)

    Squitieri, Lee; Chung, Kevin C

    2017-07-01

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

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

    Science.gov (United States)

    Gopalan, Saji S; Durairaj, Varatharajan

    2012-09-15

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

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

    Directory of Open Access Journals (Sweden)

    Gopalan Saji S

    2012-09-01

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

  6. Planning, zoning and financial incentives for ecoroofs in Portland, Oregon

    Energy Technology Data Exchange (ETDEWEB)

    Liptan, T. [City of Portland, OR (United States). Bureau of Environmental Services

    2003-07-01

    Approximately 35 to 90 per cent of the surface area of various city neighbourhoods is composed of rooftops and pavement. The City of Portland has suffered from several infrastructure and environmental problems as a result of these rooftops and pavement. In response, the City created a program to address storm water related problems and to provide other environmental benefits. This program promotes the use of Ecoroofs or vegetated roofs. City officials are investigating three specific concerns regarding Ecoroofs: (1) the extent to which Ecoroofs can manage precipitation and water quality, (2) the design, construction and maintenance issues to be addressed in order to ensure Ecoroofs are viable, and (3) the policies and economic concerns that must be addressed to determine the appropriate incentives and potential regulations for Ecoroofs. The overall city program was described in this presentation. The incentives and assistance provided by the city were reviewed, and the practical lessons learned were discussed. 1 tab., 1 fig.

  7. Financial incentives and physician commitment to guideline-recommended hypertension management.

    Science.gov (United States)

    Hysong, Sylvia J; Simpson, Kate; Pietz, Kenneth; SoRelle, Richard; Broussard Smitham, Kristen; Petersen, Laura A

    2012-10-01

    To examine the impact of financial incentives on physician goal commitment to guideline-recommended hypertension care. Clinic-level cluster-randomized trial with 4 arms: individual, group, or combined incentives, and control. A total of 83 full-time primary care physicians at 12 Veterans Affairs medical centers completed web-based surveys measuring their goal commitment to guideline-recommended hypertension care every 4 months and telephone interviews at months 8 and 16. Intervention arm participants received performance-based incentives every 4 months for 5 periods. All participants received guideline education at baseline and audit and feedback every 4 months. Physician goal commitment did not vary over time or across arms. Participants reported patient nonadherence was a perceived barrier and consistent follow-up was a perceived facilitator to successful hypertension care, suggesting that providers may perceive hypertension management as more of a patient responsibility (external locus of control). Financial incentives may constitute an insufficiently strong intervention to influence goal commitment when providers attribute performance to external forces beyond their control.

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

    Science.gov (United States)

    Blondon, Katherine S

    2015-06-10

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

  9. The impact of financial and nonfinancial incentives on business-unit outcomes over time.

    Science.gov (United States)

    Peterson, Suzanne J; Luthans, Fred

    2006-01-01

    Unlike previous behavior management research, this study used a quasi-experimental, control group design to examine the impact of financial and nonfinancial incentives on business-unit (21 stores in a fast-food franchise corporation) outcomes (profit, customer service, and employee turnover) over time. The results showed that both types of incentives had a significant impact on all measured outcomes. The financial incentive initially had a greater effect on all 3 outcomes, but over time, the financial and nonfinancial incentives had an equally significant impact except in terms of employee turnover. (c) 2006 APA, all rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Darren Flynn PhD

    2017-05-01

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

  11. Corruption of pharmaceutical markets: addressing the misalignment of financial incentives and public health.

    Science.gov (United States)

    Gagnon, Marc-André

    2013-01-01

    This paper explains how the current architecture of the pharmaceutical markets has created a misalignment of financial incentives and public health that is a central cause of harmful practices. It explores three possible solutions to address that misalignment: taxes, increased financial penalties, and drug pricing based on value. Each proposal could help to partly realign financial incentives and public health. However, because of the limits of each proposal, there is no easy solution to fixing the problem of financial incentives. © 2013 American Society of Law, Medicine & Ethics, Inc.

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

    Science.gov (United States)

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

    2017-07-26

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

  13. Pharmaceutical policies: effects of financial incentives for prescribers.

    Science.gov (United States)

    Rashidian, Arash; Omidvari, Amir-Houshang; Vali, Yasaman; Sturm, Heidrun; Oxman, Andrew D

    2015-08-04

    The proportion of total healthcare expenditures spent on drugs has continued to grow in countries of all income categories. Policy-makers are under pressure to control pharmaceutical expenditures without adversely affecting quality of care. Financial incentives seeking to influence prescribers' behaviour include budgetary arrangements at primary care and hospital settings (pharmaceutical budget caps or targets), financial rewards for target behaviours or outcomes (pay for performance interventions) and reduced benefit margin for prescribers based on medicine sales and prescriptions (pharmaceutical reimbursement rate reduction policies). This is the first update of the original version of this review. To determine the effects of pharmaceutical policies using financial incentives to influence prescribers' practices on drug use, healthcare utilisation, health outcomes and costs (expenditures). We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (searched 29/01/2015); MEDLINE, Ovid SP (searched 29/01/2015); EMBASE, Ovid SP (searched 29/01/2015); International Network for Rational Use of Drugs (INRUD) Bibliography (searched 29/01/2015); National Health Service (NHS) Economic Evaluation Database (searched 29/01/2015); EconLit - ProQuest (searched 02/02/2015); and Science Citation Index and Social Sciences Citation Index, Institute for Scientific Information (ISI) Web of Knowledge (citation search for included studies searched 10/02/2015). We screened the reference lists of relevant reports and contacted study authors and organisations to identify additional studies. We included policies that intend to affect prescribing by means of financial incentives for prescribers. Included in this category are pharmaceutical budget caps or targets, pay for performance and drug reimbursement rate reductions and other financial policies, if they were specifically targeted at prescribing or drug utilisation. Policies in this review were defined as laws, rules

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

    Science.gov (United States)

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

    2004-12-01

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

  15. The role of behavioral economic incentive design and demographic characteristics in financial incentive-based approaches to changing health behaviors: a meta-analysis.

    Science.gov (United States)

    Haff, Nancy; Patel, Mitesh S; Lim, Raymond; Zhu, Jingsan; Troxel, Andrea B; Asch, David A; Volpp, Kevin G

    2015-01-01

    To evaluate the use of behavioral economics to design financial incentives to promote health behavior change and to explore associations with demographic characteristics. Studies performed by the Center for Health Incentives and Behavioral Economics at the University of Pennsylvania published between January 2006 and March 2014. Randomized, controlled trials with available participant-level data. Studies that did not use financial incentives to promote health behavior change were excluded. Participant-level data from seven studies were pooled. Meta-analysis on the pooled sample using a random-effects model with interaction terms to examine treatment effects and whether they varied by incentive structure or demographic characteristics. The pooled study sample comprised 1403 participants, of whom 35% were female, 70% were white, 24% were black, and the mean age was 48 years (standard deviation 11.2 years). In the fully adjusted model, participants offered financial incentives had higher odds of behavior change (odds ratio [OR]: 3.96; p financial incentives and gender, age, race, income, or education. When further adjusting for incentive structure, blacks had higher odds than whites of achieving behavior change (OR: 1.67; p Financial incentives designed using concepts from behavioral economics were effective for promoting health behavior change. There were no large and consistent relationships between the effectiveness of financial incentives and observable demographic characteristics. Second-order examinations of incentive structure suggest potential relationships among the effectiveness of financial incentives, incentive structure, and the demographic characteristics of race and income.

  16. Cash or Compliment? Older employees preference of financial versus non-financial incentives

    Directory of Open Access Journals (Sweden)

    Miodraga Stefanovska-Petkovska

    2017-03-01

    Full Text Available Resulting from the emerging importance of population ageing, the last several years an increased amount of academic interest has been located in the area of motivation of older employees. In this context, job satisfaction has been used as one of the measure to evaluate older workers wellbeing in the organization. The aim of this paper is to investigate the preference of financial and nonfinancial incentives among older employees and their impact on job satisfaction. A total of 351 employees aged 40 years and over working in the telecommunication industry in the Republic of Macedonia, have been included in the study. The results indicated that although both types of incentives are positively related to job satisfaction, financial incentives tend to be stronger predictors. In addition, managerial position, tenure and intrinsic motivation have been positively related to job satisfaction among older employees as well. The current research seeks to decrease the research gap concerning the ageing workforce in developing economies and contribute to the increased understanding of these growing age group of employees.

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

    Science.gov (United States)

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

    2010-01-01

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

  18. Financial incentives for exercise adherence in adults: systematic review and meta-analysis.

    Science.gov (United States)

    Mitchell, Marc S; Goodman, Jack M; Alter, David A; John, Leslie K; Oh, Paul I; Pakosh, Maureen T; Faulkner, Guy E

    2013-11-01

    Less than 5% of U.S. adults accumulate the required dose of exercise to maintain health. Behavioral economics has stimulated renewed interest in economic-based, population-level health interventions to address this issue. Despite widespread implementation of financial incentive-based public health and workplace wellness policies, the effects of financial incentives on exercise initiation and maintenance in adults remain unclear. A systematic search of 15 electronic databases for RCTs reporting the impact of financial incentives on exercise-related behaviors and outcomes was conducted in June 2012. A meta-analysis of exercise session attendance among included studies was conducted in April 2013. A qualitative analysis was conducted in February 2013 and structured along eight features of financial incentive design. Eleven studies were included (N=1453; ages 18-85 years and 50% female). Pooled results favored the incentive condition (z=3.81, p1 year), and two studies found exercise adherence persisted after the incentive was withdrawn. Promising incentive design feature attributes were noted. Assured, or "sure thing," incentives and objective behavioral assessment in particular appear to moderate incentive effectiveness. Previously sedentary adults responded favorably to incentives 100% of the time (n=4). The effect estimate from the meta-analysis suggests that financial incentives increase exercise session attendance for interventions up to 6 months in duration. Similarly, a simple count of positive (n=8) and null (n=3) effect studies suggests that financial incentives can increase exercise adherence in adults in the short term (<6 months). © 2013 American Journal of Preventive Medicine.

  19. The impact of financial incentives on physical activity in adults: a systematic review protocol.

    Science.gov (United States)

    Luong, My-Linh Nguyen; Bennell, Kim L; Hall, Michelle; Harris, Anthony; Hinman, Rana S

    2018-01-25

    Most adults fail to meet global physical activity guidelines set out by the World Health Organization. In recent years, behavioural economic principles have been used to design novel interventions that increase physical activity. Immediate financial rewards, for instance, can motivate an individual to change physical activity behaviour by lowering the opportunity costs of exercise. This systematic review will summarise the evidence about the effectiveness of financial incentive interventions for improving physical activity in adults. We will search MEDLINE, Embase, Cochrane Central Register of Controlled Trials, the Cumulative Index to Nursing and Allied Health Literature, Web of Science, Scopus, PsycINFO, EconLit, SPORTDiscus, the National Health Service Economic Evaluation Database, ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform from inception using a comprehensive, electronic search strategy. The search strategy will include terms related to 'financial incentive' and 'physical activity'. Only randomised controlled trials that investigate the effect of financial incentives on physical activity in adult populations and that are written in the English language will be included. Two review authors will independently screen abstracts and titles, complete full text reviews and extract data on objective and self-reported physical activity outcomes. The authors will also assess the study quality using the Cochrane risk of bias tool and provide a systematic presentation and synthesis of the included studies' characteristics and results. If more than two studies are sufficiently similar in population, settings and interventions, we will pool the data to conduct a meta-analysis. If we are unable to perform a meta-analysis, we will conduct a narrative synthesis of the results and produce forest plots for individual studies. Our subgroup analyses will examine the differential effects of an intervention in healthy

  20. Administrator Responses to Financial Incentives: Insights from a TIF Program

    Science.gov (United States)

    King Rice, Jennifer; Malen, Betty; Jackson, Cara; Hoyer, Kathleen Mulvaney

    2017-01-01

    This article provides evidence and generates insights about the power of financial rewards to motivate school administrators and the design features that influence their motivational potency. The multi-year mixed-methods study is grounded in expectancy and goal setting theories that suggest (a) awards must be salient and sizable enough to appeal…

  1. What are GPs' preferences for financial and non-financial incentives in cancer screening? Evidence for breast, cervical, and colorectal cancers.

    Science.gov (United States)

    Sicsic, Jonathan; Krucien, Nicolas; Franc, Carine

    2016-10-01

    General practitioners (GPs) play a key role in the delivery of preventive and screening services for breast, cervical, and colorectal cancers. In practice, GPs' involvement varies considerably across types of cancer and among GPs, raising important questions about the determinants of GPs' implication in screening activities: what is the relative impact of financial and non-financial incentives? Are GPs' preferences for financial and non-financial incentives cancer-specific? Is there preference heterogeneity and how much does it differ according to the screening context? This study investigates the determinants of GPs' involvement in cancer screening activities using the discrete choice experiment (DCE) methodology. A representative sample of 402 GPs' was recruited in France between March and April 2014. Marginal rates of substitution were used to compare GPs' preferences for being involved in screening activities across three types of cancers: breast, cervical, and colorectal. Variability of preferences was investigated using Hierarchical Bayes mixed logit models. The results indicate that GPs are sensitive to both financial and non-financial incentives, such as a compensated training and systematic transmission of information about screened patients, aimed to facilitate communication between doctors and patients. There is also evidence that the level and variability of preferences differ across screening contexts, although the variations are not statistically significant on average. GPs appear to be relatively more sensitive to financial incentives for being involved in colorectal cancer screening, whereas they have higher and more heterogeneous preferences for non-financial incentives in breast and cervical cancers. Our study provides new findings for policymakers interested in prioritizing levers to increase the supply of cancer screening services in general practice. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Effect of incentives on the financial attractiveness of solar industrial process heating in India★

    Directory of Open Access Journals (Sweden)

    Sharma Ashish K.

    2017-01-01

    Full Text Available India has a huge industrial demand for process heating at temperatures that can be provided with commercially available solar collectors. Government of India with support from multi-lateral agencies has initiated an ambitious programme for promoting large scale adoption of Solar Industrial Process Heating (SIPH in the industrial sector of the country. This paper presents the details of an attempt to study the effect of several existing and potential incentives on the financial attractiveness of SIPH systems in India. A case of solar process heating in dairy industry has been presented to demonstrate the relative efficacy of different incentives on the economics of SIPH systems in terms of their impact on levelized cost of useful thermal energy delivered. Finally, policy implications of the results obtained have been discussed.

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

    Directory of Open Access Journals (Sweden)

    Bärnighausen Till

    2009-05-01

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

  4. Financial Incentives and Student Achievement: Evidence from Randomized Trials. NBER Working Paper No. 15898

    Science.gov (United States)

    Fryer, Roland G., Jr.

    2010-01-01

    This paper describes a series of school-based randomized trials in over 250 urban schools designed to test the impact of financial incentives on student achievement. In stark contrast to simple economic models, our results suggest that student incentives increase achievement when the rewards are given for inputs to the educational production…

  5. The importance of financial incentives on retirement choices : New evidence for Italy

    NARCIS (Netherlands)

    Belloni, Michele; Alessie, Rob

    2009-01-01

    This study exploits a new dataset to quantify the effect of financial incentives on retirement choices. This dataset contains-for the first time for Italy-information on seniority. The effects of marginal incentives and social security wealth (SSW) on retirement go in the expected direction; when

  6. Federal Financial Incentives to Induce Early Experience Producing Unconventional Liquid Fuels

    National Research Council Canada - National Science Library

    Camm, Frank; Bartis, James T; Bushman, Charles J

    2008-01-01

    This technical report explains an analytic way to design and assess packages of financial incentives that the government can use to cost effectively promote early experience with coal-to-liquids (CTL...

  7. Improving the cost effectiveness of financial incentives in managing travel demand management (TDM) : [technical summary].

    Science.gov (United States)

    2013-10-01

    During the last two decades, financial incentives : have become common in efforts to reduce : demand on roadways by motivating commuters to : use alternative modes of transportation. Despite : common use, limited effort has been made to : understand ...

  8. Financial incentive increases CPAP acceptance in patients from low socioeconomic background.

    Directory of Open Access Journals (Sweden)

    Ariel Tarasiuk

    Full Text Available OBJECTIVE: We explored whether financial incentives have a role in patients' decisions to accept (purchase a continuous positive airway pressure (CPAP device in a healthcare system that requires cost sharing. DESIGN: Longitudinal interventional study. PATIENTS: The group receiving financial incentive (n = 137, 50.8±10.6 years, apnea/hypopnea index (AHI 38.7±19.9 events/hr and the control group (n = 121, 50.9±10.3 years, AHI 39.9±22 underwent attendant titration and a two-week adaptation to CPAP. Patients in the control group had a co-payment of $330-660; the financial incentive group paid a subsidized price of $55. RESULTS: CPAP acceptance was 43% greater (p = 0.02 in the financial incentive group. CPAP acceptance among the low socioeconomic strata (n = 113 (adjusting for age, gender, BMI, tobacco smoking was enhanced by financial incentive (OR, 95% CI (3.43, 1.09-10.85, age (1.1, 1.03-1.17, AHI (>30 vs. 30 vs. 30 vs. <30 (5.25, 1.34-18.5. CONCLUSIONS: Minimizing cost sharing reduces a barrier for CPAP acceptance among low socioeconomic status patients. Thus, financial incentive should be applied as a policy to encourage CPAP treatment, especially among low socioeconomic strata patients.

  9. Financial incentive increases CPAP acceptance in patients from low socioeconomic background.

    Science.gov (United States)

    Tarasiuk, Ariel; Reznor, Gally; Greenberg-Dotan, Sari; Reuveni, Haim

    2012-01-01

    We explored whether financial incentives have a role in patients' decisions to accept (purchase) a continuous positive airway pressure (CPAP) device in a healthcare system that requires cost sharing. Longitudinal interventional study. The group receiving financial incentive (n = 137, 50.8±10.6 years, apnea/hypopnea index (AHI) 38.7±19.9 events/hr) and the control group (n = 121, 50.9±10.3 years, AHI 39.9±22) underwent attendant titration and a two-week adaptation to CPAP. Patients in the control group had a co-payment of $330-660; the financial incentive group paid a subsidized price of $55. CPAP acceptance was 43% greater (p = 0.02) in the financial incentive group. CPAP acceptance among the low socioeconomic strata (n = 113) (adjusting for age, gender, BMI, tobacco smoking) was enhanced by financial incentive (OR, 95% CI) (3.43, 1.09-10.85), age (1.1, 1.03-1.17), AHI (>30 vs. acceptance was affected by AHI (>30 vs. 30 vs. acceptance among low socioeconomic status patients. Thus, financial incentive should be applied as a policy to encourage CPAP treatment, especially among low socioeconomic strata patients.

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

    Science.gov (United States)

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

    2012-01-01

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

  11. Designing financial-incentive programmes for return of medical service in underserved areas: seven management functions

    Directory of Open Access Journals (Sweden)

    Bärnighausen Till

    2009-06-01

    Full Text Available Abstract In many countries worldwide, health worker shortages are one of the main constraints in achieving population health goals. Financial-incentive programmes for return of service, whereby participants receive payments in return for a commitment to practise for a period of time in a medically underserved area, can alleviate local and regional health worker shortages through a number of mechanisms. First, they can redirect the flow of those health workers who would have been educated without financial incentives from well-served to underserved areas. Second, they can add health workers to the pool of workers who would have been educated without financial incentives and place them in underserved areas. Third, financial-incentive programmes may improve the retention in underserved areas of those health workers who participate in a programme, but who would have worked in an underserved area without any financial incentives. Fourth, the programmes may increase the retention of all health workers in underserved areas by reducing the strength of some of the reasons why health workers leave such areas, including social isolation, lack of contact with colleagues, lack of support from medical specialists and heavy workload. We draw on studies of financial-incentive programmes and other initiatives with similar objectives to discuss seven management functions that are essential for the long-term success of financial-incentive programmes: financing (programmes may benefit from innovative donor financing schemes, such as endowment funds, international financing facilities or compensation payments; promotion (programmes should use tested communication channels in order to reach secondary school graduates and health workers; selection (programmes may use selection criteria to ensure programme success and to achieve supplementary policy goals; placement (programmes should match participants to areas in order to maximize participant satisfaction and

  12. Designing financial-incentive programmes for return of medical service in underserved areas: seven management functions.

    Science.gov (United States)

    Bärnighausen, Till; Bloom, David E

    2009-06-26

    In many countries worldwide, health worker shortages are one of the main constraints in achieving population health goals. Financial-incentive programmes for return of service, whereby participants receive payments in return for a commitment to practise for a period of time in a medically underserved area, can alleviate local and regional health worker shortages through a number of mechanisms. First, they can redirect the flow of those health workers who would have been educated without financial incentives from well-served to underserved areas. Second, they can add health workers to the pool of workers who would have been educated without financial incentives and place them in underserved areas. Third, financial-incentive programmes may improve the retention in underserved areas of those health workers who participate in a programme, but who would have worked in an underserved area without any financial incentives. Fourth, the programmes may increase the retention of all health workers in underserved areas by reducing the strength of some of the reasons why health workers leave such areas, including social isolation, lack of contact with colleagues, lack of support from medical specialists and heavy workload. We draw on studies of financial-incentive programmes and other initiatives with similar objectives to discuss seven management functions that are essential for the long-term success of financial-incentive programmes: financing (programmes may benefit from innovative donor financing schemes, such as endowment funds, international financing facilities or compensation payments); promotion (programmes should use tested communication channels in order to reach secondary school graduates and health workers); selection (programmes may use selection criteria to ensure programme success and to achieve supplementary policy goals); placement (programmes should match participants to areas in order to maximize participant satisfaction and retention); support (programmes

  13. Financial Analysis of Incentive Mechanisms to Promote Energy Efficiency: Case Study of a Prototypical Southwest Utility

    Energy Technology Data Exchange (ETDEWEB)

    Cappers, Peter; Goldman, Charles; Chait, Michele; Edgar, George; Schlegel, Jeff; Shirley, Wayne

    2009-03-04

    Many state regulatory commissions and policymakers want utilities to aggressively pursue energy efficiency as a strategy to mitigate demand and energy growth, diversify the resource mix, and provide an alternative to building new, costly generation. However, as the National Action Plan for Energy Efficiency (NAPEE 2007) points out, many utilities continue to shy away from aggressively expanding their energy efficiency efforts when their shareholder's fundamental financial interests are placed at risk by doing so. Thus, there is increased interest in developing effective ratemaking and policy approaches that address utility disincentives to pursue energy efficiency or lack of incentives for more aggressive energy efficiency efforts. New regulatory initiatives to promote increased utility energy efficiency efforts also affect the interests of consumers. Ratepayers and their advocates are concerned with issues of fairness, impacts on rates, and total consumer costs. From the perspective of energy efficiency advocates, the quid pro quo for utility shareholder incentives is the obligation to acquire all, or nearly all, achievable cost-effective energy efficiency. A key issue for state regulators and policymakers is how to maximize the cost-effective energy efficiency savings attained while achieving an equitable sharing of benefits, costs and risks among the various stakeholders. In this study, we modeled a prototypical vertically-integrated electric investor-owned utility in the southwestern US that is considering implementing several energy efficiency portfolios. We analyze the impact of these energy efficiency portfolios on utility shareholders and ratepayers as well as the incremental effect on each party when lost fixed cost recovery and/or utility shareholder incentive mechanisms are implemented. A primary goal of our quantitative modeling is to provide regulators and policymakers with an analytic framework and tools that assess the financial impacts of

  14. Behavioral implications of providing real incentives in stated choice experiments

    DEFF Research Database (Denmark)

    Mørkbak, Morten Raun; Olsen, Søren Bøye; Campbell, Danny

    2014-01-01

    the scope of research to other behavioral aspects where consumers in CE are often found to deviate from homo economicus. We develop a theoretical model where not only Willingness to pay (WTP) measures but also decision processing can be affected by the introduction of an economic incentive. Specifically...... incentive, we find marked benefits in relation to a number of behavioral aspects that together would favor the use of an economic incentive regardless of hypothetical bias being present or not....

  15. The impact of state financial incentives on market deployment of solar technology

    International Nuclear Information System (INIS)

    Sarzynski, Andrea; Larrieu, Jeremy; Shrimali, Gireesh

    2012-01-01

    Many states have adopted financial incentives to encourage market deployment of solar energy technology. This paper employs a cross-sectional time-series approach to evaluate the extent to which state solar financial incentives systematically encouraged market deployment of solar photovoltaic (PV) technology from 1997 to 2009. The results demonstrate that states offering cash incentives such as rebates and grants experienced more extensive and rapid deployment of grid-tied PV technology than states without cash incentives over the study period. The analysis also finds that the presence of state renewable energy portfolio standards and specific solar carve-out provisions within them heavily influenced the market deployment of grid-tied solar PV technology through 2009. - Highlights: ► We evaluate the impact of state financial incentives on solar technology adoption. ► Cash incentives and renewable portfolio standards strongly influenced deployment. ► The impact of cash incentives and RPS grew significantly over time. ► Tax incentives had little systematic effect on solar market deployment.

  16. Case Studies on the Effectiveness of State Financial Incentives for Renewable Energy

    Energy Technology Data Exchange (ETDEWEB)

    Gouchoe, S.; Everette, V.; Haynes, R.

    2002-09-01

    The North Carolina Solar Center at NC State University, in collaboration with the National Renewable Energy Laboratory, examined 10 state financial-incentive programs in six states using a case-study approach in order to clarify the key factors-both internal and external to the program-that influence their effectiveness at stimulating deployment of renewable energy technologies. While existing information resources such as the National Database of State Incentives for Renewable Energy (DSIRE, www.dsireusa.org) have documented what incentive programs are available, the effectiveness of such programs is not well understood. Understanding the impact of current financial incentives on the deployment of renewables and the factors that influence their effectiveness is critical to a variety of stakeholders, particularly in states considering new incentives or interested in improving or discarding existing ones.

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

    International Nuclear Information System (INIS)

    Reid, M.W.

    1990-01-01

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

  18. Financial incentives for healthy behavior: ethical safeguards for behavioral economics.

    Science.gov (United States)

    Lunze, Karsten; Paasche-Orlow, Michael K

    2013-06-01

    Economic incentives to promote healthy behavior are becoming increasingly common and have been suggested as an approach to decreasing healthcare costs. Ethical concerns about programs with such incentives are that they may contribute to inequities, be coercive, interfere with therapeutic relationships, undermine personal responsibility for health, and decrease social solidarity. Additionally, they may be a source of stigma or discrimination, promote dependence, and be unfair for those already engaged in targeted health behaviors or those who cannot fulfill the incentivized behaviors. Incentive programs need to incorporate appropriate safeguards to monitor these risks and support fairness in offering economic incentives to promote healthy behavior. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Busum, Kristin Van; Mattke, Soeren

    2013-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Kristin Van Busum

    2013-11-01

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

  1. Acceptability of financial incentives for health behaviour change to public health policymakers: a qualitative study

    Directory of Open Access Journals (Sweden)

    Emma L. Giles

    2016-09-01

    Full Text Available Abstract Background Providing financial incentives contingent on healthy behaviours is one way to encourage healthy behaviours. However, there remains substantial concerns with the acceptability of health promoting financial incentives (HPFI. Previous research has studied acceptability of HPFI to the public, recipients and practitioners. We are not aware of any previous work that has focused particularly on the views of public health policymakers. Our aim was to explore the views of public health policymakers on whether or not HPFI are acceptable; and what, if anything, could be done to maximise acceptability of HPFI. Methods We recruited 21 local, regional and national policymakers working in England via gatekeepers and snowballing. We conducted semi-structured in-depth interviews with participants exploring experiences of, and attitudes towards, HPFI. We analysed data using the Framework approach. Results Public health policymakers working in England acknowledged that HPFI could be a useful behaviour change tool, but were not overwhelmingly supportive of them. In particular, they raised concerns about effectiveness and cost-effectiveness, potential ‘gaming’, and whether or not HPFI address the underlying causes of unhealthy behaviours. Shopping voucher rewards, of smaller value, targeted at deprived groups were particularly acceptable to policymakers. Participants were particularly concerned about the response of other stakeholders to HPFI – including the public, potential recipients, politicians and the media. Overall, the interviews reflected three tensions. Firstly, a tension between wanting to trust individuals and promote responsibility; and distrust around the potential for ‘gaming the system’. Secondly, a tension between participants’ own views about HPFI; and their concerns about the possible views of other stakeholders. Thirdly, a tension between participants’ personal distaste of HPFI; and their professional view that

  2. Acceptability of financial incentives for health behaviour change to public health policymakers: a qualitative study.

    Science.gov (United States)

    Giles, Emma L; Sniehotta, Falko F; McColl, Elaine; Adams, Jean

    2016-09-15

    Providing financial incentives contingent on healthy behaviours is one way to encourage healthy behaviours. However, there remains substantial concerns with the acceptability of health promoting financial incentives (HPFI). Previous research has studied acceptability of HPFI to the public, recipients and practitioners. We are not aware of any previous work that has focused particularly on the views of public health policymakers. Our aim was to explore the views of public health policymakers on whether or not HPFI are acceptable; and what, if anything, could be done to maximise acceptability of HPFI. We recruited 21 local, regional and national policymakers working in England via gatekeepers and snowballing. We conducted semi-structured in-depth interviews with participants exploring experiences of, and attitudes towards, HPFI. We analysed data using the Framework approach. Public health policymakers working in England acknowledged that HPFI could be a useful behaviour change tool, but were not overwhelmingly supportive of them. In particular, they raised concerns about effectiveness and cost-effectiveness, potential 'gaming', and whether or not HPFI address the underlying causes of unhealthy behaviours. Shopping voucher rewards, of smaller value, targeted at deprived groups were particularly acceptable to policymakers. Participants were particularly concerned about the response of other stakeholders to HPFI - including the public, potential recipients, politicians and the media. Overall, the interviews reflected three tensions. Firstly, a tension between wanting to trust individuals and promote responsibility; and distrust around the potential for 'gaming the system'. Secondly, a tension between participants' own views about HPFI; and their concerns about the possible views of other stakeholders. Thirdly, a tension between participants' personal distaste of HPFI; and their professional view that they could be a valuable behaviour change tool. There are aspects of

  3. Are Financial Incentives for Lifestyle Behavior Change Informed or Inspired by Behavioral Economics? A Mapping Review.

    Science.gov (United States)

    McGill, Bronwyn; O'Hara, Blythe J; Bauman, Adrian; Grunseit, Anne C; Phongsavan, Philayrath

    2018-01-01

    To identify the behavioral economics (BE) conceptual underpinnings of lifestyle financial incentive (FI) interventions. A mapping review of peer-reviewed literature was conducted by searching electronic databases. Inclusion criteria were real-world FI interventions explicitly mentioning BE, targeting individuals, or populations with lifestyle-related behavioral outcomes. Exclusion criteria were hypothetical studies, health professional focus, clinically oriented interventions. Study characteristics were tabulated according to purpose, categorization of BE concepts and FI types, design, outcome measures, study quality, and findings. Data Synthesis and Analysis: Financial incentives were categorized according to type and payment structure. Behavioral economics concepts explicitly used in the intervention design were grouped based on common patterns of thinking. The interplay between FI types, BE concepts, and outcome was assessed. Seventeen studies were identified from 1452 unique records. Analysis showed 76.5% (n = 13) of studies explicitly incorporated BE concepts. Six studies provided clear theoretical justification for the inclusion of BE. No pattern in the type of FI and BE concepts used was apparent. Not all FI interventions claiming BE inclusion did so. For interventions that explicitly included BE, the degree to which this was portrayed and woven into the design varied. This review identified BE concepts common to FI interventions, a first step in providing emergent and pragmatic information to public health and health promotion program planners.

  4. Financial Incentive Increases CPAP Acceptance in Patients from Low Socioeconomic Background

    Science.gov (United States)

    Tarasiuk, Ariel; Reznor, Gally; Greenberg-Dotan, Sari; Reuveni, Haim

    2012-01-01

    Objective We explored whether financial incentives have a role in patients′ decisions to accept (purchase) a continuous positive airway pressure (CPAP) device in a healthcare system that requires cost sharing. Design Longitudinal interventional study. Patients The group receiving financial incentive (n = 137, 50.8±10.6 years, apnea/hypopnea index (AHI) 38.7±19.9 events/hr) and the control group (n = 121, 50.9±10.3 years, AHI 39.9±22) underwent attendant titration and a two-week adaptation to CPAP. Patients in the control group had a co-payment of $330–660; the financial incentive group paid a subsidized price of $55. Results CPAP acceptance was 43% greater (p = 0.02) in the financial incentive group. CPAP acceptance among the low socioeconomic strata (n = 113) (adjusting for age, gender, BMI, tobacco smoking) was enhanced by financial incentive (OR, 95% CI) (3.43, 1.09–10.85), age (1.1, 1.03–1.17), AHI (>30 vs. CPAP (4.29, 1.05–17.51). Among average/high-income patients (n = 145) CPAP acceptance was affected by AHI (>30 vs. CPAP adherence was similar in the financial incentive and control groups, 35% and 39%, respectively (p = 0.82). Adherence rate was sensitive to education (+yr) (1.28, 1.06–1.55) and AHI (>30 vs. CPAP acceptance among low socioeconomic status patients. Thus, financial incentive should be applied as a policy to encourage CPAP treatment, especially among low socioeconomic strata patients. PMID:22479368

  5. Design of effective interventions for smoking cessation through financial and non-financial incentives.

    Science.gov (United States)

    Balderrama, Fanor; Longo, Christopher J

    2017-11-01

    Smoking has a tremendous negative impact on the Canadian economy and contributes to growing costs in the healthcare system. Efforts to reduce smoking rates may therefore reduce strain on the healthcare system and free up scarce resources. Academic literature on economic smoking cessation incentives presents a countless variety of interventions that have met with varying degrees of success. This study reviews six different variables used in the design of incentives in smoking cessation interventions: direction, form, magnitude, certainty, recipient grouping, and target demographic. The purpose of this study is to provide analysis and recommendations about the contribution of each variable into the overall effectiveness of smoking cessation programs and help health leaders design better interventions according to their specific needs.

  6. A systematic review of financial incentives for physical activity: The effects on physical activity and related outcomes

    OpenAIRE

    Barte, J.C.M.; Wendel-Vos, G.C.W.

    2017-01-01

    The aim of this review is to give an overview of the available evidence on the effects of financial incentives to stimulate physical activity. Therefore, a systematic literature search was performed for randomized trials that investigate the effects of physical-activity-related financial incentives for individuals. Twelve studies with unconditional incentives (eg, free membership sport facility) and conditional incentives (ie, rewards for reaching physical-activity goals) related to physical ...

  7. Do financial incentives linked to ownership of specialty hospitals affect physicians' practice patterns?

    Science.gov (United States)

    Mitchell, Jean M

    2008-07-01

    Although physician-owned specialty hospitals have become increasingly prevalent in recent years, little research has examined whether the financial incentives linked to ownership influence physicians' referral rates for services performed at the specialty hospital. We compared the practice patterns of physician owners of specialty hospitals in Oklahoma, before and after ownership, to the practice patterns of physician nonowners who treated similar cases over the same time period in Oklahoma markets without physician-owned specialty hospitals. We constructed episodes of care for injured workers with a primary diagnosis of back/spine disorders. We used pre-post comparisons and difference-in-differences analysis to evaluate changes in practice patterns for physician owners and nonowners over the time period spanned by the entry of the specialty hospital. Findings suggest the introduction of financial incentives linked to ownership coincided with a significant change in the practice patterns of physician owners, whereas such changes were not evident among physician nonowners. After physicians established ownership interests in a specialty hospital, the frequency of use of surgery, diagnostic, and ancillary services used in the treatment of injured workers with back/spine disorders increased significantly. Physician ownership of specialty hospitals altered the frequency of use for an array of procedures rendered to patients treated at these hospitals. Given the growth in physician-owned specialty hospitals, these findings suggest that health care expenditures will be substantially greater for patients treated at these institutions relative to persons who obtain care from nonself-referral providers.

  8. Cost-effectiveness analysis of malaria rapid diagnostic test incentive schemes for informal private healthcare providers in Myanmar.

    Science.gov (United States)

    Chen, Ingrid T; Aung, Tin; Thant, Hnin Nwe Nwe; Sudhinaraset, May; Kahn, James G

    2015-02-05

    The emergence of artemisinin-resistant Plasmodium falciparum parasites in Southeast Asia threatens global malaria control efforts. One strategy to counter this problem is a subsidy of malaria rapid diagnostic tests (RDTs) and artemisinin-based combination therapy (ACT) within the informal private sector, where the majority of malaria care in Myanmar is provided. A study in Myanmar evaluated the effectiveness of financial incentives vs information, education and counselling (IEC) in driving the proper use of subsidized malaria RDTs among informal private providers. This cost-effectiveness analysis compares intervention options. A decision tree was constructed in a spreadsheet to estimate the incremental cost-effectiveness ratios (ICERs) among four strategies: no intervention, simple subsidy, subsidy with financial incentives, and subsidy with IEC. Model inputs included programmatic costs (in dollars), malaria epidemiology and observed study outcomes. Data sources included expenditure records, study data and scientific literature. Model outcomes included the proportion of properly and improperly treated individuals with and without P. falciparum malaria, and associated disability-adjusted life years (DALYs). Results are reported as ICERs in US dollars per DALY averted. One-way sensitivity analysis assessed how outcomes depend on uncertainty in inputs. ICERs from the least to most expensive intervention are: $1,169/DALY averted for simple subsidy vs no intervention, $185/DALY averted for subsidy with financial incentives vs simple subsidy, and $200/DALY averted for a subsidy with IEC vs subsidy with financial incentives. Due to decreasing ICERs, each strategy was also compared to no intervention. The subsidy with IEC was the most favourable, costing $639/DALY averted compared with no intervention. One-way sensitivity analysis shows that ICERs are most affected by programme costs, RDT uptake, treatment-seeking behaviour, and the prevalence and virulence of non

  9. Augmenting the impact of technology adoption with financial incentive to improve radiology report signature times.

    Science.gov (United States)

    Andriole, Katherine P; Prevedello, Luciano M; Dufault, Allen; Pezeshk, Parham; Bransfield, Robert; Hanson, Richard; Doubilet, Peter M; Seltzer, Steven E; Khorasani, Ramin

    2010-03-01

    Radiology report signature time (ST) can be a substantial component of total report turnaround time. Poor turnaround time resulting from lengthy ST can adversely affect patient care. The combination of technology adoption with financial incentive was evaluated to determine if ST improvement can be augmented and sustained. This prospective study was performed at a 751-bed, urban, tertiary care adult teaching hospital. Test-site imaging volume approximated 48,000 examinations per month. The radiology department has 100 trainees and 124 attending radiologists serving multiple institutions. Over a study period of 4 years and 4 months, three interventions focused on radiologist signature performance were implemented: 1) a notification paging application that alerted radiologists when reports were ready for signature, 2) a picture archiving and communications systems (PACS)-integrated speech recognition report generation system, and 3) a departmental financial incentive to reward radiologists semiannually for ST performance. Signature time was compared before and after the interventions. Wilcoxon and linear regression statistical analyses were used to assess the significance of trends. Technology adoption (paging plus speech recognition) reduced median ST from >5 to 24 to 15 to 18 hours (P financial incentive further improved 80th-percentile ST to 4 to 8 hours (P Technology interventions coupled with financial incentive can result in synergistic and sustainable improvement in radiologist report-signing behavior. The addition of a financial incentive leads to better performance than that achievable through technology alone.

  10. Framing Financial Incentives to Increase Physical Activity Among Overweight and Obese Adults: A Randomized, Controlled Trial.

    Science.gov (United States)

    Patel, Mitesh S; Asch, David A; Rosin, Roy; Small, Dylan S; Bellamy, Scarlett L; Heuer, Jack; Sproat, Susan; Hyson, Chris; Haff, Nancy; Lee, Samantha M; Wesby, Lisa; Hoffer, Karen; Shuttleworth, David; Taylor, Devon H; Hilbert, Victoria; Zhu, Jingsan; Yang, Lin; Wang, Xingmei; Volpp, Kevin G

    2016-03-15

    Financial incentive designs to increase physical activity have not been well-examined. To test the effectiveness of 3 methods to frame financial incentives to increase physical activity among overweight and obese adults. Randomized, controlled trial. (ClinicalTrials.gov: NCT 02030119). University of Pennsylvania. 281 adult employees (body mass index ≥27 kg/m2). 13-week intervention. Participants had a goal of 7000 steps per day and were randomly assigned to a control group with daily feedback or 1 of 3 financial incentive programs with daily feedback: a gain incentive ($1.40 given each day the goal was achieved), lottery incentive (daily eligibility [expected value approximately $1.40] if goal was achieved), or loss incentive ($42 allocated monthly upfront and $1.40 removed each day the goal was not achieved). Participants were followed for another 13 weeks with daily performance feedback but no incentives. Primary outcome was the mean proportion of participant-days that the 7000-step goal was achieved during the intervention. Secondary outcomes included the mean proportion of participant-days achieving the goal during follow-up and the mean daily steps during intervention and follow-up. The mean proportion of participant-days achieving the goal was 0.30 (95% CI, 0.22 to 0.37) in the control group, 0.35 (CI, 0.28 to 0.42) in the gain-incentive group, 0.36 (CI, 0.29 to 0.43) in the lottery-incentive group, and 0.45 (CI, 0.38 to 0.52) in the loss-incentive group. In adjusted analyses, only the loss-incentive group had a significantly greater mean proportion of participant-days achieving the goal than control (adjusted difference, 0.16 [CI, 0.06 to 0.26]; P = 0.001), but the adjusted difference in mean daily steps was not significant (861 [CI, 24 to 1746]; P = 0.056). During follow-up, daily steps decreased for all incentive groups and were not different from control. Single employer. Financial incentives framed as a loss were most effective for achieving physical

  11. "It Makes You Feel Like Someone Cares" acceptability of a financial incentive intervention for HIV viral suppression in the HPTN 065 (TLC-Plus study.

    Directory of Open Access Journals (Sweden)

    Elizabeth Greene

    Full Text Available HPTN 065 (TLC-Plus evaluated the feasibility and effectiveness of providing quarterly $70 gift card financial incentives to HIV-infected patients on antiretroviral therapy (ART to encourage ART adherence and viral suppression, and represents the largest study to-date of a financial incentive intervention for HIV viral suppression. A post-trial qualitative substudy was undertaken to examine acceptability of the financial incentives among those receiving and implementing the intervention.Between July and October 2013, semi-structured interviews were conducted with 72 patients and 12 investigators from 14 sites; three focus groups were conducted with 12 staff from 10 sites. Qualitative data collection elicited experiences with and attitudes about the intervention, including philosophical viewpoints and implementation experiences. Transcripts were analyzed in NVivo 10. Memos and matrices were developed to explore themes from different participant group perspectives.Patients, investigators, and staff found the intervention highly acceptable, primarily due to the emotional benefits gained through giving or receiving the incentive. Feeling rewarded or cared for was a main value perceived by patients; this was closely tied to the financial benefit for some. Other factors influencing acceptability for all included perceived effectiveness and health-related benefits, philosophical concerns about the use of incentives for health behavior change, and implementation issues. The termination of the incentive at the end of the study was disappointing to participants and unexpected by some, but generally accepted.Positive experiences with the financial incentive intervention and strategies used to facilitate implementation led to high acceptability of the intervention, despite some reluctance in principle to the use of incentives. The findings of this analysis provide encouraging evidence in support of the acceptability of a large-scale financial incentive

  12. Health spending, illicit financial flows and tax incentives in Malawi

    African Journals Online (AJOL)

    financing of health care services and a weak health system. Malawi is one of the ... and two-thirds of adults, who need antiretroviral treatment for HIV are ... health service delivery”4. There are two ... estimated the cost for the provision of minimal services .... However, the key issue is to differentiate between tax incentives that.

  13. Comparing Types of Financial Incentives to Promote Walking: An Experimental Test.

    Science.gov (United States)

    Burns, Rachel J; Rothman, Alexander J

    2018-04-19

    Offering people financial incentives to increase their physical activity is an increasingly prevalent intervention strategy. However, little is known about the relative effectiveness of different types of incentives. This study tested whether incentives based on specified reinforcement types and schedules differentially affected the likelihood of meeting a walking goal and explored if observed behavioural changes may have been attributable to the perceived value of the incentive. A 2 (reinforcement type: cash reward, deposit contract) × 2 (schedule: fixed, variable) between-subjects experiment with a hanging control condition was conducted over 8 weeks (n = 153). Although walking was greater in the incentive conditions relative to the control condition, walking did not differ across incentive conditions. Exploratory analyses indicated that the perceived value of the incentive was associated with the likelihood of meeting the walking goal, but was not affected by reinforcement type or schedule. The reinforcement type and schedule manipulations tested in this study did not differentially affect walking. Given that walking behaviour was associated with perceived value, designing incentive strategies that optimise the perceived value of the incentive may be a promising avenue for future research. © 2018 The International Association of Applied Psychology.

  14. Active Choice and Financial Incentives to Increase Rates of Screening Colonoscopy-A Randomized Controlled Trial.

    Science.gov (United States)

    Mehta, Shivan J; Feingold, Jordyn; Vandertuyn, Matthew; Niewood, Tess; Cox, Catherine; Doubeni, Chyke A; Volpp, Kevin G; Asch, David A

    2017-11-01

    Behavioral economic approaches could increase uptake for colorectal cancer screening. We performed a randomized controlled trial of 2245 employees to determine whether an email containing a phone number for scheduling (control), an email with the active choice to opt in or opt out (active choice), or the active choice email plus a $100 incentive (financial incentive) increased colonoscopy completion within 3 months. Higher proportions of participants in the financial incentive group underwent screening (3.7%) than in the control (1.6%) or active choice groups (1.5%) (P = .01 and P < .01). We found no difference in uptake of screening between the active choice and control groups (P = .88). The $100 conditional incentive modestly but significantly increased colonoscopy use. ClinicalTrials.gov no: NCT02660671. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

  15. 78 FR 25013 - Medicare Program; Requirements for the Medicare Incentive Reward Program and Provider Enrollment

    Science.gov (United States)

    2013-04-29

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

  16. Incentive structures in institutional asset management and their implications for financial markets

    OpenAIRE

    Bank for International Settlements

    2003-01-01

    Executive summary The institutional asset management industry has become an important feature of modern financial markets, with the scale of this business's importance readily apparent from the size of assets under management by different types of institutional asset managers. With asset management involving a delegation process, shaping appropriate incentive structures is essential for aligning the incentives of owners of funds with those of the institutional managers of these funds. Further...

  17. "Not Just for the Money?" How Financial Incentives Affect the Number of Publications at Danish Research Institutions

    DEFF Research Database (Denmark)

    Andersen, Lotte Bøgh; Pallesen, Thomas

    2008-01-01

    . We investigate how the introduction of financial incentives to publish affects the number of publications at 162 Danish research institutions (17 government research institutions and subunits of 10 universities) when the perception of the incentives is taken into account. The results show......Do public employees work "for the money?" Do financial incentives determine their work effort? The literature gives conflicting answers, but Frey (1997) offers a possible explanation: If financial incentives are perceived as supportive, they can "crowd in" intrinsic motivation and increase the work...... effort. But if financial incentives are perceived as controlling, the intrinsic motivation is "crowded out," and the work effort decreases with increasing financial incentives to work. However, the empirical evidence concerning Frey's proposition is limited, and our article aims to fill part of this gap...

  18. "Not Just for the Money?" How Financial Incentives Affect the Number of Publications at Danish Research Institutions

    DEFF Research Database (Denmark)

    Andersen, Lotte Bøgh; Pallesen, Thomas

    2008-01-01

    Do public employees work "for the money?" Do financial incentives determine their work effort? The literature gives conflicting answers, but Frey (1997) offers a possible explanation: If financial incentives are perceived as supportive, they can "crowd in" intrinsic motivation and increase the work...... effort. But if financial incentives are perceived as controlling, the intrinsic motivation is "crowded out," and the work effort decreases with increasing financial incentives to work. However, the empirical evidence concerning Frey's proposition is limited, and our article aims to fill part of this gap....... We investigate how the introduction of financial incentives to publish affects the number of publications at 162 Danish research institutions (17 government research institutions and subunits of 10 universities) when the perception of the incentives is taken into account. The results show...

  19. An RCT protocol of varying financial incentive amounts for smoking cessation among pregnant women

    Directory of Open Access Journals (Sweden)

    Lynagh Marita

    2012-11-01

    Full Text Available Abstract Background Smoking during pregnancy is harmful to the unborn child. Few smoking cessation interventions have been successfully incorporated into standard antenatal care. The main aim of this study is to determine the feasibility of a personal financial incentive scheme for encouraging smoking cessation among pregnant women. Design A pilot randomised control trial will be conducted to assess the feasibility and potential effectiveness of two varying financial incentives that increase incrementally in magnitude ($20 vs. $40AUD, compared to no incentive in reducing smoking in pregnant women attending an Australian public hospital antenatal clinic. Method Ninety (90 pregnant women who self-report smoking in the last 7 days and whose smoking status is biochemically verified, will be block randomised into one of three groups: a. No incentive control group (n=30, b. $20 incremental incentive group (n=30, and c. $40 incremental incentive group (n=30. Smoking status will be assessed via a self-report computer based survey in nine study sessions with saliva cotinine analysis used as biochemical validation. Women in the two incentive groups will be eligible to receive a cash reward at each of eight measurement points during pregnancy if 7-day smoking cessation is achieved. Cash rewards will increase incrementally for each period of smoking abstinence. Discussion Identifying strategies that are effective in reducing the number of women smoking during pregnancy and are easily adopted into standard antenatal practice is of utmost importance. A personal financial incentive scheme is a potential antenatal smoking cessation strategy that warrants further investigation. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR number: ACTRN12612000399897

  20. Perceived financial incentives, HMO market penetration, and physicians' practice styles and satisfaction.

    Science.gov (United States)

    Hadley, J; Mitchell, J M; Sulmasy, D P; Bloche, M G

    1999-04-01

    To estimate the effects of physicians' personal financial incentives and other measures of involvement with HMOs on three measures of satisfaction and practice style: overall practice satisfaction, the extent to which prior expectations about professional autonomy and the ability to practice good-quality medicine are met, and several specific measures of practice style. A telephone survey conducted in 1997 of 1,549 physicians who were located in the 75 largest Metropolitan Statistical Areas in 1991. Eligible physicians were under age 52, had between 8 and 17 years of post-residency practice experience, and spent at least 20 hours per week in patient care. The response rate was 74 percent. Multivariate binomial and multinomial ordered logistic regression models were estimated. Independent variables included physicians' self-reported financial incentives, measured by the extent to which their overall financial arrangements created an incentive to either reduce or increase services to patients, the level of HMO penetration in the market, employment setting, medical specialty, exposure to managed care while in medical training, and selected personal characteristics. About 15 percent of survey respondents reported a moderate or strong incentive to reduce services; 70 percent reported a neutral incentive; and 15 percent reported an incentive to increase services. Compared to physicians with a neutral incentive, physicians with an incentive to reduce services were from 1.5 to 3.5 times more likely to be very dissatisfied with their practices and were 0.2 to 0.5 times as likely to report that their expectations regarding professional autonomy and ability to practice good-quality medicine were met. They were also 0.2 to 0.6 times as likely to report having the freedom to care for patients the way they would like along several specific measures of practice style, such as sufficient time with patients, ability to hospitalize, ability to order tests and procedures, and ability

  1. The effect of financial incentives on adherence to antipsychotic depot medication: does it change over time?

    Science.gov (United States)

    Pavlickova, Hana; Bremner, Stephen A; Priebe, Stefan

    2015-08-01

    A recent cluster-randomized controlled trial found that offering financial incentives improves adherence to long-acting injectable antipsychotics (LAIs). The present study investigates whether the impact of incentives diminishes over time and whether the improvement in adherence is linked to the amount of incentives offered. Seventy-three teams with 141 patients with psychotic disorders (using ICD-10) were randomized to the intervention or control group. Over 1 year, patients in the intervention group received £15 (US $23) for each LAI, while control patients received treatment as usual. Adherence levels, ie, the percentage of prescribed LAIs that were received, were calculated for quarterly intervals. The amount of incentives offered was calculated from the treatment cycle at baseline. Multilevel models were used to examine the time course of the effect of incentives and the effect of the amount of incentives offered on adherence. Adherence increased in both the intervention and the control group over time by an average of 4.2% per quarterly interval (95% CI, 2.8%-5.6%; P time and treatment group. Further, a higher total amount of incentives was associated with poorer adherence (βbootstrapped = -0.11; 95% CIbootstrapped, -0.20 to -0.01; P = .023). A substantial effect of financial incentives on adherence to LAIs occurs within the first 3 months of the intervention and is sustained over 1 year. A higher total amount of incentives does not increase the effect. ISRCTN.com identifier: ISRCTN77769281 and UKCRN.org identifier: 7033. © Copyright 2015 Physicians Postgraduate Press, Inc.

  2. Financial incentives for antipsychotic depot medication: ethical issues.

    Science.gov (United States)

    Claassen, Dirk

    2007-04-01

    Giving money as a direct incentive for patients in exchange for depot medication has proved beneficial in some clinical cases in assertive outreach (AO). However, ethical concerns around this practice have been raised, and will be analysed in more detail here. Ethical concern voiced in a survey of all AO teams in England were analysed regarding their content. These were grouped into categories. 53 of 70 team managers mentioned concerns, many of them serious and expressing a negative attitude towards giving money for depot adherence. Four broad categories of ethical concern following Christensen's concept were distinguished: valid consent and refusal (n = 5), psychiatric paternalism (n = 31), resource allocation (n = 4), organisational relationships (n = 2), with a residual category others and unspecified (n = 11). The main concerns identified are discussed on the background of existing ethical theories in healthcare and the specific problems of community mental health and AO. Points for practice are derived from this discussion. A way forward is outlined that includes informed consent and an operational policy in the use of incentives, further randomised controlled trials and qualitative studies, and continuing discussions with all stakeholders, especially service users.

  3. Alternate financial incentives in multi-tiered formulary systems to improve accountability for outcomes.

    Science.gov (United States)

    Chung, Richard S; Taira, Deborah A; Noh, Charles

    2003-01-01

    Drug manufacturer rebates paid to health plans and pharmacy benefit management companies have come under increased public scrutiny. Over the past several years, numerous articles have appeared in the literature encouraging a shift to a more quality-based decision-making process for health plan drug formularies. To propose a new basis for formulary placement decisions that would include consideration of health-plan-specific measures (clinical outcomes, total cost, adherence, and appropriateness of care) and align incentives for health plans, physicians, pharmacists, and pharmaceutical companies to promote high-quality care. The proposed approach builds on key components of the Pharmacy's Framework for Drug Therapy Management in the 21st Century and the Academy of Managed Care Pharmacy's Format for Formulary Submission, including a focus on patient outcomes and evidence-based decision making. The proposed approach would lessen the influence of drug manufacturer rebates on formulary placement by shifting the focus to appropriateness of care, clinical outcomes, patient adherence, and total cost of care. Pharmaceutical manufacturers would benefit from the focus on adherence to drug therapy and total cost of care. Health plans and pharmacy benefit management companies would gain in that they may be able to reduce efforts in drug utilization review as pharmaceutical manufacturers are given incentives to market their drugs more appropriately. Physicians and pharmacists would benefit because the rebate money would be used to provide quality-based financial incentives related to adherence and appropriate use of drugs. The implementation of this approach would be difficult and require cooperation from employers, pharmacists, pharmaceutical manufacturers, health plans, and pharmacy benefit management companies. Aspects of this approach could be incorporated into existing pharmacy benefit management processes to encourage the delivery of high-quality health care.

  4. A systematic review of financial incentives for physical activity: The effects on physical activity and related outcomes

    NARCIS (Netherlands)

    Barte, J.C.M.; Wendel-Vos, G.C.W.

    2017-01-01

    The aim of this review is to give an overview of the available evidence on the effects of financial incentives to stimulate physical activity. Therefore, a systematic literature search was performed for randomized trials that investigate the effects of physical-activity-related financial incentives

  5. Personal financial incentives in health promotion: where do they fit in an ethic of autonomy?

    Science.gov (United States)

    Ashcroft, Richard E

    2011-06-01

    This paper reviews the ethical controversy concerning the use of monetary incentives in health promotion, focussing specifically on the arguments relating to the impact on personal autonomy of such incentives. Offering people small amounts of money in the context of health promotion and medical care has been attempted in a number of settings in recent years. This use of personal financial incentives has attracted a degree of ethical controversy. One form of criticism is that such schemes interfere with the autonomy of the patient or citizen in an illegitimate way. This paper presents a thematic analysis of the main arguments concerning personal autonomy and the use of monetary incentives in behaviour change. The main moral objections to the uses of incentives are that they may be in general or in specific instances paternalistic, coercive, involve bribery, or undermine the agency of the person. While incentive schemes may engage these problems on occasion, there is no good reason to think that they do so inherently and of necessity. We need better behavioural science evidence to understand how incentives work, in order to evaluate their moral effects in practice. © 2011 Blackwell Publishing Ltd.

  6. Financial incentives to promote active travel: an evidence review and economic framework.

    Science.gov (United States)

    Martin, Adam; Suhrcke, Marc; Ogilvie, David

    2012-12-01

    Financial incentives, including taxes and subsidies, can be used to encourage behavior change. They are common in transport policy for tackling externalities associated with use of motor vehicles, and in public health for influencing alcohol consumption and smoking behaviors. Financial incentives also offer policymakers a compromise between "nudging," which may be insufficient for changing habitual behavior, and regulations that restrict individual choice. The literature review identified studies published between January 1997 and January 2012 of financial incentives relating to any mode of travel in which the impact on active travel, physical activity, or obesity levels was reported. It encompassed macroenvironmental schemes, such as gasoline taxes, and microenvironmental schemes, such as employer-subsidized bicycles. Five relevant reviews and 20 primary studies (of which nine were not included in the reviews) were identified. The results show that more-robust evidence is required if policymakers are to maximize the health impact of fiscal policy relating to transport schemes of this kind. Drawing on a literature review and insights from the SLOTH (sleep, leisure, occupation, transportation, and home-based activities) time-budget model, this paper argues that financial incentives may have a larger role in promoting walking and cycling than is acknowledged generally. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  7. The influence of financial incentives and other socio-economic factors on electric vehicle adoption

    International Nuclear Information System (INIS)

    Sierzchula, William; Bakker, Sjoerd; Maat, Kees; Wee, Bert van

    2014-01-01

    Electric vehicles represent an innovation with the potential to lower greenhouse gas emissions and help mitigate the causes of climate change. However, externalities including the appropriability of knowledge and pollution abatement result in societal/economic benefits that are not incorporated in electric vehicle prices. In order to address resulting market failures, governments have employed a number of policies. We seek to determine the relationship of one such policy instrument (consumer financial incentives) to electric vehicle adoption. Based on existing literature, we identified several additional socio-economic factors that are expected to be influential in determining electric vehicle adoption rates. Using multiple linear regression analysis, we examined the relationship between those variables and 30 national electric vehicle market shares for the year 2012. The model found financial incentives, charging infrastructure, and local presence of production facilities to be significant and positively correlated to a country's electric vehicle market share. Results suggest that of those factors, charging infrastructure was most strongly related to electric vehicle adoption. However, descriptive analysis suggests that neither financial incentives nor charging infrastructure ensure high electric vehicle adoption rates. - Highlights: • This research analyzes electric vehicle adoption of 30 countries in 2012. • Financial incentives and charging infrastructure were statistically significant factors. • Country-specific factors help to explain diversity in national adoption rates. • Socio-demographic variables e.g., income and education level were not significant

  8. Assessment of non-financial incentives for volunteer community health workers - the case of Wukro district, Tigray, Ethiopia.

    Science.gov (United States)

    Haile, Fisaha; Yemane, Dejen; Gebreslassie, Azeb

    2014-09-22

    Volunteer community health workers (VCHW) are health care providers who are trained but do not have any professional certification. They are intended to fill the gap for unmet curative, preventative, and health promotion health needs of communities. This study aims to investigate the non-financial incentives for VCHWs and factors affecting their motivation. A cross-sectional quantitative study was performed from February to March 2013. A total of 400 randomly selected female VCHWs were included using the district health office registers. Finally, multivariate logistic regression was used to determine the independent predictors of VCHW motivation. Significant numbers (48%) of study participants have mentioned future training as a major non-financial incentive. Age between 20 and 36 years old (adjusted odds ratio (AOR) = 1.45, 95% CI = 1.18, 2.13), married VCHWs (AOR = 3.84, 95% CI = 1.73, 5.02), presence of children under five years old (AOR = 0.2, 95% CI = 0.09, 0.71), allowing volunteer withdrawal (AOR = 1.35, 95% CI = 1.06, 2.47), and establishment of a local endowment fund for community health workers after they left volunteerism (AOR = 1.11, 95% CI = 1.05, 1.91) are all factors associated with VCHW motivation. Future training was mentioned as the prime non-financial incentive. Age, marital status, presence of children under five, allowing volunteer withdrawal, and establishment of a local endowment fund were identified as the independent predictors of motivation. Therefore, considering a non-financial incentive package, including further training and allowing volunteer withdrawal, would be helpful to sustain volunteerism.

  9. Financial Statements in Providing Financial Security of Agricultural Enterprises

    OpenAIRE

    Olha Vdovenko

    2014-01-01

    In conditions of severe market competition and economic turmoil financial security of agricultural businesses largely depends on the effectiveness of management decisions, reporting being the information support to ensure such decision making. Thus, the practice of preparing accounting figures and their adjustment has a direct effect on agricultural businesses financial security. Having been generalized at the industry level, statistical and financial statements are used for the development o...

  10. Aging and Strategic Learning: The Impact of Spousal Incentives on Financial Literacy.

    Science.gov (United States)

    Hsu, Joanne W

    2016-01-01

    Women tend to be less financially literate than men, consistent with a division of labor where husbands manage finances. However, women tend to outlive their husbands. I find that older women acquire financial literacy as they approach widowhood - 80 percent would catch up with their husbands by the expected onset of widowhood. These gains are not attributable to husbands' cognitive decline, as captured by cognition tests. The results are consistent with a model in which the division of labor collapses when a spouse dies: women have incentives to delay acquiring financial human capital, but also to begin learning before widowhood.

  11. Aging and Strategic Learning: The Impact of Spousal Incentives on Financial Literacy

    Science.gov (United States)

    Hsu, Joanne W.

    2017-01-01

    Women tend to be less financially literate than men, consistent with a division of labor where husbands manage finances. However, women tend to outlive their husbands. I find that older women acquire financial literacy as they approach widowhood — 80 percent would catch up with their husbands by the expected onset of widowhood. These gains are not attributable to husbands’ cognitive decline, as captured by cognition tests. The results are consistent with a model in which the division of labor collapses when a spouse dies: women have incentives to delay acquiring financial human capital, but also to begin learning before widowhood. PMID:28148971

  12. Incentive-based Financial Support Scheme for Immature Renewable Energy Systems

    DEFF Research Database (Denmark)

    Andersen, Morten Thøtt; Frigaard, Peter Bak

    2015-01-01

    Most of today’s renewable energy systems rely heavily on investments as well as public financial support. This support is often given by means of a higher sales price for each kWh produced, i.e. feed-in tariffs (FITs), green certificates or Renewable Obligation Certificates (ROCs), or by a fixed...... amount, being a percentage of the construction costs of the facility. All these ways of financing have different downsides. The feed-in tariff based kWh prices have some incentives to improve the technology, but enables infeasible solutions to stay financially supported even while R&D is in status quo....... The fixed amount only helps with installation costs, which should not be an issue once the technology is sufficiently feasible. This means that the current ways of granting financial support all lack incentives for increasing production or decreasing construction costs. This paper presents a unique scheme...

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

    Science.gov (United States)

    Conrad, Douglas A; Perry, Lisa

    2009-01-01

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

  14. Consumer responses towards home energy financial incentives: A survey-based study

    International Nuclear Information System (INIS)

    Zhao Tingting; Bell, Lindsey; Horner, Mark W.; Sulik, John; Zhang Jinfeng

    2012-01-01

    Residential energy-efficient and renewable energy (EERE) products play an important role in energy conservation and carbon emissions reduction. Various financial incentive programs have been developed to promote the adoption of these products. However, their effectiveness in attracting consumers is not very well understood. In this study, we investigated impacts of financial incentives on homeowner's decision making towards six EERE products. Two forms of incentives, tax credits and interest-free loans, were examined through a household mailing survey in Florida, the United States. Results showed that, although half of the respondents were interested in EERE products, the high investment cost was a major concern that hindered their purchase activities. Homeowners were attracted to financial incentives and valued tax credits much higher than interest-free loans. The current federal home energy tax credit levels were found to attract only 2–12 percent of homeowners to buy EERE products. The willingness of participation was especially low for the costly products (such as solar panels). The participation rate was also very low for lower income (i.e., annual household income below $50,000) families living in older residences. This study contributes to the understanding of economic and social aspects of consumer decision making on energy efficiency and alternative energy. - Highlights: ► We investigated consumer responses to energy efficiency incentives. ► These included tax credits and interest-free loans for six types of energy products. ► We found that tax credits are more effective than interest-free loans. ► The current tax credit rates are insufficient for expensive products (e.g., solar panels). ► A higher amount of incentives is required for the lower-income (<$50 K/yr) households.

  15. Social Norms and Financial Incentives to Promote Employees’ Healthy Food Choices: A Randomized Controlled Trial

    Science.gov (United States)

    Thorndike, Anne N.; Riis, Jason; Levy, Douglas E.

    2016-01-01

    Population-level strategies to improve healthy food choices are needed for obesity prevention. We conducted a randomized controlled trial of 2,672 employees at Massachusetts General Hospital who were regular customers of the hospital cafeteria with all items labeled green (healthy), yellow (less healthy), or red (unhealthy) to determine if social norm (peer-comparison) feedback with or without financial incentives increased employees’ healthy food choices. Participants were randomized in 2012 to three arms: 1) monthly letter with social norm feedback about healthy food purchases, comparing employee to “all” and to “healthiest” customers (feedback-only); 2) monthly letter with social norm feedback plus small financial incentive for increasing green purchases (feedback-incentive); or 3) no contact (control). The main outcome was change in proportion of green-labeled purchases at end of 3-month intervention. Post-hoc analyses examined linear trends. At baseline, the proportion of green-labeled purchases (50%) did not differ between arms. At end of the 3-month intervention, the percentage increase in green-labeled purchases was larger in the feedback-incentive arm compared to control (2.2% vs. 0.1%, P=0.03), but the two intervention arms were not different. The rate of increase in green-labeled purchases was higher in both feedback-only (P=0.04) and feedback-incentive arms (P=0.004) compared to control. At end of a 3-month wash-out, there were no differences between control and intervention arms. Social norms plus small financial incentives increased employees’ healthy food choices over the short-term. Future research will be needed to assess the impact of this relatively low-cost intervention on employees’ food choices and weight over the long-term. Trial Registration: Clinical Trials.gov NCT01604499 PMID:26827617

  16. Financial and economic considerations for emergency response providers.

    Science.gov (United States)

    Liong, Anne S; Liong, Samuel U

    2010-12-01

    Catastrophic events often threaten or cause depletion of resources. It is generally accepted that changes inherent to disasters are stressful. The Conservation of Resources Theory predicts that positive and negative changes in resources will have markedly different effects.28 This theory proposes that resource losses are psychologically stressful, whereas resource gains buffer against the effects of resource loss. For first responders, the level of preparedness is crucial. Investments in planning, training, and logistics are necessary to mitigate the stress associated with a crisis. Stress is also related to not knowing the future of their loved ones if death or permanent incapacity occurs, hence specific laws and financial resources provide a safety net to dependents of first responders and survivors. This kind of safety gives the first responders peace of mind and assurance that the future of their dependents will not be jeopardized. Incentives that are offered let the first responders know that they are valued and appreciated. Indeed, financial support considerably helps first responders before, during, and after catastrophic events. It assists them to cope with stress at the individual level and allows them to become more resilient; this resonates to the community and country in which they serve and enhances their potential to save lives and prevent disabilities. Copyright © 2010 Elsevier Inc. All rights reserved.

  17. Financial incentive for the Environmental Quality of Electricity Production (MEP)

    International Nuclear Information System (INIS)

    2007-01-01

    With the MEP subsidy regulation 'Environmental quality of electricity production' The Dutch minister of Economic Affairs focussed mainly on reaching the policy objective of the EU according to which 9% of all electricity used in the Netherlands should be generated with sustainable sources. According to the opinion of the Dutch Court of Audits not enough attention has been paid to the coherence of the MEP regulation with other policy objectives in the area of sustainability, such as air quality and CO2 reduction. The same goes for the effectiveness and the financial management of the MEP regulation. Moreover, the study, which was carried out by request of the Dutch Lower House, demonstrates that it is still uncertain if the policy objective for 2010 will be reached. The report consists of two parts: part 1: Conclusions, recommendations and administrative reactions, and Part 2: Answering Lower House questions.(mk) [nl

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

    Science.gov (United States)

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

    2014-01-01

    review according to the AMSTAR criteria. We included systematic reviews of studies evaluating the effectiveness of any type of financial incentive. We grouped financial incentives into five groups: payment for working for a specified time period; payment for each service, episode or visit; payment for providing care for a patient or specific population; payment for providing a pre-specified level or providing a change in activity or quality of care; and mixed or other systems. We summarised data using vote counting. Main results We identified four reviews reporting on 32 studies. Two reviews scored 7 on the AMSTAR criteria (moderate, score 5 to 7, quality) and two scored 9 (high, score 8 to 11, quality). The reported quality of the included studies was, by a variety of methods, low to moderate. Payment for working for a specified time period was generally ineffective, improving 3/11 outcomes from one study reported in one review. Payment for each service, episode or visit was generally effective, improving 7/10 outcomes from five studies reported in three reviews; payment for providing care for a patient or specific population was generally effective, improving 48/69 outcomes from 13 studies reported in two reviews; payment for providing a pre-specified level or providing a change in activity or quality of care was generally effective, improving 17/20 reported outcomes from 10 studies reported in two reviews; and mixed and other systems were of mixed effectiveness, improving 20/31 reported outcomes from seven studies reported in three reviews. When looking at the effect of financial incentives overall across categories of outcomes, they were of mixed effectiveness on consultation or visit rates (improving 10/17 outcomes from three studies in two reviews); generally effective in improving processes of care (improving 41/57 outcomes from 19 studies in three reviews); generally effective in improving referrals and admissions (improving 11/16 outcomes from 11 studies in four

  19. Effect of Financial Constraint and Financial Incentive on Supply Efficient of Providing Public Goods in Public-Private-Partnership Mode: General Equilibrium Analysis Based on Incomplete Contracting Theory%融资激励和融资约束对PPP模式下公共产品提供效率的影响——基于不完全契约理论的一般均衡分析

    Institute of Scientific and Technical Information of China (English)

    蔡东方; 孔淑红

    2017-01-01

    This paper compares the effects of financial constraint and financial incentive in public-private-partnership(PPP) mode on the supply efficient of public goods and social welfare,and analyzes the efficiency loss under financial constraints by constructing a general equilibrium model based on the incomplete contracting theory.The result shows as follows:depending on the professionalization,financial incentives from private sectors could improve the productivity of public goods,but financial constraints eliminate the benefit of professionalization,which results in the loss of social welfare.Finally,it suggests that the government should break the financial constraints and institutional discrimination,and improve financial market,and introduce specialized private sectors into the various industries of public goods in fair and competitive market environment.%通过构建不完全契约理论下的一般均衡模型,对比分析了PPP模式中的融资约束和融资激励对公共产品提供效率和社会福利的影响,并探讨了融资约束条件下的效率损失.结果显示:私人融资的专业性可以提高公共产品合意程度,但是私人部门的融资约束会抵消其专业性带来的好处,导致社会福利损失.最后针对民营企业参与PPP项目对政府提出建议:必须打破融资约束和制度歧视,完善和规范金融市场,在公平、竞争的市场环境下引入专业机构参与公共产品提供的各个领域.

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

    Science.gov (United States)

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

    2011-01-01

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

  1. The impact of removing financial incentives from clinical quality indicators: longitudinal analysis of four Kaiser Permanente indicators.

    Science.gov (United States)

    Lester, Helen; Schmittdiel, Julie; Selby, Joe; Fireman, Bruce; Campbell, Stephen; Lee, Janelle; Whippy, Alan; Madvig, Philip

    2010-05-11

    To evaluate the effect of financial incentives on four clinical quality indicators common to pay for performance plans in the United Kingdom and at Kaiser Permanente in California. Longitudinal analysis. 35 medical facilities of Kaiser Permanente Northern California, 1997-2007. 2 523 659 adult members of Kaiser Permanente Northern California. Main outcomes measures Yearly assessment of patient level glycaemic control (HbA(1c) financial incentives were attached to screening for diabetic retinopathy (1999-2003), the rate rose from 84.9% to 88.1%. This was followed by four years without incentives when the rate fell year on year to 80.5%. During the two initial years when financial incentives were attached to cervical cancer screening (1999-2000), the screening rate rose slightly, from 77.4% to 78.0%. During the next five years when financial incentives were removed, screening rates fell year on year to 74.3%. Incentives were then reattached for two years (2006-7) and screening rates began to increase. Across the 35 facilities, the removal of incentives was associated with a decrease in performance of about 3% per year on average for screening for diabetic retinopathy and about 1.6% per year for cervical cancer screening. Policy makers and clinicians should be aware that removing facility directed financial incentives from clinical indicators may mean that performance levels decline.

  2. Are financial incentives cost-effective to support smoking cessation during pregnancy?

    Science.gov (United States)

    Boyd, Kathleen A; Briggs, Andrew H; Bauld, Linda; Sinclair, Lesley; Tappin, David

    2016-02-01

    To investigate the cost-effectiveness of up to £400 worth of financial incentives for smoking cessation in pregnancy as an adjunct to routine health care. Cost-effectiveness analysis based on a Phase II randomized controlled trial (RCT) and a cost-utility analysis using a life-time Markov model. The RCT was undertaken in Glasgow, Scotland. The economic analysis was undertaken from the UK National Health Service (NHS) perspective. A total of 612 pregnant women randomized to receive usual cessation support plus or minus financial incentives of up to £400 vouchers (US $609), contingent upon smoking cessation. Comparison of usual support and incentive interventions in terms of cotinine-validated quitters, quality-adjusted life years (QALYs) and direct costs to the NHS. The incremental cost per quitter at 34-38 weeks pregnant was £1127 ($1716).This is similar to the standard look-up value derived from Stapleton & West's published ICER tables, £1390 per quitter, by looking up the Cessation in Pregnancy Incentives Trial (CIPT) incremental cost (£157) and incremental 6-month quit outcome (0.14). The life-time model resulted in an incremental cost of £17 [95% confidence interval (CI) = -£93, £107] and a gain of 0.04 QALYs (95% CI = -0.058, 0.145), giving an ICER of £482/QALY ($734/QALY). Probabilistic sensitivity analysis indicates uncertainty in these results, particularly regarding relapse after birth. The expected value of perfect information was £30 million (at a willingness to pay of £30 000/QALY), so given current uncertainty, additional research is potentially worthwhile. Financial incentives for smoking cessation in pregnancy are highly cost-effective, with an incremental cost per quality-adjusted life years of £482, which is well below recommended decision thresholds. © 2015 Society for the Study of Addiction.

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

    Science.gov (United States)

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

    2006-10-01

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

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

    Science.gov (United States)

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

    2014-05-01

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

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

    Science.gov (United States)

    Basu, Sanjay; Kiernan, Michaela

    2016-01-01

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

  6. The Many Meanings of Money: A Health Policy Analysis Framework for Understanding Financial Incentives

    OpenAIRE

    Mita Giacomini; Jeremiah Hurley; J Lomas; V Bhatia; L Goldsmith

    1996-01-01

    Health funding reforms often fail to change organizations’ and individuals’ behaviour in the way that policy makers intend. This is perhaps because financial incentive systems traditionally have been designed according to a “reward-punishment,” or behaviourist, model of influencing human behaviour. We argue that this model inadequately captures the way that funding reforms work in real institutional environments. To supplement the behaviourist view, we propose a “communication model” for unde...

  7. Who responds to financial incentives for weight loss? Evidence from a randomized controlled trial.

    Science.gov (United States)

    Paloyo, Alfredo R; Reichert, Arndt R; Reuss-Borst, Monika; Tauchmann, Harald

    2015-11-01

    There is a paucity of evidence on the heterogeneous impacts of financial incentives on weight loss. Between March 2010 and January 2012, in a randomized controlled trial, we assigned 700 obese persons to three experimental arms. We test whether particular subgroups react differently to financial incentives for weight loss. Two treatment groups obtained a cash reward (€150 and €300 with 237 and 229 participants, respectively) for achieving an individually-assigned target weight within four months; the control group (234 participants) was not incentivized. Participants and administrators were not blinded to the intervention. We find that monetary rewards effectively induced obese individuals to reduce weight across all subgroups. However, there is no evidence for treatment-effect heterogeneity for those groups that were incentivized. Among those who were in the €300 group, statistically significant and large weight losses were observed for women, singles, and those who are not working (all above 4 kg in four months). In addition, the magnitude of the reward matters only for women and migrants. The effectiveness of financial incentives to reduce weight nevertheless raises sensitive ethical issues that should be taken into consideration by policymakers. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Small financial incentives increase smoking cessation in homeless smokers: a pilot study.

    Science.gov (United States)

    Businelle, Michael S; Kendzor, Darla E; Kesh, Anshula; Cuate, Erica L; Poonawalla, Insiya B; Reitzel, Lorraine R; Okuyemi, Kolawole S; Wetter, David W

    2014-03-01

    Although over 70% of homeless individuals smoke, few studies have examined the effectiveness of smoking cessation interventions in this vulnerable population. The purpose of this pilot study was to compare the effectiveness of shelter-based smoking cessation clinic usual care (UC) to an adjunctive contingency management (CM) treatment that offered UC plus small financial incentives for smoking abstinence. Sixty-eight homeless individuals in Dallas, Texas (recruited in 2012) were assigned to UC (n=58) or UC plus financial incentives (CM; n=10) groups and were followed for 5 consecutive weeks (1 week pre-quit through 4 weeks post-quit). A generalized linear mixed model regression analysis was conducted to compare biochemically-verified abstinence rates between groups. An additional model examined the interaction between time and treatment group. The participants were primarily male (61.8%) and African American (58.8%), and were 49 years of age on average. There was a significant effect of treatment group on abstinence overall, and effects varied over time. Follow-up logistic regression analyses indicated that CM participants were significantly more likely than UC participants to be abstinent on the quit date (50% vs. 19% abstinent) and at 4 weeks post-quit (30% vs. 1.7% abstinent). Offering small financial incentives for smoking abstinence may be an effective way to facilitate smoking cessation in homeless individuals. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Marcos Inocencio

    2010-06-01

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

  10. Impact of financial incentives on clinical autonomy and internal motivation in primary care: ethnographic study.

    Science.gov (United States)

    McDonald, Ruth; Harrison, Stephen; Checkland, Kath; Campbell, Stephen M; Roland, Martin

    2007-06-30

    To explore the impact of financial incentives for quality of care on practice organisation, clinical autonomy, and internal motivation of doctors and nurses working in primary care. Ethnographic case study. Two English general practices. 12 general practitioners, nine nurses, four healthcare assistants, and four administrative staff. Observation of practices over a five month period after the introduction of financial incentives for quality of care introduced in the 2004 general practitioner contract. After the introduction of the quality and outcomes framework there was an increase in the use of templates to collect data on quality of care. New regimens of surveillance were adopted, with clinicians seen as "chasers" or the "chased," depending on their individual responsibility for delivering quality targets. Attitudes towards the contract were largely positive, although discontent was higher in the practice with a more intensive surveillance regimen. Nurses expressed more concern than doctors about changes to their clinical practice but also appreciated being given responsibility for delivering on targets in particular disease areas. Most doctors did not question the quality targets that existed at the time or the implications of the targets for their own clinical autonomy. Implementation of financial incentives for quality of care did not seem to have damaged the internal motivation of the general practitioners studied, although more concern was expressed by nurses.

  11. Households’ Perception of Financial Incentives in Endorsing Sustainable Waste Recycling in Nigeria

    Directory of Open Access Journals (Sweden)

    Beatrice Abila

    2018-06-01

    Full Text Available Recycling is viewed as a central aspect in sustainability and mainly as pro-environmental consumer behavior. The purpose of this study is to examine the perception of households on financial incentives in endorsing sustainable recycling for municipal solid waste in Nigeria. The study was conducted in the Shomolu Local Government Area, Lagos State, Nigeria. The study also covers drivers for household willingness to recycle municipal solid waste on environmental risk, behavioral economics, resource value, economic benefit, convenience, knowledge, legislation, and belief. The result from the study asserts the hypothesis that financial incentives for recycling are vital for reducing and managing municipal solid waste sustainably. The most important driver for household willingness to recycle municipal solid waste is the detrimental environmental impacts. A moderate to positive relationship exists between households’ perception of financial incentives for recycling and drivers for household willingness to recycle municipal solid waste. The study recommends adopting the extended producer responsibility (EPR model, reverse vending options, amongst other approaches, in an effort to promote recycling culture among citizens and residents in Nigeria.

  12. The impact of financial incentives on the implementation of asthma or diabetes self-management: A systematic review

    Science.gov (United States)

    Shields, Michael D.; Heaney, Liam G.; Kendall, Marilyn; Pearce, Christina J.; Hui, Chi Yan; Pinnock, Hilary

    2017-01-01

    Introduction Financial incentives are utilised in healthcare systems in a number of countries to improve quality of care delivered to patients by rewarding practices or practitioners for achieving set targets. Objectives To systematically review the evidence investigating the impact of financial incentives for implementation of supported self-management on quality of care including: organisational process outcomes, individual behavioural outcomes, and health outcomes for individuals with asthma or diabetes; both conditions with an extensive evidence base for self-management. Methods We followed Cochrane methodology, using a PICOS search strategy to search eight databases in November 2015 (updated May 2017) including a broad range of implementation methodologies. Studies were weighted by robustness of methodology, number of participants and the quality score. We used narrative synthesis due to heterogeneity of studies. Results We identified 2,541 articles; 12 met our inclusion criteria. The articles were from the US (n = 7), UK (n = 4) and Canada (n = 1). Measured outcomes were HbA1c tests undertaken and/or the level achieved (n = 10), written action plans for asthma (n = 1) and hospital/emergency department visits (n = 1). Three of the studies were part of a larger incentive scheme including many conditions; one focused on asthma; eight focussed on diabetes. In asthma, the proportion receiving ‘perfect care’ (including providing a written action plan) increased from 4% to 88% in one study, and there were fewer hospitalisations/emergency department visits in another study. Across the diabetes studies, quality-of-care/GP performance scores improved in three, were unchanged in six and deteriorated in one. Conclusions Results for the impact of financial incentives for the implementation of self-management were mixed. The evidence in diabetes suggests no consistent impact on diabetic control. There was evidence from a single study of improved process and health

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

    International Nuclear Information System (INIS)

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

    2015-01-01

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

  14. Peer mentoring and financial incentives to improve glucose control in African American veterans: a randomized trial.

    Science.gov (United States)

    Long, Judith A; Jahnle, Erica C; Richardson, Diane M; Loewenstein, George; Volpp, Kevin G

    2012-03-20

    Compared with white persons, African Americans have a greater incidence of diabetes, decreased control, and higher rates of microvascular complications. A peer mentorship model could be a scalable approach to improving control in this population and reducing disparities in diabetic outcomes. To determine whether peer mentors or financial incentives are superior to usual care in helping African American veterans decrease their hemoglobin A(1c) (HbA(1c)) levels. A 6-month randomized, controlled trial. (ClinicalTrials.gov registration number: NCT01125956) Philadelphia Veterans Affairs Medical Center. African American veterans aged 50 to 70 years with persistently poor diabetes control. 118 patients were randomly assigned to 1 of 3 groups: usual care, a peer mentoring group, and a financial incentives group. Usual care patients were notified of their starting HbA(1c) level and recommended goals for HbA(1c). Those in the peer mentoring group were assigned a mentor who formerly had poor glycemic control but now had good control (HbA(1c) level ≤7.5%). The mentor was asked to talk with the patient at least once per week. Peer mentors were matched by race, sex, and age. Patients in the financial incentive group could earn $100 by decreasing their HbA(1c) level by 1% and $200 by decreasing it by 2% or to an HbA(1c) level of 6.5%. Change in HbA(1c) level at 6 months. Mentors and mentees talked the most in the first month (mean calls, 4; range, 0 to 30), but calls decreased to a mean of 2 calls (range, 0 to 10) by the sixth month. Levels of HbA(1c) decreased from 9.9% to 9.8% in the control group, from 9.8% to 8.7% in the peer mentor group, and from 9.5% to 9.1% in the financial incentive group. Mean change in HbA(1c) level from baseline to 6 months relative to control was -1.07% (95% CI, -1.84% to -0.31%) in the peer mentor group and -0.45% (CI, -1.23% to 0.32%) in the financial incentive group. The study included only veterans and lasted only 6 months. Peer mentorship

  15. Renewable energy rebound effect?: Estimating the impact of state renewable energy financial incentives on residential electricity consumption

    Science.gov (United States)

    Stephenson, Beth A.

    Climate change is a well-documented phenomenon. If left unchecked greenhouse gas emissions will continue global surface warming, likely leading to severe and irreversible impacts. Generating renewable energy has become an increasingly salient topic in energy policy as it may mitigate the impact of climate change. State renewable energy financial incentives have been in place since the mid-1970s in some states and over 40 states have adopted one or more incentives at some point since then. Using multivariate linear and fixed effects regression for the years 2002 through 2012, I estimate the relationship between state renewable energy financial incentives and residential electricity consumption, along with the associated policy implications. My hypothesis is that a renewable energy rebound effect is present; therefore, states with renewable energy financial incentives have a higher rate of residential electricity consumption. I find a renewable energy rebound effect is present in varying degrees for each model, but the results do not definitively indicate how particular incentives influence consumer behavior. States should use caution when adopting and keeping renewable energy financial incentives as this may increase consumption in the short-term. The long-term impact is unclear, making it worthwhile for policymakers to continue studying the potential for renewable energy financial incentives to alter consumer behavior.

  16. A Comparative Analysis of the Financial Incentives of Two Distinct Experience-Rating Programs.

    Science.gov (United States)

    Tompa, Emile; McLeod, Chris; Mustard, Cam

    2016-07-01

    The aim of this study was to compare the association between insurance premium incentives and claim outcomes in two different workers' compensation programs. Regression models were run for claim outcomes using data from two Canadian jurisdictions with different experience-rating programs-one with prospective (British Columbia) and another with retrospective (Ontario) adjustment of premiums. Key explanatory variables were past premium adjustments. For both programs, past premium adjustments were significantly associated with claim outcomes, suggesting adjustments provided incentives for claims reduction. The magnitudes of effects in the prospective program were smaller than the retrospective one, though relative persistence of effects over time was larger. Having large and immediate employer responses to incentives may appear desirable, but insurers should consider the time required for employers to improve and sustain good practices, and create incentives that parallel such time lines.

  17. Acceptability of Parental Financial Incentives and Quasi-Mandatory Interventions for Preschool Vaccinations: Triangulation of Findings from Three Linked Studies.

    Directory of Open Access Journals (Sweden)

    Jean Adams

    Full Text Available Childhood vaccinations are a core component of public health programmes globally. Recent measles outbreaks in the UK and USA have prompted debates about new ways to increase uptake of childhood vaccinations. Parental financial incentives and quasi-mandatory interventions (e.g. restricting entry to educational settings to fully vaccinated children have been successfully used to increase uptake of childhood vaccinations in developing countries, but there is limited evidence of effectiveness in developed countries. Even if confirmed to be effective, widespread implementation of these interventions is dependent on acceptability to parents, professionals and other stakeholders.We conducted a systematic review (n = 11 studies included, a qualitative study with parents (n = 91 and relevant professionals (n = 24, and an on-line survey with embedded discrete choice experiment with parents (n = 521 exploring acceptability of parental financial incentives and quasi-mandatory interventions for preschool vaccinations. Here we use Triangulation Protocol to synthesise findings from the three studies.There was a consistent recognition that incentives and quasi-mandatory interventions could be effective, particularly in more disadvantaged groups. Universal incentives were consistently preferred to targeted ones, but relative preferences for quasi-mandatory interventions and universal incentives varied between studies. The qualitative work revealed a consistent belief that financial incentives were not considered an appropriate motivation for vaccinating children. The costs of financial incentive interventions appeared particularly salient and there were consistent concerns in the qualitative work that incentives did not represent the best use of resources for promoting preschool vaccinations. Various suggestions for improving delivery of the current UK vaccination programme as an alternative to incentives and quasi-mandates were made.Parental financial

  18. Financial incentives and measurement improved physicians' quality of care in the Philippines.

    Science.gov (United States)

    Peabody, John; Shimkhada, Riti; Quimbo, Stella; Florentino, Jhiedon; Bacate, Marife; McCulloch, Charles E; Solon, Orville

    2011-04-01

    The merits of using financial incentives to improve clinical quality have much appeal, yet few studies have rigorously assessed the potential benefits. The uncertainty surrounding assessments of quality can lead to poor policy decisions, possibly resulting in increased cost with little or no quality improvement, or missed opportunities to improve care. We conducted an experiment involving physicians in thirty Philippine hospitals that overcomes many of the limitations of previous studies. We measured clinical performance and then examined whether modest bonuses equal to about 5 percent of a physician's salary, as well as system-level incentives that increased compensation to hospitals and across groups of physicians, led to improvements in the quality of care. We found that both the bonus and system-level incentives improved scores in a quality measurement system used in our study by ten percentage points. Our findings suggest that when careful measurement is combined with the types of incentives we studied, there may be a larger impact on quality than previously recognized.

  19. Simulation game provides financial management training.

    Science.gov (United States)

    Uhles, Neville; Weimer-Elder, Barbette; Lee, James G

    2008-01-01

    Adventist HealthCare developed a workshop with a reality simulation game as an engaging means to teach nonfinancial managers about the relationships between cash flow, income statements, and balance sheets. Thirty AHC staff, about half financial and half nonfinancial, were trained as workshop facilitators, and all managers with budget oversight were asked to complete the workshop. The workshop was very positively received; participants' average scores on workshop questionnaires increased from 77.4 percent correct on a presession questionnaire to 91.3 percent correct on a postsession questionnaire.

  20. FINANCIAL SYSTEM OF JAPAN: THE LEGAL REGULATION OF DISPUTES BETWEEN FINANCIAL SERVICES PROVIDERS AND CONSUMERS

    Directory of Open Access Journals (Sweden)

    E. E. Frolova

    2018-01-01

    Full Text Available Purpose: the article examines the main problems associated the regulatory acts of Japan – The Financial Instruments and Exchange Act, The Banking Act, The  Insurance Business Act, lists the types of financial disputes subject to alternative settlement, identified the parties to the financial dispute. To achieve this goal, the article must solve the following tasks: to determine whether there are institutions in Japan that provide services for resolving financial disputes; to investigate the main problems associated with the definition of the concept and types of financial dispute, the conditions for the transfer of a financial dispute to the competent authority.Methods: this article is based on an interdisciplinary concept of research, which allowed to distinguish the distinctive features of the legal regulation of the settlement of financial disputes in Malaysia.Results: acts of Japan – The Financial Instruments and Exchange Act, The Banking Act, The Insurance Business Act, – refer to financial disputes – disputes resolved by "Designated Dispute Resolution Organizations", the so-called "financial DDRO". Financial disputes are disputes between suppliers and consumers of financial services. The Financial Instruments and Exchange Act details the persons, whose activities fall within the definition of financial provider services. A brief list of financial service providers is available on the website of Japan's main financial regulator, the Financial Services Agency. The list include: Japanese banking institutions, branches and representative offices of foreign banks, business operators of financial instruments, insurance companies, trust companies, financial markets, foreign audit firms. However, unlike other countries of the Asia-Pacific region, consumers of financial services can be both physical and legal entities.Conclusions and Relevance: the materials presented in the article show the special role of "Designated Dispute Resolution

  1. Acceptability of financial incentives for maintenance of weight loss in mid-older adults: a mixed methods study.

    Science.gov (United States)

    McGill, Bronwyn; O'Hara, Blythe J; Grunseit, Anne C; Bauman, Adrian; Osborne, Dale; Lawler, Luke; Phongsavan, Philayrath

    2018-02-13

    Health insurers worldwide implement financial incentive schemes to encourage health-related behaviours, including to facilitate weight loss. The maintenance of weight loss is a public health challenge, and as non-communicable diseases become more prevalent with increasing age, mid-older adults could benefit from programs which motivate weight loss maintenance. However, little is understood about their perceptions of using financial incentives to maintain weight loss. We used mixed methods to explore the attitudes and views of participants who had completed an Australian weight loss and lifestyle modification program offered to overweight and obese health insurance members with weight-related chronic diseases, about the acceptability and usefulness of different types of financial incentives to support weight loss maintenance. An online survey was completed by 130 respondents (mean age = 64 years); and a further 28 participants (mean age = 65 years) attended six focus groups. Both independent samples of participants supported a formalised maintenance program. Online survey respondents reported that non-cash (85.2%) and cash (77%) incentives would be potentially motivating; but only 40.5% reported that deposit contracts would motivate weight loss maintenance. Results of in-depth discussions found overall low support for any type of financial incentive, but particularly deposit contracts and lotteries. Some participants expressed that improved health was of more value than a monetary incentive and that they felt personally responsible for their own health, which was at odds with the idea of financial incentives. Others suggested ongoing program and peer support as potentially useful for weight loss maintenance. If financial incentives are considered for mid-older Australian adults in the health insurance setting, program planners will need to balance the discordance between participant beliefs about the individual responsibility for health and their desire

  2. Perceptions of financial incentives for smoking cessation: a survey of smokers in a country with an endgame goal.

    Science.gov (United States)

    Robertson, Lindsay; Gendall, Philip; Hoek, Janet; Marsh, Louise; McGee, Rob

    2017-12-15

    Financial incentives can support smoking cessation, yet low acceptability may limit the wider implementation of such schemes. Few studies have examined how smokers view financial-incentive interventions aimed at reducing smoking prevalence. We recruited a sample of 623 smokers from an internet panel to a survey assessing support for, and perceived effectiveness of, financial incentives for smoking cessation. We used descriptive statistics, plus logistic regression, to test associations between demographics and smoking, and support. We used qualitative content analysis to analyse open-ended responses to a question that invited respondents to comment on financial incentives. 38.4% of smokers supported financial incentives; 42.2% did not (19.4% had no opinion). Support was higher among heavy (OR 3.96, CI 2.39 - 6.58) and moderate smokers (OR 1.68, CI 1.13 - 2.49), and those with a recent quit attempt (OR 1.47, 1.04 - 2.07). Support was strongly associated with perceived effectiveness. A Government-funded reward-only scheme was seen as the most acceptable option (preferred by 26.6% of participants), followed by a Government-funded deposit-based scheme (20.6%); few respondents supported employer-funded schemes. Open-ended responses (n=301) indicated three overarching themes expressing opposition to financial incentives: smokers' individual responsibility for quitting, concerns about abuse of an incentive scheme, and concerns about unfairness. Even amongst those who would benefit from schemes designed to reward smokers for quitting, support for such schemes is muted, despite evidence of their effectiveness. Media advocacy and health education could be used to increase understanding of, and support for, financial incentives for smoking cessation. Given the absolute effectiveness and cost-effectiveness of financial-incentive schemes for smoking cessation amongst pregnant smokers and in workplaces, implementing such schemes at a national-level could help reduce overall

  3. Environmental assessment for the electric and hybrid vehicle demonstration project, performance standards and financial incentives

    Energy Technology Data Exchange (ETDEWEB)

    LaBelle, S. J.

    1978-10-01

    The assessment is concerned with the impacts of the demonstration of electric and hybrid vehicles acquired to fulfill certain requirements of the Electric and Hybrid Vehicle Research, Development, and Demonstration Act, PL 94-413 as amended. The financial incentives programs and vehicle performance standards associated with the demonstration are also covered. Not included is an assessment of the long term effects of EHV commercialization and of the research and development program being carried out simultaneously with the demonstration, also in response to PL 94-413. These federal actions will be included in a programmatic environmental assessment scheduled for completion in FY 79.

  4. Case Studies on the Effectiveness of State Financial Incentives for Renewable Energy

    Energy Technology Data Exchange (ETDEWEB)

    None

    2002-09-01

    September 2002 · NREL/SR-620-32819 Case Studies on the Effectiveness of State Financial Incentives for Renewable Energy S. Gouchoe, V. Everette, and R. Haynes North Carolina State University Raleigh, North Carolina National Renewable Energy Laboratory 1617 Cole Boulevard Golden, Colorado 80401-3393 NREL is a U.S. Department of Energy Laboratory Operated by Midwest Research Institute · Battelle · Bechtel Contract No. DE-AC36-99-GO10337 September 2002 · NREL/SR-620-32819Case Studies on the Effecti

  5. Biomass and waste to energy. Financial incentives for renewables. Altener workshop

    International Nuclear Information System (INIS)

    Van Halen, C.; Kwant, K.W.

    1996-12-01

    The title workshop was organised by Novem in cooperation with its partners in the Altener Waste for Energy (WfE) network, and AFB-Nett (Agricultural and Forestry Biomass Network). Almost 100 participants from 13 European countries attended the workshop. The aim of the workshop was to explore the industrial potential, to discuss mutual differences and financial barriers that appear still to be present. The morning session of the workshop included country presentations of existing national financial incentives to support renewable energy. In the afternoon session three 'Dutch cases' were presented, followed by a presentation of the results of a European comparison, commissioned by Novem. The second part of the afternoon was reserved for an 'in-depth' plenary panel discussion, e.g. on best practices, new instruments, potential and need for harmonization

  6. When Do Financial Incentives Reduce Intrinsic Motivation? Comparing Behaviors Studied in Psychological and Economic Literatures

    Science.gov (United States)

    2013-01-01

    Objective: To review existing evidence on the potential of incentives to undermine or “crowd out” intrinsic motivation, in order to establish whether and when it predicts financial incentives to crowd out motivation for health-related behaviors. Method: We conducted a conceptual analysis to compare definitions and operationalizations of the effect, and reviewed existing evidence to identify potential moderators of the effect. Results: In the psychological literature, we find strong evidence for an undermining effect of tangible rewards on intrinsic motivation for simple tasks when motivation manifest in behavior is initially high. In the economic literature, evidence for undermining effects exists for a broader variety of behaviors, in settings that involve a conflict of interest between parties. By contrast, for health related behaviors, baseline levels of incentivized behaviors are usually low, and only a subset involve an interpersonal conflict of interest. Correspondingly, we find no evidence for crowding out of incentivized health behaviors. Conclusion: The existing evidence does not warrant a priori predictions that an undermining effect would be found for health-related behaviors. Health-related behaviors and incentives schemes differ greatly in moderating characteristics, which should be the focus of future research. PMID:24001245

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

    Science.gov (United States)

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

    1985-11-01

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

  8. When do financial incentives reduce intrinsic motivation? comparing behaviors studied in psychological and economic literatures.

    Science.gov (United States)

    Promberger, Marianne; Marteau, Theresa M

    2013-09-01

    To review existing evidence on the potential of incentives to undermine or "crowd out" intrinsic motivation, in order to establish whether and when it predicts financial incentives to crowd out motivation for health-related behaviors. We conducted a conceptual analysis to compare definitions and operationalizations of the effect, and reviewed existing evidence to identify potential moderators of the effect. In the psychological literature, we find strong evidence for an undermining effect of tangible rewards on intrinsic motivation for simple tasks when motivation manifest in behavior is initially high. In the economic literature, evidence for undermining effects exists for a broader variety of behaviors, in settings that involve a conflict of interest between parties. By contrast, for health related behaviors, baseline levels of incentivized behaviors are usually low, and only a subset involve an interpersonal conflict of interest. Correspondingly, we find no evidence for crowding out of incentivized health behaviors. The existing evidence does not warrant a priori predictions that an undermining effect would be found for health-related behaviors. Health-related behaviors and incentives schemes differ greatly in moderating characteristics, which should be the focus of future research. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  9. Heterogeneity in the Effects of Reward- and Deposit-based Financial Incentives on Smoking Cessation

    Science.gov (United States)

    French, Benjamin; Small, Dylan S.; Saulsgiver, Kathryn; Harhay, Michael O.; Audrain-McGovern, Janet; Loewenstein, George; Asch, David A.; Volpp, Kevin G.

    2016-01-01

    Rationale: Targeting different smoking cessation programs to smokers most likely to quit when using them could reduce the burden of lung disease. Objectives: To identify smokers most likely to quit using pure reward-based financial incentives or incentive programs requiring refundable deposits to become eligible for rewards. Methods: We conducted prespecified secondary analyses of a randomized trial in which 2,538 smokers were assigned to an $800 reward contingent on sustained abstinence from smoking, a refundable $150 deposit plus a $650 reward, or usual care. Measurements and Main Results: Using logistic regression, we identified characteristics of smokers that were most strongly associated with accepting their assigned intervention and ceasing smoking for 6 months. We assessed modification of the acceptance, efficacy, and effectiveness of reward and deposit programs by 11 prospectively selected demographic, smoking-related, and psychological factors. Predictors of sustained smoking abstinence differed among participants assigned to reward- versus deposit-based incentives. However, greater readiness to quit and less steep discounting of future rewards were consistently among the most important predictors. Deposit-based programs were uniquely effective relative to usual care among men, higher-income participants, and participants who more commonly failed to pay their bills (all interaction P values patient characteristics. Clinical trial registered with www.clinicaltrials.gov (NCT 01526265). PMID:27064456

  10. Effectiveness and acceptability of parental financial incentives and quasi-mandatory schemes for increasing uptake of vaccinations in preschool children: systematic review, qualitative study and discrete choice experiment.

    Science.gov (United States)

    Adams, Jean; Bateman, Belinda; Becker, Frauke; Cresswell, Tricia; Flynn, Darren; McNaughton, Rebekah; Oluboyede, Yemi; Robalino, Shannon; Ternent, Laura; Sood, Benjamin Gardner; Michie, Susan; Shucksmith, Janet; Sniehotta, Falko F; Wigham, Sarah

    2015-11-01

    Uptake of preschool vaccinations is less than optimal. Financial incentives and quasi-mandatory policies (restricting access to child care or educational settings to fully vaccinated children) have been used to increase uptake internationally, but not in the UK. To provide evidence on the effectiveness, acceptability and economic costs and consequences of parental financial incentives and quasi-mandatory schemes for increasing the uptake of preschool vaccinations. Systematic review, qualitative study and discrete choice experiment (DCE) with questionnaire. Community, health and education settings in England. Qualitative study - parents and carers of preschool children, health and educational professionals. DCE - parents and carers of preschool children identified as 'at high risk' and 'not at high risk' of incompletely vaccinating their children. Qualitative study - focus groups and individual interviews. DCE - online questionnaire. The review included studies exploring the effectiveness, acceptability or economic costs and consequences of interventions that offered contingent rewards or penalties with real material value for preschool vaccinations, or quasi-mandatory schemes that restricted access to 'universal' services, compared with usual care or no intervention. Electronic database, reference and citation searches were conducted. Systematic review - there was insufficient evidence to conclude that the interventions considered are effective. There was some evidence that the quasi-mandatory interventions were acceptable. There was insufficient evidence to draw conclusions on economic costs and consequences. Qualitative study - there was little appetite for parental financial incentives. Quasi-mandatory schemes were more acceptable. Optimising current services was consistently preferred to the interventions proposed. DCE and questionnaire - universal parental financial incentives were preferred to quasi-mandatory interventions, which were preferred to targeted

  11. A Trial of Financial and Social Incentives to Increase Older Adults' Walking.

    Science.gov (United States)

    Harkins, Kristin A; Kullgren, Jeffrey T; Bellamy, Scarlett L; Karlawish, Jason; Glanz, Karen

    2017-05-01

    Despite evidence that regular physical activity confers health benefits, physical activity rates among older adults remain low. Both personal and social goals may enhance older adults' motivation to become active. This study tested the effects of financial incentives, donations to charity, and the combined effects of both interventions on older adults' uptake and retention of increased levels of walking. RCT comparing three interventions to control. Data collection occurred from 2012 to 2013. Analyses were conducted in 2013-2016. Ninety-four adults aged ≥65 years from Philadelphia-area retirement communities. All participants received digital pedometers, walking goals of a 50% increase in daily steps, and weekly feedback on goal attainment. Participants were randomized to one of four groups: (1) Control: received weekly feedback only; (2) Financial Incentives: received payment of $20 each week walking goals were met; (3) Social Goals: received donation of $20 to a charity of choice each week walking goals were met; and (4) Combined: received $20 each week walking goals were met that could be received by participant, donated to a charity of choice, or divided between the participant and charity. Mean proportion of days walking goals were met during the 16-week intervention and 4-week follow-up period. After adjusting for baseline walking, the proportion of days step goals were met during the 16-week intervention period was higher in all intervention groups versus controls (relative risk, 3.71; 95% CI=1.37, 10.01). During the 4-week follow up period, the proportion of days step goals were met did not differ in intervention groups compared to control (relative risk, 2.91; 95% CI=0.62, 13.64). Incentive schemes that use donations to a charity of choice, personal financial incentives, or a combination of the two can each increase older adults' initial uptake of increased levels of walking. This study is registered at www.clinicaltrials.gov NCT01643538. Copyright

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

    Science.gov (United States)

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

    2009-04-01

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

  13. Heterogeneity in the Effects of Reward- and Deposit-based Financial Incentives on Smoking Cessation.

    Science.gov (United States)

    Halpern, Scott D; French, Benjamin; Small, Dylan S; Saulsgiver, Kathryn; Harhay, Michael O; Audrain-McGovern, Janet; Loewenstein, George; Asch, David A; Volpp, Kevin G

    2016-10-15

    Targeting different smoking cessation programs to smokers most likely to quit when using them could reduce the burden of lung disease. To identify smokers most likely to quit using pure reward-based financial incentives or incentive programs requiring refundable deposits to become eligible for rewards. We conducted prespecified secondary analyses of a randomized trial in which 2,538 smokers were assigned to an $800 reward contingent on sustained abstinence from smoking, a refundable $150 deposit plus a $650 reward, or usual care. Using logistic regression, we identified characteristics of smokers that were most strongly associated with accepting their assigned intervention and ceasing smoking for 6 months. We assessed modification of the acceptance, efficacy, and effectiveness of reward and deposit programs by 11 prospectively selected demographic, smoking-related, and psychological factors. Predictors of sustained smoking abstinence differed among participants assigned to reward- versus deposit-based incentives. However, greater readiness to quit and less steep discounting of future rewards were consistently among the most important predictors. Deposit-based programs were uniquely effective relative to usual care among men, higher-income participants, and participants who more commonly failed to pay their bills (all interaction P values rewards, deposits were more effective among black persons (P = 0.022) and those who more commonly failed to pay their bills (P = 0.082). Relative to rewards, deposits were more commonly accepted by higher-income participants, men, white persons, and those who less commonly failed to pay their bills (all P incentives suggests potential benefits of targeting behavior-change interventions based on patient characteristics. Clinical trial registered with www.clinicaltrials.gov (NCT 01526265).

  14. Doing More for More: Unintended Consequences of Financial Incentives for Oncology Specialty Care.

    Science.gov (United States)

    O'Neil, Brock; Graves, Amy J; Barocas, Daniel A; Chang, Sam S; Penson, David F; Resnick, Matthew J

    2016-02-01

    Specialty care remains a significant contributor to health care spending but largely unaddressed in novel payment models aimed at promoting value-based delivery. Bladder cancer, chiefly managed by subspecialists, is among the most costly. In 2005, Centers for Medicare and Medicaid Services (CMS) dramatically increased physician payment for office-based interventions for bladder cancer to shift care from higher cost facilities, but the impact is unknown. This study evaluated the effect of financial incentives on patterns of fee-for-service (FFS) bladder cancer care. Data from a 5% sample of Medicare beneficiaries from 2001-2013 were evaluated using interrupted time-series analysis with segmented regression. Primary outcomes were the effects of CMS fee modifications on utilization and site of service for procedures associated with the diagnosis and treatment of bladder cancer. Rates of related bladder cancer procedures that were not affected by the fee change were concurrent controls. Finally, the effect of payment changes on both diagnostic yield and need for redundant procedures were studied. All statistical tests were two-sided. Utilization of clinic-based procedures increased by 644% (95% confidence interval [CI] = 584% to 704%) after the fee change, but without reciprocal decline in facility-based procedures. Procedures unaffected by the fee incentive remained unchanged throughout the study period. Diagnostic yield decreased by 17.0% (95% CI = 12.7% to 21.3%), and use of redundant office-based procedures increased by 76.0% (95% CI = 59% to 93%). Financial incentives in bladder cancer care have unintended and costly consequences in the current FFS environment. The observed price sensitivity is likely to remain a major issue in novel payment models failing to incorporate procedure-based specialty physicians. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

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

    Science.gov (United States)

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

    2012-01-01

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

  16. Effect of Financial Incentives on Breastfeeding: A Cluster Randomized Clinical Trial.

    Science.gov (United States)

    Relton, Clare; Strong, Mark; Thomas, Kate J; Whelan, Barbara; Walters, Stephen J; Burrows, Julia; Scott, Elaine; Viksveen, Petter; Johnson, Maxine; Baston, Helen; Fox-Rushby, Julia; Anokye, Nana; Umney, Darren; Renfrew, Mary J

    2018-02-05

    Although breastfeeding has a positive effect on an infant's health and development, the prevalence is low in many communities. The effect of financial incentives to improve breastfeeding prevalence is unknown. To assess the effect of an area-level financial incentive for breastfeeding on breastfeeding prevalence at 6 to 8 weeks post partum. The Nourishing Start for Health (NOSH) trial, a cluster randomized trial with 6 to 8 weeks follow-up, was conducted between April 1, 2015, and March 31, 2016, in 92 electoral ward areas in England with baseline breastfeeding prevalence at 6 to 8 weeks post partum less than 40%. A total of 10 010 mother-infant dyads resident in the 92 study electoral ward areas where the infant's estimated or actual birth date fell between February 18, 2015, and February 17, 2016, were included. Areas were randomized to the incentive plus usual care (n = 46) (5398 mother-infant dyads) or to usual care alone (n = 46) (4612 mother-infant dyads). Usual care was delivered by clinicians (mainly midwives, health visitors) in a variety of maternity, neonatal, and infant feeding services, all of which were implementing the UNICEF UK Baby Friendly Initiative standards. Shopping vouchers worth £40 (US$50) were offered to mothers 5 times based on infant age (2 days, 10 days, 6-8 weeks, 3 months, 6 months), conditional on the infant receiving any breast milk. The primary outcome was electoral ward area-level 6- to 8-week breastfeeding period prevalence, as assessed by clinicians at the routine 6- to 8-week postnatal check visit. Secondary outcomes were area-level period prevalence for breastfeeding initiation and for exclusive breastfeeding at 6 to 8 weeks. In the intervention (5398 mother-infant dyads) and control (4612 mother-infant dyads) group, the median (interquartile range) percentage of women aged 16 to 44 years was 36.2% (3.0%) and 37.4% (3.6%) years, respectively. After adjusting for baseline breastfeeding prevalence and local government

  17. The effectiveness of financial incentives for smoking cessation during pregnancy: is it from being paid or from the extra aid?

    Directory of Open Access Journals (Sweden)

    Mantzari Eleni

    2012-04-01

    Full Text Available Abstract Background Financial incentives appear to be effective in promoting smoking cessation in pregnancy. The mechanisms by which they might operate however, are poorly understood. The present study examines how financial incentives for smoking cessation during pregnancy may work, by exploring pregnant women's experiences of trying to stop smoking, within and outside of a financial incentives scheme. Methods Thirty-six (n = 36 UK-based pregnant smokers (n = 36, offered standard NHS Stop-Smoking Services, of whom twenty (n = 20 were enrolled in a financial incentives scheme for smoking cessation (n = 20 and sixteen (n = 16 were not, were interviewed about (i their motivation to stop smoking, and (ii the factors they perceived as influencing their quitting efforts. Framework Analysis was used to analyse the data. Results Women in the two groups reported similar reasons for wanting to stop smoking during pregnancy. However, they described dissimilar experiences of the Stop-Smoking Services, which they perceived to have differentially influenced their quit attempts. Women who were incentivised reported using the services more than women who were not incentivised. In addition, they described the motivating experience of being monitored and receiving feedback on their progress. Non-incentivised women reported problems receiving the appropriate Nicotine Replacement Therapy, which they described as having a detrimental effect on their quitting efforts. Conclusion Women participating in a financial incentives scheme to stop smoking reported greater engagement with the Stop-Smoking Services, from which they described receiving more help in quitting than women who were not part of the scheme. These results highlight the complexity of financial incentives schemes and the intricacies surrounding the ways in which they operate to affect smoking cessation. These might involve influencing individuals' motivation and self-regulation, changing engagement with

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

    OpenAIRE

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

    2014-01-01

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

  19. What explains DRG upcoding in neonatology? The roles of financial incentives and infant health.

    Science.gov (United States)

    Jürges, Hendrik; Köberlein, Juliane

    2015-09-01

    We use the introduction of diagnosis related groups (DRGs) in German neonatology to study the determinants of upcoding. Since 2003, reimbursement is based inter alia on birth weight, with substantial discontinuities at eight thresholds. These discontinuities create incentives to upcode preterm infants into classes of lower birth weight. Using data from the German birth statistics 1996-2010 and German hospital data from 2006 to 2011, we show that (1) since the introduction of DRGs, hospitals have upcoded at least 12,000 preterm infants and gained additional reimbursement in excess of 100 million Euro; (2) upcoding rates are systematically higher at thresholds with larger reimbursement hikes and in hospitals that subsequently treat preterm infants, i.e. where the gains accrue; (3) upcoding is systematically linked with newborn health conditional on birth weight. Doctors and midwives respond to financial incentives by not upcoding newborns with low survival probabilities, and by upcoding infants with higher expected treatment costs. Copyright © 2015 Elsevier B.V. All rights reserved.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1986-09-01

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

  1. A "nudge" at all? The jury is still out on financial health incentives.

    Science.gov (United States)

    Mitchell, Marc; Faulkner, Guy

    2012-01-01

    A comprehensive, multi-level approach to curb chronic disease-related costs in Canada is needed. One target for intervention is the economic domain. The emergence of user financial incentives (UFI) in public health policy as well as their broad implementation in corporate settings has stimulated a growing but limited body of research in this area. The authors'position is that the jury is still out on the question of their effectiveness in sustaining long-term health behaviour change, given the nature of the UFI that have been designed and delivered to date--that is, UFI with limited theoretical and contextual consideration. It is their contention that manipulating UFI design features (there are seven core features with a range of attributes) to exploit contextual (e.g., personal income) and theoretical (e.g., self-efficacy) factors may optimize UFI effectiveness over the long term. Although UFI are not the solution, they might very well be apart.

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

    Science.gov (United States)

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

    2013-04-01

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

  3. Effects of Performance-Based Financial Incentives on Work Performance: A Study of Technical-Level Employees in the Private Sector in Sri Lanka

    Science.gov (United States)

    Wickramasinghe, Vathsala; Dabere, Sampath

    2012-01-01

    The objective of the study is to investigate the effect of performance-based financial incentives on work performance. The study hypothesized that the design features of performance-based financial incentive schemes themselves may influence individuals' work performance. For the study, survey methodology was used and 93 technical-level employees…

  4. Take the Money and Run: The Challenges of Designing and Evaluating Financial Incentives in Healthcare; Comment on “Paying for Performance in Healthcare Organisations”

    Directory of Open Access Journals (Sweden)

    Russell Mannion

    2014-02-01

    Full Text Available Many countries are turning their attention to the use of explicit financial incentives to drive desired improvements in healthcare performance. However, we have only a weak evidence-base to inform policy in this area. The research challenge is to generate robust evidence on what financial incentives work, under what circumstances, for whom and with what intended and unintended consequences.

  5. Simulation of the impact of financial incentives on solar energy utilization for space conditioning and water heating: 1985

    Energy Technology Data Exchange (ETDEWEB)

    Petersen, H C

    1979-01-01

    Financial incentives designed to accelerate the use of solar energy for heating, cooling, and water heating of buildings have been proposed by both state and federal legislative bodies in the U.S.A. Among the most frequently mentioned incentives are sales and property tax exemptions, tax deductions and credits, rapid amortization provisions, and interest rate subsidies. At the present time there is little available information regarding the ability of such incentives to advance the rate of solar energy utilization. This paper describes the derivation and use of a computer simulation model designed to estimate solar energy use for space conditioning and water heating for given economic, climatic, and technological conditions. When applied to data from the Denver, Colorado metropolitan area, the simulation model predicts that sales tax exemptions would have little impact over the next decade, interest rate subsidies could more than double solar energy use, and the other proposed incentives would have an intermediate impact.

  6. The financial impact of deployments on reserve health care providers.

    Science.gov (United States)

    Petinaux, Bruno

    2008-08-01

    This study retrospectively surveyed the financial impact of deployments on 17 U.S. Army Reserve health care providers. Due to multiple mobilizations, 29 separate deployments were reported. The deployments, mostly between 2001 and 2005, typically lasted 3 months during which 86% reported no civilian income and 76% reported no civilian benefits. Solo practice providers reported the greatest financial losses due to continuing financial responsibility related to their civilian practice despite being deployed. Overall, 2 deployments did not change, 9 increased, and 16 decreased the medical officer's income. Two were not reported. In this small retrospective convenience sample study, solo practice U.S. Army Reserve health care providers were found to be at highest risk of financial losses during military deployments. This being said, no price can be put on the privilege of serving our men and women in uniform.

  7. A Mixed-Methods Randomized Controlled Trial of Financial Incentives and Peer Networks to Promote Walking among Older Adults

    Science.gov (United States)

    Kullgren, Jeffrey T.; Harkins, Kristin A.; Bellamy, Scarlett L.; Gonzales, Amy; Tao, Yuanyuan; Zhu, Jingsan; Volpp, Kevin G.; Asch, David A.; Heisler, Michele; Karlawish, Jason

    2014-01-01

    Background: Financial incentives and peer networks could be delivered through eHealth technologies to encourage older adults to walk more. Methods: We conducted a 24-week randomized trial in which 92 older adults with a computer and Internet access received a pedometer, daily walking goals, and weekly feedback on goal achievement. Participants…

  8. Impact of financial environmental incentives in the potential of electric power generation on the sugar cane plants

    International Nuclear Information System (INIS)

    Pinto, Claudio Plaza; Walter, Arnaldo

    1999-01-01

    The aim of the work is to present the electric power generation from biomass and the economic potential from sugar cane plants in Brazil. Computerized electricity costs simulation are presented and several financial incentives and external market effects are considered. The results are also presented and criticized

  9. Effect of Non Financial Incentives on Job Satisfaction of Teachers in Public Secondary Schools--Survey of Kisii Sub County

    Science.gov (United States)

    Sabina, Asiago Lenah; Okibo, Walter; Nyang'au, Andrew; Ondima, Cleophas

    2015-01-01

    Job satisfaction is a major challenge among employees in many organizations. The purpose of this research project is to assess the effect of non-financial incentives on job satisfaction of teachers in public secondary schools of Kisii Sub County in the Republic of Kenya. The specific objectives for the study include: to assess the effect of…

  10. The impact of removing financial incentives from clinical quality indicators: longitudinal analysis of four Kaiser Permanente indicators.

    NARCIS (Netherlands)

    Lester, H.; Schmittdiel, J.; Selby, J.; Fireman, B.; Campbell, S.M.; Lee, J.; Whippy, A.; Madvig, P.

    2010-01-01

    OBJECTIVE: To evaluate the effect of financial incentives on four clinical quality indicators common to pay for performance plans in the United Kingdom and at Kaiser Permanente in California. DESIGN: Longitudinal analysis. SETTING: 35 medical facilities of Kaiser Permanente Northern California,

  11. Legal and financial methods for reducing low emission sources: Options for incentives

    Energy Technology Data Exchange (ETDEWEB)

    Samitowski, W. [Office of Economic and Legal Advisors POLINVEST Ltd., Cracow (Poland)

    1995-12-31

    There are two types of the so-called low emission sources in Cracow: over 1,000 local boiler houses and several thousand solid fuel-fired stoves. The accomplishment of each of 5 sub-projects offered under the American-Polish program entails solving the technical, financial, legal and public relations-related problems. The elimination of the low emission source requires, therefore, a joint effort of the following pairs: (a) local authorities, (b) investors, (c) owners and users of low emission sources, and (d) inhabitants involved in particular projects. The results of the studies developed by POLINVEST indicate that the accomplishment of the projects for the elimination of low emission sources will require financial incentives. Bearing in mind the today`s resources available from the community budget, this process may last as long as a dozen or so years. The task of the authorities of Cracow City is making a long-range operational strategy enabling reduction of low emission sources in Cracow.

  12. Incentives and compensation: providing resources for communities hosting low-level waste facilities

    International Nuclear Information System (INIS)

    Anon.

    1982-01-01

    State responsibility for the management of low-level radioactive waste necessitates the selection of candidate locations for a disposal facility. Concern over potential impacts can be expected from segments of the citizenry neighboring a proposed site. A number of national organizations comprising state and local officials have recommended the use of incentives and compensation to help offset the negative local impacts. This document explores that concept. Discussion provides background information on potential local impacts from a low-level waste facility and considers the nature and types of incentives and compensation benefits that could be provided. The document then examines realistic options for planning and implementing the benefit program. This information is intended, primarily, to assist state officials - executive, legislative, and agency - in planning for and managing low-level waste disposal facilities

  13. Customer satisfaction surveys: Methodological recommendations for financial service providers

    Directory of Open Access Journals (Sweden)

    Đorđić Marko

    2010-01-01

    Full Text Available This methodological article investigates practical challenges that emerge when conducting customer satisfaction surveys (CSS for financial service providers such as banks, insurance or leasing companies, and so forth. It displays methodological recommendations in reference with: (a survey design, (b sampling, (c survey method, (d questionnaire design, and (e data acquisition. Article provides appropriate explanations that usage of: two-stage survey design, SRS method, large samples, and rigorous fieldwork preparation can enhance the overall quality of CSS in financial services. Proposed methodological recommendations can primarily be applied to the primary quantitative marketing research in retail financial services. However, majority of them can be successfully applied when conducting primary quantitative marketing research in corporate financial services as well. .

  14. What factors influence the effectiveness of financial incentives on long-term natural resource management practice change?

    Directory of Open Access Journals (Sweden)

    Emma Swann

    2016-12-01

    Full Text Available Financial incentives are used by natural resource management organisations to encourage landholders to adopt sustainable practices where the outcomes on a farm scale may be negative or marginal. There is a growing body of research aimed at understanding why landholders do or do not agree to participate in financial incentive programs, however research that considers when and how financial incentives work to bring about long-term behaviour change is relatively immature. The purpose of this review is to answer the question ‘What factors influence the effectiveness of financial incentives on long-term natural resource management practice change?’ In synthesising the evidence, it was found that there are numerous characteristics of the practice change itself, along with the program design and implementation, which are important to understand long-term behaviour change. These include whether inexpensive maintenance or long-term funding is available; whether the changes are relatively simple to sustain; whether the program involves structural changes; whether there is land use rigidity; and whether the changes have resulting environmental benefits that are highly observable. Additionally, it is advisable for programs that use financial incentives to include the following program features: ongoing extension support and a focus on building relationship and trust; flexibility in how the practice change is applied; active landholder involvement from planning to evaluation; and contract length that is appropriate for the complexity of the NRM practice. These characteristics can be used to guide policy makers in their natural resource management investment decisions. There is a clear need for greatly increased monitoring and evaluation of existing programs, both during the program and after its conclusion, in order to more fully understand its long-term impacts and ultimate effectiveness. Finally, landholders undertaking a practice change generally

  15. Financial incentive policies at workplace cafeterias for preventing obesity--a systematic review and meta-analysis (Protocol).

    Science.gov (United States)

    Sawada, Kimi; Ota, Erika; Shahrook, Sadequa; Mori, Rintaro

    2014-10-28

    Various studies are currently investigating ways to prevent lifestyle-related diseases and obesity among workers through interventions using incentive strategies, including price discounts for low-fat snacks and sugar-free beverages at workplace cafeterias or vending machines, and the provision of a free salad bar in cafeterias. Rather than assessing individual or group interventions, we will focus on the effectiveness of nutrition education programs at the population level, which primarily incorporate financial incentive strategies to prevent obesity. This paper describes the protocol of a systematic review that will examine the effectiveness of financial incentive programs at company cafeterias in improving dietary habits, nutrient intake, and obesity prevention. We will conduct searches in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and PsycINFO. Interventions will be assessed using data from randomized control trials (RCTs) and cluster RCTs. However, if few such trials exist, we will include quasi-RCTs. We will exclude controlled before-and-after studies and crossover RCTs. We will assess food-based interventions that include financial incentive strategies (discount strategies or social marketing) for workplace cafeterias, vending machines, and kiosks. Two authors will independently review studies for inclusion and will resolve differences by discussion and, if required, through consultation with a third author. We will assess the risk of bias of included studies according to the Cochrane Collaboration's "risk of bias" tool. The purpose of this paper is to outline the study protocol for a systematic review and meta-analysis that will investigate the effectiveness of population-level, incentive-focused interventions at the workplace cafeteria that aim to promote and prevent obesity. This review will give an important overview of the available evidence about the effectiveness of incentive-based environmental interventions to

  16. [Factors Influencing Participation in Financial Incentive Programmes of Health Insurance Funds. Results of the Study 'German Health Update'].

    Science.gov (United States)

    Jordan, S; von der Lippe, E; Starker, A; Hoebel, J; Franke, A

    2015-11-01

    The statutory health insurance can offer their insured incentive programmes that will motivate for healthy behaviour through a financial or material reward. This study will show results about what factors influence financial incentive programme participation (BPT) including all sorts of statutory health insurance funds and taking into account gender differences. For the cross-sectional analysis, data were used from 15,858 participants in the study 'Germany Health Update' (GEDA) from 2009, who were insured in the statutory health insurance. The selection of potential influencing variables for a BPT is based on the "Behavioural Model for Health Service Use" of Andersen. Accordingly, various factors were included in logistic regression models, which were calculated separately by gender: predisposing factors (age, education, social support, and health awareness), enabling factors (income, statutory health insurance fund, and family physician), and need factors (smoking, fruit and vegetable consumption, sports, body mass index, and general health status). In consideration of all factors, for both sexes, BPT is associated with age, health awareness, education, use of a family physician, smoking, and sports activities. In addition, income, body mass index, and diet are significant in women and social support and kind of statutory health insurance fund in men. It is found that predisposing, enabling and need factors are relevant. Financial incentive programmes reach population groups with greatest need less than those groups who already have a health-conscious behaviour, who receive a reward for this. In longitudinal studies, further research on financial incentive programmes should investigate the existence of deadweight effects and whether incentive programmes can contribute to the reduction of the inequity in health. © Georg Thieme Verlag KG Stuttgart · New York.

  17. Public acceptability of financial incentives for smoking cessation in pregnancy and breast feeding: a survey of the British public

    Science.gov (United States)

    Hoddinott, Pat; Morgan, Heather; MacLennan, Graeme; Sewel, Kate; Thomson, Gill; Bauld, Linda; Yi, Deokhee; Ludbrook, Anne; Campbell, Marion K

    2014-01-01

    Objective To survey public attitudes about incentives for smoking cessation in pregnancy and for breast feeding to inform trial design. Design Cross-sectional survey. Setting and participants British general public. Methods Seven promising incentive strategies had been identified from evidence syntheses and qualitative interview data from service users and providers. These were shopping vouchers for: (1) validated smoking cessation in pregnancy and (2) after birth; (3) for a smoke-free home; (4) for proven breast feeding; (5) a free breast pump; (6) payments to health services for reaching smoking cessation in pregnancy targets and (7) breastfeeding targets. Ipsos MORI used area quota sampling and home-administered computer-assisted questionnaires, with randomised question order to assess agreement with different incentives (measured on a five-point scale). Demographic data and target behaviour experience were recorded. Analysis used multivariable ordered logit models. Results Agreement with incentives was mixed (ranging from 34% to 46%) among a representative sample of 1144 British adults. Mean agreement score was highest for a free breast pump, and lowest for incentives for smoking abstinence after birth. More women disagreed with shopping vouchers than men. Those with lower levels of education disagreed more with smoking cessation incentives and a breast pump. Those aged 44 or under agreed more with all incentive strategies compared with those aged 65 and over, particularly provider targets for smoking cessation. Non-white ethnic groups agreed particularly with breastfeeding incentives. Current smokers with previous stop attempts and respondents who had breast fed children agreed with providing vouchers for the respective behaviours. Up to £40/month vouchers for behaviour change were acceptable (>85%). Conclusions Women and the less educated were more likely to disagree, but men and women of childbearing age to agree, with incentives designed for their benefit

  18. The effect of financial incentives on top of behavioral support on quit rates in tobacco smoking employees: study protocol of a cluster-randomized trial.

    Science.gov (United States)

    van den Brand, F A; Nagelhout, G E; Winkens, B; Evers, S M A A; Kotz, D; Chavannes, N H; van Schayck, C P

    2016-10-06

    Stimulating successful tobacco cessation among employees has multiple benefits. Employees who quit tobacco are healthier, more productive, less absent from work, and longer employable than employees who continue to use tobacco. Despite the evidence for these benefits of tobacco cessation, a successful method to stimulate employees to quit tobacco is lacking. The aim of this study is to evaluate whether adding a financial incentive to behavioral support (compared with no additional incentive) is effective and cost-effective in increasing abstinence rates in tobacco smoking employees participating in a smoking cessation group training. In this cluster-randomized trial employees in the intervention and control group both participate in a smoking cessation group training consisting of seven weekly counseling sessions of ninety minutes each. In addition to the training, employees in the intervention group receive a voucher as an incentive for being abstinent from smoking at the end of the training (€50), after three months (€50), after six months (€50), and after one year (€200). The control group does not receive any incentive. The primary outcome is carbon monoxide validated 12-month continuous abstinence from smoking (Russel's standard). Additionally, an economic evaluation is performed from a societal and an employer perspective. The present paper describes the methods and design of this cluster-randomized trial in detail. We hypothesize that the financial incentive for abstinence in the form of vouchers increases abstinence rates over and above the group training. The results of this study can provide important recommendations for enhancement of employee tobacco cessation. Dutch Trial Register: NTR5657 . First received 27-01-2016.

  19. Financial incentives for smoking cessation in low-income smokers: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Etter Jean-François

    2012-06-01

    Full Text Available Abstract Background Tobacco smoking is the leading avoidable cause of death in high-income countries. The smoking-related disease burden is borne primarily by the least educated and least affluent groups. Thus, there is a need for effective smoking cessation interventions that reach to, and are effective in this group. Research suggests that modest financial incentives are not very effective in helping smokers quit. What is not known is whether large financial incentives can enhance longer-term (1 year smoking cessation rates, outside clinical and workplace settings. Trial design A randomized, parallel groups, controlled trial. Methods Participants: Eight hundred low-income smokers in Switzerland (the less affluent third of the population, based on fiscal taxation. Intervention: A smoking cessation program including: (a financial incentives given during 6 months; and (b Internet-based counseling. Financial rewards will be offered for biochemically verified smoking abstinence after 1, 2, and 3 weeks and 1, 3, and 6 months, for a maximum of 1,500 CHF (1,250 EUR, 1,500 USD for those abstinent at all time-points. All participants, including controls, will receive Internet-based, individually-tailored, smoking cessation counseling and self-help booklets, but there will be no in-person or telephone counseling, and participants will not receive medications. The control group will not receive financial incentives. Objective: To increase smoking cessation rates. Outcome: Smoking abstinence after 6 and 18 months, not contradicted by biochemical tests. We will assess relapse after the end of the intervention, to test whether 6-month effects translate into sustained abstinence 12 months after the incentives are withdrawn. Randomization: Will be done using sealed envelopes drawn by participants. Blinding: Is not possible in this context. Discussion Smoking prevention policies and interventions have been least effective in the least educated, low

  20. Interventions to increase recommendation and delivery of screening for breast, cervical, and colorectal cancers by healthcare providers systematic reviews of provider assessment and feedback and provider incentives.

    Science.gov (United States)

    Sabatino, Susan A; Habarta, Nancy; Baron, Roy C; Coates, Ralph J; Rimer, Barbara K; Kerner, Jon; Coughlin, Steven S; Kalra, Geetika P; Chattopadhyay, Sajal

    2008-07-01

    Most major medical organizations recommend routine screening for breast, cervical, and colorectal cancers. Screening can lead to early detection of these cancers, resulting in reduced mortality. Yet not all people who should be screened are screened, either regularly or, in some cases, ever. This report presents results of systematic reviews of effectiveness, applicability, economic efficiency, barriers to implementation, and other harms or benefits of two provider-directed intervention approaches to increase screening for breast, cervical, and colorectal cancers. These approaches, provider assessment and feedback, and provider incentives encourage providers to deliver screening services at appropriate intervals. Evidence in these reviews indicates that provider assessment and feedback interventions can effectively increase screening by mammography, Pap test, and fecal occult blood test. Health plans, healthcare systems, and cancer control coalitions should consider such evidence-based findings when implementing interventions to increase screening use. Evidence was insufficient to determine the effectiveness of provider incentives in increasing use of any of these tests. Specific areas for further research are suggested in this report, including the need for additional research to determine whether provider incentives are effective in increasing use of any of these screening tests, and whether assessment and feedback interventions are effective in increasing other tests for colorectal cancer (i.e., flexible sigmoidoscopy, colonoscopy, or double-contrast barium enema).

  1. Financial incentives and psychiatric services in Australia: an empirical analysis of three policy changes.

    Science.gov (United States)

    Doessel, D P; Scheurer, Roman W; Chant, David C; Whiteford, Harvey

    2007-01-01

    Australia has a national, compulsory and universal health insurance scheme, called Medicare. In 1996 the Government changed the Medicare Benefit Schedule Book in such a way as to create different financial incentives for consumers or producers of out-of-hospital private psychiatric services, once an individual consumer had received 50 such services in a 12-month period. The Australian Government introduced a new Item (319) to cover some special cases that were affected by the policy change. At the same time, the Commonwealth introduced a 'fee-freeze' for all medical services. The purpose of this study is two-fold. First, it is necessary to describe the three policy interventions (the constraints on utilization, the operation of the new Item and the general 'fee-freeze'.) The new Item policy was essentially a mechanism to 'dampen' the effect of the 'constraint' policy, and these two policy changes will be consequently analysed as a single intervention. The second objective is to evaluate the policy intervention in terms of the (stated) Australian purpose of reducing utilization of psychiatric services, and thus reducing financial outlays. Thus, it is important to separate out the different effects of the three policies that were introduced at much the same time in November 1996 and January 1997. The econometric results indicate that the composite policy change (constraining services and the new 319 Item) had a statistically significant effect. The analysis of the Medicare Benefit (in constant prices) indicates that the 'fee-freeze' policy also had a statistically significant effect. This enables separate determination of the several policy changes. In fact, the empirical results indicate that the Commonwealth Government underestimated the 'savings' that would arise from the 'constraint' policy.

  2. Incentives in Diabetic Eye Assessment by Screening (IDEAS): study protocol of a three-arm randomized controlled trial using financial incentives to increase screening uptake in London.

    Science.gov (United States)

    Judah, Gaby; Vlaev, Ivo; Gunn, Laura; King, Dominic; King, Derek; Valabhji, Jonathan; Darzi, Ara; Bicknell, Colin

    2016-03-18

    Diabetes is an increasing public health problem in the UK and globally. Diabetic retinopathy is a microvascular complication of diabetes, and is one of the leading causes of blindness in the UK working age population. The diabetic eye screening programme in England aims to invite all people with diabetes aged 12 or over for retinal photography to screen for the presence of diabetic retinopathy. However, attendance rates are only 81 %, leaving many people at risk of preventable sight loss. This is a three arm randomized controlled trial to investigate the impact of different types of financial incentives (based on principles from behavioral economics) on increasing attendance at diabetic eye screening appointments in London. Eligible participants will be aged 16 or over, and are those who have been invited to screening appointments annually, but who have not attended, or telephoned to rearrange an appointment, within the last 24 months. Eligible participants will be randomized to one of three conditions: 1. Control condition (usual invitation letter) 2. Fixed incentive condition (usual invitation letter, including a voucher for £10 if they attend their appointment) 3. Probabilistic incentive condition (invitation letter, including a voucher for a 1 in 100 chance of winning £1000 if they attend their appointment). Participants will be sent invitation letters, and the primary outcome will be whether or not they attend their appointment. One thousand participants will be included in total, randomized with a ratio of 1.4:1:1. In order to test whether the incentive scheme has a differential impact on patients from different demographic or socio-economic groups, information will be recorded on age, gender, distance from screening center, socio-economic status and length of time since they were last screened. A cost-effectiveness analysis will also be performed. This study will be the first trial of financial incentives for improving uptake of diabetic eye screening. If

  3. Financial analysis on the proposed renewable heat incentive for residential houses in the United Kingdom: A case study on the solar thermal system

    International Nuclear Information System (INIS)

    Abu-Bakar, Siti Hawa; Muhammad-Sukki, Firdaus; Ramirez-Iniguez, Roberto; Munir, Abu Bakar; Mohd Yasin, Siti Hajar; Mallick, Tapas Kumar; McLennan, Campbell; Abdul Rahim, Ruzairi

    2014-01-01

    This short communication paper focuses on the renewable heat incentive (RHI) scheme in the United Kingdom (UK); and in particular, on its implication on domestic installations of solar thermal systems (STSs). First, a short review on the STS in the UK is provided. Then, a detailed description of the RHI is discussed. A financial analysis is presented afterwards, analysing the impact of the RHI scheme on the applicants, in terms of the net present value and the internal rate of return. From the financial analysis it has been found that the RHI scheme for domestic installations is only attractive if a longer period of RHI payment, i.e. 17 years, or a higher RHI rate i.e. £0.32 per kW h is implemented. The current proposal from the UK government is not financially viable, and as a result, it may hinder the penetration of domestic solar thermal systems in the residential sector in the UK. - Highlights: • A short review on solar thermal system (STS) is presented. • The renewable heat incentive (RHI) scheme is discussed. • A financial analysis is evaluated under the RHI scheme in the UK. • The analysis indicates the current proposal is not desirable to consumers

  4. Financial incentives to increase Canadian organ donation: quick fix or fallacy?

    Science.gov (United States)

    Gill, John S; Klarenbach, Scott; Barnieh, Lianne; Caulfield, Timothy; Knoll, Greg; Levin, Adeera; Cole, Edward H

    2014-01-01

    Unlike the United States, the potential to increase organ donation in Canada may be sufficient to meet the need for transplantation. However, there has been no national coordinated effort to increase organ donation. Strategies that do not involve payment for organs, such as investment in health care resources to support deceased donor organ donation and introduction of a remuneration framework for the work of deceased organ donation, should be prioritized for implementation. Financial incentives that may be permitted under existing legislation and that pose little risk to existing donation sources should be advanced, including the following: payment of funeral expenses for potential donors who register their decision on organ donation during life (irrespective of the decision to donate or actual organ donation) and removal of disincentives for directed and paired exchange living donation, such as payment of wages, payment for pain and suffering related to the donor surgery, and payment of directed living kidney donors for participation in Canada's paired exchange program. In contrast, it would be premature to contemplate a regulated system of organ sales that would require a paradigm shift in the current approach to organ donation and legislative change to implement. Copyright © 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  5. A business case for HIT adoption: effects of "meaningful use" EHR financial incentives on clinic revenue.

    Science.gov (United States)

    Behkami, Nima A; Dorr, David A; Morrice, Stuart

    2010-01-01

    The goal of this study is to describe a framework that allows decision makers to efficiently evaluate factors that affect Electronic Health Record (EHR) adoption and test suitable interventions; specifically financial incentives. The United States healthcare delivery system is experiencing a transformation to improve population health. There is strong agreement that "meaningful use" of Health Information Technology (HIT) is a major enabler in this effort. However it's also understood that the high cost of implementing an EHR is an obstacle for adoption. To help understand these complexities we developed a simulation model designed to capture the dynamic nature of policy interventions that affect the adoption of EHR. We found that "Effective" use of HIT approaches break-even-point and larger clinic revenue many times faster that "average" or "poor" use of HIT. This study uses a systems perspective to the evaluate EHR adoption process through the "meaningful use" redesign as proposed in the American Reinvestment and Recovery Act 2009 in the United States healthcare industry by utilizing the System Dynamics methodology and Scenario Analysis.

  6. Benefits of adding small financial incentives or optional group meetings to a web-based statewide obesity initiative.

    Science.gov (United States)

    Leahey, Tricia M; Subak, Leslee L; Fava, Joseph; Schembri, Michael; Thomas, Graham; Xu, Xiaomeng; Krupel, Katie; Kent, Kimberly; Boguszewski, Katherine; Kumar, Rajiv; Weinberg, Brad; Wing, Rena

    2015-01-01

    To examine whether adding either small, variable financial incentives or optional group sessions improves weight losses in a community-based, Internet behavioral program. Participants (N = 268) from Shape Up Rhode Island 2012, a 3-month Web-based community wellness initiative, were randomized to: Shape Up+Internet behavioral program (SI), Shape Up+Internet program+incentives (SII), or Shape Up+Internet program+group sessions (SIG). At the end of the 3-month program, SII achieved significantly greater weight losses than SI (SII: 6.4% [5.1-7.7]; SI: 4.2% [3.0-5.6]; P = 0.03); weight losses in SIG were not significantly different from the other two conditions (SIG: 5.8% [4.5-7.1], P's ≥ 0.10). However, at the 12-month no-treatment follow-up visit, both SII and SIG had greater weight losses than SI (SII: 3.1% [1.8-4.4]; SIG: 4.5% [3.2-5.8]; SI: 1.2% [-0.1-2.6]; P's ≤ 0.05). SII was the most cost-effective approach at both 3 (SII: $34/kg; SI: $34/kg; SIG: $87/kg) and 12 months (SII: $64/kg; SI: $140/kg; SIG: $113/kg). Modest financial incentives enhance weight losses during a community campaign, and both incentives and optional group meetings improved overall weight loss outcomes during the follow-up period. However, the use of the financial incentives is the most cost-effective approach. © 2014 The Obesity Society.

  7. Derivative financial instruments and nonprofit health care providers.

    Science.gov (United States)

    Stewart, Louis J; Owhoso, Vincent

    2004-01-01

    This article examines the extent of derivative financial instrument use among US nonprofit health systems and the impact of these financial instruments on their cash flows, reported operating results, and financial risks. Our examination is conducted through a case study of New Jersey hospitals and health systems. We review the existing literature on interest rate derivative instruments and US hospitals and health systems. This literature describes the design of these derivative financial instruments and the theoretical benefits of their use by large health care provider organizations. Our contribution to the literature is to provide an empirical evaluation of derivative financial instruments usage among a geographically limited sample of US nonprofit health systems. We reviewed the audited financial statements of the 49 community hospitals and multi-hospital health systems operating in the state of New Jersey. We found that 8 percent of New Jersey's nonprofit health providers utilized interest rate derivatives with an aggregate principle value of $229 million. These derivative users combine interest rate swaps and caps to lower the effective interest costs of their long-term debt while limiting their exposure to future interest rate increases. In addition, while derivative assets and liabilities have an immaterial balance sheet impact, derivative related gains and losses are a material component of their reported operating results. We also found that derivative usage among these four health systems was responsible for generating positive cash flows in the range of 1 percent to 2 percent of their total 2001 cash flows from operations. As a result of our admittedly limited samples we conclude that interest rate swaps and caps are effective risk management tools. However, we also found that while these derivative financial instruments are useful hedges against the risks of issuing long-term financing instruments, they also expose derivative users to credit, contract

  8. Financial Incentives Differentially Regulate Neural Processing of Positive and Negative Emotions during Value-Based Decision-Making

    Directory of Open Access Journals (Sweden)

    Anne M. Farrell

    2018-02-01

    Full Text Available Emotional and economic incentives often conflict in decision environments. To make economically desirable decisions then, deliberative neural processes must be engaged to regulate automatic emotional reactions. In this functional magnetic resonance imaging (fMRI study, we evaluated how fixed wage (FW incentives and performance-based (PB financial incentives, in which pay is proportional to outcome, differentially regulate positive and negative emotional reactions to hypothetical colleagues that conflicted with the economics of available alternatives. Neural activity from FW to PB incentive contexts decreased for positive emotional stimuli but increased for negative stimuli in middle temporal, insula, and medial prefrontal regions. In addition, PB incentives further induced greater responses to negative than positive emotional decisions in the frontal and anterior cingulate regions involved in emotion regulation. Greater response to positive than negative emotional features in these regions also correlated with lower frequencies of economically desirable choices. Our findings suggest that whereas positive emotion regulation involves a reduction of responses in valence representation regions, negative emotion regulation additionally engages brain regions for deliberative processing and signaling of incongruous events.

  9. Financial Incentives Differentially Regulate Neural Processing of Positive and Negative Emotions during Value-Based Decision-Making.

    Science.gov (United States)

    Farrell, Anne M; Goh, Joshua O S; White, Brian J

    2018-01-01

    Emotional and economic incentives often conflict in decision environments. To make economically desirable decisions then, deliberative neural processes must be engaged to regulate automatic emotional reactions. In this functional magnetic resonance imaging (fMRI) study, we evaluated how fixed wage (FW) incentives and performance-based (PB) financial incentives, in which pay is proportional to outcome, differentially regulate positive and negative emotional reactions to hypothetical colleagues that conflicted with the economics of available alternatives. Neural activity from FW to PB incentive contexts decreased for positive emotional stimuli but increased for negative stimuli in middle temporal, insula, and medial prefrontal regions. In addition, PB incentives further induced greater responses to negative than positive emotional decisions in the frontal and anterior cingulate regions involved in emotion regulation. Greater response to positive than negative emotional features in these regions also correlated with lower frequencies of economically desirable choices. Our findings suggest that whereas positive emotion regulation involves a reduction of responses in valence representation regions, negative emotion regulation additionally engages brain regions for deliberative processing and signaling of incongruous events.

  10. Financial Incentives for Chronic Disease Management: Results and Limitations of 2 Randomized Clinical Trials With New York Medicaid Patients.

    Science.gov (United States)

    VanEpps, Eric M; Troxel, Andrea B; Villamil, Elizabeth; Saulsgiver, Kathryn A; Zhu, Jingsan; Chin, Jo-Yu; Matson, Jacqueline; Anarella, Joseph; Roohan, Patrick; Gesten, Foster; Volpp, Kevin G

    2018-01-01

    To identify whether financial incentives promote improved disease management in Medicaid recipients diagnosed with hypertension or diabetes, respectively. Four-group, multicenter, randomized clinical trials. Between 2013 and 2016, New York State Medicaid managed care members diagnosed with hypertension (N = 920) or with diabetes (N = 959). Participants in each 6-month trial were randomly assigned to 1 of 4 arms: (1) process incentives-earned by attending primary care visits and/or receiving prescription medication refills, (2) outcome incentives-earned by reducing systolic blood pressure (hypertension) or hemoglobin A 1c (HbA 1c ; diabetes) levels, (3) combined process and outcome incentives, and (4) control (no incentives). Systolic blood pressure (hypertension) and HbA 1c (diabetes) levels, primary care visits, and medication prescription refills. Analysis and Results: At 6 months, there were no statistically significant differences between intervention arms and the control arm in the change in systolic blood pressure, P = .531. Similarly, there were no significant differences in blood glucose control (HbA 1c ) between the intervention arms and control after 6 months, P = .939. The majority of participants had acceptable systolic blood pressure (operational limitations, the majority of recipients had relatively well-controlled diseases at the time of enrollment.

  11. Banca Nazionale del Lavoro (B. N. L. Italy) financial incentives for energy conservation and environmenal protection ENERAMBIENTE

    Energy Technology Data Exchange (ETDEWEB)

    Rutondi, L

    1989-02-01

    This paper outlines the Banca Nazionale del Lavoro (B.N.L., Italy) financial incentive program, ENERAMBIENTE and explains how it relates to overall E.E.C. plans (for the year 1992) promoting, in various sectors (industry, agricolture, etc.), the rational use of energy and environmental protection. The program's objectives are to ensure the prospective user's awareness of the mechanics, possibilities and limits of financial assistence plans, supply technical and organizational assistance and collaborate with local and regional government administrations, as well as public and private enterprises.

  12. Policy implementation and financial incentives for nurses in South Africa: a case study on the occupation-specific dispensation

    Directory of Open Access Journals (Sweden)

    Duane Blaauw

    2013-01-01

    Full Text Available Background: In 2007, the South African government introduced the occupation-specific dispensation (OSD, a financial incentive strategy, to attract, motivate, and retain health professionals in the public sector. Implementation commenced with the nursing sector, but there have been unintended negative consequences. Objective: First, to examine implementation of the OSD for nurses using Hogwood and Gunn's framework that outlines ‘perfect implementation’ pre-conditions. Second, to highlight the conditions for the successful implementation of financial incentives. Methods: A qualitative case study design using a combination of a document review and in-depth interviews with 42 key informants. Results: The study found that there were several implementation weaknesses. Only a few of the pre-conditions were met for OSD policy implementation. The information systems required for successful policy implementation, such as the public sector human resource data base and the South African Nursing Council register of specialised nurses were incomplete and inaccurate, thus undermining the process. Insufficient attention was paid to time and resources, dependency relationships, task specification, and communication and coordination. Conclusion: The implementation of financial incentives requires careful planning and management in order to avoid loss of morale and staff grievances.

  13. Financial protection of patients through compensation of providers: the impact of Health Equity Funds in Cambodia.

    Science.gov (United States)

    Flores, Gabriela; Ir, Por; Men, Chean R; O'Donnell, Owen; van Doorslaer, Eddy

    2013-12-01

    Public providers have no financial incentive to respect their legal obligation to exempt the poor from user fees. Health Equity Funds (HEFs) aim to make exemptions effective by giving NGOs responsibility for assessing eligibility and compensating providers for lost revenue. We use the geographic spread of HEFs over time in Cambodia to identify their impact on out-of-pocket (OOP) payments. Among households with some OOP payment, HEFs reduce the amount paid by 35%, on average. The effect is larger for households that are poorer and mainly use public health care. Reimbursement of providers through a government operated scheme also reduces household OOP payments but the effect is not as well targeted on the poor. Both compensation models raise household non-medical consumption but have no impact on health-related debt. HEFs reduce the probability of primarily seeking care in the private sector. Copyright © 2013 Elsevier B.V. All rights reserved.

  14. Investigation of existing financial incentive policies for solar photovoltaic systems in U.S. regions

    Directory of Open Access Journals (Sweden)

    Jian Zhang

    2017-12-01

    Full Text Available This paper analyzes some of the existing incentives for solar photovoltaic (PV energy generation in the U.S. Four types of buildings (e.g., hospitals, large offices, large hotels, and secondary schools located in five different U.S. states, each having their own incentives, are selected and analyzed for the PV incentive policies. The payback period of the PV system is chosen as an indicator to analyze and critique the effectiveness of each incentive by comparing the payback periods before and after taking the incentive into consideration. Then a parametric analysis is conducted to determine the influence of the variation in key parameters, such as PV system capacity, capital cost of PV, sell back ratio and the performance-based incentive rate, on the performance of the PV system. The results show how the existing incentives can be effectively used to promote the PV systems in the U.S. and how variations of the parameters can impact the payback period of the PV systems. Through the evaluation of the existing incentive policies and the parametric study, this paper demonstrates that the type and level of incentives should be carefully determined in policy-making processes to effectively promote the PV systems.

  15. Payeeship, financial leverage, and the client-provider relationship.

    Science.gov (United States)

    Angell, Beth; Martinez, Noriko I; Mahoney, Colleen A; Corrigan, Patrick W

    2007-03-01

    Although representative payeeship provided within clinical settings is believed to have therapeutic benefits, its potential negative impact on the therapeutic alliance or client-provider relationship is of concern. This study examined the effects of payeeship and perceived financial leverage on positive and negative dimensions of the client-provider relationship. The sample consisted of 205 adults ages 18 to 65 with axis I disorders who were receiving mental health services from a large urban community mental health clinic. Information about money management characteristics and ratings of the client-provider relationship were collected via face-to-face interview. Fifty-three percent of the sample had a payee or money manager, and 79% of this group had a clinician payee. Respondents with co-occurring psychotic and substance use disorders, lower functioning, and lower insight about their illness were more likely to have a clinician payee. Forty percent of those with a clinician payee reported perceived financial leverage. Having a clinician payee was also associated with perceived financial leverage and with higher levels of conflict in the case management relationship. When examined in combination, financial leverage was found to mediate the effects of payeeship on conflict in the case management relationship (mean+/-SE=2.37+/-1.33, 95% confidence interval=16-5.52, pconflict in the therapeutic alliance when used as a source of treatment leverage. Although payeeship provides important support and may enhance functional outcomes for the patient, decisions about using the mechanism for promoting treatment adherence should take into account the potential disruption to the client-provider relationship.

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

    Science.gov (United States)

    Zhang, Chun-Yu; Hashimoto, Hideki

    2015-03-05

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

  17. Financial incentives to improve adherence to antipsychotic maintenance medication in non-adherent patients: a cluster randomised controlled trial.

    Science.gov (United States)

    Priebe, Stefan; Bremner, Stephen A; Lauber, Christoph; Henderson, Catherine; Burns, Tom

    2016-09-01

    Poor adherence to long-term antipsychotic injectable (LAI) medication in patients with psychotic disorders is associated with a range of negative outcomes. No psychosocial intervention has been found to be consistently effective in improving adherence. To test whether or not offering financial incentives is effective and cost-effective in improving adherence and to explore patient and clinician experiences with such incentives. A cluster randomised controlled trial with economic and nested qualitative evaluation. The intervention period lasted for 12 months with 24 months' follow-up. The unit of randomisation was mental health teams in the community. Community teams in secondary mental health care. Patients with a diagnosis of schizophrenia, schizoaffective psychosis or bipolar illness, receiving ≤ 75% of their prescribed LAI medication. In total, 73 teams with 141 patients (intervention n = 78 and control n = 63) were included. Participants in the intervention group received £15 for each LAI medication. Patients in the control group received treatment as usual. adherence to LAI medication (the percentage of received out of those prescribed). percentage of patients with at least 95% adherence; clinical global improvement; subjective quality of life; satisfaction with medication; hospitalisation; adverse events; and costs. Qualitative evaluation: semistructured interviews with patients in the intervention group and their clinicians. outcome data were available for 131 patients. Baseline adherence was 69% in the intervention group and 67% in the control group. During the intervention period, adherence was significantly higher in the intervention group than in the control group (85% vs. 71%) [adjusted mean difference 11.5%, 95% confidence interval (CI) 3.9% to 19.0%; p = 0.003]. Secondary outcome: patients in the intervention group showed statistically significant improvement in adherence of at least 95% (adjusted odds ratio 8.21, 95% CI 2.00 to 33

  18. Multifaceted intervention including education, rounding checklist implementation, cost feedback, and financial incentives reduces inpatient laboratory costs.

    Science.gov (United States)

    Yarbrough, Peter M; Kukhareva, Polina V; Horton, Devin; Edholm, Karli; Kawamoto, Kensaku

    2016-05-01

    Inappropriate laboratory testing is a contributor to waste in healthcare. To evaluate the impact of a multifaceted laboratory reduction intervention on laboratory costs. A retrospective, controlled, interrupted time series (ITS) study. University of Utah Health Care, a 500-bed academic medical center in Salt Lake City, Utah. All patients 18 years or older admitted to the hospital to a service other than obstetrics, rehabilitation, or psychiatry. Multifaceted quality-improvement initiative in a hospitalist service including education, process change, cost feedback, and financial incentive. Primary outcomes of lab cost per day and per visit. Secondary outcomes of number of basic metabolic panel (BMP), comprehensive metabolic panel (CMP), complete blood count (CBC), and prothrombin time/international normalized ratio tests per day; length of stay (LOS); and 30-day readmissions. A total of 6310 hospitalist patient visits (intervention group) were compared to 25,586 nonhospitalist visits (control group). Among the intervention group, the unadjusted mean cost per day was reduced from $138 before the intervention to $123 after the intervention (P analysis showed significant reductions in cost per day, cost per visit, and the number of BMP, CMP, and CBC tests per day (P = 0.034, 0.02, <0.001, 0.004, and <0.001). LOS was unchanged and 30-day readmissions decreased in the intervention group. A multifaceted approach to laboratory reduction demonstrated a significant reduction in laboratory cost per day and per visit, as well as common tests per day at a major academic medical center. Journal of Hospital Medicine 2016;11:348-354. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

  19. The Relationship of Financial Incentives and Consumers' Willingness to Disclose Information to eCommerce Marketers

    Science.gov (United States)

    Pourhosseini, Parissa

    2009-01-01

    In this study the problem examined was a lack of research based information on the degree to which incentives can be used to encourage consumers to volunteer private information. The purpose of this study was to determine if monetary incentives would be a beneficial means to increase consumers' involvement in eCommerce and thereby boost the growth…

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

    Directory of Open Access Journals (Sweden)

    Sredojević Slađana

    2017-01-01

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

  1. Discerning Novel Value Chains in Financial Malware : On the Economic Incentives and Criminal Business Models in Financial Malware Schemes

    NARCIS (Netherlands)

    Wegberg, R.S. van; Klievink, A.J.; Eeten, M.J.G. van

    2017-01-01

    Fraud with online payment services is an ongoing problem, with significant financial-economic and societal impact. One of the main modus operandi is financial malware that compromises consumer and corporate devices, thereby potentially undermining the security of critical financial systems. Recent

  2. Discerning Novel Value Chains in Financial Malware : On the Economic Incentives and Criminal Business Models in Financial Malware Schemes

    NARCIS (Netherlands)

    van Wegberg, R.S.; Klievink, A.J.; van Eeten, M.J.G.

    Fraud with online payment services is an ongoing problem, with significant financial-economic and societal impact. One of the main modus operandi is financial malware that compromises consumer and corporate devices, thereby potentially undermining the security of critical financial systems.

  3. Effect of Patient Navigation With or Without Financial Incentives on Viral Suppression Among Hospitalized Patients With HIV Infection and Substance Use

    Science.gov (United States)

    Metsch, Lisa R.; Feaster, Daniel J.; Gooden, Lauren; Matheson, Tim; Stitzer, Maxine; Das, Moupali; Jain, Mamta K.; Rodriguez, Allan E.; Armstrong, Wendy S.; Lucas, Gregory M.; Nijhawan, Ank E.; Drainoni, Mari-Lynn; Herrera, Patricia; Vergara-Rodriguez, Pamela; Jacobson, Jeffrey M.; Mugavero, Michael J.; Sullivan, Meg; Daar, Eric S.; McMahon, Deborah K.; Ferris, David C.; Lindblad, Robert; VanVeldhuisen, Paul; Oden, Neal; Castellón, Pedro C.; Tross, Susan; Haynes, Louise F.; Douaihy, Antoine; Sorensen, James L.; Metzger, David S.; Mandler, Raul N.; Colfax, Grant N.; del Rio, Carlos

    2017-01-01

    IMPORTANCE Substance use is a major driver of the HIV epidemic and is associated with poor HIV care outcomes. Patient navigation (care coordination with case management) and the use of financial incentives for achieving predetermined outcomes are interventions increasingly promoted to engage patients in substance use disorders treatment and HIV care, but there is little evidence for their efficacy in improving HIV-1 viral suppression rates. OBJECTIVE To assess the effect of a structured patient navigation intervention with or without financial incentives to improve HIV-1 viral suppression rates among patients with elevated HIV-1 viral loads and substance use recruited as hospital inpatients. DESIGN, SETTING, AND PARTICIPANTS From July 2012 through January 2014, 801 patients with HIV infection and substance use from 11 hospitals across the United States were randomly assigned to receive patient navigation alone (n = 266), patient navigation plus financial incentives (n = 271), or treatment as usual (n = 264). HIV-1 plasma viral load was measured at baseline and at 6 and 12 months. INTERVENTIONS Patient navigation included up to 11 sessions of care coordination with case management and motivational interviewing techniques over 6 months. Financial incentives (up to $1160) were provided for achieving targeted behaviors aimed at reducing substance use, increasing engagement in HIV care, and improving HIV outcomes. Treatment as usual was the standard practice at each hospital for linking hospitalized patients to outpatient HIV care and substance use disorders treatment. MAIN OUTCOMES AND MEASURES The primary outcome was HIV viral suppression (≤200 copies/mL) relative to viral nonsuppression or death at the 12-month follow-up. RESULTS Of 801 patients randomized, 261 (32.6%) were women (mean [SD] age, 44.6 years [10.0 years]). There were no differences in rates of HIV viral suppression versus nonsuppression or death among the 3 groups at 12 months. Eighty-five of 249

  4. The effects of information, social and financial incentives on voluntary undirected blood donations: evidence from a field experiment in Argentina.

    Science.gov (United States)

    Iajya, Victor; Lacetera, Nicola; Macis, Mario; Slonim, Robert

    2013-12-01

    In many low- and middle-income countries blood donations per capita are substantially lower than in advanced economies. In these countries blood supply is mostly collected through directed donations from relatives and friends to individuals needing transfusions or to replace blood used in emergencies. The World Health Organization considers this method of blood supply inefficient compared to undirected voluntary donations. To examine methods to motivate undirected voluntary donations, we ran a large-scale, natural field experiment in Argentina, testing the effectiveness of information, social and financial incentives. We find that only higher-valued financial incentives generated more donations, increasing with the value of the reward. These incentives did not create adverse selection in the safety or usability of the donated blood. We discuss the implications of our findings for researchers interested in understanding motivations for pro-social behavior and for health agencies and policymakers concerned with the current and growing shortages in blood supply in low- and middle-income countries. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. To bail out or not to bail out systemically relevant financial institutions: The incentives of policy makers

    Directory of Open Access Journals (Sweden)

    Lucas Marc Fuhrer

    2012-11-01

    Full Text Available The recent financial crisis has shown that many financial institutions may be systemically relevant. Their bankruptcy would cause significant costs for the overall economy. However, a clear definition of systemic risks still does not exist. Thus, the decision, whether an institution is, or is not systemically relevant is in the end made by policy makers. This paper takes a closer look at the incentives available to policy makers and their influence on the bailout decision. In the model presented here it is possible to show, that too many financial institutions get bailed out, when assuming that policy makers tend to be more risk-averse than socially optimal. The costs due to this misallocation of resources can be significant.

  6. The complex remuneration of human resources for health in low-income settings: policy implications and a research agenda for designing effective financial incentives.

    Science.gov (United States)

    Bertone, Maria Paola; Witter, Sophie

    2015-07-28

    Human resources for health represent an essential component of health systems and play a key role to accelerate progress towards universal health coverage. Many countries in sub-Saharan Africa face challenges regarding the availability, distribution and performance of health workers, which could be in part addressed by providing effective financial incentives. Based on an overview of the existing literature, the paper highlights the gaps in the existing research in low-income countries exploring the different components of health workers' incomes. It then proposes a novel approach to the analysis of financial incentives and delineates a research agenda, which could contribute to shed light on this topic. The article finds that, while there is ample research that investigates separately each of the incomes health workers may earn (for example, salary, fee-for-service payments, informal incomes, "top-ups" and per diems, dual practice and non-health activities), there is a dearth of studies which look at the health workers' "complex remuneration", that is, the whole of the financial incentives available. Little research exists which analyses simultaneously all revenues of health workers, quantifies the overall remuneration and explores its complexity, its multiple components and their features, as well as the possible interaction between income components. However, such a comprehensive approach is essential to fully comprehend health workers' incentives, by investigating the causes (at individual and system level) of the fragmentation in the income structure and the variability in income levels, as well as the consequences of the "complex remuneration" on motivation and performance. This proposition has important policy implications in terms of devising effective incentive packages as it calls for an active consideration of the role that "complex remuneration" plays in determining recruitment, retention and motivation patterns, as well as, more broadly, the

  7. Financial disincentives? A three-armed randomised controlled trial of the effect of financial Incentives  in Diabetic Eye Assessment  by Screening (IDEAS) trial.

    Science.gov (United States)

    Judah, Gaby; Darzi, Ara; Vlaev, Ivo; Gunn, Laura; King, Derek; King, Dominic; Valabhji, Jonathan; Bicknell, Colin

    2018-05-23

    Conflicting evidence exists regarding the impact of financial incentives on encouraging attendance at medical screening appointments. The primary aim was to determine whether financial incentives increase attendance at diabetic eye screening in persistent non-attenders. A three-armed randomised controlled trial was conducted in London in 2015. 1051 participants aged over 16 years, who had not attended eye screening appointments for 2 years or more, were randomised (1.4:1:1 randomisation ratio) to receive the usual invitation letter (control), an offer of £10 cash for attending screening (fixed incentive) or a 1 in 100 chance of winning £1000 (lottery incentive) if they attend. The primary outcome was the proportion of invitees attending screening, and a comparative analysis was performed to assess group differences. Pairwise comparisons of attendance rates were performed, using a conservative Bonferroni correction for independent comparisons. 34/435 (7.8%) of control, 17/312 (5.5%) of fixed incentive and 10/304 (3.3%) of lottery incentive groups attended. Participants who received any incentive were significantly less likely to attend their appointment compared with controls (risk ratio (RR)=0.56; 95% CI 0.34 to 0.92). Those in the probabilistic incentive group (RR=0.42; 95% CI 0.18 to 0.98), but not the fixed incentive group (RR=1.66; 95% CI 0.65 to 4.21), were significantly less likely to attend than those in the control group. Financial incentives, particularly lottery-based incentives, attract fewer patients to diabetic eye screening than standard invites in this population. Financial incentives should not be used to promote screening unless tested in context, as they may negatively affect attendance rates. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. Public acceptability of financial incentives for smoking cessation in pregnancy and breast feeding: a survey of the British public.

    Science.gov (United States)

    Hoddinott, Pat; Morgan, Heather; MacLennan, Graeme; Sewel, Kate; Thomson, Gill; Bauld, Linda; Yi, Deokhee; Ludbrook, Anne; Campbell, Marion K

    2014-07-18

    To survey public attitudes about incentives for smoking cessation in pregnancy and for breast feeding to inform trial design. Cross-sectional survey. British general public. Seven promising incentive strategies had been identified from evidence syntheses and qualitative interview data from service users and providers. These were shopping vouchers for: (1) validated smoking cessation in pregnancy and (2) after birth; (3) for a smoke-free home; (4) for proven breast feeding; (5) a free breast pump; (6) payments to health services for reaching smoking cessation in pregnancy targets and (7) breastfeeding targets. Ipsos MORI used area quota sampling and home-administered computer-assisted questionnaires, with randomised question order to assess agreement with different incentives (measured on a five-point scale). Demographic data and target behaviour experience were recorded. Analysis used multivariable ordered logit models. Agreement with incentives was mixed (ranging from 34% to 46%) among a representative sample of 1144 British adults. Mean agreement score was highest for a free breast pump, and lowest for incentives for smoking abstinence after birth. More women disagreed with shopping vouchers than men. Those with lower levels of education disagreed more with smoking cessation incentives and a breast pump. Those aged 44 or under agreed more with all incentive strategies compared with those aged 65 and over, particularly provider targets for smoking cessation. Non-white ethnic groups agreed particularly with breastfeeding incentives. Current smokers with previous stop attempts and respondents who had breast fed children agreed with providing vouchers for the respective behaviours. Up to £40/month vouchers for behaviour change were acceptable (>85%). Women and the less educated were more likely to disagree, but men and women of childbearing age to agree, with incentives designed for their benefit. Trials evaluating reach, impact on health inequalities and ethnic

  9. 78 FR 16159 - Application Procedures and Criteria for Approval of Providers of a Personal Financial Management...

    Science.gov (United States)

    2013-03-14

    ... and Criteria for Approval of Providers of a Personal Financial Management Instructional Course by... personal financial management instructional course (``providers'') satisfy all prerequisites of the United... in an instructional course concerning personal financial management (``instructional course'' or...

  10. The Effect of Financial Incentives on Quality of Care: The Case of Diabetes

    OpenAIRE

    Anthony Scott; Stefanie Schurer; Paul H. Jensen; Peter Sivey

    2008-01-01

    Australia introduced an incentive payment scheme for general practitioners to ensure systematic and high quality care in chronic disease management. There is little empirical evidence and ambiguous theoretical guidance on which effects to expect on the quality of care. This paper evaluates the impact of the payment incentives on quality of care in diabetes, as measured by the probability of ordering an HbA1c test. The empirical analysis is conducted with a unique data set and a multivariate p...

  11. The Effects of Financial Incentives on Quality of Care: The Case of Diabetes

    OpenAIRE

    Scott, A; Schurer, S; Jensen, P H; Sivey, P

    2008-01-01

    Australia introduced an incentive payment scheme for general practitioners to ensure systematic and high quality care in chronic disease management. There is little empirical evidence and ambiguous theoretical guidance on which effects to expect on the quality of care. This paper evaluates the impact of the payment incentives on quality of care in diabetes, as measured by the probability of ordering an HbA1c test. The empirical analysis is conducted with a unique data set and a multivariate p...

  12. Effects of Individual Physician-Level and Practice-Level Financial Incentives on Hypertension Care: A Cluster Randomized Trial

    Science.gov (United States)

    Petersen, Laura A.; Simpson, Kate; Pietz, Kenneth; Urech, Tracy H.; Hysong, Sylvia J.; Profit, Jochen; Conrad, Douglas A.; Dudley, R. Adams; Woodard, LeChauncy D.

    2014-01-01

    Importance Pay for performance is intended to align incentives to promote high quality care, but results have been contradictory. Objective To test the effect of explicit financial incentives to reward guideline-recommended hypertension care. Design, Setting, and Participants Cluster randomized controlled trial of 12 Veterans Affairs hospital-based outpatient clinics with five performance periods and a 12-month washout. We enrolled 83 primary care physicians and 42 non-physician personnel (e.g., nurses, pharmacists) working with physicians to deliver hypertension care. Interventions Clinics randomized to one of four groups: physician-level (individual) incentives; practice-level incentives; individual- plus practice-level incentives (combined); or none. Intervention participants received up to five payments every four months; all participants could access feedback reports. Main outcome measures For each four-month period, the number of hypertensive patients among a random sample who achieved guideline-recommended blood pressure thresholds or received an appropriate response to uncontrolled blood pressure; and/or been prescribed guideline-recommended medications and the number who developed hypotension. Results Mean (standard deviation) total payments over the study were $4,270 ($459), $2,672 ($153), and $1,648 ($248) for the combined, individual, and practice-level interventions, respectively. The adjusted change over the study in patients meeting the combined blood pressure/appropriate response measure was 8.84 percentage points (95% confidence interval [CI], 4.20–11.80) for the individual-level, 3.70 (95% CI, 0.24–7.68) for the practice-level, 5.54 (95% CI, 1.92–9.52) for the combined, and 0.47 (95% CI, −3.12–4.04) for the control groups. For medications, the change was 9.07 (95% CI, 4.52–13.44), 4.98 (95% CI, 0.64–10.08), 7.26 (95% CI, 2.92–12.48), and 4.35 (95% CI, −0.28–9.28) percentage points, respectively. The adjusted estimated

  13. Discerning Novel Value Chains in Financial Malware: On the Economic Incentives and Criminal Business Models in Financial Malware Schemes

    OpenAIRE

    van Wegberg, R.S.; Klievink, A.J.; van Eeten, M.J.G.

    2017-01-01

    Fraud with online payment services is an ongoing problem, with significant financial-economic and societal impact. One of the main modus operandi is financial malware that compromises consumer and corporate devices, thereby potentially undermining the security of critical financial systems. Recent research into the underground economy has shown that cybercriminals are organised around highly specialised tasks, such as pay-per-install markets for infected machines, malware-as-a-service and mon...

  14. Incentive Compatibility

    OpenAIRE

    Ledyard, John O.

    1987-01-01

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

  15. Financial impact to providers using pediatric combination vaccines.

    Science.gov (United States)

    Shen, Angela K; Sobczyk, Elizabeth; Simonsen, Lone; Khan, Farid; Esber, Allahna; Andreae, Margie C

    2011-12-01

    To understand the financial impact to providers for using a combination vaccine (Pediarix [GlaxoSmithKline Biologicals, King of Prussia, PA]) versus its equivalent component vaccines for children aged 1 year or younger. Using a subscription remittance billing service offered to private-practice office-based physicians, we analyzed charge and payment information submitted by providers to insurance payers from June 2007 through July 2009. We analyzed provider and payer characteristics, payer comments, and the ratio of vaccine product to immunization administration (IA) codes and computed total charges and payments to providers for both arms of the study. Most providers in our data set were pediatricians (74%), and most payers were commercial (75%), primarily managed care. The ratio of the number of vaccine products to the number of IAs was 1:1 in the majority of the claims. Twenty percent of claims were paid with no adjustment by the payer, whereas 76% of the claims were adjusted for charges that exceeded the contract arrangement or the fee schedule. Providers received $23 less from commercial payers and $13 less from Medicaid for the use of Pediarix compared with the equivalent component vaccines. The mean commercial payment was greater for age-specific Current Procedural Terminology IA codes 90465 and 90466 than for non-age-specific codes 90471 and 90472, whereas the reverse was true for Medicaid. Providers who administer vaccines to children face a reduction in payment when choosing to provide combination vaccines. The new IA codes should be monitored for correction of financial barriers to the use of combination vaccines.

  16. Providing adequate economic incentives for bioenergies with CO2 capture and geological storage

    International Nuclear Information System (INIS)

    Ricci, Olivia

    2012-01-01

    Knowing that carbon capture and storage (CCS) could play an important role in reducing emissions, it is important to have a good understanding of this role and the importance of environmental policies to support carbon capture and geological storage from bioenergies (BECCS). To date CCS technologies are not deployed on a commercial level, and policy instruments should be used to provide incentives to firms to use these technologies to reduce pollution. The aim of this paper is to compare the cost-efficiency of several incentive-based instruments (a fossil fuel tax, an emissions tax, a cap and trade system, and a subsidy on captured emissions) needed to spur the adoption of CCS and BECCS, using a dynamic general equilibrium model. This type of model has become the standard for assessing economy-wide impacts of environmental and technological policies. The study shows that BECCS will be deployed only if a specific subsidy per unit of biomass emissions captured with a CCS technology is available. We show also that the two most cost-efficient instruments for achieving a given emissions reduction target are a specific subsidy that rewards captured emissions and a carbon tax whose revenues are recycled to subsidize BECCS. - Highlights: ► We investigate the suitability of economic instruments to support CCS and BECCS. ► We model CCS and BECCS in a dynamic general equilibrium model. ► We compare the cost-efficiency of economic instruments to reduce emissions. ► A subsidy that rewards biomass captured emissions is appropriate to encourage BECCS. ► A carbon tax whose revenues are recycled to subsidize BECCS is cost-efficient.

  17. Birth weight differences between those offered financial voucher incentives for verified smoking cessation and control participants enrolled in the Cessation in Pregnancy Incentives Trial (CPIT), employing an intuitive approach and a Complier Average Causal Effects (CACE) analysis.

    Science.gov (United States)

    McConnachie, Alex; Haig, Caroline; Sinclair, Lesley; Bauld, Linda; Tappin, David M

    2017-07-20

    The Cessation in Pregnancy Incentives Trial (CPIT), which offered financial incentives for smoking cessation during pregnancy showed a clinically and statistically significant improvement in cessation. However, infant birth weight was not seen to be affected. This study re-examines birth weight using an intuitive and a complier average causal effects (CACE) method to uncover important information missed by intention-to-treat analysis. CPIT offered financial incentives up to £400 to pregnant smokers to quit. With incentives, 68 women (23.1%) were confirmed non-smokers at primary outcome, compared to 25 (8.7%) without incentives, a difference of 14.3% (Fisher test, p financial incentives to quit. Viewed in this way, the overall birth weight gain with incentives is attributable only to potential quitters. We compared an intuitive approach to a CACE analysis. Mean birth weight of potential quitters in the incentives intervention group (who therefore quit) was 3338 g compared with potential quitters in the control group (who did not quit) 3193 g. The difference attributable to incentives, was 3338 - 3193 = 145 g (95% CI -617, +803). The mean difference in birth weight between the intervention and control groups was 21 g, and the difference in the proportion who managed to quit was 14.3%. Since the intervention consisted of the offer of incentives to quit smoking, the intervention was received by all women in the intervention group. However, "compliance" was successfully quitting with incentives, and the CACE analysis yielded an identical result, causal birth weight increase 21 g ÷ 0.143 = 145 g. Policy makers have great difficulty giving pregnant women money to stop smoking. This study indicates that a small clinically insignificant improvement in average birth weight is likely to hide an important clinically significant increase in infants born to pregnant smokers who want to stop but cannot achieve smoking cessation without the addition of financial

  18. Pattern of the rational worker incentive system

    Directory of Open Access Journals (Sweden)

    Kopytova A.V.

    2017-01-01

    Full Text Available The article presents a model of rational incentive system with the structure consisting of three blocks. The first block (financial incentives provides monetary compensation to a worker. The second block (stimulating by comfortable living conditions is aimed to regulate the quality of a worker’s life in and outside the place he works. The third block (non-financial incentives takes into account cultural and social worker’s needs. The proposed structure of incentive system provides the most comprehensive coverage to the employee’s needs and organizes them in the way accessible both for specialists of labor economics and human resource management and for ordinary workers.

  19. Assessing the Financial Condition of Provider-Sponsored Health Plans.

    Science.gov (United States)

    McCue, Michael J

    2015-06-01

    The aim of this study was to assess the performance of health plans sponsored by provider organizations, with respect to plans generating strong positive cash flow relative to plans generating weaker cash flow. A secondary aim was to assess their capital adequacy. The study identified 24 provider-sponsored health plans (PSHPs) with an average positive cash flow margin from 2011 through 2013 at or above the top 75th percentile, defined as "strong cash flow PSHPs:" This group was compared with 72 PSHPs below the 75th percentile, defined as "weak cash flow PSHPs:" Atlantic Information Services Directory of Health Plans was used to identify the PSHPs. Financial ratios were computed from 2013 National Association of Insurance Commissioners Financial Filings. The study conducted a t test mean comparison between strong and weak cash flow PSHPs across an array of financial performance and capital adequacy measures. In 2013, the strong cash flow PSHPs averaged a cash-flow margin ratio of 6.6%. Weak cash flow PSHPs averaged a cash-flow margin of -0.4%. The net worth capital position of both groups was more than 4.5 times authorized capital. The operational analysis shows that strong cash-flow margin PSHPs are managing their medical costs to achieve this position. Although their medical loss ratio increased by almost 300 basis points from 2011 to 2013, it was still statistically significantly lower than the weaker cash flow PSHP group (P<.001). In terms of capital adequacy, both strong and weak cash-flow margin PSHP groups possessed sufficient capital to ensure the viability of these plans.

  20. Study protocol for Log2Lose: A feasibility randomized controlled trial to evaluate financial incentives for dietary self-monitoring and interim weight loss in adults with obesity.

    Science.gov (United States)

    Voils, Corrine I; Levine, Erica; Gierisch, Jennifer M; Pendergast, Jane; Hale, Sarah L; McVay, Megan A; Reed, Shelby D; Yancy, William S; Bennett, Gary; Strawbridge, Elizabeth M; White, Allison C; Shaw, Ryan J

    2018-02-01

    The obesity epidemic has negative physical, psychological, and financial consequences. Despite the existence of effective behavioral weight loss interventions, many individuals do not achieve adequate weight loss, and most regain lost weight in the year following intervention. We report the rationale and design for a 2×2 factorial study that involves financial incentives for dietary self-monitoring (yes vs. no) and/or interim weight loss (yes vs. no). Outpatients with obesity participate in a 24-week, group-based weight loss intervention. All participants are asked to record their daily dietary and liquid intake on a smartphone application (app) and to weigh themselves daily at home on a study-provided cellular scale. An innovative information technology (IT) solution collates dietary data from the app and weight from the scale. Using these data, an algorithm classifies participants weekly according to whether they met their group's criteria to receive a cash reward ranging from $0 to $30 for dietary self-monitoring and/or interim weight loss. Notice of the reward is provided via text message, and credit is uploaded to a gift card. This pilot study will provide information on the feasibility of using this novel IT solution to provide variable-ratio financial incentives in real time via its effects on recruitment, intervention adherence, retention, and cost. This study will provide the foundation for a comprehensive, adequately-powered, randomized controlled trial to promote short-term weight loss and long-term weight maintenance. If efficacious, this approach could reduce the prevalence, adverse outcomes, and costs of obesity for millions of Americans. Clinicaltrials.gov registration: NCT02691260. Published by Elsevier Inc.

  1. Evidence acquisition and evaluation for evidence summit on enhancing provision and use of maternal health services through financial incentives.

    Science.gov (United States)

    Higgs, Elizabeth S; Stammer, Emily; Roth, Rebecca; Balster, Robert L

    2013-12-01

    Recognizing the need for evidence to inform US Government and governments of the low- and middle-income countries on efficient, effective maternal health policies, strategies, and programmes, the US Government convened the Evidence Summit on Enhancing Provision and Use of Maternal Health Services through Financial Incentives in April 2012 in Washington, DC, USA. This paper summarizes the background and methods for the acquisition and evaluation of the evidence used for achieving the goals of the Summit. The goal of the Summit was to obtain multidisciplinary expert review of literature to inform both US Government and governments of the low- and middle-income countries on evidence-informed practice, policies, and strategies for financial incentives. Several steps were undertaken to define the tasks for the Summit and identify the appropriate evidence for review. The process began by identifying focal questions intended to inform governments of the low-and middle-income countries and the US Government about the efficacy of supply- and demand-side financial incentives for enhanced provision and use of quality maternal health services. Experts were selected representing the research and programme communities, academia, relevant non-governmental organizations, and government agencies and were assembled into Evidence Review Teams. This was followed by a systematic process to gather relevant peer-reviewed literature that would inform the focal questions. Members of the Evidence Review Teams were invited to add relevant papers not identified in the initial literature review to complete the bibliography. The Evidence Review Teams were asked to comply with a specific evaluation framework for recommendations on practice and policy based on both expert opinion and the quality of the data. Details of the search processes and methods used for screening and quality reviews are described.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    how a REP with light physical assets, such as DG (distributed generation) units and ESS (energy storage systems), can survive in a competitive retail market. The paper discusses the effective risk management strategies for the REPs to deal with the uncertainties of the DAM (day-ahead market) and how...... to hedge the financial losses in the market. A two-stage stochastic programming problem is formulated. It aims to establish the financial incentive-based DR programs and the optimal dispatch of the DG units and ESSs. The uncertainty of the forecasted day-ahead load demand and electricity price is also...... taken into account with a scenario-based approach. The principal advantage of this model for REPs is reducing the risk of financial losses in DAMs, and the main benefit for the whole system is market power mitigation by virtually increasing the price elasticity of demand and reducing the peak demand....

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

    OpenAIRE

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

    2017-01-01

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

  4. Incentives and regulation in banking

    NARCIS (Netherlands)

    Martynova, N.

    2015-01-01

    The financial crisis of 2007-2008 has unveiled the hidden flaws in the regulatory framework of the financial sector. The rules of the game established by regulators were not stringent enough and provided bankers with wrong incentives to gamble with depositors’ money. There are two major challenges

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

    Science.gov (United States)

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

    2017-09-16

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

  6. Perceived Self-Efficacy and Financial Incentives: Factors Affecting Health Behaviors and Weight Loss in a Workplace Weight Loss Intervention.

    Science.gov (United States)

    Faghri, Pouran D; Simon, Julia; Huedo-Medina, Tania; Gorin, Amy

    2017-05-01

    To evaluate if self-efficacy (SE) and financial incentives (FI) mediate the effect of health behavior on weight loss in a group of overweight and obese nursing-home employees participating in a 16-week weight-loss intervention with 12-week follow-up. Ninety nine overweight/obese (body mass index [BMI] > 25) employees from four nursing-homes participated, with a mean age of 46.98 years and BMI of 35.33. Nursing-homes were randomized to receiving an incentive-based intervention (n = 51) and no incentive (n = 48). Participants' health behaviors and eating and exercise self-efficacy (Ex-SE) were assessed at week 1, 16, and 28 using a self-reported questionnaire. Mediation and moderated mediation analysis assessed relationships among these variables. Eating self-efficacy (Eat-SE) and Ex-SE were significant mediators between health behaviors and weight loss (P self-efficacy (P = 0.00) on weight loss. Self-efficacy and FI may affect weight loss and play a role in weight-loss interventions.

  7. Behavior analysts in the war on poverty: A review of the use of financial incentives to promote education and employment.

    Science.gov (United States)

    Holtyn, August F; Jarvis, Brantley P; Silverman, Kenneth

    2017-01-01

    Poverty is a pervasive risk factor underlying poor health. Many interventions that have sought to reduce health disparities associated with poverty have focused on improving health-related behaviors of low-income adults. Poverty itself could be targeted to improve health, but this approach would require programs that can consistently move poor individuals out of poverty. Governments and other organizations in the United States have tested a diverse range of antipoverty programs, generally on a large scale and in conjunction with welfare reform initiatives. This paper reviews antipoverty programs that used financial incentives to promote education and employment among welfare recipients and other low-income adults. The incentive-based, antipoverty programs had small or no effects on the target behaviors; they were implemented on large scales from the outset, without systematic development and evaluation of their components; and they did not apply principles of operant conditioning that have been shown to determine the effectiveness of incentive or reinforcement interventions. By applying basic principles of operant conditioning, behavior analysts could help address poverty and improve health through development of effective antipoverty programs. This paper describes a potential framework for a behavior-analytic antipoverty program, with the goal of illustrating that behavior analysts could be uniquely suited to make substantial contributions to the war on poverty. © 2017 Society for the Experimental Analysis of Behavior.

  8. The effect of financial incentives on patients' motivation for treatment: results of "Money for Medication," a randomised controlled trial.

    Science.gov (United States)

    Noordraven, Ernst L; Wierdsma, André I; Blanken, Peter; Bloemendaal, Anthony F T; Mulder, Cornelis L

    2018-05-24

    Offering financial incentives is an effective intervention for improving adherence in patients taking antipsychotic depot medication. We assessed whether patients' motivation for treatment might be reduced after receiving financial rewards. This study was part of Money for Medication, a multicentre, open-label, randomised controlled trial, which demonstrated the positive effects of financial incentives on antipsychotic depot compliance. Three mental healthcare institutions in Dutch secondary psychiatric care services participated. Eligible patients were aged 18-65 years, had been diagnosed with schizophrenia or another psychotic disorder, had been prescribed antipsychotic depot medication or had an indication to start using depot medication, and were participating in outpatient treatment. For 12 months, patients were randomly assigned either to treatment as usual (control group) or to treatment as usual plus a financial reward for each depot of medication received (€30 per month if fully compliant; intervention group). They were followed up for 6 months, during which time no monetary rewards were offered for taking antipsychotic medication. To assess treatment motivation after 0, 12 and 18 months, interviews were conducted using a supplement to the Health of the Nation Outcome Scales (HoNOS) and the Treatment Entry Questionnaire (TEQ). Patients were randomly assigned to the intervention (n = 84) or the control group (n = 85). After 12 months, HoNOS motivation scores were available for 131 patients (78%). Ninety-one percent of the patients had no or mild motivational problems for overall treatment; over time, there were no significant differences between the intervention and control groups. TEQ data was available for a subgroup of patients (n = 61), and showed no significant differences over time between the intervention and control groups for external motivation (β = 0.37 95% CI: -2.49 - 3.23, p = 0.799); introjected motivation (

  9. Motivation and incentives of rural maternal and neonatal health care providers: a comparison of qualitative findings from Burkina Faso, Ghana and Tanzania.

    Science.gov (United States)

    Prytherch, Helen; Kagoné, Moubassira; Aninanya, Gifty A; Williams, John E; Kakoko, Deodatus C V; Leshabari, Melkidezek T; Yé, Maurice; Marx, Michael; Sauerborn, Rainer

    2013-04-25

    In Burkina Faso, Ghana and Tanzania strong efforts are being made to improve the quality of maternal and neonatal health (MNH) care. However, progress is impeded by challenges, especially in the area of human resources. All three countries are striving not only to scale up the number of available health staff, but also to improve performance by raising skill levels and enhancing provider motivation. In-depth interviews were used to explore MNH provider views about motivation and incentives at primary care level in rural Burkina Faso, Ghana and Tanzania. Interviews were held with 25 MNH providers, 8 facility and district managers, and 2 policy-makers in each country. Across the three countries some differences were found in the reasons why people became health workers. Commitment to remaining a health worker was generally high. The readiness to remain at a rural facility was far less, although in all settings there were some providers that were willing to stay. In Burkina Faso it appeared to be particularly difficult to recruit female MNH providers to rural areas. There were indications that MNH providers in all the settings sometimes failed to treat their patients well. This was shown to be interlinked with differences in how the term 'motivation' was understood, and in the views held about remuneration and the status of rural health work. Job satisfaction was shown to be quite high, and was particularly linked to community appreciation. With some important exceptions, there was a strong level of agreement regarding the financial and non-financial incentives that were suggested by these providers, but there were clear country preferences as to whether incentives should be for individuals or teams. Understandings of the terms and concepts pertaining to motivation differed between the three countries. The findings from Burkina Faso underline the importance of gender-sensitive health workforce planning. The training that all levels of MNH providers receive in

  10. National differences in incentive compensation practices : The differing roles of financial performance measurement in the United States and the Netherlands

    NARCIS (Netherlands)

    Jansen, E. Pieter; Merchant, Kenneth A.; Van der Stede, Wim A.

    This paper describes the findings of a study aimed at providing an international replication of a US-based study by Gibbs et al. [Gibbs, M., Merchant, K., Van der Stede, W., & Vargus, M. (2004). Determinants and effects of subjectivity in incentives. The Accounting Review, 79(2), 409-436; Gibbs, M.,

  11. Financial risk sharing with providers in health maintenance organizations, 1999.

    Science.gov (United States)

    Gold, Marsha R; Lake, Timothy; Hurley, Robert; Sinclair, Michael

    2002-01-01

    The transfer of financial risk from health maintenance organizations (HMOs) to providers is controversial. To provide timely national data on these practices, we conducted a telephone survey in 1999 of a multi-staged probability sample of HMOs in 20 of the nation's 60 largest markets, accounting for 86% of all HMO enrollees nationally. Among those sampled, 82% responded. We found that HMOs' provider networks with physicians, hospitals, skilled nursing homes, and home health agencies are complex and multi-tiered Seventy-six percent of HMOs in our study use contracts for their HMO products that involve global, professional services, or hospital risk capitation to intermediate entities. These arrangements account for between 24.5 million and 27.4 million of the 55.9 million commercial and Medicare HMO enrollees in the 60 largest markets. While capitation arrangements are particularly common in California, they are more common elsewhere than many assume. The complex layering of risk sharing and delegation of care management responsibility raise questions about accountability and administrative costs in managed care. Do complex structures provide a way to involve providers more directly in managed care, or do they diffuse authority and add to administrative costs?

  12. 42 CFR 495.370 - Appeals process for a Medicaid provider receiving electronic health record incentive payments.

    Science.gov (United States)

    2010-10-01

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

  13. Decision-making in general practice: the effect of financial incentives on the use of laboratory analyses.

    Science.gov (United States)

    Munkerud, Siri Fauli

    2012-04-01

    This paper examines the reaction of general practitioners (GPs) to a reform in 2004 in the remuneration system for using laboratory services in general practice. The purpose of this paper is to study whether income motivation exists regarding the use of laboratory services in general practice, and if so, the degree of income motivation among general practitioners (GPs) in Norway. We argue that the degree of income motivation is stronger when the physicians are uncertain about the utility of the laboratory service in question. We have panel data from actual physician-patient encounters in general practices in the years 2001-2004 and use discrete choice analysis and random effects models. Estimation results show that an increase in the fees will lead to a small but significant increase in use. The reform led to minor changes in the use of laboratory analyses in GPs' offices, and we argue that financial incentives were diluted because they were in conflict with medical recommendations and existing medical practice. The patient's age has the most influence and the results support the hypothesis that the impact of income increases with increasing uncertainty about diagnosis and treatment. The policy implication of our results is that financial incentives alone are not an effective tool for influencing the use of laboratory services in GPs' offices.

  14. Paying the piper: additional considerations of the theoretical, ethical and moral basis of financial incentives for health behaviour change.

    Science.gov (United States)

    Stephens, Christine

    2014-02-01

    Lynagh, Sanson-Fisher and Bonevski's article entitled "What's good for the goose is good for the gander. Guiding principles for the use of financial incentives in health behaviour change" (Int J Behav Med 20:114-120, 2012) reviews evidence for the use of financial incentives for encouraging health behaviour change. Their discussion of the practical and moral issues involved is a timely contribution which will encourage consideration of the implications of such interventions. In this response to their paper, I suggest that there are also broader aspects that we must consider before developing principles for public policy intervention. First, we must include good theories that explain in a great deal more depth what we mean by health-related behaviours, and secondly, we need to understand the location of these behaviours in social life and within structural inequalities. To ignore these fundamental aspects of health is to risk increasing social injustice and worsening health inequalities, a facet of the morality of health promotion activities which is not touched upon by the Lynagh et al. paper.

  15. Using a Financial Health Model to Provide Context for Financial Literacy Education Research: A Commentary

    Science.gov (United States)

    Huston, Sandra J.

    2015-01-01

    In the article, "Enhancing links between research and practice to improve consumer financial education and well-being" Billy J. Hensley, Director of Education at National Endowment for Financial Education® (NEFE®), outlines his perspective on the current relation between financial education and financial outcome (downstream financial…

  16. Implementation of Responsible Research and Innovation (RRI Practices in Industry: Providing the Right Incentives

    Directory of Open Access Journals (Sweden)

    Agata Gurzawska

    2017-09-01

    Full Text Available Abstract: Responsible Research and Innovation (RRI is a term used by policy-makers and academics to refer to research and innovation that is ethically acceptable and socially desirable. Despite the fact that the vast majority of research and innovation (R&I is funded and produced by industry, companies tend to have no awareness or recognition of this concept. This is unfortunate, as the RRI paradigm could be mutually beneficial for both business and society: it could help businesses realise competitive opportunities while also leading to positive economic, societal and environmental impacts. This paper investigates how industry can be incentivised to engage in research and innovation following the approach of RRI. We propose a matrix of incentives for stimulating the adoption of RRI. We categorise incentives according to three dichotomies: external and internal, instrumental and non-instrumental, direct and indirect. The incentives are formalised in a causal loop diagram, which can be used to demonstrate the sound character of investing in RRI from a business perspective. We discuss examples of incentives, including corporate reputation and critical consumerism, certification, employee engagement, and governance. Lastly, to ensure effective implementation of RRI, we outline factors for the realisation of successful incentives for RRI in industry.

  17. Health worker motivation in Africa: the role of non-financial incentives and human resource management tools

    Directory of Open Access Journals (Sweden)

    Imhoff Ingo

    2006-08-01

    Full Text Available Abstract Background There is a serious human resource crisis in the health sector in developing countries, particularly in Africa. One of the challenges is the low motivation of health workers. Experience and the evidence suggest that any comprehensive strategy to maximize health worker motivation in a developing country context has to involve a mix of financial and non-financial incentives. This study assesses the role of non-financial incentives for motivation in two cases, in Benin and Kenya. Methods The study design entailed semi-structured qualitative interviews with doctors and nurses from public, private and NGO facilities in rural areas. The selection of health professionals was the result of a layered sampling process. In Benin 62 interviews with health professionals were carried out; in Kenya 37 were obtained. Results from individual interviews were backed up with information from focus group discussions. For further contextual information, interviews with civil servants in the Ministry of Health and at the district level were carried out. The interview material was coded and quantitative data was analysed with SPSS software. Results and discussion The study shows that health workers overall are strongly guided by their professional conscience and similar aspects related to professional ethos. In fact, many health workers are demotivated and frustrated precisely because they are unable to satisfy their professional conscience and impeded in pursuing their vocation due to lack of means and supplies and due to inadequate or inappropriately applied human resources management (HRM tools. The paper also indicates that even some HRM tools that are applied may adversely affect the motivation of health workers. Conclusion The findings confirm the starting hypothesis that non-financial incentives and HRM tools play an important role with respect to increasing motivation of health professionals. Adequate HRM tools can uphold and strengthen the

  18. Health worker motivation in Africa: the role of non-financial incentives and human resource management tools.

    Science.gov (United States)

    Mathauer, Inke; Imhoff, Ingo

    2006-08-29

    There is a serious human resource crisis in the health sector in developing countries, particularly in Africa. One of the challenges is the low motivation of health workers. Experience and the evidence suggest that any comprehensive strategy to maximize health worker motivation in a developing country context has to involve a mix of financial and non-financial incentives. This study assesses the role of non-financial incentives for motivation in two cases, in Benin and Kenya. The study design entailed semi-structured qualitative interviews with doctors and nurses from public, private and NGO facilities in rural areas. The selection of health professionals was the result of a layered sampling process. In Benin 62 interviews with health professionals were carried out; in Kenya 37 were obtained. Results from individual interviews were backed up with information from focus group discussions. For further contextual information, interviews with civil servants in the Ministry of Health and at the district level were carried out. The interview material was coded and quantitative data was analysed with SPSS software. The study shows that health workers overall are strongly guided by their professional conscience and similar aspects related to professional ethos. In fact, many health workers are demotivated and frustrated precisely because they are unable to satisfy their professional conscience and impeded in pursuing their vocation due to lack of means and supplies and due to inadequate or inappropriately applied human resources management (HRM) tools. The paper also indicates that even some HRM tools that are applied may adversely affect the motivation of health workers. The findings confirm the starting hypothesis that non-financial incentives and HRM tools play an important role with respect to increasing motivation of health professionals. Adequate HRM tools can uphold and strengthen the professional ethos of doctors and nurses. This entails acknowledging their

  19. Using provider performance incentives to increase HIV testing and counseling services in Rwanda.

    Science.gov (United States)

    de Walque, Damien; Gertler, Paul J; Bautista-Arredondo, Sergio; Kwan, Ada; Vermeersch, Christel; de Dieu Bizimana, Jean; Binagwaho, Agnès; Condo, Jeanine

    2015-03-01

    Paying for performance provides financial rewards to medical care providers for improvements in performance measured by utilization and quality of care indicators. In 2006, Rwanda began a pay for performance scheme to improve health services delivery, including HIV/AIDS services. Using a prospective quasi-experimental design, this study examines the scheme's impact on individual and couples HIV testing. We find a positive impact of pay for performance on HIV testing among married individuals (10.2 percentage points increase). Paying for performance also increased testing by both partners by 14.7 percentage point among discordant couples in which only one of the partners is an AIDS patient. Copyright © 2014. Published by Elsevier B.V.

  20. Financial incentives to promote renewable energy systems in European electricity markets: a survey

    International Nuclear Information System (INIS)

    Haas, R.; Huber, C.; Wohlgemuth, N.

    2001-01-01

    Renewable energy systems may contribute to sustainable development. Therefore, one of the challenges for energy policy is to ensure that renewable energy options have a fair opportunity to compete with other supply resources. This paper presents a survey on promotion mechanisms to enhance the market penetration of renewable energies in European electricity markets. Strategies include rebates and tax incentives, regulated rates, system benefit charges, bidding-oriented mechanisms and various types of green pricing programs. The paper concludes that efficient promotion mechanisms should focus on incentives per kWh generated rather than on rebates on the investment in generating capacity (kW), and that there is no one single program type which has the best application to the promotion of all renewable technologies. For example, enhanced buy-back rates work as a dissemination strategy for wind energy but they do not work for photovoltaics. (author)

  1. Use of care management practices in small- and medium-sized physician groups: do public reporting of physician quality and financial incentives matter?

    Science.gov (United States)

    Alexander, Jeffrey A; Maeng, Daniel; Casalino, Lawrence P; Rittenhouse, Diane

    2013-04-01

    To examine the effect of public reporting (PR) and financial incentives tied to quality performance on the use of care management practices (CMPs) among small- and medium-sized physician groups. Survey data from The National Study of Small and Medium-sized Physician Practices were used. Primary data collection was also conducted to assess community-level PR activities. The final sample included 643 practices engaged in quality reporting; about half of these practices were subject to PR. We used a treatment effects model. The instrumental variables were the community-level variables that capture the level of PR activity in each community in which the practices operate. (1) PR is associated with increased use of CMPs, but the estimate is not statistically significant; (2) financial incentives are associated with greater use of CMPs; (3) practices' awareness/sensitivity to quality reports is positively related to their use of CMPs; and (4) combined PR and financial incentives jointly affect CMP use to a greater degree than either of these factors alone. Small- to medium-sized practices appear to respond to PR and financial incentives by greater use of CMPs. Future research needs to investigate the appropriate mix and type of incentive arrangements and quality reporting. © Health Research and Educational Trust.

  2. The Effects of Financial Incentives on Women’s Performance: The Tournament Theory Applied to Female Tennis Players

    Directory of Open Access Journals (Sweden)

    Matthieu LLORCA

    2017-06-01

    Full Text Available The purpose of this paper is to analyze the management model of women’s professional tennis by using the theoretical framework of the tournament theory. Indeed, this sport is particularly appropriate to study the effects of financial incentives on women’s performance in the context of competitive elimination tournament. Moreover, we take into account the direct opposition between players by building two relative performance indicators. Empirical tests are conducted, by using Ordinary Least Squares method, on the whole tournaments played by the 30 best women’s tennis players, over the 2011 season. Interesting implication found is that one tournament theory principle, the incentive effect, is confirmed. In other words, an undistributed prize structure between tournament rounds increases the player performance. However, the other consequence of the tournament theory, the participative effect, is rejected because the monetary gains distributed by the tournament’s organizer (either the premium earned or the total dollar endowment do not induce better player performance.

  3. Financial incentives for smoking cessation among depression-prone pregnant and newly postpartum women: effects on smoking abstinence and depression ratings.

    Science.gov (United States)

    Lopez, Alexa A; Skelly, Joan M; Higgins, Stephen T

    2015-04-01

    We examined whether pregnant and newly postpartum smokers at risk for postpartum depression respond to an incentive-based smoking-cessation treatment and how the intervention impacts depression ratings. This study is a secondary data analysis. Participants (N = 289; data collected 2001-2013) were smokers at the start of prenatal care who participated in 4 controlled clinical trials on the efficacy of financial incentives for smoking cessation. Women were assigned either to an intervention wherein they earned vouchers exchangeable for retail items contingent on abstaining from smoking or to a control condition wherein they received vouchers of comparable value independent of smoking status. Treatments were provided antepartum through 12-weeks postpartum. Depression ratings (Beck Depression Inventory [BDI]-1A) were examined across 7 antepartum/postpartum assessments. Women who reported a history of prior depression or who had BDI scores ≥ 17 at the start of prenatal care were categorized as depression-prone (Dep+), while those meeting neither criterion were categorized as depression-negative (Dep-). The intervention increased smoking abstinence independent of depression status (p postpartum BDI ratings as well as the proportion of women scoring in the clinical range (≥17 and >21) compared with the control treatment (ps ≤ .05). Treatment effects on depression ratings were attributable to changes in Dep+ women. These results demonstrate that depression-prone pregnant and newly postpartum women respond well to this incentive-based smoking-cessation intervention in terms of achieving abstinence, and the intervention also reduces the severity of postpartum depression ratings in this at-risk population. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. Can a return to Glass-Steagall provide financial stability in the US financial system?

    Directory of Open Access Journals (Sweden)

    Jan Kregel

    2010-01-01

    Full Text Available In the immediate aftermath of the current financial crisis in the United States the response has been to resolve small and medium size banks, while large banks experiencing financial trouble have been given both direct and indirect government support. This, however, has resulted in a number of larger banks absorbing smaller ones, creating an even smaller number of even larger banks that dominate the financial system. This article deals first with a comparison of the problems created by “too big to fail†financial institutions. The second section deals with the possible restoration of Glass-Steagall type legislation as a means of restoring single-function financial institutions. It concludes that alternatives to separation of functions will have to be found to deal with multifunction financial institutions since most lending activity requires securities markets activities.

  5. The goose is (half) cooked: a consideration of the mechanisms and interpersonal context is needed to elucidate the effects of personal financial incentives on health behaviour.

    Science.gov (United States)

    Hagger, Martin S; Keatley, David A; Chan, Derwin C K; Chatzisarantis, Nikos L D; Dimmock, James A; Jackson, Ben; Ntoumanis, Nikos

    2014-02-01

    While we agree that personal financial incentives (PFIs) may have some utility in public health interventions to motivate people in the uptake and persistence of health behaviour, we disagree with some of the sentiments outlined by Lynagh et al. (Int J Behav Med 20:114-120, 2012). Specifically, we feel that the article gives a much stronger impression that PFIs will likely lead to long-term behaviour change once the incentive has been removed than is warranted by current research. This claim has not received strong empirical support nor is it grounded in psychological theory on the role of incentives and motivation. We also feel that the presentation of some of the tenets of self-determination theory by the authors is misleading. Based on self-determination theory, we propose that PFIs, without sufficient consideration of the mechanisms by which external incentives affect motivation and the interpersonal context in which they are presented, are unlikely to lead to persistence in health behaviour once the incentive is removed. We argue that interventions that adopt PFIs as a strategy to promote health-behaviour change should incorporate strategies in the interpersonal context to minimise the undermining effect of the incentives on intrinsic motivation. Interventions should present incentives as informational regarding individuals' competence rather than as purely contingent on behavioural engagement and emphasise self-determined reasons for pursuing the behaviour.

  6. Acceptability and feasibility of a financial incentive intervention to improve retention in HIV care among pregnant women in Johannesburg, South Africa.

    Science.gov (United States)

    Clouse, Kate; Mongwenyana, Constance; Musina, Melda; Bokaba, Dorah; Long, Lawrence; Maskew, Mhairi; Ahonkhai, Aima; Fox, Matthew P

    2018-04-01

    Women initiating antiretroviral therapy during pregnancy are at high risk of dropping out of HIV care after delivery. We assessed the acceptability and feasibility of a financial incentive - a one-time R50 (∼USD4) supermarket voucher for completing one postpartum visit ≤10 weeks of delivery - to improve postpartum retention. We enrolled 100 pregnant, HIV-positive women at a primary health clinic in Johannesburg, South Africa. Participants were interviewed at enrollment and we reviewed files to assess retention ≥14 weeks postpartum. Median (IQR) respondent age was 28 years (24-31) and 31% were employed. Most (86%) said the incentive would motivate them to return and 76% supported clinics offering incentives. Among the 23% who found the intervention unacceptable, the most frequent reason was perceived personal responsibility for health. Feasibility was demonstrated, as 79.7% (51/64) of eligible participants received a voucher. When asked to rank preferred hypothetical incentive interventions, assistance with social services ranked first (29%), followed by infant formula (22%) and cash (21%); assistance with social services was the top-ranked choice by both those who found the voucher incentive intervention acceptable and unacceptable. To encourage HIV-positive women to remain in care, respondents most frequently suggested health education (34%), counseling (29%), financial incentives (25%), home visits (13%), and better service (6%). Our results suggest financial incentives are acceptable, but women frequently expressed preference for integrated services and improved education and counseling to improve retention. Interventions exploring the feasibility and efficacy of education and counseling interventions to improve postpartum HIV care are warranted.

  7. Ethical acceptability of offering financial incentives for taking antipsychotic depot medication: Patients' and clinicians' perspectives after a 12-month randomized controlled trial

    NARCIS (Netherlands)

    E.L. Noordraven (Ernst); M.H.N. Schermer (Maartje); P. Blanken (Peter); C.L. Mulder (Niels); A.I. Wierdsma (André)

    2017-01-01

    textabstractBackground: A randomized controlled trial 'Money for Medication'(M4M) was conducted in which patients were offered financial incentives for taking antipsychotic depot medication. This study assessed the attitudes and ethical considerations of patients and clinicians who participated in

  8. Financial incentives improve recognition but not treatment of cardiovascular risk factors in severe mental illness.

    Directory of Open Access Journals (Sweden)

    Carol L Wilson

    Full Text Available Severe mental illness (SMI is associated with premature cardiovascular disease, prompting the UK primary care payment-for-performance system (Quality and Outcomes Framework, QOF to incentivise annual physical health reviews. This study aimed to assess the QOF's impact on detection and treatment of cardiovascular risk factors in people with SMI.A retrospective open cohort study of UK general practice was conducted between 1996 and 2014, using segmented logistic regression with 2004 and 2011 as break points, reflecting the introduction of relevant QOF incentives in these years. 67239 SMI cases and 359951 randomly-selected unmatched controls were extracted from the Clinical Practice Research Datalink (CPRD.There was strong evidence (p≤0.015 the 2004 QOF indicator (general health resulted in an immediate increase in recording of elevated cholesterol (odds ratio 1.37 (95% confidence interval 1.24 to 1.51; obesity (OR 1.21 (1.06 to 1.38; and hypertension (OR 1.19 (1.04 to 1.38 in the SMI group compared with the control group, which was sustained in subsequent years. Similar findings were found for diabetes, although the evidence was weaker (p = 0.059; OR 1.21 (0.99 to 1.49. There was evidence (p<0.001 of a further, but unsustained, increase in recording of elevated cholesterol and obesity in the SMI group following the 2011 QOF indicator (cardiovascular specific. There was no clear evidence that the QOF indicators affected the prescribing of lipid modifying medications or anti-diabetic medications.Incentivising general physical health review for SMI improves identification of cardiovascular risk factors, although the additional value of specifically incentivising cardiovascular risk factor assessment is unclear. However, incentives do not affect pharmacological management of these risks.

  9. ABOUT THE MECHANISM OF FINANCIAL INCENTIVE FOR THE DEVELOPERS OF IT SYSTEMS

    Directory of Open Access Journals (Sweden)

    Alexey S. Dobrynin

    2015-01-01

    Full Text Available Improving the performance of the developers of hardware and software systems and IT systems it is inextricably linked with quality incentives. People are motivated to work and are able to achieve good results, focusing on decent remuneration. Non-rational approaches to remuneration are able to generate social problems and greatly reduce the overall efficiency of the organizational systems. Motivation mobile teams of IT developers and individuals engaged in the operational management of the project implementation is of paramount importance. The article examines the mechanisms for stimulating the synthesis development of IT systems based on the principle of coordinated control that allows you to bring together the interests of the customers and performers. It is expected that customers and performers interested in creating all the necessary conditions (investment, social, technological to obtain high-quality final product. The customer agrees with the developer on the approximate number of design iterations, each iteration of the composition, timing and budgets required to achieve the desired result. By means of evaluating the effectiveness of business results are metric tests, including functional and modular (unit tests, created in direct contact representatives of the customer and the developer. This mechanism should be used in mobile teams, in which the development is relatively short iterations with stepwise refinement of business requirements.

  10. Lightweight electric-powered vehicles. Which financial incentives after the large-scale field tests at Mendrisio?

    International Nuclear Information System (INIS)

    Keller, M.; Frick, R.; Hammer, S.

    1999-08-01

    How should lightweight electric-powered vehicles be promoted, after the large-scale fleet test being conducted at Mendrisio (southern Switzerland) is completed in 2001, and are there reasons to put question marks behind the current approach? The demand for electric vehicles, and particularly the one in the automobile category, has remained at a persistently low level. As it proved, any appreciable improvement of this situation is almost impossible, even with substantial financial incentives. However, the unsatisfactory sales figures have little to do with the nature of the fleet test itself or with the specific conditions at Mendrisio. The problem is rather of structural nature. For (battery-operated) electric cars the main problem at present is the lack of an expanding market which could become self-supporting with only a few additional incentives. Various strategies have been evaluated. Two alternatives were considered in particular: a strategy to promote explicitly electric vehicles ('EL-strategy'), and a strategy to promote efficient road vehicles in general which would have to meet specific energy and environmental-efficiency criteria ('EF-strategy'). The EL-strategies make the following dilemma clear. If the aim is to raise the share of these vehicles up to 5% of all cars on the road (or even 8%) in a mid-term prospect, then substantial interventions in the relevant vehicle markets would be required, either with penalties for conventional cars, or a large-scale funding scheme, or interventions at the supply level. The study suggests a differentiated strategy with two components: (i) 'institutionalised' promotion with the aim of a substantial increase of the share of 'efficient' vehicles (independently of the propulsion technology), and (ii) the continuation of pilot and demonstration projects for the promotion of different types of innovative technologies. (author) [de

  11. A small unconditional non-financial incentive suggests an increase in survey response rates amongst older general practitioners (GPs): a randomised controlled trial study.

    Science.gov (United States)

    Pit, Sabrina Winona; Hansen, Vibeke; Ewald, Dan

    2013-07-30

    Few studies have investigated the effect of small unconditional non-monetary incentives on survey response rates amongst GPs or medical practitioners. This study assessed the effectiveness of offering a small unconditional non-financial incentive to increase survey response rates amongst general practitioners within a randomised controlled trial (RCT). An RCT was conducted within a general practice survey that investigated how to prolong working lives amongst ageing GPs in Australia. GPs (n = 125) were randomised to receive an attractive pen or no pen during their first invitation for participation in a survey. GPs could elect to complete the survey online or via mail. Two follow up reminders were sent without a pen to both groups. The main outcome measure was response rates. The response rate for GPs who received a pen was higher in the intervention group (61.9%) compared to the control group (46.8%). This study did not find a statistically significant effect of a small unconditional non-financial incentive (in the form of a pen) on survey response rates amongst GPs (Odds ratio, 95% confidence interval: 1.85 (0.91 to 3.77). No GPs completed the online version. A small unconditional non-financial incentives, in the form of a pen, may improve response rates for GPs.

  12. Quality Quandaries: Improving a customer value stream at a financial service provider

    NARCIS (Netherlands)

    Kuiper, A.; van de Hoef, R.; Wesseling, M.; Lameijer, B.A.; Does, R.J.M.M.

    2016-01-01

    In the wake of the financial crisis, the financial sector had to make tremendous efforts in being more transparent and cost efficient (Blom and Kuenen 2009). As a consequence, over the last decade, various financial service providers have embraced a range of methods for improving their customer

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

    Science.gov (United States)

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

    2017-05-18

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

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

    Directory of Open Access Journals (Sweden)

    Nicholas D. Gilson

    2017-05-01

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

  15. Is there a financial incentive to immigrate? Examining of the health worker salary gap between India and popular destination countries.

    Science.gov (United States)

    George, Gavin; Rhodes, Bruce

    2017-10-19

    International migration is one of the factors resulting in the shortage of Human Resources for Health (HRH) in India. Literature suggests that migration is fuelled by the prospect of higher salaries available abroad. The extent of these salary differentials are unknown, and this study seeks to examine the salaries of selected HRH in India and four popular destination countries (United States of America, United Kingdom, Canada and the United Arab Emirates), whilst accounting for the in-country cost of living. This study will therefore determine truer financial incentives for Indian HRH to migrate abroad. A purchasing power parity (PPP) ratio is employed to equalise the international price of buying a representative basket of commonly bought goods (including food, entertainment, fuel and utilities). Using the PPP index, real differences in salaries are directly compared for selected work categories and different levels of work experience in the four respective countries. Nurses in the USA can earn up to 82.7% more than their Indian counterparts. Nurses in Canada and the UAE reveal more modest salary differentials, yet still significant better off by up to 28 and 20% respectively. Only nurses in the UK are potentially materially worse off than nurses working in India. We observe significant potential PPP gains of up to 57.4, 99.1 and 94.4% for medical doctors in the USA, Canada and the UAE respectively. Medical specialists potentially experience the greatest income disparities with anaesthetists potentially earning up to 600% more than their counterparts in India. Radiologists operating in the UK and general surgeons working in the USA can potentially earn more than double that of their counterparts working in India. We observe more modest positive or negligible PPP gains in other selected countries for health specialists. Even when considering the differences in the cost of living, the financial incentive for selected cadres of Indian HRH to seek work abroad remains

  16. Sex-based differences in income and response to proposed financial incentives among general practitioners in France.

    Science.gov (United States)

    Weeks, William B; Paraponaris, Alain; Ventelou, Bruno

    2013-11-01

    Women represent a growing proportion of the physician workforce, worldwide. Therefore, for the purposes of workforce planning, it is increasingly important to understand differences in how male and female physicians work and might respond to financial incentives. A recent survey allowed us to determine whether sex-based differences in either physician income or responses to a hypothetical increase in reimbursement exist among French General Practitioners (GPs). Our analysis of 828 male and 244 female GPs' responses showed that females earned 35% less per year from medical practice than their male counterparts. After adjusting for the fact that female GPs had practiced medicine fewer years, worked 11% fewer hours per year, and spent more time with each consultation, female GPs earned 11,194€, or 20.6%, less per year (95% CI: 7085€-15,302€ less per year). Male GPs were more likely than female GPs to indicate that they would work fewer hours if consultation fees were to be increased. Our findings suggest that, as the feminization of medicine increases, the need to address gender-based income disparities increases and the tools that French policymakers use to regulate the physician supply might need to change. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  17. Cluster randomised controlled trial of a financial incentive for mothers to improve breast feeding in areas with low breastfeeding rates: the NOSH study protocol.

    Science.gov (United States)

    Relton, Clare; Strong, Mark; Renfrew, Mary J; Thomas, Kate; Burrows, Julia; Whelan, Barbara; Whitford, Heather M; Scott, Elaine; Fox-Rushby, Julia; Anoyke, Nana; Sanghera, Sabina; Johnson, Maxine; Easton, Sue; Walters, Stephen

    2016-04-11

    Breast feeding can promote positive long-term and short-term health outcomes in infant and mother. The UK has one of the lowest breastfeeding rates (duration and exclusivity) in the world, resulting in preventable morbidities and associated healthcare costs. Breastfeeding rates are also socially patterned, thereby potentially contributing to health inequalities. Financial incentives have been shown to have a positive effect on health behaviours in previously published studies. Based on data from earlier development and feasibility stages, a cluster (electoral ward) randomised trial with mixed-method process and content evaluation was designed. The 'Nourishing Start for Health' (NOSH) intervention comprises a financial incentive programme of up to 6 months duration, delivered by front-line healthcare professionals, in addition to existing breastfeeding support. The intervention aims to increase the prevalence and duration of breast feeding in wards with low breastfeeding rates. The comparator is usual care (no offer of NOSH intervention). Routine data on breastfeeding rates at 6-8 weeks will be collected for 92 clusters (electoral wards) on an estimated 10,833 births. This sample is calculated to provide 80% power in determining a 4% point difference in breastfeeding rates between groups. Content and process evaluation will include interviews with mothers, healthcare providers, funders and commissioners of infant feeding services. The economic analyses, using a healthcare provider's perspective, will be twofold, including a within-trial cost-effectiveness analysis and beyond-trial modelling of longer term expectations for cost-effectiveness. Results of economic analyses will be expressed as cost per percentage point change in cluster level in breastfeeding rates between trial arms. In addition, we will present difference in resource use impacts for a range of acute conditions in babies aged 0-6 months. Participating organisations Research and Governance

  18. Better quality of life in patients offered financial incentives for taking anti-psychotic medication: Linked to improved adherence or more money?

    Science.gov (United States)

    Moran, Katherine; Priebe, Stefan

    2016-08-01

    In a randomised controlled trial, patients were offered financial incentives to improve their adherence to anti-psychotic maintenance medication. Compared to a control group without the incentives, they had an improved adherence and also better subjective quality of life (SQOL) after 1 year. This paper explores the question as to whether this improvement in SQOL was associated with the amount of money received or with the improved adherence itself. A secondary analysis was performed using data of the experimental group in the trial. Adherence was assessed as the percentage of all prescribed long-acting anti-psychotic injections that were taken by the patient. In regression models, we tested whether changes in medication adherence and/or the amount of incentives received over the 12-month period was associated with SQOL, as rated on the DIALOG scale. Adherence changed from 68.49 % at baseline to 88.23 % (mean difference in adherence = 19.59 %, SD = 17.52 %). The total amount of incentives received within the 1-year study period varied between £75 and £735, depending on the treatment cycle and the number of long-acting injections taken. Improvement in adherence was found to be a significant predictor of better subjective quality of life (β = 0.014, 95 % CI 0.003-0.025, p = 0.014), whilst the amount of incentives received was not (β = 0.0002, 95 % CI -0.002 to 0.002, p = 0.818). Improved medication adherence is associated with a more favourable SQOL. This underlines the clinical relevance of improved adherence in response to financial incentives in this patient group.

  19. Using educational outreach and a financial incentive to increase general practices’ contribution to chlamydia screening in South-East London 2003–2011

    Directory of Open Access Journals (Sweden)

    Kalwij Sebastian

    2012-09-01

    rate in 2010/11 was 5.8% in men and 6.0% in women. In Southwark positivity rate was 3.9% in men and 5.3% in women. In 2003/04 13% tests in general practice (Lambeth were from men, this increased to 25% in 2010/11. In Southwark this increased from 20% in 2003/04 to 27.6% in 2010/11. We compared the results with London and national data and showed significant differences between GP testing in Lambeth and Southwark, and GP testing in London and the rest of England. Conclusions General practices can be important potential providers of chlamydia tests. With a combination of sustained support, financial incentives and feedback on performance, general practice may be able to test a large percentage of 15–24 year olds. General practice is also a potentially important provider of chlamydia tests to young men.

  20. 42 CFR 422.356 - Determining substantial financial risk and majority financial interest.

    Science.gov (United States)

    2010-10-01

    ... the PSO's revenue. (3) The PSO's use of significant financial incentives for its affiliated providers... and to subsequent significant financial rewards and penalties (which may include a reduction in...

  1. Recorded quality of primary care for patients with diabetes in England before and after the introduction of a financial incentive scheme: a longitudinal observational study.

    Science.gov (United States)

    Kontopantelis, Evangelos; Reeves, David; Valderas, Jose M; Campbell, Stephen; Doran, Tim

    2013-01-01

    The UK's Quality and Outcomes Framework (QOF) was introduced in 2004/5, linking remuneration for general practices to recorded quality of care for chronic conditions, including diabetes mellitus. We assessed the effect of the incentives on recorded quality of care for diabetes patients and its variation by patient and practice characteristics. Using the General Practice Research Database we selected a stratified sample of 148 English general practices in England, contributing data from 2000/1 to 2006/7, and obtained a random sample of 653,500 patients in which 23,920 diabetes patients identified. We quantified annually recorded quality of care at the patient-level, as measured by the 17 QOF diabetes indicators, in a composite score and analysed it longitudinally using an Interrupted Time Series design. Recorded quality of care improved for all subgroups in the pre-incentive period. In the first year of the incentives, composite quality improved over-and-above this pre-incentive trend by 14.2% (13.7-14.6%). By the third year the improvement above trend was smaller, but still statistically significant, at 7.3% (6.7-8.0%). After 3 years of the incentives, recorded levels of care varied significantly for patient gender, age, years of previous care, number of co-morbid conditions and practice diabetes prevalence. The introduction of financial incentives was associated with improvements in the recorded quality of diabetes care in the first year. These improvements included some measures of disease control, but most captured only documentation of recommended aspects of clinical assessment, not patient management or outcomes of care. Improvements in subsequent years were more modest. Variation in care between population groups diminished under the incentives, but remained substantial in some cases.

  2. Ethical acceptability of offering financial incentives for taking antipsychotic depot medication: patients' and clinicians' perspectives after a 12-month randomized controlled trial.

    Science.gov (United States)

    Noordraven, Ernst L; Schermer, Maartje H N; Blanken, Peter; Mulder, Cornelis L; Wierdsma, André I

    2017-08-29

    A randomized controlled trial 'Money for Medication'(M4M) was conducted in which patients were offered financial incentives for taking antipsychotic depot medication. This study assessed the attitudes and ethical considerations of patients and clinicians who participated in this trial. Three mental healthcare institutions in secondary psychiatric care in the Netherlands participated in this study. Patients (n = 169), 18-65 years, diagnosed with schizophrenia, schizoaffective disorder or another psychotic disorder who had been prescribed antipsychotic depot medication, were randomly assigned to receive 12 months of either treatment as usual plus a financial reward for each depot of medication received (intervention group) or treatment as usual alone (control group). Structured questionnaires were administered after the 12-month intervention period. Data were available for 133 patients (69 control and 64 intervention) and for 97 clinicians. Patients (88%) and clinicians (81%) indicated that financial incentives were a good approach to improve medication adherence. Ethical concerns were categorized according to the four-principles approach (autonomy, beneficence, non-maleficence, and justice). Patients and clinicians alike mentioned various advantages of M4M in clinical practice, such as increased medication adherence and improved illness insight; but also disadvantages such as reduced intrinsic motivation, loss of autonomy and feelings of dependence. Overall, patients evaluated financial incentives as an effective method of improving medication adherence and were willing to accept this reward during clinical treatment. Clinicians were also positive about the use of this intervention in daily practice. Ethical concerns are discussed in terms of patient autonomy, beneficence, non-maleficence and justice. We conclude that this intervention is ethically acceptable under certain conditions, and that further research is necessary to clarify issues of benefit

  3. First do no harm - The impact of financial incentives on dental X-rays

    NARCIS (Netherlands)

    Chalkley, M.; Listl, S.

    2018-01-01

    This article assesses the impact of dentist remuneration on the incidence of potentially harmful dental X-rays. We use unique panel data which provide details of 1.3 million treatment claims by Scottish NHS dentists made between 1998 and 2007. Controlling for unobserved heterogeneity of both

  4. Database of Renewable Energy and Energy Efficiency Incentives and Policies Final Technical Report

    Energy Technology Data Exchange (ETDEWEB)

    Lips, Brian

    2018-03-28

    The Database of State Incentives for Renewables and Efficiency (DSIRE) is an online resource that provides summaries of all financial incentives and regulatory policies that support the use of renewable energy and energy efficiency across all 50 states. This project involved making enhancements to the database and website, and the ongoing research and maintenance of the policy and incentive summaries.

  5. California Energy Incentive Programs: An Annual Update on Key Energy Issues and Financial Opportunities for Federal Sites in California

    Energy Technology Data Exchange (ETDEWEB)

    None

    2011-12-01

    A spate of recently enacted energy legislation and associated program changes is providing numerous opportunities to help California federal energy managers cut costs and meet their renewables, energy efficiency and GHG emissions goals. In April 2011, Governor Jerry Brown approved the nation’s most ambitious renewable portfolio standard (RPS), which requires 33% of the state’s electricity to come from renewable energy sources by 2020. Policy changes that will support the RPS include expanded eligibility rules that fill previous gaps in incentives for certain sizes of on-site renewable energy systems. Program updates described in this document include: $200 million more in funding for California Solar Initiative rebates to commercial and industrial customers; an increase in the eligible system size for the Feed-In-Tariff (FIT) from 1.5MW to 3MW; and pending changes that may allow customer-side systems to sell tradable renewable energy credits (TRECs) to entities with RPS compliance obligations in California.

  6. Compliance Performance: Effects of a Provider Incentive Program and Coding Compliance Plan

    National Research Council Canada - National Science Library

    Tudela, Joseph A

    2004-01-01

    The purpose of this project is to study provider and coder related performance, i.e., provider compliance rate and coder productivity/accuracy rates and average dollar difference between coder and auditor, at Brooke Army Medical Center...

  7. Medicare program; requirements for the Medicare incentive reward program and provider enrollment. Final rule.

    Science.gov (United States)

    2014-12-05

    This final rule implements various provider enrollment requirements. These include: Expanding the instances in which a felony conviction can serve as a basis for denial or revocation of a provider or supplier's enrollment; if certain criteria are met, enabling us to deny enrollment if the enrolling provider, supplier, or owner thereof had an ownership relationship with a previously enrolled provider or supplier that had a Medicare debt; enabling us to revoke Medicare billing privileges if we determine that the provider or supplier has a pattern or practice of submitting claims that fail to meet Medicare requirements; and limiting the ability of ambulance suppliers to "backbill" for services performed prior to enrollment.

  8. Aligning ambition and incentives

    DEFF Research Database (Denmark)

    Koch, Alexander; Peyrache, Eloïc

    2011-01-01

    Labor turnover creates longer term career concerns incentives that motivate employees in addition to the short term monetary incentives provided by the current employer. We analyze how these incentives interact, and derive implications for the design of incentive contracts and organizational choice...

  9. Aligning Ambition and Incentives

    DEFF Research Database (Denmark)

    Koch, Alexander; Peyrache, Eloïc

    Labor turnover creates longer term career concerns incentives that motivate employees in addition to the short term monetary incentives provided by the current employer. We analyze how these incentives interact and derive implications for the design of incentive contracts and organizational choice...

  10. Industry Related Financial Incentives.

    Science.gov (United States)

    1987-09-29

    experienced the underwriter in determining premiums, the more accurate the premium since premiums are basically subjective determinations. After a...the expert panel had noted that insurers rarely disclose supporting analyses behind their ratemaking decisions. Liberty and Arkwright cited market...Liberty basically agreed with Arkwright’s view, but felt that tort liability was most influential, followed closely by production interruption, then

  11. Solar workshops financial incentives

    Energy Technology Data Exchange (ETDEWEB)

    None

    1979-01-01

    Ten one-day workshops were held across the United States. Information in this workbook is compiled in conjunction with those workshops. The following discussions are included: solar as a fuel (history); why alternative fuels are being sought today; the need for conservation; advantages of solar energy; the potential of solar energy; why solar energy is not more widely used; a definition of solar; how solar can help meet energy demands; Federal policies and programs; what solar technologies exist today that can be effectively utilized (thermal applications, fuels from biomass, solar electric). Additional information is presented in three attachments: Energy-Conserving Methods; Domestic Policy Review of Solar Energy; and DOE Secretary's Annual Report to Congress-Solar Section. (MCW)

  12. Not fully charged: Welfare effects of tax incentives for employer-provided electric cars

    NARCIS (Netherlands)

    Dimitropoulos, A.; van Ommeren, J.N.; Koster, P.R.; Rietveld, P.

    2016-01-01

    More than 15 million cars are provided as fringe benefits by employers in Europe. The company car market is the driving force of changes in European car fleets and one of the main channels for the penetration of low emission vehicles. Policies in support of low emission vehicles through this channel

  13. Do Financial Incentives Influence GPs' Decisions to Do After-hours Work? A Discrete Choice Labour Supply Model.

    Science.gov (United States)

    Broadway, Barbara; Kalb, Guyonne; Li, Jinhu; Scott, Anthony

    2017-12-01

    This paper analyses doctors' supply of after-hours care (AHC), and how it is affected by personal and family circumstances as well as the earnings structure. We use detailed survey data from a large sample of Australian General Practitioners (GPs) to estimate a structural, discrete choice model of labour supply and AHC. This allows us to jointly model GPs' decisions on the number of daytime-weekday working hours and the probability of providing AHC. We simulate GPs' labour supply responses to an increase in hourly earnings, both in a daytime-weekday setting and for AHC. GPs increase their daytime-weekday working hours if their hourly earnings in this setting increase, but only to a very small extent. GPs are somewhat more likely to provide AHC if their hourly earnings in that setting increase, but again, the effect is very small and only evident in some subgroups. Moreover, higher earnings in weekday-daytime practice reduce the probability of providing AHC, particularly for men. Increasing GPs' earnings appears to be at best relatively ineffective in encouraging increased provision of AHC and may even prove harmful if incentives are not well targeted. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  14. Financial incentives to influence maternal mortality in a low-income setting: making available 'money to transport' - experiences from Amarpatan, India.

    Science.gov (United States)

    De Costa, Ayesha; Patil, Rajkumar; Kushwah, Surgiv Singh; Diwan, Vinod Kumar

    2009-03-18

    Only 40.7% women in India deliver in an institution; leaving many vulnerable to maternal morbidity and mortality (India has 22% of global maternal deaths). While limited accessibility to functioning institutions may account in part, a common reason why women deliver at home is poverty. A lack of readily available financial resources for families to draw upon at the time of labor to transport the mother to an institution, is often observed. This paper reports a yearlong collaborative intervention (between the University and Department of Health) to study if providing readily available and easily accessible funds for emergency transportation would reduce maternal deaths in a rural, low income, and high maternal mortality setting in central India. It aimed to obviate a deterrent to emergency obstetric care; the non-availability of resources with mothers when most needed. Issues in implementation are also discussed. Maternal deaths were actively identified in block Amarpatan (0.2 million population) over a 2-year period. The project, with participation from local government and other groups, trained 482 local health care providers (public and private) to provide antenatal care. Emergency transport money (in cash) was placed with one provider in each village. Maternal mortality in the adjacent block (Maihar) was followed (as a 'control' block). Maternal deaths in Amarpatan decreased during the project year relative to the previous year, or in the control block the same year. Issues in implementation of the cash incentive scheme are discussed. Although the intervention reduced maternal deaths in this low-income setting, chronic poverty and malnutrition are underlying structural problems that need to be addressed.

  15. Issues - III. Renewable energies and financial issues - The organisation of a renewable energy sector: the supply in wood-fuel in Auvergne; profitable ecology: which incentive financial and tax tools in favour of renewable energies?; the mechanism of mandatory purchase of electricity production: a precarious support mechanism

    International Nuclear Information System (INIS)

    Amblard, Laurence; Taverne, Marie; Guerra, Fabien; Rouge, Sandra; Gelas, Helene

    2012-01-01

    A first article reports the results of an investigation of the organisation of wood-fuel supply in the French region of Auvergne (presentation of the supply chain analysis, use of the transaction cost theory, factors affecting organisational choices within supply chains). The second article presents and comments the various incentive financial and tax measures in favour of renewable energies (State tax incentives for companies and for individuals, local incentives, and financial incentives). The third article outlines the precarious legal character of the mechanism of mandatory purchase of electricity production, as well as the precarious will of the Government regarding this mandatory purchase

  16. Closing the gap between socioeconomic and financial implications of residential and community level hydrogen-based energy systems: Incentives needed for a bridge to the future

    Science.gov (United States)

    Verduzco, Laura E.

    The use of hydrogen as an energy carrier has the potential to decrease the amount of pollutants emitted to the atmosphere, significantly reduce our dependence on imported oil and resolve geopolitical issues related to energy consumption. The current status of hydrogen technology makes it prohibitive and financially risky for most investors to commit the money required for large-scale hydrogen production. Therefore, alternative strategies such as small and medium-scale hydrogen applications should be implemented during the early stages of the transition to the hydrogen economy in order to test potential markets and technology readiness. While many analysis tools have been built to estimate the requirements of the transition to a hydrogen economy, few have focused on small and medium-scale hydrogen production and none has paired financial with socioeconomic costs at the residential level. The computer-based tool (H2POWER) presented in this study calculates the capacity, cost and socioeconomic impact of the systems needed to meet the energy demands of a home or a community using home and neighborhood refueling units, which are systems that can provide electricity and heat to meet the energy demands of either (1) a home and automobile or (2) a cluster of homes and a number of automobiles. The financial costs of the production, processing and delivery sub-systems that conform the refueling units are calculated using cost data of existing technology and normalizing them to calculate capital and net present cost. The monetary value of the externalities (socioeconomic analysis) caused by each system is calculated by H2POWER through a statistical analysis of the cost associated to various externalities. Additionally, H2POWER calculates the financial impact of different penalties and incentives (such as net metering, low interest loans, fuel taxes, and emission penalties) on the cost of the system from the point of view of a developer and a homeowner. In order to assess the

  17. Providing Quality Therapeutics in Switzerland: Role of the Stakeholders and Recent Incentives for Further Improvements.

    Science.gov (United States)

    Besson, Marie; Samer, Caroline; Rollason, Victoria; Dayer, Pierre; Desmeules, Jules

    2015-07-01

    Quality therapeutics play an important role in Switzerland's health care and economy. Switzerland holds a key position in the world of research and development, as well as in drug production. Recently, new emphasis has been placed on promoting clinical research and maintaining Switzerland's position as a center of excellence in the field. Recent revisions to the law regarding medical trials in human research allow for better allocation of regulatory resources and simplified procedures for drugs already authorized in Switzerland. The country has its own regulatory agency, the Swiss Agency for Therapeutic Products (Swissmedic), which is a public institution of the Swiss government. Swissmedic is responsible for ensuring safety in medicines, particularly regarding authorizations and market surveillance in the sector of medicinal products and medical devices. Although the centralized authorization procedure of the European Union for medicines does not apply to Switzerland, there are mutual recognition mechanisms between the Swiss medicine regulatory authority and the European Medicines Agency. Swissmedic is also in charge of postmarketing safety and oversees the national pharmacovigilance center, which collaborates closely with the World Health Organization center in Uppsala. In addition, university hospital-based clinical pharmacologists, who are involved in basic science and clinical research, regulatory affairs, ethics committees, and pharmacovigilance, promote quality therapeutics. This article discusses the role of the various stakeholders and the recent efforts made to provide a better allocation of resources aimed at further improving quality therapeutics in Switzerland. Copyright © 2015 Elsevier HS Journals, Inc. All rights reserved.

  18. Financial health and customer satisfaction in private health care providers in Brazil.

    Science.gov (United States)

    Schiozer, Rafael Felipe; Saito, Cristiana Checchia; Saito, Richard

    2011-11-01

    This paper analyzes the relationship between the financial health and organizational form of private health care providers in Brazil. It also examines the major determinants of customer satisfaction associated with the provider's organizational form. An adjusted Altman's z-score is used as an indicator of financial health. A proxy variable based on customer complaints filed at the Brazilian National Agency for Supplementary Health is used as an indicator for customer satisfaction. The study uses a sample of 270 private health care providers and their operations over the period 2003-2005. Panel data analysis includes control variables related to market, operations, and management. Principal results indicate that: (1) private health care providers benefit from economies of scale; (2) self-funded health plans have better financial health; (3) spending on marketing does not have a significant impact on customer satisfaction in Brazil; (4) weak empirical evidence exists showing that good financial performance enhances customer's satisfaction.

  19. A lesson in business: cost-effectiveness analysis of a novel financial incentive intervention for increasing physical activity in the workplace.

    Science.gov (United States)

    Dallat, Mary Anne T; Hunter, Ruth F; Tully, Mark A; Cairns, Karen J; Kee, Frank

    2013-10-10

    Recently both the UK and US governments have advocated the use of financial incentives to encourage healthier lifestyle choices but evidence for the cost-effectiveness of such interventions is lacking. Our aim was to perform a cost-effectiveness analysis (CEA) of a quasi-experimental trial, exploring the use of financial incentives to increase employee physical activity levels, from a healthcare and employer's perspective. Employees used a 'loyalty card' to objectively monitor their physical activity at work over 12 weeks. The Incentive Group (n=199) collected points and received rewards for minutes of physical activity completed. The No Incentive Group (n=207) self-monitored their physical activity only. Quality of life (QOL) and absenteeism were assessed at baseline and 6 months follow-up. QOL scores were also converted into productivity estimates using a validated algorithm. The additional costs of the Incentive Group were divided by the additional quality adjusted life years (QALYs) or productivity gained to calculate incremental cost effectiveness ratios (ICERs). Cost-effectiveness acceptability curves (CEACs) and population expected value of perfect information (EVPI) was used to characterize and value the uncertainty in our estimates. The Incentive Group performed more physical activity over 12 weeks and by 6 months had achieved greater gains in QOL and productivity, although these mean differences were not statistically significant. The ICERs were £2,900/QALY and £2,700 per percentage increase in overall employee productivity. Whilst the confidence intervals surrounding these ICERs were wide, CEACs showed a high chance of the intervention being cost-effective at low willingness-to-pay (WTP) thresholds. The Physical Activity Loyalty card (PAL) scheme is potentially cost-effective from both a healthcare and employer's perspective but further research is warranted to reduce uncertainty in our results. It is based on a sustainable "business model" which

  20. Major risks and financial guarantees provided by the State in France

    International Nuclear Information System (INIS)

    Brassard, Guy

    2012-01-01

    France's system for indemnifying damage from natural catastrophe is exemplary, whether for floods, storms, or subsidence. However, France is not equipped with the financial capacity to deal with the damage resulting from an exceptional disaster, such as an earthquake on the Mediterranean coast, or a nuclear meltdown. Major catastrophes could be a significant risk to the financial stability of the State today, because the State is in fact the ultimate insurer of its citizens and its institutions. It would be wise to built up reserves in order to enhance the financial resources of the State and to provide a uniform guarantee covering major risks, whatever the cause of the damage may be. (author)

  1. The marketing-finance interface towards financial services with special reference to the new services provided by futures exchanges

    NARCIS (Netherlands)

    Pennings, J.M.E.; Wetzels, M.G.M.; Meulenberg, M.T.G.

    1999-01-01

    The financial services industry is one of the fastest growing service industries. The financial services industry includes financial derivatives markets such as options and futures markets. In order to ensure survival, firms providing financial services show a rapid product innovation. However, for

  2. The Marketing-Finance Interface Towards Financial Services: with Special Reference to New Services Provided by Futures Exchanges

    NARCIS (Netherlands)

    Pennings, J.M.E.; Wetzels, M.G.M.; Meulenberg, M.T.G.

    1999-01-01

    The financial services industry is one of the fastest growing service industries. The financial services industry includes financial derivatives markets such as options and futures markets. In order to ensure survival, firms providing financial services show a rapid product innovation. However, for

  3. Application of 'Process management' methodology in providing financial services of PE 'Post Serbia'

    Directory of Open Access Journals (Sweden)

    Kujačić Momčilo D.

    2014-01-01

    Full Text Available The paper describes application of the methodology 'Process management', in providing of financial services at the post office counter hall. An overview of the methodology is given, as one of the most commonly used qualitative methodology, whereby Process management's technics are described , those can better meet user needs and market demands, as well as to find more effectively way to resist current competition in the postal service market. One of the main problem that pointed out is a long waiting time in the counter hall during providing financial services, which leads to the formation of queue lines, and thus to customer dissatisfaction. According that, paper points steps that should be taken during provide of financial services in a postal network unit for providing services to customers by optimizing user time waiting in line and increasing the satisfaction of all participants in that process.

  4. Incentive regulation of nuclear power plants by state Public Utility Commissions

    International Nuclear Information System (INIS)

    Martin, R.L.; Olson, J.; Hendrickson, P.

    1989-12-01

    Economic performance incentives established by state Public Utility Commissions (PUCs) currently are applicable to the construction or operation of approximately 73 nuclear power reactors owned by 27 utilities with investment greater than 10% in 18 states. The NRC staff monitors development of the incentives and periodically provides an updated report on all nuclear plant incentives to its headquarters and regional offices. The staff maintains contact with the PUCs and the utilities responsible for implementing the incentives in order to obtain the updated information and to consider potential safety effects of the incentives. This report on incentive regulation of nuclear power plants by state PUCs presents the NRC staff's concerns on potential safety effects of economic performance incentives. It also includes a plant-by-plant survey that describes the mechanics of each incentive and discusses the financial effects of the incentive on the utility-owner(s) of the plant

  5. Incentive regulation of nuclear power plants by state public utility commissions

    International Nuclear Information System (INIS)

    Petersen, J.C.

    1987-12-01

    This report on incentive regulation of nuclear power plants by state public utility commissions (PUCs). Economic performance incentives established by state PUCs are applicable to the construction or operation of about 45 nuclear power reactors owned by 30 utilities in 17 states. The NRC staff monitors development of the incentives and periodically provides an updated report on all nuclear plant incentives to its regional offices. The staff maintains contact with the PUCs and the utilities responsible for implementing the incentives in order to obtain the updated information and to consider potential safety effects of the incentives. This report presents the NRC staff's concerns on potential safety effects of economic performance incentives. It also includes a plant-by-plant survey that describes the mechanics of each incentive and discusses the financial effects of the incentive on the utility-owner(s) of the plant

  6. Impact of gender and professional education on attitudes towards financial incentives for organ donation: results of a survey among 755 students of medicine and economics in Germany.

    Science.gov (United States)

    Inthorn, Julia; Wöhlke, Sabine; Schmidt, Fabian; Schicktanz, Silke

    2014-07-05

    There is an ongoing expert debate with regard to financial incentives in order to increase organ supply. However, there is a lacuna of empirical studies on whether citizens would actually support financial incentives for organ donation. Between October 2008 and February 2009 a quantitative survey was conducted among German students of medicine and economics to gain insights into their point of view regarding living and deceased organ donation and different forms of commercialization (n = 755). The average (passive) willingness to donate is 63.5% among medical students and 50.0% among students of economics (p = 0.001), while only 24.1% of the respondents were actually holding an organ donor card. 11.3% of students of economics had signed a donor card, however, the number is significantly higher among students of medicine (31.9%, p economics (p = 0.034). Despite a generally positive view on organ donation the respondents refuse to consent to commercialization, but are in favor of removing disincentives or are in favor of indirect models of reward.

  7. Rising labor costs, earnings management, and financial performance of health care providers around the world.

    Science.gov (United States)

    Dong, Gang Nathan

    2015-01-01

    Amid increasing interest in how government regulation and market competition affect the cost and financial sustainability in health care sector, it remains unclear whether health care providers behave similarly to their counterparts in other industries. The goal of this chapter is to study the degree to which health care providers manipulate accruals in periods of financial difficulties caused, in part, by the rising costs of labor. We collected the financial information of health care provider in 43 countries from 1984 to 2013 and conducted a pooled cross-sectional study with country and year fixed-effects. The empirical evidence shows that health care providers with higher wage costs are more likely to smooth their earnings in order to maintain financial sustainability. The finding of this study not only informs regulators that earnings management is pervasive in health care organizations around the world, but also contributes to the studies of financial booktax reporting alignment, given the existing empirical evidence linking earnings management to corporate tax avoidance in this very sector.

  8. Requesting a unique personal identifier or providing a souvenir incentive did not affect overall consent to health record linkage: evidence from an RCT nested within a cohort.

    Science.gov (United States)

    Ni, Michael Y; Li, Tom K; Hui, Rex W H; McDowell, Ian; Leung, Gabriel M

    2017-04-01

    It is unclear if unique personal identifiers should be requested from participants for health record linkage: this permits high-quality data linkage but at the potential cost of lower consent rates due to privacy concerns. Drawing from a sampling frame based on the FAMILY Cohort, using a 2 × 2 factorial design, we randomly assigned 1,200 participants to (1) request for Hong Kong Identity Card number (HKID) or no request and (2) receiving a souvenir incentive (valued at USD4) or no incentive. The primary outcome was consent to health record linkage. We also investigated associations between demographics, health status, and postal reminders with consent. Overall, we received signed consent forms from 33.3% (95% confidence interval [CI] 30.6-36.0%) of respondents. We did not find an overall effect of requesting HKID (-4.3%, 95% CI -9.8% to 1.2%) or offering souvenir incentives (2.4%, 95% CI -3.1% to 7.9%) on consent to linkage. In subgroup analyses, requesting HKID significantly reduced consent among adults aged 18-44 years (odds ratio [OR] 0.53, 95% CI 0.30-0.94, compared to no request). Souvenir incentives increased consent among women (OR 1.55, 95% CI 1.13-2.11, compared to no souvenirs). Requesting a unique personal identifier or providing a souvenir incentive did not affect overall consent to health record linkage. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. How uniform incentives can provide a negative motivation: an application to early school leaving in two large cities

    NARCIS (Netherlands)

    de Witte, K.; van Klaveren, C.

    2010-01-01

    In case of regional discretionary on the implementation of policy measures, central govern­ments may consider the differences in outcomes as an indication on the effectiveness of policy. In turn, to motivate regional policy makers uniform incentives might be developed. However, if the underlying

  10. The financial value of services provided by a rural community health fair.

    Science.gov (United States)

    Dulin, Mary Katherine; Olive, Kenneth E; Florence, Joseph A; Sliger, Carolyn

    2006-11-01

    There has been little discussion in the literature regarding the financial value of the services provided to the participants in health fairs. This article examines the financial value of preventive services provided through a community health fair in an economically depressed area of southwest Virginia. Current Procedural Terminology codes were assigned to the services provided in order to estimate costs participants might incur for such services. An average 50-year-old man would have paid up to $320 to obtain commonly recommended preventive services available free at the fair. An average 50-year-old woman would have paid up to $495. Overall, over $58,000 in services were provided through the health fair. This community health fair provided preventive services that many participants otherwise might have found to be cost-prohibitive.

  11. Effect of Financial Incentives on Glucose Monitoring Adherence and Glycemic Control Among Adolescents and Young Adults With Type 1 Diabetes: A Randomized Clinical Trial.

    Science.gov (United States)

    Wong, Charlene A; Miller, Victoria A; Murphy, Kathryn; Small, Dylan; Ford, Carol A; Willi, Steven M; Feingold, Jordyn; Morris, Alexander; Ha, Yoonhee P; Zhu, Jingsan; Wang, Wenli; Patel, Mitesh S

    2017-12-01

    Glycemic control often deteriorates during adolescence and the transition to young adulthood for patients with type 1 diabetes. The inability to manage type 1 diabetes effectively during these years is associated with poor glycemic control and complications from diabetes in adult life. To determine the effect of daily financial incentives on glucose monitoring adherence and glycemic control in adolescents and young adults with type 1 diabetes. The Behavioral Economic Incentives to Improve Glycemic Control Among Adolescents and Young Adults With Type 1 Diabetes (BE IN CONTROL) study was an investigator-blinded, 6-month, 2-arm randomized clinical trial conducted between January 22 and November 2, 2016, with 3-month intervention and follow-up periods. Ninety participants (aged 14-20) with suboptimally controlled type 1 diabetes (hemoglobin A1c [HbA1c] >8.0%) were recruited from the Diabetes Center for Children at the Children's Hospital of Philadelphia. All participants were given daily blood glucose monitoring goals of 4 or more checks per day with 1 or more level within the goal range (70-180 mg/dL) collected with a wireless glucometer. The 3-month intervention consisted of a $60 monthly incentive in a virtual account, from which $2 was subtracted for every day of nonadherence to the monitoring goals. During a 3-month follow-up period, the intervention was discontinued. The primary outcome was change in HbA1c levels at 3 months. Secondary outcomes included adherence to glucose monitoring and change in HbA1c levels at 6 months. All analyses were by intention to treat. Of the 181 participants screened, 90 (52 [57.8%] girls) were randomized to the intervention (n = 45) or control (n = 45) arms. The mean (SD) age was 16.3 (1.9) years. The intervention group had significantly greater adherence to glucose monitoring goals in the incentive period (50.0% vs 18.9%; adjusted difference, 27.2%; 95% CI, 9.5% to 45.0%; P = .003) but not in the follow-up period (15

  12. Traffic-light labels and financial incentives to reduce sugar-sweetened beverage purchases by low-income Latino families: a randomized controlled trial.

    Science.gov (United States)

    Franckle, Rebecca L; Levy, Douglas E; Macias-Navarro, Lorena; Rimm, Eric B; Thorndike, Anne N

    2018-06-01

    The objective of the present study was to test the effectiveness of financial incentives and traffic-light labels to reduce purchases of sugar-sweetened beverages in a community supermarket. In this randomized controlled trial, after a 2-month baseline period (February-March 2014), in-store traffic-light labels were posted to indicate healthy (green), less healthy (yellow) or unhealthy (red) beverages. During the subsequent five months (April-August 2014), participants in the intervention arm were eligible to earn a $US 25 in-store gift card each month they refrained from purchasing red-labelled beverages. Urban supermarket in Chelsea, MA, USA, a low-income Latino community. Participants were customers of this supermarket who had at least one child living at home. A total of 148 customers (n 77 in the intervention group and n 71 in the control group) were included in the final analyses. Outcomes were monthly in-store purchases tracked using a store loyalty card and self-reported consumption of red-labelled beverages. Compared with control participants, the proportion of intervention participants who purchased any red-labelled beverages decreased by 9 % more per month (P=0·002). More intervention than control participants reduced their consumption of red-labelled beverages (-23 % v. -2 % for consuming ≥1 red beverage/week, P=0·01). Overall, financial incentives paired with in-store traffic-light labels modestly reduced purchase and consumption of sugar-sweetened beverages by customers of a community supermarket.

  13. 28 CFR 58.25 - Qualifications for approval as providers of a personal financial management instructional course.

    Science.gov (United States)

    2010-07-01

    ... of a personal financial management instructional course. 58.25 Section 58.25 Judicial Administration... Qualifications for approval as providers of a personal financial management instructional course. (a) Definition... personal financial management instructional course must be in compliance with all applicable laws and...

  14. 25 CFR 20.102 - What is the Bureau's policy in providing financial assistance and social services under this part?

    Science.gov (United States)

    2010-04-01

    ..., DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Definitions... this part to eligible Indians when comparable financial assistance or social services are either not... 25 Indians 1 2010-04-01 2010-04-01 false What is the Bureau's policy in providing financial...

  15. Using 340B drug discounts to provide a financially sustainable medication discharge service.

    Science.gov (United States)

    Wu, Timothy; Williams, Carla; Vranek, Kathryn; Mattingly, T Joseph

    2018-03-27

    The 340B Drug Pricing Program was intended to stretch federal resources by providing significant discounts to covered entities providing care to underserved populations. Program implementation and evidence of expanding services to higher income patients has brought more scrutiny and calls for elimination of the program. While additional review and reform may be warranted, profitability from 340B discounts enables covered entities to provide additional services that may not be feasible in absence of the program. This case report demonstrates one institution's use of 340B discounts to financially justify providing bedside medication delivery services for patients at the time of discharge from an inpatient admission. A simple financial model was developed using hospital data and inputs from available literature to estimate gross profit and earnings before interest, taxes, depreciation, and amortization (EBITDA) with and without 340B discounts. Without the 340B drug price discounts, the service would operate at a financial loss, and further investigation must be done to determine whether other clinical or economic benefits would warrant discharge medication delivery at the institution. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  16. Improving uptake and use of malaria rapid diagnostic tests in the context of artemisinin drug resistance containment in eastern Myanmar: an evaluation of incentive schemes among informal private healthcare providers.

    Science.gov (United States)

    Aung, Tin; White, Christopher; Montagu, Dominic; McFarland, Willi; Hlaing, Thaung; Khin, Hnin Su Su; San, Aung Kyaw; Briegleb, Christina; Chen, Ingrid; Sudhinaraset, May

    2015-03-06

    As efforts to contain artemisinin resistance and eliminate Plasmodium falciparum intensify, the accurate diagnosis and prompt effective treatment of malaria are increasingly needed in Myanmar and the Greater Mekong Sub-region (GMS). Rapid diagnostic tests (RDTs) have been shown to be safe, feasible, and effective at promoting appropriate treatment for suspected malaria, which are of particular importance to drug resistance containment. The informal private sector is often the first point of care for fever cases in malaria endemic areas across Myanmar and the GMS, but there is little published information about informal private provider practices, quality of service provision, or potential to contribute to malaria control and elimination efforts. This study tested different incentives to increase RDT use and improve the quality of care among informal private healthcare providers in Myanmar. The study randomized six townships in the Mon and Shan states of rural Myanmar into three intervention arms: 1) RDT price subsidies, 2) price subsidies with product-related financial incentives, and 3) price subsidies with intensified information, education and counselling (IEC). The study assessed the uptake of RDT use in the communities by cross-sectional surveys of 3,150 households at baseline and six months post-intervention (6,400 households total, 832 fever cases). The study also used mystery clients among 171 providers to assess quality of service provision across intervention arms. The pilot intervention trained over 600 informal private healthcare providers. The study found a price subsidy with intensified IEC, resulted in the highest uptake of RDTs in the community, as compared to subsidies alone or merchandise-related financial incentives. Moreover, intensified IEC led to improvements in the quality of care, with mystery client surveys showing almost double the number of correct treatment following diagnostic test results as compared to a simple subsidy. Results show

  17. Impact of financial environmental incentives in the potential of electric power generation on the sugar cane plants; Impacto de incentivos financeiros de natureza ambiental no potencial de geracao de eletricidade nas usinas de cana-de-acucar

    Energy Technology Data Exchange (ETDEWEB)

    Pinto, Claudio Plaza; Walter, Arnaldo [Universidade Estadual de Campinas, SP (Brazil). Faculdade de Engenharia Mecanica. Area Interdisciplinar de Planejamento de Sistemas Energeticos]. E-mail: claudiop@fem.unicamp.br; awalter@fem.unicamp.br

    1999-07-01

    The aim of the work is to present the electric power generation from biomass and the economic potential from sugar cane plants in Brazil. Computerized electricity costs simulation are presented and several financial incentives and external market effects are considered. The results are also presented and criticized.

  18. Financial Management: DOD Needs to Clarify Its General Gift Fund Policies to Provide for Effective Oversight

    Science.gov (United States)

    2009-05-27

    Representatives Subject: Financial Management: DOD Needs to Clarify Its General Gift Fund Policies to Provide for Effective Oversight From fiscal...year 2005 through fiscal year 2008, the military services received about $295 million in monetary and nonmonetary gifts from individuals and...organizations wishing to donate gifts to the Department of Defense (DOD).1 Section 2601(a) of Title 10, U.S. Code is a long-standing authority under which

  19. Directions in low-level radioactive-waste management. Incentives and compensation: providing resources for communities hosting low-level waste facilities

    International Nuclear Information System (INIS)

    1982-10-01

    State responsibility for the management of low-level radioactive waste necessitates the selection of candidate locations for a disposal facility. Concern over potential impacts can be expected from segments of the citizenry neighboring a proposed site. A number of national organizations comprising state and local officials have recommended the use of incentives and compensation to help offset the negative local impacts. This document explores that concept. Discussion provides background information on potential local impacts from a low-level waste facility and considers the nature and types of incentives and compensation benefits that could be provided. The document then examines realistic options for planning and implementing the benefit program. This information is intended, primarily, to assist state officials - executive, legislative, and agency - in planning for and managing low-level waste disposal facilities

  20. Financial incentives for improving adherence to maintenance treatment in patients with psychotic disorders (Money for Medication): a multicentre, open-label, randomised controlled trial.

    Science.gov (United States)

    Noordraven, Ernst L; Wierdsma, André I; Blanken, Peter; Bloemendaal, Anthony F T; Staring, Anton B P; Mulder, Cornelis L

    2017-03-01

    Provision of financial incentives is a promising intervention for improving adherence in patients taking antipsychotic medication. We aimed to assess the effectiveness of this intervention for improving adherence to antipsychotic depot medication in patients with psychotic disorders, irrespective of their previous compliance. We did this multicentre, open-label, randomised controlled trial at three mental health-care institutions in secondary psychiatric care services in the Netherlands. Eligible patients were aged 18-65 years, had been diagnosed with schizophrenia or another psychotic disorder, had been prescribed antipsychotic depot medication or had an indication to start using depot medication, and were participating in outpatient treatment. Patients were randomly assigned (1:1), via computer-generated randomisation with a block size of four, to receive 12 months of either treatment as usual plus a financial reward for each depot of medication received (€30 per month if fully compliant; intervention group) or treatment as usual alone (control group). Randomisation was stratified by treatment site and suspected prognostic factors: sex, comorbid substance-use disorder (absent vs present), and compliance with antipsychotic medication in the 4 months before baseline (taking antipsychotic medication. We did analysis by intention to treat. This trial is registered with the Nederlands Trial Register, number NTR2350. Between May 21, 2010, and Oct 15, 2014, we randomly assigned 169 patients to the intervention group (n=84) or the control group (n=85). Primary outcome data were available for 155 (92%) patients. At baseline, the mean MPR was 76·0% (SD 28·2%) in the intervention group versus 77·9% (28·5%) in the control group. At 12 months, the mean MPR was higher in the intervention group (94·3% [SD 11·3%]) than in the control group (80·3% [19·1%]), with an adjusted difference of 14·9% (95% CI 8·9-20·9%; pcontrol group (adjusted difference 6·5%, 95% CI 2·0

  1. Patient-centered medical home initiatives expanded in 2009-13: providers, patients, and payment incentives increased.

    Science.gov (United States)

    Edwards, Samuel T; Bitton, Asaf; Hong, Johan; Landon, Bruce E

    2014-10-01

    Patient-centered medical home initiatives are central to many efforts to reform the US health care delivery system. To better understand the extent and nature of these initiatives, in 2013 we performed a nationwide cross-sectional survey of initiatives that included payment reform incentives in their models, and we compared the results to those of a similar survey we conducted in 2009. We found that the number of initiatives featuring payment reform incentives had increased from 26 in 2009 to 114 in 2013. The number of patients covered by these initiatives had increased from nearly five million to almost twenty-one million. We also found that the proportion of time-limited initiatives--those with a planned end date--was 20 percent in 2013, a decrease from 77 percent in 2009. Finally, we found that the dominant payment model for patient-centered medical homes remained fee-for-service payments augmented by per member per month payments and pay-for-performance bonuses. However, those payments and bonuses were higher in 2013 than they were in 2009, and the use of shared-savings models was greater. The patient-centered medical home model is likely to continue both to become more common and to play an important role in delivery system reform. Project HOPE—The People-to-People Health Foundation, Inc.

  2. Reforestation tax incentives under the American jobs creation act of 2004

    Science.gov (United States)

    Thomas J. Straka; John L. Greene

    2007-01-01

    The American jobs creation act of 2004 made significant changes in the reforestation tax incentives available to private forest owners. Owners can now deduct outright reforestation costs up to $10,000 per year for each qualifying timber property and amortize any additional amount over 8 tax years. to assess the financial benefit the new incentives provide to forest...

  3. Managerial strategies to make incentives meaningful and motivating.

    Science.gov (United States)

    Korlén, Sara; Essén, Anna; Lindgren, Peter; Amer-Wahlin, Isis; von Thiele Schwarz, Ulrica

    2017-04-10

    Purpose Policy makers are applying market-inspired competition and financial incentives to drive efficiency in healthcare. However, a lack of knowledge exists about the process whereby incentives are filtered through organizations to influence staff motivation, and the key role of managers is often overlooked. The purpose of this paper is to explore the strategies managers use as intermediaries between financial incentives and the individual motivation of staff. The authors use empirical data from a local case in Swedish specialized care. Design/methodology/approach The authors conducted an exploratory qualitative case study of a patient-choice reform, including financial incentives, in specialized orthopedics in Sweden. In total, 17 interviews were conducted with professionals in managerial positions, representing six healthcare providers. A hypo-deductive, thematic approach was used to analyze the data. Findings The results show that managers applied alignment strategies to make the incentive model motivating for staff. The managers' strategies are characterized by attempts to align external rewards with professional values based on their contextual and practical knowledge. Managers occasionally overruled the financial logic of the model to safeguard patient needs and expressed an interest in having a closer dialogue with policy makers about improvements. Originality/value Externally imposed incentives do not automatically motivate healthcare staff. Managers in healthcare play key roles as intermediaries by aligning external rewards with professional values. Managers' multiple perspectives on healthcare practices and professional culture can also be utilized to improve policy and as a source of knowledge in partnership with policy makers.

  4. Essays on financial analysts' forecasts

    OpenAIRE

    Rodriguez, Marius del Giudice

    2006-01-01

    This dissertation contains three self-contained chapters dealing with specific aspects of financial analysts' earnings forecasts. After recent accounting scandals, much attention has turned to the incentives present in the career of professional financial analysts. The literature points to several reasons why financial analysts behave overoptimistically when providing their predictions. In particular, analysts may wish to maintain good relations with firm management, to please the underwriter...

  5. Summary of Carbon Storage Incentives and Potential Legislation: East Sub-Basin Project Task 3.1 Business and Financial Case Study

    Energy Technology Data Exchange (ETDEWEB)

    Trabucchi, Chiara [Industrial Economics, Incorporated

    2018-05-16

    The CarbonSAFE Illinois – East Sub-Basin project is conducting a pre-feasibility assessment for commercial-scale CO2 geological storage complexes. The project aims to identify sites capable of storing more than 50 million tons of industrially-sourced CO2. To support the business development assessment of the economic viability of potential sites in the East Sub-Basin and explore conditions under which a carbon capture and storage (CCS) project therein might be revenue positive, this document provides a summary of carbon storage incentives and legislation of potential relevance to the project.

  6. CONCEPTUAL BASES OF FORMING THE SYSTEM OF FINANCIAL AND ECONOMIC PROVIDING SOCIAL PROTECTION INVOLUNTARILY DISPLACED PERSONS WITH CLUSTER APPROACH

    Directory of Open Access Journals (Sweden)

    Svitlana Kropelnytska

    2017-08-01

    Full Text Available The article systematizes approaches to financial support and social adaptation of internally displaced persons (IDPs as well as their social protection, that is based on the analysis of legal framework, situation and sources of financial and social support to the EU member states of the IDPs in Ukraine and their social security. The study of the IDPs situation and the assessment of the required resources are based on a cluster approach, which defines optimal set of problem areas requiring priority social and financial support. This allowed to develop practical recommendations for the development of a comprehensive, transparent and unified policy of social protection through the development of a conceptual framework for the financial and economic provision of social protection IDPs, which will be the basic solution to the problems of social and financial provision forced migrants in Ukraine. Key words: forced migrants, internally displaced persons, cluster, social policy, social protection, social providing, financial providing.

  7. Effects of compensation methods and physician group structure on physicians' perceived incentives to alter services to patients.

    Science.gov (United States)

    Reschovsky, James D; Hadley, Jack; Landon, Bruce E

    2006-08-01

    To examine how health plan payment, group ownership, compensation methods, and other practice management tools affect physician perceptions of whether their overall financial incentives tilt toward increasing or decreasing services to patients. Nationally representative data on physicians are from the 2000-2001 Community Tracking Study Physician Survey (N=12,406). Ordered and multinomial logistic regression were used to explore how physician, group, and market characteristics are associated with physician reports of whether overall financial incentives are to increase services, decrease services, or neither. Seven percent of physicians report financial incentives are to reduce services to patients, whereas 23 percent report incentives to increase services. Reported incentives to reduce services were associated with reports of lower ability to provide quality care. Group revenue in the form of capitation was associated with incentives to reduce services whereas practice ownership and variable compensation and bonuses for employee physicians were mostly associated with incentives to increase services to patients. Full ownership of groups, productivity incentives, and perceived competitive markets for patients were associated with incentives to both increase and reduce services. Practice ownership and the ways physicians are compensated affect their perceived incentives to increase or decrease services to patients. In the latter case, this adversely affects perceived quality of care and satisfaction, although incentives to increase services may also have adverse implications for quality, cost, and insurance coverage.

  8. Marine Corps Pay Incentives

    Science.gov (United States)

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

  9. 12 CFR 989.3 - Requirement to provide financial and other information to the Finance Board and the Office of...

    Science.gov (United States)

    2010-01-01

    ... information to the Finance Board and the Office of Finance. 989.3 Section 989.3 Banks and Banking FEDERAL HOUSING FINANCE BOARD OFFICE OF FINANCE FINANCIAL STATEMENTS OF THE BANKS § 989.3 Requirement to provide financial and other information to the Finance Board and the Office of Finance. In order to facilitate the...

  10. Dynamic Incentives in Organizations

    DEFF Research Database (Denmark)

    Ruckes, Martin; Rønde, Thomas

    2015-01-01

    to this inertial tendency is either to increase the financial incentives to encourage searching or to accept no searching. The former response increases search efforts and total profits; the latter response has the opposite results. Inertia can be removed by restructuring the firm in period 2, but this may create...

  11. Revenue Based Budgeting at VA Northern California Health Care System: A Model for Financially Aligning Organizational Incentives and Operations

    National Research Council Canada - National Science Library

    Stockwell, David

    1999-01-01

    .... Changes in sharing agreement regulations, TRICARE, and Medical Care Cost Recovery (MCCR) also provided each network with the ability to generate revenue from sources outside the traditional VA appropriation...

  12. Unintended consequences of incentive provision for behaviour change and maintenance around childbirth.

    Science.gov (United States)

    Thomson, Gill; Morgan, Heather; Crossland, Nicola; Bauld, Linda; Dykes, Fiona; Hoddinott, Pat; Dombrowski, Stephan; MacLennan, Graeme; Rothnie, Kieran; Stewart, Fiona; Farrar, Shelley; Yi, Deokhee; Hislop, Jenni; Ludbrook, Anne; Campbell, Marion; Moran, Victoria Hall; Sniehotta, Falko; Tappin, David

    2014-01-01

    Financial (positive or negative) and non-financial incentives or rewards are increasingly used in attempts to influence health behaviours. While unintended consequences of incentive provision are discussed in the literature, evidence syntheses did not identify any primary research with the aim of investigating unintended consequences of incentive interventions for lifestyle behaviour change. Our objective was to investigate perceived positive and negative unintended consequences of incentive provision for a shortlist of seven promising incentive strategies for smoking cessation in pregnancy and breastfeeding. A multi-disciplinary, mixed-methods approach included involving two service-user mother and baby groups from disadvantaged areas with experience of the target behaviours as study co-investigators. Systematic reviews informed the shortlist of incentive strategies. Qualitative semi-structured interviews and a web-based survey of health professionals asked open questions on positive and negative consequences of incentives. The participants from three UK regions were a diverse sample with and without direct experience of incentive interventions: 88 pregnant women/recent mothers/partners/family members; 53 service providers; 24 experts/decision makers and interactive discussions with 63 conference attendees. Maternity and early years health professionals (n = 497) including doctors, midwives, health visitors, public health and related staff participated in the survey. Qualitative analysis identified ethical, political, cultural, social and psychological implications of incentive delivery at population and individual levels. Four key themes emerged: how incentives can address or create inequalities; enhance or diminish intrinsic motivation and wellbeing; have a positive or negative effect on relationships with others within personal networks or health providers; and can impact on health systems and resources by raising awareness and directing service delivery

  13. Unintended consequences of incentive provision for behaviour change and maintenance around childbirth.

    Directory of Open Access Journals (Sweden)

    Gill Thomson

    Full Text Available Financial (positive or negative and non-financial incentives or rewards are increasingly used in attempts to influence health behaviours. While unintended consequences of incentive provision are discussed in the literature, evidence syntheses did not identify any primary research with the aim of investigating unintended consequences of incentive interventions for lifestyle behaviour change. Our objective was to investigate perceived positive and negative unintended consequences of incentive provision for a shortlist of seven promising incentive strategies for smoking cessation in pregnancy and breastfeeding. A multi-disciplinary, mixed-methods approach included involving two service-user mother and baby groups from disadvantaged areas with experience of the target behaviours as study co-investigators. Systematic reviews informed the shortlist of incentive strategies. Qualitative semi-structured interviews and a web-based survey of health professionals asked open questions on positive and negative consequences of incentives. The participants from three UK regions were a diverse sample with and without direct experience of incentive interventions: 88 pregnant women/recent mothers/partners/family members; 53 service providers; 24 experts/decision makers and interactive discussions with 63 conference attendees. Maternity and early years health professionals (n = 497 including doctors, midwives, health visitors, public health and related staff participated in the survey. Qualitative analysis identified ethical, political, cultural, social and psychological implications of incentive delivery at population and individual levels. Four key themes emerged: how incentives can address or create inequalities; enhance or diminish intrinsic motivation and wellbeing; have a positive or negative effect on relationships with others within personal networks or health providers; and can impact on health systems and resources by raising awareness and directing

  14. Incentives for breastfeeding and for smoking cessation in pregnancy: an exploration of types and meanings.

    Science.gov (United States)

    Crossland, Nicola; Thomson, Gill; Morgan, Heather; Dombrowski, Stephan U; Hoddinott, Pat

    2015-03-01

    Financial or tangible incentives are a strategy for improving health behaviours. The mechanisms of action of incentives are complex and debated. Using a multidisciplinary integrated mixed methods study, with service-user collaboration throughout, we developed a typology of incentives and their meanings for initiating and sustaining smoking cessation in pregnancy and breastfeeding. The ultimate aim was to inform incentive intervention design by providing insights into incentive acceptability and mechanisms of action. Systematic evidence syntheses of incentive intervention studies for smoking cessation in pregnancy or breastfeeding identified incentive characteristics, which were developed into initial categories. Little published qualitative data on user perspectives and acceptability was available. Qualitative interviews and focus groups conducted in three UK regions with a diverse socio-demographic sample of 88 women and significant others from the target population, 53 service providers, 24 experts/decision makers, and conference attendees identified new potential incentives and providers, with and without experience of incentives. Identified incentives (published and emergent) were classified into eight categories: cash and shopping vouchers, maternal wellbeing, baby and pregnancy-related, behaviour-related, health-related, general utility, awards and certificates, and experiences. A typology was refined iteratively through concurrent data collection and thematic analysis to explore participants' understandings of 'incentives' and to compare and contrast meanings across types. Our typology can be understood in three dimensions: the degree of restriction, the extent to which each is hedonic and/or utilitarian, and whether each has solely monetary value versus monetary with added social value. The layers of autonomy, meanings and the social value of incentive types influence their acceptability and interact with structural, social, and personal factors. Dimensions

  15. Effect of Electronic Reminders, Financial Incentives, and Social Support on Outcomes After Myocardial Infarction: The HeartStrong Randomized Clinical Trial.

    Science.gov (United States)

    Volpp, Kevin G; Troxel, Andrea B; Mehta, Shivan J; Norton, Laurie; Zhu, Jingsan; Lim, Raymond; Wang, Wenli; Marcus, Noora; Terwiesch, Christian; Caldarella, Kristen; Levin, Tova; Relish, Mike; Negin, Nathan; Smith-McLallen, Aaron; Snyder, Richard; Spettell, Claire M; Drachman, Brian; Kolansky, Daniel; Asch, David A

    2017-08-01

    Adherence to medications prescribed after acute myocardial infarction (AMI) is low. Wireless technology and behavioral economic approaches have shown promise in improving health behaviors. To determine whether a system of medication reminders using financial incentives and social support delays subsequent vascular events in patients following AMI compared with usual care. Two-arm, randomized clinical trial with a 12-month intervention conducted from 2013 through 2016. Investigators were blinded to study group, but participants were not. Design was a health plan-intermediated intervention for members of several health plans. We recruited 1509 participants from 7179 contacted AMI survivors (insured with 5 large US insurers nationally or with Medicare fee-for-service at the University of Pennsylvania Health System). Patients aged 18 to 80 years were eligible if currently prescribed at least 2 of 4 study medications (statin, aspirin, β-blocker, antiplatelet agent), and were hospital inpatients for 1 to 180 days and discharged home with a principal diagnosis of AMI. Patients were randomized 2:1 to an intervention using electronic pill bottles combined with lottery incentives and social support for medication adherence (1003 patients), or to usual care (506 patients). Primary outcome was time to first vascular rehospitalization or death. Secondary outcomes were time to first all-cause rehospitalization, total number of repeated hospitalizations, medication adherence, and total medical costs. A total of 35.5% of participants were female (n = 536); mean (SD) age was 61.0 (10.3) years. There were no statistically significant differences between study arms in time to first rehospitalization for a vascular event or death (hazard ratio, 1.04; 95% CI, 0.71 to 1.52; P = .84), time to first all-cause rehospitalization (hazard ratio, 0.89; 95% CI, 0.73 to 1.09; P = .27), or total number of repeated hospitalizations (hazard ratio, 0.94; 95% CI, 0.60 to 1.48; P

  16. Mergers, managerial incentives, and efficiencies

    OpenAIRE

    Jovanovic, Dragan

    2014-01-01

    We analyze the effects of synergies from horizontal mergers in a Cournot oligopoly where principals provide their agents with incentives to cut marginal costs prior to choosing output. We stress that synergies come at a cost which possibly leads to a countervailing incentive effect: The merged firm's principal may be induced to stifle managerial incentives in order to reduce her agency costs. Whenever this incentive effect dominates the well-known direct synergy effect, synergies actually red...

  17. Associations between introduction and withdrawal of a financial incentive and timing of attendance for antenatal care and incidence of small for gestational age: natural experimental evaluation using interrupted time series methods

    Science.gov (United States)

    van der Waal, Zelda; Rushton, Steven; Rankin, Judith

    2018-01-01

    Objectives To determine whether introduction or withdrawal of a maternal financial incentive was associated with changes in timing of first attendance for antenatal care (‘booking’), or incidence of small for gestational age. Design A natural experimental evaluation using interrupted time series analysis. Setting A hospital-based maternity unit in the north of England. Participants 34 589 women (and their live-born babies) who delivered at the study hospital and completed the 25th week of pregnancy in the 75 months before (January 2003 to March 2009), 21 months during (April 2009 to December 2010) and 36 months after (January 2011 to December 2013) the incentive was available. Intervention The Health in Pregnancy Grant was a financial incentive of £190 ($235; €211) payable to pregnant women in the UK from the 25th week of pregnancy, contingent on them receiving routine antenatal care. Primary and secondary outcome measures The primary outcome was mean gestational age at booking. Secondary outcomes were proportion of women booking by 10, 18 and 25 weeks’ gestation; and proportion of babies that were small for gestational age. Results By 21 months after introduction of the grant (ie, immediately prior to withdrawal), compared with what was predicted given prior trends, there was an reduction in mean gestational age at booking of 4.8 days (95% CI 2.3 to 8.2). The comparable figure for 24 months after withdrawal was an increase of 14.0 days (95% CI 2.8 to 16.8). No changes in incidence of small for gestational age babies were seen. Conclusions The introduction of a universal financial incentive for timely attendance at antenatal care was associated with a reduction in mean gestational age at first attendance, but not the proportion of babies that were small for gestational age. Future research should explore the effects of incentives offered at different times in pregnancy and of differing values; and how stakeholders view such incentives. PMID:29391362

  18. Associations between introduction and withdrawal of a financial incentive and timing of attendance for antenatal care and incidence of small for gestational age: natural experimental evaluation using interrupted time series methods.

    Science.gov (United States)

    Adams, Jean; van der Waal, Zelda; Rushton, Steven; Rankin, Judith

    2018-01-31

    To determine whether introduction or withdrawal of a maternal financial incentive was associated with changes in timing of first attendance for antenatal care ('booking'), or incidence of small for gestational age. A natural experimental evaluation using interrupted time series analysis. A hospital-based maternity unit in the north of England. 34 589 women (and their live-born babies) who delivered at the study hospital and completed the 25th week of pregnancy in the 75 months before (January 2003 to March 2009), 21 months during (April 2009 to December 2010) and 36 months after (January 2011 to December 2013) the incentive was available. The Health in Pregnancy Grant was a financial incentive of £190 ($235; €211) payable to pregnant women in the UK from the 25th week of pregnancy, contingent on them receiving routine antenatal care. The primary outcome was mean gestational age at booking. Secondary outcomes were proportion of women booking by 10, 18 and 25 weeks' gestation; and proportion of babies that were small for gestational age. By 21 months after introduction of the grant (ie, immediately prior to withdrawal), compared with what was predicted given prior trends, there was an reduction in mean gestational age at booking of 4.8 days (95% CI 2.3 to 8.2). The comparable figure for 24 months after withdrawal was an increase of 14.0 days (95% CI 2.8 to 16.8). No changes in incidence of small for gestational age babies were seen. The introduction of a universal financial incentive for timely attendance at antenatal care was associated with a reduction in mean gestational age at first attendance, but not the proportion of babies that were small for gestational age. Future research should explore the effects of incentives offered at different times in pregnancy and of differing values; and how stakeholders view such incentives. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No

  19. Photovoltaic Incentive Design Handbook

    Energy Technology Data Exchange (ETDEWEB)

    Hoff, T. E.

    2006-12-01

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

  20. EQUILIBRIUM ANALYSIS OF FINANCIAL COMPANY BASED ON INFORMATION PROVIDED BY THE BALANCE SHEET

    Directory of Open Access Journals (Sweden)

    Ștefăniță ȘUȘU

    2014-06-01

    Full Text Available This article highlights the importance of indicators (as net working capital, working capital requirements and net cash by means of which it is considered in the context of financial balances capitalization information released by the balance sheet of an entity tourist profile. Theoretical concepts presented in a logical sequence are combined with the practical example transposed Turism Covasna company. The results of the analysis are interpreted while trying to formulate solutions to the economic and financial viability of the entity.

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

    Directory of Open Access Journals (Sweden)

    Sagandykov Michail

    2017-01-01

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

  2. Patient Experience Assessment is a Requisite for Quality Evaluation: A Discussion of the In-Center Hemodialysis Consumer Assessment of Health Care Providers and Systems (ICH CAHPS) Survey.

    Science.gov (United States)

    Cavanaugh, Kerri L

    2016-01-01

    Patient experience surveys provide a critical and unique perspective on the quality of patient-centered healthcare delivery. These surveys provide a mechanism to systematically express patients' voice on topics valued by patients to make decisions about choices in care. They also provide an assessment to healthcare organizations about their service that cannot be obtained from any other source. Regulatory agencies have mandated the assessment of patients' experience as part of healthcare value based purchasing programs and weighted the results to account for up to 30% of the total scoring. This is a testimony to the accepted importance of this metric as a fundamental assessment of quality. After more than a decade of rigorous research, there is a significant body of growing evidence supporting specifically the validity and use of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys, including a version specific to in-center hemodialysis (ICH CAHPS). This review will focus on the ICH CAHPS survey including a review of its development, content, administration, and also a discussion of common criticisms. Although it is suggested that the survey assesses activities and experiences that are not modifiable by the healthcare organization (or the dialysis facility in our case) emerging evidence suggests otherwise. Dialysis providers have an exclusive opportunity to lead the advancement of understanding the implications and serviceability of the evaluation of the patient experience in health care. © 2016 Wiley Periodicals, Inc.

  3. The use of financial incentives to help improve health outcomes: is the quality and outcomes framework fit for purpose? A systematic review.

    Science.gov (United States)

    Langdown, Carwyn; Peckham, Stephen

    2014-06-01

    The quality and outcomes framework (QOF) is one of the world's largest pay-for-performance schemes, rewarding general practitioners for the quality of care they provide. This review examines the evidence on the efficacy of the scheme for improving health outcomes, its impact on non-incentivized activities and the robustness of the clinical targets adopted in the scheme. The review was conducted using six electronic databases, six sources of grey literature and bibliography searches from relevant publications. Studies were identified using a comprehensive search strategy based on MeSH terms and keyword searches. A total of 21,543 references were identified of which 32 met the eligibility criteria with 11 studies selected for the review. Findings provide strong evidence that the QOF initially improved health outcomes for a limited number of conditions but subsequently fell to the pre-existing trend. There was limited impact on non-incentivized activities with adverse effects for some sub-population groups. The QOF has limited impact on improving health outcomes due to its focus on process-based indicators and the indicators' ceiling thresholds. Further research is required to strengthen the quality of evidence available on the QOF's impact on population health to ensure that the incentive scheme is both clinically and cost-effective. © The Author 2013. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. Effectiveness of employer financial incentives in reducing time to report worker injury: an interrupted time series study of two Australian workers' compensation jurisdictions.

    Science.gov (United States)

    Lane, Tyler J; Gray, Shannon; Hassani-Mahmooei, Behrooz; Collie, Alex

    2018-01-05

    Early intervention following occupational injury can improve health outcomes and reduce the duration and cost of workers' compensation claims. Financial early reporting incentives (ERIs) for employers may shorten the time between injury and access to compensation benefits and services. We examined ERI effect on time spent in the claim lodgement process in two Australian states: South Australia (SA), which introduced them in January 2009, and Tasmania (TAS), which introduced them in July 2010. Using administrative records of 1.47 million claims lodged between July 2006 and June 2012, we conducted an interrupted time series study of ERI impact on monthly median days in the claim lodgement process. Time periods included claim reporting, insurer decision, and total time. The 18-month gap in implementation between the states allowed for a multiple baseline design. In SA, we analysed periods within claim reporting: worker and employer reporting times (similar data were not available in TAS). To account for external threats to validity, we examined impact in reference to a comparator of other Australian workers' compensation jurisdictions. Total time in the process did not immediately change, though trend significantly decreased in both jurisdictions (SA: -0.36 days per month, 95% CI -0.63 to -0.09; TAS: 0.35, -0.50 to -0.20). Claim reporting time also decreased in both (SA: -1.6 days, -2.4 to -0.8; TAS: -5.4, -7.4 to -3.3). In TAS, there was a significant increase in insurer decision time (4.6, 3.9 to 5.4) and a similar but non-significant pattern in SA. In SA, worker reporting time significantly decreased (-4.7, -5.8 to -3.5), but employer reporting time did not (-0.3, -0.8 to 0.2). The results suggest that ERIs reduced claim lodgement time and, in the long-term, reduced total time in the claim lodgement process. However, only worker reporting time significantly decreased in SA, indicating that ERIs may not have shortened the process through the intended target of

  5. Gift card incentives and non-response bias in a survey of vaccine providers: the role of geographic and demographic factors.

    Science.gov (United States)

    Van Otterloo, Joshua; Richards, Jennifer L; Seib, Katherine; Weiss, Paul; Omer, Saad B

    2011-01-01

    This study investigates the effects of non-response bias in a 2010 postal survey assessing experiences with H1N1 influenza vaccine administration among a diverse sample of providers (N = 765) in Washington state. Though we garnered a high response rate (80.9%) by using evidence-based survey design elements, including intensive follow-up and a gift card incentive from Target, non-response bias could exist if there were differences between respondents and non-respondents. We investigated differences between the two groups for seven variables: road distance to the nearest Target store, practice type, previous administration of vaccines, region, urbanicity, size of practice, and Vaccines for Children (VFC) program enrollment. We also examined the effect of non-response bias on survey estimates. Statistically significant differences between respondents and non-respondents were found for four variables: miles to the nearest Target store, type of medical practice, whether the practice routinely administered additional vaccines besides H1N1, and urbanicity. Practices were more likely to respond if they were from a small town or rural area (OR = 7.68, 95% CI = 1.44-40.88), were a non-traditional vaccine provider type (OR = 2.08, 95% CI = 1.06-4.08) or a pediatric provider type (OR = 4.03, 95% CI = 1.36-11.96), or administered additional vaccines besides H1N1 (OR = 1.80, 95% CI = 1.03-3.15). Of particular interest, for each ten mile increase in road distance from the nearest Target store, the likelihood of provider response decreased (OR = 0.73, 95% CI = 0.60-0.89). Of those variables associated with response, only small town or rural practice location was associated with a survey estimate of interest, suggesting that non-response bias had a minimal effect on survey estimates. These findings show that gift card incentives alongside survey design elements and follow-up can achieve high response rates. However, there is evidence that

  6. The role of hosting providers in fighting command and control infrastructure of financial malware

    NARCIS (Netherlands)

    Tajalizadehkhoob, S.; Hernandez Ganan, C.; Noroozian, A.; van Eeten, M.J.G.

    2017-01-01

    A variety of botnets are used in attacks on financial services. Banks and security firms invest a lot of effort in detecting and combating malware-assisted takeover of customer accounts. A critical resource of these botnets is their command-and-control (C&C) infrastructure. Attackers rent or

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

    Science.gov (United States)

    Amit, Ronit; Jacobson, Susan K

    2018-01-22

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

  8. Irregular incentives

    International Nuclear Information System (INIS)

    Cicchetti, M.A.

    1993-01-01

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

  9. 34 CFR 366.11 - What financial assistance does the Secretary provide for training and technical assistance?

    Science.gov (United States)

    2010-07-01

    ... for training and technical assistance? 366.11 Section 366.11 Education Regulations of the Offices of..., DEPARTMENT OF EDUCATION CENTERS FOR INDEPENDENT LIVING Training and Technical Assistance § 366.11 What financial assistance does the Secretary provide for training and technical assistance? (a) From funds, if...

  10. Information sharing for effective IT incident resolving in IT service provider networks: A financial service case study

    NARCIS (Netherlands)

    Vlietland, J.; Vliet, J.C.

    2015-01-01

    Information technology (IT)-enabled financial services are typically delivered by a network of interdependent IT service providers. Such networks need information to resolve IT incidents in their delivered IT services. The objective of this research is to identify the set of information that needs

  11. 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

  12. Non-organ donors' attitudes toward incentives.

    Science.gov (United States)

    Tumin, Makmor; Noh, Abdillah; Chong, Chin-Sieng; Lim, Soo-Kun; Abdullah, Nawi; Ng, Kok-Peng

    2013-01-01

    Malaysians indicating that they did not intend to become organ donors upon their death were surveyed regarding interest in non-fungible financial incentives to be granted to surviving family members. Among the 730 (56% of the total sample of 1311) indicating unwillingness to be donors, 29.6% (216/730) subsequently indicated that they would be willing donors if the government introduced policies that, upon their death, "rewarded your (their) family with incentives for your (their) deeds." Among the 69% (504/730) who insisted that they would not become organ donor even with incentive, nearly 80% (404/501) of them were able to identify relevant incentives they thought should be provided by the state to those who make organ donations upon death. The majority of both groups preferred the state provide medical benefits to a surviving family member, suggesting this may be an attractive policy option for the state to raise the deceased organ donation pool. © 2013 John Wiley & Sons A/S.

  13. Application service provider (ASP) financial models for off-site PACS archiving

    Science.gov (United States)

    Ratib, Osman M.; Liu, Brent J.; McCoy, J. Michael; Enzmann, Dieter R.

    2003-05-01

    For the replacement of its legacy Picture Archiving and Communication Systems (approx. annual workload of 300,000 procedures), UCLA Medical Center has evaluated and adopted an off-site data-warehousing solution based on an ASP financial with a one-time single payment per study archived. Different financial models for long-term data archive services were compared to the traditional capital/operational costs of on-site digital archives. Total cost of ownership (TCO), including direct and indirect expenses and savings, were compared for each model. Financial parameters were considered: logistic/operational advantages and disadvantages of ASP models versus traditional archiving systems. Our initial analysis demonstrated that the traditional linear ASP business model for data storage was unsuitable for large institutions. The overall cost markedly exceeds the TCO of an in-house archive infrastructure (when support and maintenance costs are included.) We demonstrated, however, that non-linear ASP pricing models can be cost-effective alternatives for large-scale data storage, particularly if they are based on a scalable off-site data-warehousing service and the prices are adapted to the specific size of a given institution. The added value of ASP is that it does not require iterative data migrations from legacy media to new storage media at regular intervals.

  14. Incentive contracts for development projects

    Science.gov (United States)

    Finley, David T.; Smith, Byron; DeGroff, B.

    2012-09-01

    Finding a contract vehicle that balances the concerns of the customer and the contractor in a development project can be difficult. The customer wants a low price and an early delivery, with as few surprises as possible as the project progresses. The contractor wants sufficient cost and schedule to cover risk. Both want to clearly define what each party will provide. Many program offices do not want to award cost plus contracts because their funding sources will not allow it, their boards do not want an open ended commitment, and they feel like they lose financial control of the project. A fixed price incentive contract, with a mutually agreed upon target cost, provides the owner with visibility into the project and input into the execution of the project, encourages both parties to save costs, and stimulates a collaborative atmosphere by aligning the respective interests of customers and contractors.

  15. Does the National Health Insurance Scheme provide financial protection to households in Ghana?

    Science.gov (United States)

    Kusi, Anthony; Hansen, Kristian Schultz; Asante, Felix A; Enemark, Ulrika

    2015-08-15

    Excessive healthcare payments can impede access to health services and also disrupt the welfare of households with no financial protection. Health insurance is expected to offer financial protection against health shocks. Ghana began the implementation of its National Health Insurance Scheme (NHIS) in 2004. The NHIS is aimed at removing the financial barrier to healthcare by limiting direct out-of-pocket health expenditures (OOPHE). The study examines the effect of the NHIS on OOPHE and how it protects households against catastrophic health expenditures. Data was obtained from a cross-sectional representative household survey involving 2,430 households from three districts across Ghana. All OOPHE associated with treatment seeking for reported illness in the household in the last 4 weeks preceding the survey were analysed and compared between insured and uninsured persons. The incidence and intensity of catastrophic health expenditures (CHE) among households were measured by the catastrophic health payment method. The relative effect of NHIS on the incidence of CHE in the household was estimated by multiple logistic regression analysis. About 36% of households reported at least one illness during the 4 weeks period. Insured patients had significantly lower direct OOPHE for out-patient and in-patient care compared to the uninsured. On financial protection, the incidence of CHE was lower among insured households (2.9%) compared to the partially insured (3.7%) and the uninsured (4.0%) at the 40% threshold. The incidence of CHE was however significantly lower among fully insured households (6.0%) which sought healthcare from NHIS accredited health facilities compared to the partially insured (10.1%) and the uninsured households (23.2%). The likelihood of a household incurring CHE was 4.2 times less likely for fully insured and 2.9 times less likely for partially insured households relative to being uninsured. The NHIS has however not completely eliminated OOPHE for the

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

    Directory of Open Access Journals (Sweden)

    Caryl Feldacker

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

  17. The adoption of residential solar photovoltaic systems in the presence of a financial incentive: A case study of consumer experiences with the Renewable Energy Standard Offer Program in Ontario (Canada)

    Science.gov (United States)

    Adachi, Christopher William Junji

    2009-12-01

    Traditionally, high initial capital costs and lengthy payback periods have been identified as the most significant barriers that limit the diffusion of solar photovoltaic (PV) systems. In response, the Ontario Government, through the Ontario Power Authority (OPA), introduced the Renewable Energy Standard Offer Program (RESOP) in November, 2006. The RESOP offers owners of solar PV systems with a generation capacity under 10MW a 20 year contract to sell electricity back to the grid at a guaranteed rate of $0.42/kWh. While it is the intent of incentive programs such as the RESOP to begin to lower financial barriers in order to increase the uptake of solar PV systems, there is no guarantee that the level of participation will in fact rise. The "on-the-ground" manner in which consumers interact with such an incentive program ultimately determines its effectiveness. The purpose of this thesis is to analyze the relationship between the RESOP and solar PV system consumers. To act on this purpose, the experiences of current RESOP participants are presented, wherein the factors that are either hindering or promoting utilization of the RESOP and the adoption of solar PV systems are identified. This thesis was conducted in three phases--a literature review, preliminary key informant interviews, and primary RESOP participant interviews--with each phase informing the scope and design of the subsequent stage. First, a literature survey was completed to identify and to understand the potential drivers and barriers to the adoption of a solar PV system from the perspective of a consumer. Second, nine key informant interviews were completed to gain further understanding regarding the specific intricacies of the drivers and barriers in the case of Ontario, as well as the overall adoption system in the province. These interviews were conducted between July and September, 2008. Third, interviews with 24 RESOP participants were conducted; they constitute the primary data set. These

  18. General Fund Enterprise Business System Did Not Provide Required Financial Information

    Science.gov (United States)

    2012-03-26

    Management of the General Fund Enterprise Business System,” January 14, 2008 Army AAA Report No. A-2010-0187- FFM , “General Fund Enterprise Business System...A-2009-0232- FFM , “General Fund Enterprise Business System – Federal Financial Management Improvement Act Compliance, Examination of Releases...1.4.1, 1.4.2, 1.4.3, and 1.4.4 Requirements,” September 30, 2009 AAA Report No. A-2009-0231- FFM , “General Fund Enterprise Business System – Federal

  19. Firms as liquidity providers: Evidence from the 2007-2008 financial crisis

    OpenAIRE

    García-Appendini, Emilia; Montoriol-Garriga, Judit

    2013-01-01

    Using a supplier-client matched sample, we study the effect of the 2007-2008 financial crisis on between-firm liquidity provision. Consistent with a causal effect of a negative shock to bank credit, we find that firms with high pre-crisis liquidity levels increased the trade credit extended to other corporations and subsequently experienced better performance as compared to ex-ante cash-poor firms. Trade credit taken by constrained firms increased during this period. These findings are consis...

  20. Incentives for smoking cessation.

    Science.gov (United States)

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

    2015-05-18

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

  1. Two sides of the same coin: Monetary incentives concurrently improve and bias confidence judgments.

    Science.gov (United States)

    Lebreton, Maël; Langdon, Shari; Slieker, Matthijs J; Nooitgedacht, Jip S; Goudriaan, Anna E; Denys, Damiaan; van Holst, Ruth J; Luigjes, Judy

    2018-05-01

    Decisions are accompanied by a feeling of confidence, that is, a belief about the decision being correct. Confidence accuracy is critical, notably in high-stakes situations such as medical or financial decision-making. We investigated how incentive motivation influences confidence accuracy by combining a perceptual task with a confidence incentivization mechanism. By varying the magnitude and valence (gains or losses) of monetary incentives, we orthogonalized their motivational and affective components. Corroborating theories of rational decision-making and motivation, our results first reveal that the motivational value of incentives improves aspects of confidence accuracy. However, in line with a value-confidence interaction hypothesis, we further show that the affective value of incentives concurrently biases confidence reports, thus degrading confidence accuracy. Finally, we demonstrate that the motivational and affective effects of incentives differentially affect how confidence builds on perceptual evidence. Together, these findings may provide new hints about confidence miscalibration in healthy or pathological contexts.

  2. Two sides of the same coin: Monetary incentives concurrently improve and bias confidence judgments

    Science.gov (United States)

    Lebreton, Maël; Slieker, Matthijs J.; Nooitgedacht, Jip S.; van Holst, Ruth J.; Luigjes, Judy

    2018-01-01

    Decisions are accompanied by a feeling of confidence, that is, a belief about the decision being correct. Confidence accuracy is critical, notably in high-stakes situations such as medical or financial decision-making. We investigated how incentive motivation influences confidence accuracy by combining a perceptual task with a confidence incentivization mechanism. By varying the magnitude and valence (gains or losses) of monetary incentives, we orthogonalized their motivational and affective components. Corroborating theories of rational decision-making and motivation, our results first reveal that the motivational value of incentives improves aspects of confidence accuracy. However, in line with a value-confidence interaction hypothesis, we further show that the affective value of incentives concurrently biases confidence reports, thus degrading confidence accuracy. Finally, we demonstrate that the motivational and affective effects of incentives differentially affect how confidence builds on perceptual evidence. Together, these findings may provide new hints about confidence miscalibration in healthy or pathological contexts. PMID:29854944

  3. Peace Incentives

    DEFF Research Database (Denmark)

    Emmanuel, Nikolas G.

    2015-01-01

    How does economic assistance influence the success or failure of peace processes in Africa? Can economic assistance act as an incentive to facilitate an end to conflict? The literature largely ignores aid as a factor supporting peace processes. In addressing this topic, the current study tries...

  4. Risk management versus incentives

    International Nuclear Information System (INIS)

    Aven, E.; Lovas, K.; Osmundsen, P.

    2006-01-01

    Portfolio theory indicates that risk management should take place at the group level. Hedging at the project level or in the individual business areas may lead to suboptimal results. However, the efficiency of a profit centre depends on its management's being able to influence factors that are crucial to the unit's financial results. Price hedging could be one such factor. In the wider perspective, this constitutes part of the balancing between centralisation and decentralisation. This article covers important elements of risk management and incentive design. It goes on to discuss the balancing of overall risk management at the group level and incentive design in profit centres and corporate units. Throughout the article, the oil industry serves as a case. (author)

  5. The effects of financial incentives for case finding for depression in patients with diabetes and coronary heart disease: interrupted time series analysis.

    Science.gov (United States)

    McLintock, Kate; Russell, Amy M; Alderson, Sarah L; West, Robert; House, Allan; Westerman, Karen; Foy, Robbie

    2014-08-20

    To evaluate the effects of Quality and Outcomes Framework (QOF) incentivised case finding for depression on diagnosis and treatment in targeted and non-targeted long-term conditions. Interrupted time series analysis. General practices in Leeds, UK. 65 (58%) of 112 general practices shared data on 37,229 patients with diabetes and coronary heart disease targeted by case finding incentives, and 101,008 patients with four other long-term conditions not targeted (hypertension, epilepsy, chronic obstructive pulmonary disease and asthma). Incentivised case finding for depression using two standard screening questions. Clinical codes indicating new depression-related diagnoses and new prescriptions of antidepressants. We extracted routinely recorded data from February 2002 through April 2012. The number of new diagnoses and prescriptions for those on registers was modelled with a binomial regression, which provided the strength of associations between time periods and their rates. New diagnoses of depression increased from 21 to 94/100,000 per month in targeted patients between the periods 2002-2004 and 2007-2011 (OR 2.09; 1.92 to 2.27). The rate increased from 27 to 77/100,000 per month in non-targeted patients (OR 1.53; 1.46 to 1.62). The slopes in prescribing for both groups flattened to zero immediately after QOF was introduced but before incentivised case finding (p<0.01 for both). Antidepressant prescribing in targeted patients returned to the pre-QOF secular upward trend (Wald test for equivalence of slope, z=0.73, p=0.47); the slope was less steep for non-targeted patients (z=-4.14, p<0.01). Incentivised case finding increased new depression-related diagnoses. The establishment of QOF disrupted rising trends in new prescriptions of antidepressants, which resumed following the introduction of incentivised case finding. Prescribing trends are of concern given that they may include people with mild-to-moderate depression unlikely to respond to such treatment

  6. Nationwide expansion of a financial incentive program on fruit and vegetable purchases among Supplemental Nutrition Assistance Program participants: A cost-effectiveness analysis.

    Science.gov (United States)

    An, Ruopeng

    2015-12-01

    High prices remain a formidable barrier for many people, especially those of low socioeconomic status, to adopt a healthier diet. The Food, Conservation, and Energy Act of 2008 mandated the U.S. Department of Agriculture (USDA) to conduct a pilot study to assess the impact of making fruits and vegetables more affordable for households in the Supplemental Nutrition Assistance Program (SNAP). Based on the USDA final report of the Healthy Incentives Pilot (HIP), a large-scale randomized trial in 2011-2012 that provided 30% rebate on targeted fruits and vegetables to 7500 study participants enrolled in the SNAP, we constructed a decision model to evaluate the cost-effectiveness of an expansion of the HIP to all SNAP households nationwide. The estimated life-time per capita costs of the HIP to the Federal government is $1323 in 2012 U.S. dollars, and the average gains in quality-adjusted life expectancy to a SNAP participant is 0.082 quality-adjusted life year (QALY), resulting in an incremental cost-effectiveness ratio (ICER) of $16,172 per QALY gained. Sensitivity analysis using Monte Carlo simulations indicates a 94.4% and 99.6% probability that the estimated ICER would be lower than the cost-effective threshold of $50,000 and $100,000 per QALY gained, respectively. Moreover, the estimated ICER of the HIP expansion tends to be competitive in comparison to other interventions that aimed at promoting fruit/vegetable intake among adult population. Findings from this study suggest that a nationwide expansion of the HIP is likely to nudge SNAP households towards purchasing and consuming more targeted fruits and vegetables. However, diet behavior modification is proportional to price change. When people's actual eating behaviors and what dietary guidelines recommend differ by several folds, even a 30% rebate closes just a small fraction of that gap and has limited beneficial impact on participants' weight management, disease prevention, and health-related quality of life

  7. Incentives, health promotion and equality.

    Science.gov (United States)

    Voigt, Kristin

    2012-07-01

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

  8. The Promise of Tailoring Incentives for Healthy Behaviors.

    Science.gov (United States)

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

    2016-01-01

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

  9. Behavioural economics: Cash incentives avert deforestation

    Science.gov (United States)

    Cárdenas, Juan Camilo

    2017-10-01

    There is tension in developing countries between financial incentives to clear forests and climate regulation benefits of preserving trees. Now research shows that paying private forest owners in Uganda reduced deforestation, adding to the debate on the use of monetary incentives in forest conservation.

  10. Providing Coverage for the Unique Lifelong Health Care Needs of Living Kidney Donors Within the Framework of Financial Neutrality.

    Science.gov (United States)

    Gill, J S; Delmonico, F; Klarenbach, S; Capron, A M

    2017-05-01

    Organ donation should neither enrich donors nor impose financial burdens on them. We described the scope of health care required for all living kidney donors, reflecting contemporary understanding of long-term donor health outcomes; proposed an approach to identify donor health conditions that should be covered within the framework of financial neutrality; and proposed strategies to pay for this care. Despite the Affordable Care Act in the United States, donors continue to have inadequate coverage for important health conditions that are donation related or that may compromise postdonation kidney function. Amendment of Medicare regulations is needed to clarify that surveillance and treatment of conditions that may compromise postdonation kidney function following donor nephrectomy will be covered without expense to the donor. In other countries lacking health insurance for all residents, sufficient data exist to allow the creation of a compensation fund or donor insurance policies to ensure appropriate care. Providing coverage for donation-related sequelae as well as care to preserve postdonation kidney function ensures protection against the financial burdens of health care encountered by donors throughout their lives. Providing coverage for this care should thus be cost-effective, even without considering the health care cost savings that occur for living donor transplant recipients. © 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

  11. [Assessment of financial performance improves the quality of healthcare provided by medical organizations].

    Science.gov (United States)

    Afek, Arnon; Meilik, Ahuva; Rotstein, Zeev

    2009-01-01

    Today, medical organizations have to contend with a highly competitive environment, an atmosphere saturated with a multitude of innovative new technologies and ever-increasing costs. The ability of these organizations to survive and to develop and expand their services mandates adoption of management guidelines based on the world of finance/commerce, adapted to make them relevant to the world of medical service. In this article the authors chose to present a management administration assessment which is a process that ensures that the management will effectively administer the organization's resources, and meet the goals set by the organization. The system demands that hospital "centers of responsibility" be defined, a management information system be set up, activities be priced, budget be defined and the expenses assessed. These processes make it possible to formulate a budget and assess any possible deviation between the budget and the actual running costs. An assessment of deviations will reveal any possible deviation of the most significant factor--efficiency. Medical organization managers, with the cooperation of the directors of the "centers of responsibility", can assess subunit activities and gain an understanding of the significance of management decisions and thus improve the quality of management, and the medical organization. The goal of this management system is not only to Lower costs and to meet the financial goals that were set; it is a tool that ensures quality. Decreasing expenditure is important in this case, but is only secondary in importance and will be a result of reducing the costs incurred by services lacking in quality.

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

    Directory of Open Access Journals (Sweden)

    Isamu Okada

    2015-05-01

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

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

    Science.gov (United States)

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

    2015-05-01

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

  14. Tax Incentives for Industry Synergy in Nigeria: A Pragmatic ...

    African Journals Online (AJOL)

    gold

    2012-07-26

    Jul 26, 2012 ... the impact of tax incentives on corporate financial performance in Nigeria. The specific ..... many contemporary researchers in the field of financial/taxation accounting. .... The Principle of Personal Income Taxation in Nigeria.

  15. Drilling contracts and incentives

    International Nuclear Information System (INIS)

    Osmundsen, Petter; Sorenes, Terje; Toft, Anders

    2008-01-01

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

  16. Energy management in the patrimonial buildings of European territorial organizations in the framework of markets liberalization. Economic study of financial incentive mechanisms in favor of energy efficiency investment

    International Nuclear Information System (INIS)

    Gayral, L.

    2005-12-01

    The territorial and patrimonial components of energy savings are not well developed because many barriers - political, organisational and financial - prevent investments in energy efficiency. Although investing in the improvement of the energy efficiency of their public buildings is a rational process, the local authorities are far from systematically carrying out this type of investment. Their limited investment capacity, associated to the lack of spare capital to finance their projects leads them to a 'vicious circle of energy wasting'. Our thesis analyzes the economic and financial tools a local authority can use to invest and enter a 'virtuous circle of energy efficiency'. Our topic deals with the financing of energy efficiency investments at a local level. We describe with details the functioning of each financial mechanism indexed. We illustrate their implementation within European municipalities through many case studies. Finally, we suggest recommendations for their broad reproducibility within French local authorities. (author)

  17. Incentives for Recruiters

    Science.gov (United States)

    1992-09-01

    promotions, with prizes for the kids: anything from football ti’kets to trips to Disneyland ." [Ref. 10:p. 68] Any publisher who wants a successful...such as a trip to Disneyland . The latter focuses more on providing an 29 incentive to the carrier to get a certain number of new customers in a short

  18. Relationships among providing maternal, child, and adolescent health services; implementing various financial strategy responses; and performance of local health departments.

    Science.gov (United States)

    Issel, L Michele; Olorunsaiye, Comfort; Snebold, Laura; Handler, Arden

    2015-04-01

    We explored the relationships between local health department (LHD) structure, capacity, and macro-context variables and performance of essential public health services (EPHS). In 2012, we assessed a stratified, random sample of 195 LHDs that provided data via an online survey regarding performance of EPHS, the services provided or contracted out, the financial strategies used in response to budgetary pressures, and the extent of collaborations. We performed weighted analyses that included analysis of variance, pairwise correlations by jurisdiction population size, and linear regressions. On average, LHDs provided approximately 13 (36%) of 35 possible services either directly or by contract. Rather than cut services or externally consolidating, LHDs took steps to generate more revenue and maximize capacity. Higher LHD performance of EPHS was significantly associated with delivering more services, initiating more financial strategies, and engaging in collaboration, after adjusting for the effects of the Affordable Care Act and jurisdiction size. During changing economic and health care environments, we found that strong structural capacity enhanced local health department EPHS performance for maternal, child, and adolescent health.

  19. The role of micro health insurance in providing financial risk protection in developing countries--a systematic review.

    Science.gov (United States)

    Habib, Shifa Salman; Perveen, Shagufta; Khuwaja, Hussain Maqbool Ahmed

    2016-03-22

    Out of pocket payments are the predominant method of financing healthcare in many developing countries, which can result in impoverishment and financial catastrophe for those affected. In 2010, WHO estimated that approximately 100 million people are pushed below the poverty line each year by payments for healthcare. Micro health insurance (MHI) has been used in some countries as means of risk pooling and reducing out of pocket health expenditure. A systematic review was conducted to assess the extent to which MHI has contributed to providing financial risk protection to low-income households in developing countries, and suggest how the findings can be applied in the Pakistani setting. We conducted a systematic search for published literature using the search terms "Community based health insurance AND developing countries", "Micro health insurance AND developing countries", "Mutual health insurance AND developing countries", "mutual OR micro OR community based health insurance" "Health insurance AND impact AND poor" "Health insurance AND financial protection" and "mutual health organizations" on three databases, Pubmed, Google Scholar and Science Direct (Elsevier). Only those records that were published in the last ten years, in English language with their full texts available free of cost, were considered for inclusion in this review. Hand searching was carried out on the reference lists of the retrieved articles and webpages of international organizations like World Bank, World Health Organization and International Labour Organization. Twenty-three articles were eligible for inclusion in this systematic review (14 from Asia and 9 from Africa). Our analysis shows that MHI, in the majority of cases, has been found to contribute to the financial protection of its beneficiaries, by reducing out of pocket health expenditure, catastrophic health expenditure, total health expenditure, household borrowings and poverty. MHI also had a positive safeguarding effect on

  20. The role of micro health insurance in providing financial risk protection in developing countries- a systematic review

    Directory of Open Access Journals (Sweden)

    Shifa Salman Habib

    2016-03-01

    Full Text Available Abstract Background Out of pocket payments are the predominant method of financing healthcare in many developing countries, which can result in impoverishment and financial catastrophe for those affected. In 2010, WHO estimated that approximately 100 million people are pushed below the poverty line each year by payments for healthcare. Micro health insurance (MHI has been used in some countries as means of risk pooling and reducing out of pocket health expenditure. A systematic review was conducted to assess the extent to which MHI has contributed to providing financial risk protection to low-income households in developing countries, and suggest how the findings can be applied in the Pakistani setting. Methods We conducted a systematic search for published literature using the search terms “Community based health insurance AND developing countries”, “Micro health insurance AND developing countries”, “Mutual health insurance AND developing countries”, “mutual OR micro OR community based health insurance” “Health insurance AND impact AND poor” “Health insurance AND financial protection” and “mutual health organizations” on three databases, Pubmed, Google Scholar and Science Direct (Elsevier. Only those records that were published in the last ten years, in English language with their full texts available free of cost, were considered for inclusion in this review. Hand searching was carried out on the reference lists of the retrieved articles and webpages of international organizations like World Bank, World Health Organization and International Labour Organization. Results Twenty-three articles were eligible for inclusion in this systematic review (14 from Asia and 9 from Africa. Our analysis shows that MHI, in the majority of cases, has been found to contribute to the financial protection of its beneficiaries, by reducing out of pocket health expenditure, catastrophic health expenditure, total health expenditure

  1. A model of strategic product quality and process improvement incentives

    NARCIS (Netherlands)

    Veldman, Jasper; Gaalman, G.

    2013-01-01

    In many production firms it is common practice to financially reward managers for firm performance improvement. The use of financial incentives for improvement has been widely researched in several analytical and empirical studies. Literature has also addressed the strategic effect of incentives, in

  2. Correlated Default and Financial Intermediation

    OpenAIRE

    Gregory Phelan

    2015-01-01

    Financial intermediation naturally arises when knowledge about the aggregate state is valuable for managing investments and lenders cannot easily observe the aggregate state. I show this using a costly enforcement model in which lenders need ex-post incentives to enforce payments from defaulted loans and borrowers' payoffs are correlated. When projects have correlated outcomes, learning the state of one project (via enforcement) provides information about the states of other projects. A large...

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

    Energy Technology Data Exchange (ETDEWEB)

    Barbose, Galen; Wiser, Ryan; Bolinger, Mark

    2007-06-01

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

  4. 10 CFR Appendix A to Part 30 - Criteria Relating to Use of Financial Tests and Parent Company Guarantees for Providing...

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Criteria Relating to Use of Financial Tests and Parent... MATERIAL Pt. 30, App. A Appendix A to Part 30—Criteria Relating to Use of Financial Tests and Parent... on a demonstration that the parent company passes a financial test. This appendix establishes...

  5. Panel presentation: Should some type of incentive regulation replace traditional methods for regulating LDC's?

    International Nuclear Information System (INIS)

    Farman, R.D.

    1992-01-01

    This paper discusses the wants and fears of gas utility companies with regards to incentive regulation. The idea of replacing the traditional rate-of-return regulation with incentive regulation sound very desirous in that it should provide greater management flexibility, quicker and more streamlined regulatory processes, and utility financial rewards based on how well customer needs are met. However, the main fear is that this could result in arbitrary, inappropriate productivity or efficiency targets, or would embody a risk/reward ratio skewed more heavily toward financial penalties than opportunities to increase earnings. The paper presents some of the obstacles of traditional regulation which include a lack of incentive to minimize operational costs; a lack of incentive to introduce new technology, products, or services; prevent the need for flexibility to compete in contestable markets; and the diversion caused by utility managers having to manage the regulatory process rather than delivering value to customers. The paper concludes by comparing the incentive regulation program used in the telecommunications industry to the natural gas industry to demonstrate why the success of the telecommunications model doesn't apply to the gas utilities incentive model

  6. Patient satisfaction as a predictor of return-to-provider behavior: analysis and assessment of financial implications.

    Science.gov (United States)

    Garman, Andrew N; Garcia, Joanne; Hargreaves, Marcia

    2004-01-01

    Although customer loyalty is frequently cited as a benefit of patient satisfaction, an empirical link between the two has not, to our knowledge, ever been statistically established in a hospital setting. The goal of the present study was to evaluate the relationship between self-reported patient satisfaction measures and subsequent return to the provider for care at a large academic medical center. Data from all adult medical patients responding to a patient satisfaction survey distributed by a large midwestern academic medical center during fiscal year 1997 (n = 1485) were analyzed. Response patterns were examined as they related to whether patients returned to the provider during the subsequent 2-year period. Analyses suggested that return-to-provider was associated with only a minority of the satisfaction items (approx. 11%). All items showing a significant relationship measured perceptions of how well physicians and nurses attended to, and provided information to, patients and their families. Although the size of these relationships was generally small, the estimated financial implications are substantial. Other implications of these findings for planning effective service improvement initiatives as well as improving patient survey design are discussed.

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

    OpenAIRE

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

    2015-01-01

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

  8. Incentives to promote family planning.

    Science.gov (United States)

    Heil, Sarah H; Gaalema, Diann E; Herrmann, Evan S

    2012-11-01

    Over the past 60 years, population control has become an increasingly urgent issue worldwide as a growing population strains already limited resources. The use of financial incentives to promote family planning is an innovative approach that has potential to make a contribution to efforts to better manage population growth. This report reviews eight studies that examined the effect of incentives on family planning. Published studies that tested the impact of incentives to promote some aspect of family planning and included an appropriate control or comparison condition were reviewed. Incentives have been used to promote attendance at contraceptive education sessions, adoption and continuation of contraceptive methods, sterilization, and to limit family size. All but one of the eight studies reviewed reported positive outcomes, but weaknesses in study design and execution limit the strength of the conclusions that can be drawn. Review of this literature suggests that family planning behaviors, like other behaviors, are sensitive to incentives. Given the tremendous need for efficacious interventions in global efforts to manage population growth, further research on this topic using more rigorous experimental methods is warranted. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. [Increased financial risks for health insurers: a challenge for providers of mental health care in the Netherlands].

    Science.gov (United States)

    Daansen, P J; van Schilt, J

    2014-01-01

    As from 2014 Dutch health insurance companies will bear the full financial risk for their clients in mental health care. Over the next years the existing risk settlement shared between insurance companies will gradually be brought to a close. Municipalities and the Ministry of Justice are already responsible for or will soon become responsible for financing health care for adolescents, patients with severe psychiatric disorders and forensic psychiatric patients. As a result, the health insurance companies are beginning to impose ever stricter conditions regarding the care 'product' they are 'buying'. To study the possible consequences, for mental health care institutions, of the increased risk to be borne by health care insurers. Use was made of relevant marketing literature and literature relating to mental health care. Studies of Dutch mental health care literature indicate that in the future the purchasing procedure will no longer consider the immediate treatment outcome as the sole performance indicator but will also take into account additional factors such as long-term improvements in patients' health, customer satisfaction and degree of patient participation, patient empowerment and autonomy. In formulating the details of their health products and business strategies, health care providers will now have to take into account not only the efficacy of the treatment they provide but also the purchasing policy and strategy of the health insurance companies.

  10. A time series analysis of the effects of financial incentives and mandatory clinical applications as interventions to improve spontaneous adverse drug reaction reporting by hospital medical staff in China.

    Science.gov (United States)

    Chang, Feng; Xi, Yue; Zhao, Jie; Zhang, Xiaojian; Lu, Yun

    2017-12-01

    Spontaneous reporting of adverse drug reactions (ADRs) in hospitals is often under-reported, which may lead to problems in patient management. This study was aimed to assess the effectiveness of a financial intervention based on a fine and a bonus for improving spontaneous reporting of ADRs by physicians in a hospital setting. This study was conducted at the First Affiliated Hospital of Zhengzhou University (China). Starting in 2009, a bonus of 20 RMB (Chinese currency) was given for each spontaneous ADR report, and a fine of 50 RMB was given for any withheld ADR report. A time series analysis using autoregressive integrated moving average models was performed to assess the changes in the total number of spontaneous ADR reports between the preintervention period (2006-2008) and during the first (2009-2011) and second (2012-2014) intervention periods. The median number of reported ADRs per year increased from 29 (range 27-72) in the preintervention period to 277 (range 199-284) in the first intervention period and to 666 in the second (range 644-691). The monthly number of reported ADRs was stable during the 3 periods: 3.56 ± 3.60/month (95% confidence interval (CI), 2.42-4.75) during the preintervention period, 21 ± 13/month (95% CI, 16.97-25.80) in the first intervention period, and 56 ± 20/month (95% CI, 48.81-62.17) in the second intervention period. A financial incentive and ADR management regulations had a significant effect on the increase of reported ADRs. © 2017 John Wiley & Sons, Ltd.

  11. Does public insurance provide better financial protection against rising health care costs for families of children with special health care needs?

    Science.gov (United States)

    Yu, Hao; Dick, Andrew W; Szilagyi, Peter G

    2008-10-01

    Health care costs grew rapidly since 2001, generating substantial economic pressures on families, especially those with children with special health care needs (CSHCN). To examine how the growth of health care costs affected financial burden for families of CSHCN between 2001 and 2004 and to determine the extent to which health insurance coverage protected families of CSHCN against financial burden. In 2001-2004, 5196 families of CSHCN were surveyed by the national Medical Expenditure Panel Survey (MEPS). The main outcome was financial burden, defined as the proportion of family income spent on out-of-pocket (OOP) health care expenditures for all family members, including OOP costs and premiums. Family insurance coverage was classified as: (1) all members publicly insured, (2) all members privately insured, (3) all members uninsured, (4) partial coverage, and (5) a mix of public and private with no uninsured periods. An upward trend in financial burden for families of CSHCN occurred and was associated with growth of economy-wide health care costs. A multivariate analysis indicated that, given the economy-wide increase in medical costs between 2001 and 2004, a family with CSHCN was at increased risk in 2004 for having financial burden exceeding 10% of family income [odds ratio (OR) = 1.39; P financial burden exceeding 20% of family income. Over 15% of families with public insurance had financial burden exceeding 10% of family income compared with 20% of families with private insurance (P financial burden of >10% or 20% of family income than privately-insured families. Rising health care costs increased financial burden on families of CSHCN in 2001-2004. Public insurance coverage provided better financial protection than private insurance against the rapidly rising health care costs for families of CSHCN.

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

    OpenAIRE

    Patrick Button

    2015-01-01

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

  13. The relationship of financial and mission factors to the level of uncompensated care provided in California hospitals.

    Science.gov (United States)

    Kim, Tae Hyun; Mccue, Michael J; Thompson, Jon M

    2009-01-01

    Community hospitals in the United States have experienced a substantial rise in the burden of uncompensated care over the past few years. Debate continues, however, about whether hospitals, especially private not-for-profits, are providing sufficient levels of uncompensated care. Increased scrutiny regarding uncompensated care and the community benefit of not-for-profit hospitals may be fueled in part by the growing profitability of community hospitals. This study assesses how and whether a hospital's financial performance, mission characteristics, or other significant factors influence its provision of uncompensated care. The study sample consists of 193 short-term, private, acute care community hospitals in California. Results from multivariate regression suggest that free cash flow is positively associated with the provision of uncompensated care in not-for-profit hospitals, whereas a higher level of debt is related to a lower level of uncompensated care. Ownership type (for-profit versus private not-for-profit) does not make a significant difference in the provision of uncompensated care, and overall levels of uncompensated care in the local market are positively associated with a hospital's level of uncompensated care.

  14. Federal tax effects on the financial attractiveness of renewable versus conventional power plants

    International Nuclear Information System (INIS)

    Hill, L.J.; Hadley, S.W.

    1995-01-01

    In this paper, we examine the effects of federal tax laws on the financial attractiveness of seven renewable and four conventional electric power generating technologies adopted by investor owned utilities (IOUs) and non-utility electricity generators (NUGs). The results show that federal income tax laws applicable to renewable generating technologies generally provide very attractive financial incentives for the adoption of these technologies by IOUs and NUGs. If an IOU and NUG is subject to the alternative minimum tax, however, it may not be able to take full advantage of these financial incentives. (author)

  15. Adaptive goal setting and financial incentives: a 2 × 2 factorial randomized controlled trial to increase adults’ physical activity

    Directory of Open Access Journals (Sweden)

    Marc A. Adams

    2017-03-01

    Full Text Available Abstract Background Emerging interventions that rely on and harness variability in behavior to adapt to individual performance over time may outperform interventions that prescribe static goals (e.g., 10,000 steps/day. The purpose of this factorial trial was to compare adaptive vs. static goal setting and immediate vs. delayed, non-contingent financial rewards for increasing free-living physical activity (PA. Methods A 4-month 2 × 2 factorial randomized controlled trial tested main effects for goal setting (adaptive vs. static goals and rewards (immediate vs. delayed and interactions between factors to increase steps/day as measured by a Fitbit Zip. Moderate-to-vigorous PA (MVPA minutes/day was examined as a secondary outcome. Results Participants (N = 96 were mainly female (77%, aged 41 ± 9.5 years, and all were insufficiently active and overweight/obese (mean BMI = 34.1 ± 6.2. Participants across all groups increased by 2389 steps/day on average from baseline to intervention phase (p < .001. Participants receiving static goals showed a stronger increase in steps per day from baseline phase to intervention phase (2630 steps/day than those receiving adaptive goals (2149 steps/day; difference = 482 steps/day, p = .095. Participants receiving immediate rewards showed stronger improvement (2762 step/day increase from baseline to intervention phase than those receiving delayed rewards (2016 steps/day increase; difference = 746 steps/day, p = .009. However, the adaptive goals group showed a slower decrease in steps/day from the beginning of the intervention phase to the end of the intervention phase (i.e. less than half the rate compared to the static goals group (−7.7 steps vs. -18.3 steps each day; difference = 10.7 steps/day, p < .001 resulting in better improvements for the adaptive goals group by study end. Rate of change over the intervention phase did not differ between reward groups. Significant goal phase x goal

  16. Does a local financial incentive scheme reduce inequalities in the delivery of clinical care in a socially deprived community? A longitudinal data analysis.

    Science.gov (United States)

    Glidewell, Liz; West, Robert; Hackett, Julia E C; Carder, Paul; Doran, Tim; Foy, Robbie

    2015-05-14

    osteoporosis risk). For one indicator the deprivation-achievement gap reduced over time (repeat prednisolone prescription (OR 1.01; 1.01,1.01). Larger practices and those serving more affluent areas earned more income per patient than smaller practices and those serving more deprived areas (t = -3.99; p =0.0001). Any gaps in achievement between practices were modest but mostly sustained or widened over the duration of the scheme. Given that financial rewards may not reflect the amount of work undertaken by practices serving more deprived patients, future pay-for-performance schemes also need to address fairness of rewards in relation to workload.

  17. Incentives and performance governance of research organizations

    CERN Document Server

    Wollersheim, Jutta; Ringelhan, Stefanie; Osterloh, Margit

    2015-01-01

    ​This book contributes to the current discussion in society, politics and higher education on innovation capacity and the financial and non-financial incentives for researchers. The expert contributions in the book deal with implementation of incentive systems at higher education institutions in order to foster innovation. On the other hand, the book also discusses the extent to which governance structures from economy can be transferred to universities and how scientific performance can be measured and evaluated. This book is essential for decision-makers in knowledge-intensive organizations and higher-educational institutions dealing with the topic of performance management.

  18. Tax Incentives for Education. Hearing before the Committee on Finance. United States Senate, One Hundredth Congress, Second Session.

    Science.gov (United States)

    Congress of the U.S., Washington, DC. Senate Committee on Finance.

    The transcript of a hearing before the Senate Committee on Finance concerning tax incentives for education is presented. The statements of committee members and public witnesses testimony, both oral and written, are provided, as well as letters of support. Current tax expenditures for financial aid to college students, including student loan…

  19. State Incentives for Innovation, Star Scientists, and Jobs: Evidence from Biotech. Upjohn Institute Working Paper No. 14-203

    Science.gov (United States)

    Moretti, Enrico; Wilson, Daniel J.

    2013-01-01

    We evaluate the effects of state-provided financial incentives for biotech companies, which are part of a growing trend of placed-based policies designed to spur innovation clusters. We estimate that the adoption of subsidies for biotech employers by a state raises the number of star biotech scientists in that state by about 15 percent over a…

  20. DO FINANCIAL STATEMENTS PROVIDE ADEQUATE INFORMATION ABOUT THE CAPITALIZATION OF COSTS RELATED TO INTANGIBLE ASSETS?: AN EMPIRICAL RESEARCH ON ITALIAN LISTED COMPANIES

    Directory of Open Access Journals (Sweden)

    Stefania Vignini

    2015-11-01

    Full Text Available The aim of our research is to verify if Italian listed companies financial statements provide adequate information about the capitalization of costs related to intangible assets and if the information provided are reliable. Moreover, we investigated if they merely comply with law or provide additional information on cost capitalization and reveal if internal control systems (especially managerial accounting systems or other information systems are applied to support the measurement process and the cost control, thus guaranteeing the verifiability and representational faithfulness of the information disclosed. This paper is an empirical analysis and is concerned to investigate the financial statements of 250 Italian listed companies.

  1. State tax incentives for persons giving informal care to the elderly

    Science.gov (United States)

    Hendrickson, Michael C.

    1988-01-01

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

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

    Science.gov (United States)

    Hendrickson, M C

    1988-12-01

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

  3. Economic incentives to promote innovation in healthcare delivery.

    Science.gov (United States)

    Luft, Harold S

    2009-10-01

    Economics influences how medical care is delivered, organized, and progresses. Fee-for-service payment encourages delivery of services. Fee-for-individual-service, however, offers no incentives for clinicians to efficiently organize the care their patients need. Global capitation provides such incentives; it works well in highly integrated practices but not for independent practitioners. The failures of utilization management in the 1990s demonstrated the need for a third alternative to better align incentives, such as bundling payment for an episode of care. Building on Medicare's approach to hospital payment, one can define expanded diagnosis-related groups that include all hospital, physician, and other costs during the stay and appropriate preadmission and postdischarge periods. Physicians and hospitals voluntarily forming a new entity (a care delivery team) would receive such bundled payments along with complete flexibility in allocating the funds. Modifications to gainsharing and antikickback rules, as well as reforms to malpractice liability laws, will facilitate the functioning of the care delivery teams. The implicit financial incentives encourage efficient care for the patient; the episode focus will facilitate measuring patient outcomes. Payment can be based on the resources used by those care delivery teams achieving superior outcomes, thereby fostering innovation improving outcomes and reducing waste.

  4. 76 FR 21169 - Incentive-Based Compensation Arrangements

    Science.gov (United States)

    2011-04-14

    ... financial officer, chief investment officer, chief legal officer, chief lending officer, chief risk officer... Mac: The Chairman of the Board of Directors, chief executive officer, chief financial officer, chief... aspects of financial oversight, can play an important role in helping ensure that incentive compensation...

  5. Cogeneration plants: SNAM (Italy) initiatives and incentives

    International Nuclear Information System (INIS)

    Pipparelli, M.

    1991-01-01

    First, an overall picture is presented of the extension of the use of cogeneration by the Italian brick industry. The particular suitability and usefulness of this form of energy to the brick industry are pointed out. Then a look is given at the legal and financial incentives which have been built into the National Energy Plan to encourage on-site production by Italian industries. Finally, a review is made of initiatives made by SNAM (the Italian National Methane Distribution Society) to develop a favourable tariff structure for on-site power producers using methane as their energy source, as well as, of the Society's efforts to set up a cogeneration equipment consulting service which would provide advice on cogeneration plant design, operation and maintenance

  6. Financial Statements

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

    Financial Statements and accompanying notes provided on .... to good governance principles. there is the risk that ...... responsibilities of the centre's internal auditor includes reviewing internal controls, including accounting and financial.

  7. Acceptability of financial incentives or quasi-mandatory schemes to increase uptake of immunisations in preschool children in the United Kingdom: Qualitative study with parents and service delivery staff.

    Science.gov (United States)

    McNaughton, Rebekah Jayne; Adams, Jean; Shucksmith, Janet

    2016-04-27

    Since the 1990 s strenuous attempts have been made to rebuild trust in childhood immunisations. This study aimed to understand if financial incentives (FI) or quasi-mandatory schemes (QMS), e.g. mandating immunisations for entry to universal services such as day care or school, might be acceptable interventions to increase immunisations uptake for preschool children. Parents and carers of preschool children (n=91); health and other professionals (n=18); and those responsible for developing and commissioning immunisation services (n=6) took part in the study. Qualitative methods were employed to explore the acceptability of FI/QMS with stakeholders. Framework analysis was used to develop a coding framework that was applied to the whole dataset. Interpretations of the emergent themes were verified between researchers and presented to the project's Parent Reference Group to ensure coherence and relevance. (1) FI: parents and professionals felt introducing FI was inappropriate. It was acknowledged FI may encourage families living in disadvantage to prioritise immunisation, but unintended consequences could outweigh any advantage. FI essentially changes behaviour into a cash transaction which many equated to bribery that could inadvertently create inequalities. (2) QMS: parents and professionals highlighted the positives of introducing QMS, stating it felt natural, fair and less likely to create inequality. Despite QMS' potential to positively impact on uptake there were concerns about the implementation and workability of such schemes. FI for preschool immunisation may not be acceptable, within a UK context. Introducing FI could have detrimental effects on uptake if it were associated with bribery and coercion. Quasi-mandatory schemes, mandating immunisation for universal service entry, was the most acceptable option and could contribute to the normalising of immunisation. Future work would be needed to assess how this could be successfully implemented and if it did

  8. The Role of Hosting Providers in Web Security : Understanding and Improving Security Incentives and Performance via Analysis of Large-scale Incident Data

    NARCIS (Netherlands)

    Tajalizadehkhoob, S.

    2018-01-01

    In theory, hosting providers can play an important role in fighting cybercrime and misuse. This is because many online threats, be they high-profile or mundane, use online storage infrastructure maintained by hosting providers at the core of their criminal operations.
    However, in practice, we

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

    Science.gov (United States)

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

    2017-03-21

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

  10. Creating New Economic Incentives for Repurposing Generic Drugs for Unsolved Diseases Using Social Finance.

    Science.gov (United States)

    Bloom, Bruce E

    2015-12-01

    Repurposing research improves patient lives by taking drugs approved for one disease and clinically testing them to create a treatment for a different disease. Repurposing drugs that are generic, inexpensive, and widely available and that can be taken in their current dosage and formulation in the new indication provide a quick, affordable, and effective way to create "new" treatments. However, generic drug repurposing often provides no profit potential, and so there is no economic incentive for industry to pursue this, and philanthropy and government funds are often insufficient. One way to create new economic incentive for the repurposing of generic drugs is through social finance. This perspective describes how social finance can create a new economic incentive by using a social impact bond, or similar financial structure, to repay for-profit investors who fund the repurposing research from the proceeds of healthcare cost reductions generated when these affordable, effective, and widely available repurposed therapies improve healthcare outcomes.

  11. Incentive delegation and collusion

    NARCIS (Netherlands)

    Mukherjee, A.

    2000-01-01

    In an infinitely repeated duopoly the implications of strategic incentive delegation are shown. Whether incentive delegation makes consumers or producers better-off depends on the nature of competition. WeThe presence or absence of incentive delegation may affect the interests of the consumers and

  12. Countervailing incentives in value-based payment.

    Science.gov (United States)

    Arnold, Daniel R

    2017-09-01

    Payment reform has been at the forefront of the movement toward higher-value care in the U.S. health care system. A common belief is that volume-based incentives embedded in fee-for-service need to be replaced with value-based payments. While this belief is well-intended, value-based payment also contains perverse incentives. In particular, behavioral economists have identified several features of individual decision making that reverse some of the typical recommendations for inducing desirable behavior through financial incentives. This paper discusses the countervailing incentives associated with four behavioral economic concepts: loss aversion, relative social ranking, inertia or status quo bias, and extrinsic vs. intrinsic motivation. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Higher education reform: getting the incentives right

    NARCIS (Netherlands)

    Canton, Erik; Venniker, Richard; Jongbloed, Benjamin W.A.; Koelman, Jos; Koelman, Jos; van der Meer, Peter; van der Meer, Peter; Vossensteyn, Johan J.

    2001-01-01

    This study is a joint effort by the Netherlands Bureau for Economic Policy Analysis (CPB) and the Center for Higher Education Policy Studies. It analyses a number of `best practices¿ where the design of financial incentives working on the system level of higher education is concerned. In Chapter 1,

  14. 75 FR 76079 - Sound Incentive Compensation Guidance

    Science.gov (United States)

    2010-12-07

    ... management; and Be supported by strong corporate governance, including active and effective oversight by the... Sound Compensation Practices adopted by the Financial Stability Board (FSB) in April 2009, as well as... will promote the prompt improvement of incentive compensation practices in the banking industry by...

  15. 75 FR 53023 - Sound Incentive Compensation Guidance

    Science.gov (United States)

    2010-08-30

    ... management; and Be supported by strong corporate governance, including active and effective oversight by the... Sound Compensation Practices adopted by the Financial Stability Board (FSB) in April 2009, as well as... will promote the prompt improvement of incentive compensation practices in the banking industry by...

  16. 75 FR 22679 - Sound Incentive Compensation Guidance

    Science.gov (United States)

    2010-04-29

    ... management; and Be supported by strong corporate governance, including active and effective oversight by the... Sound Compensation Practices adopted by the Financial Stability Board (FSB) in April 2009, as well as... will promote the prompt improvement of incentive compensation practices in the banking industry by...

  17. Does carbetocin for prevention of postpartum haemorrhage at caesarean section provide clinical or financial benefit compared with oxytocin?

    Science.gov (United States)

    Higgins, L; Mechery, J; Tomlinson, A J

    2011-11-01

    Postpartum haemorrhage is a major cause of maternal morbidity and mortality worldwide. A recent Cochrane review of carbetocin (long-acting oxytocin analogue) concluded that its use decreased additional uterotonic requirements, however, no included studies compared its use against intravenous bolus oxytocin. The majority of studies of carbetocin have considered its use in vaginal delivery; no studies have examined the economic implications of its use. This study describes a clinical and financial evaluation undertaken at a United Kingdom District General Hospital surrounding the introduction of carbetocin for prophylaxis against postpartum haemorrhage at caesarean deliveries. A range of clinical outcomes were observed including frequency of postpartum haemorrhage, estimated blood loss, transfusion requirements, change in haemoglobin or haemodynamics, use of additional uterotonics and perioperative recovery. Finally, a composite financial analysis was performed. No clinically significant benefit was found, however associated costs increased by £18.52/patient.

  18. The use of fund accounting and the need for single fund reporting by institutional healthcare providers. Principles and Practices Board Statement No. 8. Healthcare Financial Management Association.

    Science.gov (United States)

    1986-06-01

    For many years, hospitals and other institutional healthcare providers used fund accounting as a basis for presenting their financial statements. Recently, authoritative literature has placed less emphasis on separate fund reporting. This is evidenced by the reduction of fund classifications specified in the literature. This trend seems to follow the recognition that institutional healthcare activities should be reported in a manner comparable to other businesses. The Principles and Practices Board (P&P Board) of the Healthcare Financial management Association believes that general purpose financial statements of institutional healthcare providers should be comparable to reporting by other businesses. That is, all assets, liabilities, and equity are presented in a single aggregated balance sheet without differentiation by fund. This form of presentation, referred to in this statement as single fund reporting, should be used by all institutional healthcare providers including those that are part of HMOs, universities, municipalities, and other larger entities when separate reports of the provider are issued. The P&P Board is studying other significant issues concerning the reporting of revenues and components of equity and changes therein. The conclusion in this statement can be implemented even though conclusions on these related subjects are not yet complete. The P&P Board recognizes that certain circumstances may require detailed records and reports for special purposes. This statement deals only with those general purpose financial statements on which an independent accountant's opinion is expressed.

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

    Science.gov (United States)

    2012-02-01

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

  20. Financial Incentives in Long-Term Care

    NARCIS (Netherlands)

    P.L.H. Bakx (Pieter)

    2015-01-01

    markdownabstract__Abstract__ Long-term care (ltc) aims to help individuals to cope with their impairments. In my thesis, I describe ltc financing alternatives and their consequences for the allocation of ltc. This thesis consists of two parts. In the first part, I investigate how alternative ways

  1. Financial Derivatives

    OpenAIRE

    Janečková, Alena

    2011-01-01

    1 Abstract/ Financial derivatives The purpose of this thesis is to provide an introduction to financial derivatives which has been, from the legal perspective, described in a not satisfactory manner as quite little literature that can be found about this topic. The main objectives of this thesis are to define the term "financial derivatives" and its particular types and to analyse legal nature of these financial instruments. The last objective is to try to draft future law regulation of finan...

  2. The effect of reimbursement on medical decision making: do physicians alter treatment in response to a managed care incentive?

    Science.gov (United States)

    Melichar, Lori

    2009-07-01

    The empirical literature that explores whether physicians respond to financial incentives has not definitively answered the question of whether physicians alter their treatment behavior at the margin. Previous research has not been able to distinguish that part of a physician response that uniformly alters treatment of all patients under a physician's care from that which affects some, but not all of a physician's patients. To explore physicians' marginal responses to financial incentives while accounting for the selection of physicians into different financial arrangements where others could not, I use data from a survey of physician visits to isolate the effect that capitation, a form of reimbursement wherein physicians receive zero marginal revenue for a range of physician provided services, has on the care provided by a physician. Fixed effects regression results reveal that physicians spend less time with their capitated patients than with their non-capitated patients.

  3. The US Financial Crisis

    DEFF Research Database (Denmark)

    Campbell, John L.

    2011-01-01

    Many comparative political economists hold that market performance depends on the presence of institutional complementarities. Some argue that when institutions reinforce similar incentives markets work best. Others disagree and argue that for markets to function well institutions must compensate...... for each other's shortcomings rather than reinforce each other's incentives. This paper uses evidence from the US financial crisis of 2008 to adjudicate this debate. It argues that different types of institutional complementarities are necessary in combination to ensure market stability and successful...

  4. Regulatory Incentives and Disincentives for Utility Investments in Grid Modernization

    Energy Technology Data Exchange (ETDEWEB)

    Kihm, Steve [Seventhware, Madison, WI (United States); Beecher, Janice [Michigan State Univ., East Lansing, MI (United States). Inst. of Public Utilities; Lehr, Ronald L.

    2017-05-31

    Electric power is America's most capital-intensive industry, with more than $100 billion invested each year in energy infrastructure. Investment needs are likely to grow as electric utilities make power systems more reliable and resilient, deploy advanced digital technologies, and facilitate new services to meet some consumers' expectations for greater choice and control. But do current regulatory approaches provide the appropriate incentives for grid modernization investments? This report presents three perspectives: -Financial analyst Steve Kihm begins by explaining that any major investor-owned electric utility that wants to raise capital today can do so at a reasonable cost. The question is whether utility managers want to raise capital for grid modernization. Specifically, they look for investments that create the most value for their existing shareholders. In cases where grid modernization investments are not the best choice in terms of shareholder value, Kihm describes shareholder incentive mechanisms that regulators could consider to encourage such investments when they are in the public interest. -From an institutional perspective, Dr. Janice Beecher finds that the traditional rate-base/rate of return regulatory model provides powerful incentives for utilities to pursue investments, cost control, efficiency and even innovation, and it is well suited to the policy objectives of grid modernization. Prudence of grid modernization investments (fair returns) depends on careful evaluation of the specific asset, and any special incentives (bonus returns) should be used only if they promote economic efficiency consistent with the core goals of economic regulation. According to Beecher, realizing the promises of grid modernization depends on effective implementation of the traditional regulatory model and ratemaking tools to serve the public interest. -Conversely, former commissioner and clean energy consultant Ron Lehr says that rapid electric industry

  5. Using Effective Contractual Incentives to Obtain Superior Contractor Performance

    National Research Council Canada - National Science Library

    Venable, Timothy

    2000-01-01

    The purpose of this thesis is to provide the reader with the ability to analyze the effectiveness of incentives and to document innovative approaches to incentive contracting that can be applied to Cost-Plus-Award-Fee (CPAF) contracts...

  6. Financial Motivation Undermines Maintenance in an Intensive Diet and Activity Intervention

    Science.gov (United States)

    Moller, Arlen C.; McFadden, H. Gene; Hedeker, Donald; Spring, Bonnie

    2012-01-01

    Financial incentives are widely used in health behavior interventions. However, self-determination theory posits that emphasizing financial incentives can have negative consequences if experienced as controlling. Feeling controlled into performing a behavior tends to reduce enjoyment and undermine maintenance after financial contingencies are removed (the undermining effect). We assessed participants' context-specific financial motivation to participate in the Make Better Choices trial—a trial testing four different strategies for improving four health risk behaviors: low fruit and vegetable intake, high saturated fat intake, low physical activity, and high sedentary screen time. The primary outcome was overall healthy lifestyle change; weight loss was a secondary outcome. Financial incentives were contingent upon meeting behavior goals for 3 weeks and became contingent upon merely providing data during the 4.5-month maintenance period. Financial motivation for participation was assessed at baseline using a 7-item scale (α = .97). Across conditions, a main effect of financial motivation predicted a steeper rate of weight regained during the maintenance period, t(165) = 2.15, P = .04. Furthermore, financial motivation and gender interacted significantly in predicting maintenance of healthy diet and activity changes, t(160) = 2.42, P = .016, such that financial motivation had a more deleterious influence among men. Implications for practice and future research on incentivized lifestyle and weight interventions are discussed. PMID:22548152

  7. Financial Motivation Undermines Maintenance in an Intensive Diet and Activity Intervention

    Directory of Open Access Journals (Sweden)

    Arlen C. Moller

    2012-01-01

    Full Text Available Financial incentives are widely used in health behavior interventions. However, self-determination theory posits that emphasizing financial incentives can have negative consequences if experienced as controlling. Feeling controlled into performing a behavior tends to reduce enjoyment and undermine maintenance after financial contingencies are removed (the undermining effect. We assessed participants’ context-specific financial motivation to participate in the Make Better Choices trial—a trial testing four different strategies for improving four health risk behaviors: low fruit and vegetable intake, high saturated fat intake, low physical activity, and high sedentary screen time. The primary outcome was overall healthy lifestyle change; weight loss was a secondary outcome. Financial incentives were contingent upon meeting behavior goals for 3 weeks and became contingent upon merely providing data during the 4.5-month maintenance period. Financial motivation for participation was assessed at baseline using a 7-item scale (=.97. Across conditions, a main effect of financial motivation predicted a steeper rate of weight regained during the maintenance period, (165=2.15, =.04. Furthermore, financial motivation and gender interacted significantly in predicting maintenance of healthy diet and activity changes, (160=2.42, =.016, such that financial motivation had a more deleterious influence among men. Implications for practice and future research on incentivized lifestyle and weight interventions are discussed.

  8. Energy efficiency investments in the context of split incentives among French households

    International Nuclear Information System (INIS)

    Charlier, Dorothée

    2015-01-01

    The residential sector offers considerable potential for reducing energy use and greenhouse gas (GHG) emissions, particularly through energy-efficient renovations. The objective of this study is twofold. First, I aim to provide initial empirical evidence of the extent to which split incentives between landlords and tenants may lead to underinvestment. Second, I investigate the influence of tax credits and energy burdens on energy efficiency expenditures. Given the complexity of studying the decision to invest in energy-saving renovations, I use a bivariate Tobit model to compare decisions about energy-efficient works and repair works, even when the renovation expenditures seem quite similar. The analysis shows that tenants are doubly penalized: they have high energy expenditures due to energy-inefficient building characteristics, and because they are poorer than homeowners, they are unable to invest in energy-saving systems. The results also confirm that tax credits are ineffective in the split incentives context. In terms of public policy, the government should focus on low-income tenants, and mandatory measures such as minimum standards seem appropriate. Financial support from a third-party financer also might be a solution. - Highlights: • I provide empirical evidence of underinvestment due to split incentives. • I investigate the influence of tax credit and energy burden on EE expenditures. • Results show that tax credits are ineffective in a context of split incentives. • Mandatory measures such as minimum standards seem to be appropriate. • Financial support from a third party financer can be also a solution.

  9. Network versus Economic Incentives

    DEFF Research Database (Denmark)

    Larsen, Christian Albrekt

    The article supplements the traditional economic line of reasoning with an economic sociological account of the transition from unemployment to employment. The lack of full information is recognised by economic theory while the focus on network within the tradition of economic sociology has...... not been adopted. The article argues that the importance of network actually might be very well understood within recent economic theories that emphasise the lack of full information. The empirical evidence for the importance of network both for employed and unemployed is provided by analysing a best case...... might be an important part of the vicious circles of unemployment. Finally, the article analyse the importance of network versus the importance of economic incentives. The result supports the thesis that economic sociology provides a better account of the transition from unemployment to employment than...

  10. Providing incentives to buy US enrichment

    International Nuclear Information System (INIS)

    Steyn, J.

    1985-01-01

    The U.S. Department of Energy is making a series of commercial and technological decisions crucial to its future as an enriching enterprise. The state of US enrichment, as revealed in this years AIF Fuel Cycle conference, is reported. (U.K.)

  11. Financial Statements Analysis

    OpenAIRE

    Tănase Alin-Eliodor

    2014-01-01

    This article focuses on analyzing of a consolidated financial statements of a hypothetically SME. The interpretation of the financial position and performances is based on the more than 40 financial key ratios computed by using financial data from consolidated income statement, consolidated financial position and cash flow. However additional data from notes to financial statements are provided.

  12. State property tax incentives for promoting ecosystem goods and services from private forest land in the United States: a review and analysis

    Science.gov (United States)

    Michael A. Kilgore; Paul B. Ellefson; Travis J. Funk; Gregory E. Frey

    2017-01-01

    Financial incentives provided by State property tax programs are a means of promoting ecosystem services from private forest land. Identified by this 50-State 2015 review, categories of ecosystem services frequently promoted by such programs are open space and scenic resources, conservation of...

  13. The effect of task demand and incentive on neurophysiological and cardiovascular markers of effort.

    Science.gov (United States)

    Fairclough, Stephen H; Ewing, Kate

    2017-09-01

    According to motivational intensity theory, effort is proportional to the level of task demand provided that success is possible and successful performance is deemed worthwhile. The current study represents a simultaneous manipulation of demand (working memory load) and success importance (financial incentive) to investigate neurophysiological (EEG) and cardiovascular measures of effort. A 2×2 repeated-measures study was conducted where 18 participants performed a n-back task under three conditions of demand: easy (1-back), hard (4-back) and very hard (7-back). In addition, participants performed these tasks in the presence of performance-contingent financial incentive or in a no-incentive (pilot trial) condition. Three bands of EEG activity were quantified: theta (4-7Hz), lower-alpha (7.5-10Hz) and upper-alpha (10.5-13Hz). Fronto-medial activity in the theta band and activity in the upper-alpha band at frontal, central and parietal sites were sensitive to demand and indicated greatest effort when the task was challenging and success was possible. Mean systolic blood pressure and activity in the lower-alpha band at parietal sites were also sensitive to demand but also increased in the incentive condition across all levels of task demand. The results of the study largely support the predictions of motivational intensity using neurophysiological markers of effort. Copyright © 2017. Published by Elsevier B.V.

  14. The impact of facility audits, evaluation reports and incentives on motivation and supply management among family planning service providers: an interventional study in two districts in Maputo Province, Mozambique.

    Science.gov (United States)

    Vermandere, Heleen; Galle, Anna; Griffin, Sally; de Melo, Málica; Machaieie, Lino; Van Braeckel, Dirk; Degomme, Olivier

    2017-05-02

    Good progress is being made towards universal access to contraceptives, however stock-outs still jeopardize progress. A seldom considered but important building block in optimizing supply management is the degree to which health workers feel motivated and responsible for monitoring supply. We explored how and to what extent motivation can be improved, and the impact this can have on avoiding stock-outs. Fifteen health facilities in Maputo Province, Mozambique, were divided into 3 groups (2 intervention groups and 1 control), and 10 monthly audits were implemented in each of these 15 facilities to collect data through examination of stock cards and stock-counts of 6 contraceptives. Based on these audits, the 2 intervention groups received a monthly evaluation report reflecting the quality of their supply management. One of these 2 groups was also awarded material incentives conditional on their performance. A Wilcoxon-Mann Whitney test was used to detect differences between the groups in the average number of stocked-out centres, while changes over time were verified through applying a Friedman test. Additionally, staff motivation was measured through interviewing health care providers of all centres at baseline, and after 5 and 10 months. To detect differences between the groups and changes over time, a Kruskal Wallis and a Wilcoxon signed-rank test were applied, respectively. Motivation reported by providers (n = 55, n = 40 and n = 39 at baseline, 1st and 2nd follow-up respectively) was high in all groups, during all rounds, and did not change over time. Facilities in the intervention groups had better supply management results (including less stock-outs) during the entire intervention period compared with those in the control group, but the difference was only significant for the group receiving both material incentives and a monthly evaluation. However, our data also suggest that supply management also improved in control facilities, receiving

  15. Survey of state approaches to solar energy incentives

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, S. B.

    1979-07-01

    A comprehensive survey is presented of state statutes designed to encourage the application of solar technology. A large majority of the states have enacted financial incentives designed to stimulate solar energy use. Commonly, these incentives include preferential property tax treatment of solar systems, and income tax benefits to solar users. There are a wide variety of other tax breaks as well, including excise and franchise tax incentives. Some states have recently developed loan or grant programs for solar installations. Other states have addressed aspects of real property and land-use planning law, which have served as barriers to either the installation of solar technology or access to sunlight. In addition to removing such obstacles as restrictive convenants and zoning limitations, the legislation of several states provides affirmative recognition of the potential of real property law to serve as a spur to solar development, through solar easements, planning and zoning, and public nuisance. A small number of states have legislated in the field of utility regulation, addressing important questions of (1) nondiscriminatory rates for utility backup to solar systems and public utility commissions, and (2) utility involvement in solar energy applicatons.

  16. The roles of incentives and voluntary cooperation for contractual compliance

    OpenAIRE

    Gächter, Simon; Kessler, Esther; Königstein, Manfred

    2011-01-01

    Efficiency under contractual incompleteness often requires voluntary cooperation in situations where self-regarding incentives for contractual compliance are present as well. Here we provide a comprehensive experimental analysis based on the gift-exchange game of how explicit and implicit incentives affect cooperation. We first show that there is substantial cooperation under non-incentive compatible contracts. Incentive-compatible contracts induce best-reply effort and crowd out any voluntar...

  17. Cost-Effectiveness of Rural Incentive Packages for Graduating Medical Students in Lao PDR.

    Science.gov (United States)

    Keuffell, Eric; Jaskiewicz, Wanda; Theppanya, Khampasong; Tulenko, Kate

    2016-10-29

    The dearth of health workers in rural settings in Lao People's Democratic Republic (PDR) and other developing countries limits healthcare access and outcomes. In evaluating non-wage financial incentive packages as a potential policy option to attract health workers to rural settings, understanding the expected costs and effects of the various programs ex ante can assist policy-makers in selecting the optimal incentive package. We use discrete choice experiments (DCEs), costing analyses and recent empirical results linking health worker density and health outcomes to estimate the future location decisions of physicians and determine the cost-effectiveness of 15 voluntary incentives packages for new physicians in Lao PDR. Our data sources include a DCE survey completed by medical students (n = 329) in May 2011 and secondary cost, economic and health data. Mixed logit regressions provide the basis for estimating how each incentive package influences rural versus urban location choice over time. We estimate the expected rural density of physicians and the cost-effectiveness of 15 separate incentive packages from a societal perspective. In order to generate the cost-effectiveness ratios we relied on the rural uptake probabilities inferred from the DCEs, the costing data and prior World Health Organization (WHO) estimates that relate health outcomes to health worker density. Relative to no program, the optimal voluntary incentive package would increase rural physician density by 15% by 2016 and 65% by 2041. After incorporating anticipated health effects, seven (three) of the 15 incentive packages have anticipated average cost-effectiveness ratio less than the WHO threshold (three times gross domestic product [GDP] per capita) over a 5-year (30 year) period. The optimal package's incremental cost-effectiveness ratio is $1454/QALY (quality-adjusted life year) over 5 years and $2380/QALY over 30 years. Capital intensive components, such as housing or facility improvement

  18. The Mixed Nature of Incentives of Community Health Workers: Lessons from a Qualitative Study in Two Districts in India

    Directory of Open Access Journals (Sweden)

    Enisha eSarin

    2016-03-01

    Full Text Available Incentives play an important role in motivating community health workers (CHWs. In India, accredited social health activists (ASHAs are female CHWs who provide a range of services, including those specific to reproductive, maternal, neonatal, child, and adolescent health. Qualitative interviews were conducted with 49 ASHAs and one of their family members (husband, mother-in-law, sister-in-law, or son from Gurdarspur and Mewat districts to explore the role of family, community, and health system in supporting ASHAs in their work. Thematic analysis revealed that incentives were both empowering and a source of distress for ASHAs and their families. Earning income and contributing to the household’s financial wellbeing inspired a sense of financial independence and self-confidence for ASHAs, especially with respect to relations with their husbands and parents-in-law. In spite of the empowering effects of the incentives, they were a cause of distress. Low incentive rates relative to the level of effort required to complete ASHA responsibilities, compounded by irregular and incomplete payment, put pressure on families. ASHAs dedicated much of their time and own resources to perform their duties, drawing them away from their household responsibilities. Communication around incentives from supervisors may have led ASHAs to prioritize and promote those services that yielded higher incentives, as opposed to focusing on the most appropriate services for the client. ASHAs and their families maintained hope that their positions would eventually bring in a regular salary, which contributed to retention of ASHAs. Incentives, therefore, are both motivating and inspiring as well as a cause dissatisfaction among ASHAs and their families. Recommendations include revising the incentive scheme to be responsive to the time and effort required to complete tasks and the out-of-pocket costs incurred while working as an ASHA; improve communication to ASHAs on

  19. The Mixed Nature of Incentives for Community Health Workers: Lessons from a Qualitative Study in Two Districts in India.

    Science.gov (United States)

    Sarin, Enisha; Lunsford, Sarah Smith; Sooden, Ankur; Rai, Sanjay; Livesley, Nigel

    2016-01-01

    Incentives play an important role in motivating community health workers (CHWs). In India, accredited social health activists (ASHAs) are female CHWs who provide a range of services, including those specific to reproductive, maternal, neonatal, child, and adolescent health. Qualitative interviews were conducted with 49 ASHAs and one of their family members (husband, mother-in-law, sister-in-law, or son) from Gurdaspur and Mewat districts to explore the role of family, community, and health system in supporting ASHAs in their work. Thematic analysis revealed that incentives were both empowering and a source of distress for ASHAs and their families. Earning income and contributing to the household's financial wellbeing inspired a sense of financial independence and self-confidence for ASHAs, especially with respect to relations with their husbands and parents-in-law. In spite of the empowering effects of the incentives, they were a cause of distress. Low incentive rates relative to the level of effort required to complete ASHA responsibilities, compounded by irregular and incomplete payment, put pressure on families. ASHAs dedicated much of their time and own resources to perform their duties, drawing them away from their household responsibilities. Communication around incentives from supervisors may have led ASHAs to prioritize and promote those services that yielded higher incentives, as opposed to focusing on the most appropriate services for the client. ASHAs and their families maintained hope that their positions would eventually bring in a regular salary, which contributed to retention of ASHAs. Incentives, therefore, are both motivating and inspiring as well as a cause dissatisfaction among ASHAs and their families. Recommendations include revising the incentive scheme to be responsive to the time and effort required to complete tasks and the out-of-pocket costs incurred while working as an ASHA; improve communication to ASHAs on incentives and

  20. 28 CFR 30.8 - How does the Attorney General provide an opportunity to comment on proposed Federal financial...

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false How does the Attorney General provide an... PROGRAMS AND ACTIVITIES § 30.8 How does the Attorney General provide an opportunity to comment on proposed... Attorney General gives state processes or directly affected state, areawide, regional, and local officials...

  1. 49 CFR 17.8 - How does the Secretary provide states an opportunity to comment on proposed Federal financial...

    Science.gov (United States)

    2010-10-01

    ... 17.8 Transportation Office of the Secretary of Transportation INTERGOVERNMENTAL REVIEW OF DEPARTMENT OF TRANSPORTATION PROGRAMS AND ACTIVITIES § 17.8 How does the Secretary provide states an opportunity... 49 Transportation 1 2010-10-01 2010-10-01 false How does the Secretary provide states an...

  2. Enhancing Readiness of the Unmanned Aerial Vehicle (UAV) System via Use of Simulation Modeling and Contract Incentives

    National Research Council Canada - National Science Library

    Kasal, Omer

    1999-01-01

    ...) test system of the Turkish Army Command are the failure to address life cycle cost (LCC) considerations during financial resource allocations and the absence of contract reliability incentives...

  3. RECRUITING NEW TEACHERS TO URBAN SCHOOL DISTRICTS: WHAT INCENTIVES

    Directory of Open Access Journals (Sweden)

    ANTHONY T. MILANOWSKI

    2009-08-01

    Full Text Available Many urban districts in the United States have difficulty attracting and retaining quality teachers, yet they are often themost in need of them. In response, U.S. states and districts are experimenting with financial incentives to attract andretain high-quality teachers in high-need, low-achieving, or hard-to-staff urban schools. However, relatively little isknown about how effective financial incentives are for recruiting new teachers to high-need urban schools. This researchexplores factors that are important to the job choices of teachers in training. Focus groups were held with students atthree universities, and a policy-capturing study was done using 64 job scenarios representing various levels of pay andworking conditions. Focus group results suggested that: a many pre-service teachers, even relatively late in their preparation,are not committed to a particular district and are willing to consider many possibilities, including high needschools; b although pay and benefits were attractive to the students, loan forgiveness and subsidies for further educationwere also attractive; and c small increments of additional salary did not appear as important or attractive as otherjob characteristics. The policy-capturing study showed that working conditions factors, especially principal support, hadmore influence on simulated job choice than pay level, implying that money might be better spent to attract, retain, ortrain better principals than to provide higher beginning salaries to teachers in schools with high-poverty or a high proportionof students of color.

  4. EHR Incentive Programs - Data and Reports

    Data.gov (United States)

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

  5. BSN completion barriers, challenges, incentives, and strategies.

    Science.gov (United States)

    Duffy, Marie T; Friesen, Mary Ann; Speroni, Karen Gabel; Swengros, Diane; Shanks, Laura A; Waiter, Pamela A; Sheridan, Michael J

    2014-04-01

    The objectives of this study were to explore RN perceptions regarding barriers/challenges and incentives/supports for BSN completion and identify recommendations to increase RN BSN completion. The Institute of Medicine's 2011 The Future of Nursing report recommended the proportion of RNs with a BSN increase to 80% by 2020. This qualitative study included 41 RNs who participated in 1 of 6 focus groups based on their BSN completion status. Primary themes were sacrifices, barriers/challenges, incentives/supports, value, how to begin, and pressure. Primary BSN completion barriers/challenges were work-life balance and economic issues. Incentives/supports identified were financial compensation, assistance from employer and academic institution, and encouragement from family. Institutional strategies recommended for increasing BSN completion rates were improved access to education and financial support facilitated by collaboration between hospitals and academic institutions. Exploring RN barriers/challenges and incentives/supports for BSN completion can lead to implementation of institutional strategies, such as tuition reimbursement and academic collaboration.

  6. Financial considerations of policy options to enhance biomass utilization for reducing wildfire hazards

    Science.gov (United States)

    Dennis R. Becker; Debra Larson; Eini C. Lowell

    2009-01-01

    The Harvest Cost-Revenue Estimator, a financial model, was used to examine the cost sensitivity of forest biomass harvesting scenarios to targeted policies designed to stimulate wildfire hazardous fuel reduction projects. The policies selected represent actual policies enacted by federal and state governments to provide incentive to biomass utilization and are aimed at...

  7. CROSS-CULTURAL INCENTIVES FOR THE FDI

    Directory of Open Access Journals (Sweden)

    Dumitru ZAIȚ

    2014-06-01

    Full Text Available In order to invest there are some incentives needed, including among them, certainly, the ones discussed and analysed in the scientific literature such as: specific earning chances (expectations of each participant (wage, profit, dividend, budget revenue, etc., potential investor’s general or current state, etc.. Less visible incentives from complex areas not obviously related to the investment are, however, less considered. Among these could be incentives arising from inherited or education and culture transmitted philosophy, generally regarding earnings, business and investment. We notice these incentives in case of FDI in different shades and intensities.Investor’s decision to acquire, sell or to carry out projects in a particular area, region or country is not only due to purely economic, commercial or financial reasoning. In such operations, meeting among businessmen, managers and other professionals in the field is, first of all, meeting in specific circumstances, among more or less different cultures.Both theory and practice must be concerned in what way and to what extent these factors influence the investment intention, outcome and yield. Our study proposes a list of the most important cultural type incentives for investment (mainly FDI, based on a set of cases, through a logical and empirical research, using some of the most relevant and recent studies and several real situations to which we got access. These are early data and analysis that will allow us to draw attention to the problem and to develop further research to reach generalizable results

  8. The Economics of Foreign Direct Investment Incentives

    OpenAIRE

    Magnus Blomstrom; Ari Kokko

    2003-01-01

    This Paper suggests that the use of investment incentives focusing exclusively on foreign firms - although motivated in some cases from a theoretical point of view - is generally not an efficient way to raise national welfare. The main reason is that the strongest theoretical motive for financial subsidies to inward FDI – spillovers of foreign technology and skills to local industry – is not an automatic consequence of foreign investment. The potential spillover benefits are realized only if ...

  9. Financial Statements

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

    users make on the basis of the financial information. .... IDRC's brand and reputation could impact partner- .... building and to provide internal services in support of the ...... maintains books of accounts, information systems, and financial and management controls that .... The significant accounting policies of the Centre are: a.

  10. Extrinsic incentives and tax compliance

    OpenAIRE

    Sour, Laura; Gutiérrez Andrade, Miguel Ángel

    2011-01-01

    This paper models the impact of extrinsic incentives in a tax compliance model. It also provides experimental evidence that confirms the existence of a positive relationship between rewards and tax compliance. If individuals are audited, rewards for honest taxpayers are effective in increasing the level of tax compliance. These results are particularly relevant in countries where there is little respect for tax law since rewards can contribute to crowding in the intrinsic motivation to comply.

  11. Rewards and Performance Incentives.

    Science.gov (United States)

    Zigon, Jack

    1994-01-01

    Discusses rewards and performance incentives for employees, including types of rewards; how rewards help in managing; dysfunctional awards; selecting the right reward; how to find rewards that fit; and delivering rewards effectively. Examples are included. (three references) (LRW)

  12. Incentive Problems in Banking Supervision: The European Case

    OpenAIRE

    Schüler, Martin

    2003-01-01

    This paper discusses the incentive conflicts that arise in banking supervision in the EU in a principal-agent framework, where the regulator is the agent and the taxpayers is the principal. The regulatory agent in addition to maintaining financial stability (the objective of the principal) may pursue private interests. Incomplete information, insufficient accountability of the agent and lack of enforceability of compliance result in an incentive problem. A reform of the European supervisory s...

  13. Managerial incentives for attracting attention and firm investor base

    OpenAIRE

    Papiashvili, Nino

    2016-01-01

    This thesis studies how managerial incentives relate to strategic transmission of soft information from managers to investors in order to attract attention of financial markets. Additionally, I study trading reaction of different investors (large sophisticated vs. small individual) to CEO voluntary announcements and how their trading is affected when managerial incentives are taken into account. I use large panel data and several alternative proxies for soft information togethe...

  14. Hermann agreement updates IRS guidelines for incentives.

    Science.gov (United States)

    Broccolo, B M; Peregrine, M W

    1995-01-01

    The October 1994 agreement between the Internal Revenue Service (IRS) and Hermann Hospital of Houston, Texas, elucidates current IRS policy on physician recruitment incentives. The IRS distinguishes between the recruiting and the retention of physicians and perimts incentives beyond reasonable compensation in the former but not the latter circumstance. This new agreement, while not legally precedential, nevertheless provides guidance for healthcare organizations seeking safe harbor protection.

  15. Altruism, Conformism, and Incentives in the Workplace

    OpenAIRE

    Tichem, Jan

    2014-01-01

    markdownabstractPerformance pay can motivate employees, but money is not the only motivation in the workplace. Altruism, which means that someone enjoys the well-being of someone else, can also provide a powerful motivation. The first part of this thesis studies theoretically how altruism between an employee and his superior affects the optimal use of monetary incentives. Among others, the analysis reveals how altruism influences the credibility of monetary incentive schemes, and how altruist...

  16. 48 CFR 16.304 - Cost-plus-incentive-fee contracts.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost-plus-incentive-fee...-incentive-fee contracts. A cost-plus-incentive-fee contract is a cost-reimbursement contract that provides... allowable costs to total target costs. Cost-plus-incentive-fee contracts are covered in subpart 16.4...

  17. Incentives for cogeneration in Italy: Logic and implementation

    International Nuclear Information System (INIS)

    Tomassetti, G.

    1992-01-01

    Within the framework of legal and financial incentives made possible through Italian legislation on cogeneration plants for on-site power generation, this paper reviews the planning criteria that went into the formulation of the incentives and the response obtained from small, medium and large industrial firms. The discussion takes into account the following aspects: the optimal timing of retrofits, national energy conservation and environmental policy objectives, energy surcharges, benefits to consumers as compared with those for energy producers, benefits from incentives as a function of cogeneration plant size, and the technical complexity of application requirements for prospective applicants

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

    Energy Technology Data Exchange (ETDEWEB)

    Barbose, Galen; Wiser, Ryan; Bolinger, Mark

    2006-10-06

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

  19. Approaches and incentives to implement integrated pest management that addresses regional and environmental issues.

    Science.gov (United States)

    Brewer, Michael J; Goodell, Peter B

    2012-01-01

    Agricultural, environmental, and social and policy interests have influenced integrated pest management (IPM) from its inception. The first 50 years of IPM paid special attention to field-based management and market-driven decision making. Concurrently, IPM strategies became available that were best applied both within and beyond the bounds of individual fields and that also provided environmental benefits. This generated an incentives dilemma for farmers: selecting IPM activities for individual fields on the basis of market-based economics versus selecting IPM activities best applied regionally that have longer-term benefits, including environmental benefits, that accrue to the broader community as well as the farmer. Over the past several decades, public-supported incentives, such as financial incentives available to farmers from conservation programs for farms, have begun to be employed to encourage use of conservation techniques, including strategies with IPM relevance. Combining private investments with public support may effectively address the incentives dilemma when advanced IPM strategies are used regionally and provide public goods such as those benefiting resource conservation. This review focuses on adaptation of IPM to these broader issues, on transitions of IPM from primarily individual field-based decision making to coordinated community decision making, and on the form of partnerships needed to gain long-lasting regional and environmental benefits. Copyright © 2012 by Annual Reviews. All rights reserved.

  20. Adoption of International Financial Accounting Reporting Standards ...

    African Journals Online (AJOL)

    This study examines the International Financial Accounting Reporting Standards adoption practices around the world and the way these practices are reflected in the financial statements of companies in different countries. It also examines the incentives/ motivations for the variations in the type of International Financial ...

  1. 公共图书馆服务社会力量供给的经济激励%Economic Incentive Provided by Social Forces in Public Library Service

    Institute of Scientific and Technical Information of China (English)

    赵斯霞

    2015-01-01

    Economic incentive is the use of funds or material means satisifes materially prompted personnel so as to mobilize the enthusiasm, initiative and creativity in order to achieve common goals. Social forces participate in the supply of public cultural services for different forms can be through cooperation proift, publicity, state subsidies and preferential tax incentives, economic incentive directly or indirectly. China will continue to improve the relevant laws and regulations, optimize the social investment environment, promoting the public library service and government procurement, improve the public welfare social organizations, improve the self-development ability of enterprises private library, safeguard their legitimate income and other lawful rights and interests, the role of economic incentive to play.%经济激励是运用资金或物质手段使受激励者得到物质上的满足,从而调动其积极性、主动性和创造性,以实现双方共同目标。社会力量参与公共文化服务供给可以通过合作获利、宣传效应、国家补贴奖励和税费优惠,获得直接或间接的经济激励。我国需不断完善相关法规、优化社会投资环境,推进公共图书馆服务政府采购,健全公益社会组织,提高民办图书馆自我发展能力,保障企业个人的合法收入和正当权益,切实发挥经济激励的现实作用。

  2. Stock-based Compensation Plans and Employee Incentives

    OpenAIRE

    Jan Zabojnik

    2014-01-01

    Standard principal-agent theory predicts that large firms should not use employee stock options and other stock-based compensation to provide incentives to non-executive employees. Yet, business practitioners appear to believe that stock-based compensation improves incentives, and mounting empirical evidence points to the same conclusion. This paper provides an explanation for why stock-based incentives can be effective. In the model of this paper, employee stock options complement individual...

  3. Large Retailers’ Financial Services

    OpenAIRE

    Risso, Mario

    2010-01-01

    Over the last few years, large retailers offering financial services have considerably grown in the financial services sector. Retailers are increasing the wideness and complexity of their offer of financial services. Large retail companies provide financial services to their customers following different strategic ways. The provision of financial services in the retailers offer is implemented in several different ways related to the strategies, the structures and the degree of financial know...

  4. Essays in corporate finance and financial intermediation

    NARCIS (Netherlands)

    Kempf, Elisabeth

    2016-01-01

    This thesis consists of three chapters in corporate finance and financial intermediation. The first two chapters explore sources of incentives and learning for finance professionals. Specifically, the first chapter studies how the option to go work for an investment bank affects the incentives of

  5. Cost incentives for doctors

    DEFF Research Database (Denmark)

    Schottmüller, Christoph

    2013-01-01

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

  6. Incentives and Earnings Growth

    DEFF Research Database (Denmark)

    Frederiksen, Anders

    2013-01-01

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

  7. Differential dependence of Pavlovian incentive motivation and instrumental incentive learning processes on dopamine signaling

    Science.gov (United States)

    Wassum, Kate M.; Ostlund, Sean B.; Balleine, Bernard W.; Maidment, Nigel T.

    2011-01-01

    Here we attempted to clarify the role of dopamine signaling in reward seeking. In Experiment 1, we assessed the effects of the dopamine D1/D2 receptor antagonist flupenthixol (0.5 mg/kg i.p.) on Pavlovian incentive motivation and found that flupenthixol blocked the ability of a conditioned stimulus to enhance both goal approach and instrumental performance (Pavlovian-to-instrumental transfer). In Experiment 2 we assessed the effects of flupenthixol on reward palatability during post-training noncontingent re-exposure to the sucrose reward in either a control 3-h or novel 23-h food-deprived state. Flupenthixol, although effective in blocking the Pavlovian goal approach, was without effect on palatability or the increase in reward palatability induced by the upshift in motivational state. This noncontingent re-exposure provided an opportunity for instrumental incentive learning, the process by which rats encode the value of a reward for use in updating reward-seeking actions. Flupenthixol administered prior to the instrumental incentive learning opportunity did not affect the increase in subsequent off-drug reward-seeking actions induced by that experience. These data suggest that although dopamine signaling is necessary for Pavlovian incentive motivation, it is not necessary for changes in reward experience, or for the instrumental incentive learning process that translates this experience into the incentive value used to drive reward-seeking actions, and provide further evidence that Pavlovian and instrumental incentive learning processes are dissociable. PMID:21693635

  8. Financial Participation of Employees in Lithuania

    DEFF Research Database (Denmark)

    Darskuviené, Valdoné; Hanisch, Stefan; Mygind, Niels

    2006-01-01

    Participation of employees in decision-making in Lithuanian companies has its roots in trade union movement as well as in the practice of managing companies under Soviet rule. After Lithuania regained independence, employee ownership was used to facilitate privatization. A notable success...... as participation in decision-making - is not well developed and does not provide for stronger incentives. The solution of current employment and social problems by the Government, ruling parties as well as social partners is not associated with a higher level of participation of employees. Financial participation...... is viewed mainly as a way of employee motivation as initiated by managers and current owners of companies....

  9. Alternative energy companies : a financier's view

    International Nuclear Information System (INIS)

    Aitken, J.

    2002-01-01

    The Canadian energy technology sector can be divided into 2 categories: (1) alternative energy generators which include small hydro, wind, biomass, solar energy and fuel cells, and (2) energy technology services. This presentation focused on publicly traded entities and how financing alternatives are limited to project finance, and venture capital. This situation may change as the long term winners emerge and various segments are recognized as not requiring special regulatory and price incentives. Case studies were presented of financing renewable energy projects and the commitment of the Royal Bank of Canada's (RBC) Financial Group to provide financing for alternative energy projects that impact the transportation sector. 15 figs

  10. Cost-benefit of tax incentives and performance indicators: a case study in the company GRENDENE S/A

    Directory of Open Access Journals (Sweden)

    Josiane Marostica

    2017-09-01

    Full Text Available This study aimed to analyze the cost/benefit of tax incentives and performance indicators of Grendene S/A footwear company in the period of 2010 to 2014. The research is justified by the importance of companies seeking techniques and methodologies that are more advantageous corporately to achieve better performance. In this sense, the accounting is shown as an important tool, acting as a source of information for decision-making and wealth measurement of their investors. The methodology will be through case study in a company in the footwear sector, listed on the BM & FBovespa, with data in the periods of 2010 to 2014 available at the base of Economatica and the Financial Statements. Having the data has been identified, the modalities of tax incentives that the company benefited during the study, as well as the traditional performance indicators. To analyze the cost/benefit of tax incentives was used data from DVA and tax subsidies provided in the notes to DFPs. The results show that the company needs a constant and effective monitoring of the costs and benefits of tax waiver. Also identifies that the value of tax incentives received does not equal proportion the generation of net wealth. The results of this study confirm the theoretical basis that the benefits brought by tax incentives outnumber the costs of tax waiver, but may represent a dangerous dependence as to jeopardize the continuity of the company if they were removed.

  11. Designing effective incentives for energy conservation in the public sector

    Science.gov (United States)

    Drezner, Jeffrey Alan

    Understanding why government officials behave in certain ways under particular circumstances is an important theme in political science. This research explores the design of policies and incentives targeted at public sector officials, in particular the use of market based policy tools in a non-market environment, and the influence of that organizational environment on the effectiveness of the policy. The research examines the case of Department of Defense (DoD) facility energy management. DoD energy policy includes a provision for the retention of savings generated by conservation activities: two-thirds of the savings is retained at the installation generating the savings, half to used for further investment in energy conservation, and half to be used for general morale, welfare, and recreation activities. This policy creates a financial incentive for installation energy managers to establish higher quality and more active conservation programs. A formal written survey of installation energy managers within DoD was conducted, providing data to test hypotheses regarding policy effectiveness and factors affecting policy implementation. Additionally, two detailed implementation case studies were conducted in order to gain further insights. Results suggest that policy design needs to account for the environment within which the policy will be implemented, particularly organizational culture and standard operating procedures. The retention of savings policy failed to achieve its intended outcome---retention of savings for re-investment in energy conservation---because the role required of the financial management community was outside its normal mode of operation and interests and the budget process for allocating resources did not include a mechanism for retention of savings. The policy design did not adequately address these start-up barriers to implementation. This analysis has shown that in order for retention of savings, or similar policies based on market

  12. Tax Incentives : Using Tax Incentives to Attract Foreign Direct Investment

    OpenAIRE

    Morisset, Jacques

    2003-01-01

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

  13. Incentives for partitioning, revisited

    International Nuclear Information System (INIS)

    Cloninger, M.O.

    1980-01-01

    The incentives for separating and eliminating various elements from radioactive waste prior to final geologic disposal were investigated. Exposure pathways to humans were defined, and potential radiation doses to an individual living within the region of influence of the underground storage site were calculated. The assumed radionuclide source was 1/5 of the accumulated high-level waste from the US nuclear power economy through the year 2000. The repository containing the waste was assumed to be located in a reference salt site geology. The study required numerous assumptions concerning the transport of radioactivity from the geologic storage site to man. The assumptions used maximized the estimated potential radiation doses, particularly in the case of the intrusion water well scenario, where hydrologic flow field dispersion effects were ignored. Thus, incentives for removing elements from the waste tended to be maximized. Incentives were also maximized by assuming that elements removed from the waste could be eliminated from the earth without risk. The results of the study indicate that for reasonable disposal conditions, incentives for partitioning any elements from the waste in order to minimize the risk to humans are marginal at best

  14. Incentives and moral hazard

    DEFF Research Database (Denmark)

    Wendimu, Mengistu Assefa; Henningsen, Arne; Czekaj, Tomasz Gerard

    2017-01-01

    system and thus, the incentives to the workers. We compare the productivity of these two production schemes using a cross-sectional plot-level data set. As sugarcane production depends on various exogenous factors that are measured as categorical variables (e.g., soil type, cane variety, etc.), we...

  15. Motivating employees through incentives: productive or a counterproductive strategy.

    Science.gov (United States)

    Qayum, Mehran; Sawal, Shefa Haider; Khan, Hassan Mehmood

    2014-05-01

    The disparity between human resource in health and provision of health services is a growing concern worldwide. Many developing countries are facing this crisis and therefore human resource in health is considered a high priority on their agenda.This imbalance between supplies of human resource is exacerbated by migration of health workers in many countries. Understanding the motivational factor is an important aspect to retain the migrating health workforce. This paper analyses the role of financial and non financial incentives in motivating the health work force. A review of available literature was conducted to understand the role of motivational factor in retaining health workforce. A review of current literature found that an incentive plays a key role in motivating a health worker. Financial incentives are useful in improving the compliance to standard policies and procedures. Comprehensive integrated incentive system approach should be established to develop a sustainable health workforce with required skill. Likewise monetary incentives should be linked to adherence to provincial and national guidelines and procedures. Sustainability could be ensured by commitment of government, political will and involvement of key stakeholders and decision makers.

  16. The Role of the Government in Providing Access to Higher Education: The Case of Government-Sponsored Financial Aid in the US

    Science.gov (United States)

    Landry, Lynette; Neubauer, Deane

    2016-01-01

    The overall financial structure of US higher education has changed dramatically over the past 30 years, resulting in a significant reduction of public funding. One result of this shift has been the steadily increasing costs of tuition as an increasing portion of the financial structure of higher education is shifted to students. Increased costs to…

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

    Energy Technology Data Exchange (ETDEWEB)

    1980-04-01

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

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

    Science.gov (United States)

    Gosman, Nathaniel

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

  19. Incentives for improvement of CANDU

    International Nuclear Information System (INIS)

    Hart, R.S.; Dunn, J.T.; Finlay, R.B.

    1988-12-01

    CANDU is a relatively young technology which has demonstrated many achievements as an electrical power generation system. These achievements include an unsurpassed safety record, high annual and lifetime capacity factors, low electricity cost and a broad range of other performance strengths which together indicate that the CANDU technology is fundamentally sound. Known capabilities not yet fully exploited, such as advanced fuel cycle options, indicate that CANDU technology will continue to pay strong dividends on research, development and design investment. This provides a strong incentive for the improvement of CANDU on a continuing basis

  20. Financialization and financial profit

    Directory of Open Access Journals (Sweden)

    Arturo Guillén

    2014-09-01

    Full Text Available This article starts from the critical review of the concept of financial capital. I consider it is necessary not to confuse this category with of financialization, which has acquired a certificate of naturalization from the rise of neoliberalism. Although financial monopoly-financial capital is the hegemonic segment of the bourgeoisie in the major capitalist countries, their dominance does not imply, a fortiori, financialization of economic activity, since it depends of the conditions of the process reproduction of capital. The emergence of joint stock companies modified the formation of the average rate of profit. The "promoter profit" becomes one of the main forms of income of monopoly-financial capital. It is postulated that financial profit is a kind of "extraordinary surplus-value" which is appropriated by monopoly-financial capital by means of the monopolistic control it exerts on the issue and circulation of fictitious capital.

  1. Incentives Between Firms (and Within)

    OpenAIRE

    Robert Gibbons

    2005-01-01

    This paper reviews the significant progress in Üagency theoryÝ (i.e., the economic theory of incentives) during the 1990s, with an eye toward applications to supply transactions. I emphasize six recent models, in three pairs: (1) new foundations for the theory of incentive contracts, (2) new directions in incentive theory, and (3) new applications to supply transactions. By reviewing these six models, I hope to establish three things. First, the theory of incentive contracts needed and receiv...

  2. Water Conservation and Economic Incentives

    Science.gov (United States)

    Narayanan, M.

    2016-12-01

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

  3. Nudge or not: can incentives change health behaviours?

    Science.gov (United States)

    Ries, Nola M

    2012-01-01

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

  4. CEOs´ monetary incentives and performance of Mexican firms

    Directory of Open Access Journals (Sweden)

    Karen Watkins-Fassler

    2017-02-01

    Full Text Available This paper analyzes if changes in CEO remuneration and the execution of CEO stock options impact firm performance, under an emerging market context. Data is obtained from 88 non-financial companies listed in the Mexican Stock Exchange (2001-2012. A dynamic panel specification is employed, and regressions are run through the Generalized Method of Moments. Some evidence is found on the negative relationship between flat monetary incentives and Mexican firm performance, specifically for normal times. In addition, financial incentives based on results (particularly CEO stock options do not imply higher firm performance. Results suggest that companies in particular contexts should move towards the development of CEOs, more than promoting mostly monetary incentives for boosting firm performance. Companies operating in Mexico will gain from hiring intrinsically motivated CEOs, together with testing different extrinsic rewards (neither flat nor stock options in order to attain additive effects on intrinsic motivation.

  5. A performance incentive contract that pays off for all parties

    International Nuclear Information System (INIS)

    Krummrich, C.R.; Johnston, R.E.; Crist, T.W.

    1995-01-01

    The Western Business Unit Bakersfield drilling department of Chevron, U.S.A. Production Company developed a drilling performance incentive contract that was implemented during 1994 in the Lost Hills field of California. The performance incentive contract (PIC) financially rewarded all of the drilling contractor's rig employees for outperforming pre-established drilling performance goals. The key elements of the performance incentive program are: (1) Goals that rigger incentives are based on cost categories that are controllable by the drilling team; (2) Goals were established using a database of past years performance; (3) Goals that are not achieved negatively impact the incentive earned in an effort to deter repeated errors; (4) Accidents that occur on the job negatively impact the incentive earned; (5) Administration of the program is not time consuming. The results of using an incentive contract in the Lost Hills drilling program are: (1) Time and cost of operations are reduced; (2) The results are measurable and repeatable; (3) A team environment develops in which ideas are shared and acted upon by crew members and supervisory personnel

  6. Incentive Pass-through for Residential Solar Systems in California

    Energy Technology Data Exchange (ETDEWEB)

    Dong, C. G. [Univ. of Texas, Austin, TX (United States); Wiser, Ryan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Rai, Varun [Univ. of Texas, Austin, TX (United States)

    2014-10-01

    The deployment of solar photovoltaic (PV) systems has grown rapidly over the last decade, partly because of various government incentives. In the United States, among the largest and longest-running incentives have been those established in California. Building on past research, this report addresses the still-unanswered question: to what degree have the direct PV incentives in California been passed through from installers to consumers? This report helps address this question by carefully examining the residential PV market in California (excluding a certain class of third-party-owned PV systems) and applying both a structural-modeling approach and a reduced-form regression analysis to estimate the incentive pass-through rate. The results suggest an average pass-through rate of direct incentives of nearly 100%, though with regional differences among California counties. While these results could have multiple explanations, they suggest a relatively competitive market and well-functioning subsidy program. Further analysis is required to determine whether similar results broadly apply to other states, to other customer segments, to all third-party-owned PV systems, or to all forms of financial incentives for solar (considering not only direct state subsidies, but also utility electric bill savings and federal tax incentives).

  7. Incentive Issues in Information Security Management

    Science.gov (United States)

    Lee, Chul Ho

    2012-01-01

    This dissertation studies three incentive issues in information security management. The first essay studies contract issues between a firm that outsources security functions and a managed security service provider (MSSP) that provides security functions to the firm. Since MSSP and firms cannot observe each other's actions, both can suffer…

  8. Health Workers' Incentives in South Sudan (IMCHA) | IDRC ...

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

    The findings from this project will address gaps in knowledge for cost-effective measures, such as non-financial incentives, to improve access to health care for mothers and children in high conflict contexts. The results will directly inform, strengthen, and scale community health-worker program efforts implemented by BRAC ...

  9. “Europa 2020”, nuovo governo economico e ri-regolamentazione finanziaria:incentivi o vincoli alla crescita?(“Europe 2010”, a new economic governance and financial re-regulation: incentives or constraints to growth?

    Directory of Open Access Journals (Sweden)

    Mario Sarcinelli

    2010-12-01

    Full Text Available Despite the launch of a new strategy for growth in Europe (the Europe 2020 strategy and the ongoing efforts to design a new international financial architecture, prospects for an economic recovery of Europe remain dim. Public deficits and debts will have to be reduced at a faster pace, with contractionary effects unless a strong recovery of private expenditure will materialize. Financial re-regulation is projected to further depress the economy by imposing higher capital ratios, lower leverage, a late (though welcome discipline of liquidity. The compound effect of the two policy trends pose a serious threat on the social sustainability of the European social market economy.   JEL: H6, F3, O52

  10. Financial incentive does not affect P300 (in response to certain episodic and semantic probe stimuli) in the Complex Trial Protocol (CTP) version of the Concealed Information Test (CIT) in detection of malingering.

    Science.gov (United States)

    Rosenfeld, J Peter; Labkovsky, Elena; Davydova, Elena; Ward, Anne; Rosenfeld, Lauren

    2017-05-01

    Previous research indicated that the skin conductance response of the autonomic nervous system in the Concealed Information Test (CIT) is typically increased in subjects who are financially and otherwise incentivized to defeat the CIT (the paradoxical "motivational impairment" effect). This is not the case for RT-based CITs, nor P300 tests based on the three-stimulus protocol for detection of cognitive malingering (although these are not the same as CITs). The present report is the first attempt to study the effect of financial motivation on the P300-based Complex Trial Protocol using both episodic and semantic memory probe and irrelevant stimuli. The Test of Memory Malingering (TOMM) was used to validate behavioral differences between the two groups we created by offering one (paid) group but not another (unpaid) group a financial reward for beating our tests. Group behavioral differences on the TOMM did confirm group manipulations. Probe-minus-irrelevant P300 differences did not differ between groups, although as previously, semantic memory-evoked P300s were larger than episodic memory-evoked P300s. © 2017 Society for Psychophysiological Research.

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

    Science.gov (United States)

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

    2016-09-13

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

  12. Team incentives in relational contracts

    International Nuclear Information System (INIS)

    Kvaloey, Ola

    2003-01-01

    Incentive schemes for teams are compared. I ask: under which conditions are relational incentive contracts based on joint performance evaluation, relative performance evaluation and independent performance evaluation self-enforceable. The framework of Che and Yoo (2001) on team incentives is combined with the framework of Baker, Gibbons and Murphy (2002) on relational contracts. In a repeated game between one principal and two agents, I find that incentives based on relative or independent performance are expected to dominate when the productivity of effort is high, while joint performance evaluation dominates when productivity is low. Incentives based on independent performance are more probable if the agents own critical assets. (author)

  13. Reduction of the renewable energy incentives

    International Nuclear Information System (INIS)

    Rigaud, Ch.

    2010-01-01

    In order to reduce the state deficit the French government plans to reduce the financial incentives in all sectors and particularly in the sector of renewable energies. The photovoltaic sector is the most hit with a tax credit rate dropping from 50% (in 2009) to 22.5% (in 2011). For the other renewable energy sectors the tax credit rate will be reduced by 10% in 2011. The French government wants the cost of the tax credit on the renewable energies to drop from 2.8*10 9 euros in 2009 to 2.0*10 9 euros in 2011. (A.C.)

  14. Opposing incentives for collaboration

    DEFF Research Database (Denmark)

    Dorch, Bertil F.; Wien, Charlotte; Larsen, Asger Væring

    , and gives a bonus for publications done through inter-institutionary collaboration. Credits given to universities are fractionalized between the participating universities. So far credits are not assigned to the individual authors but only to their institutions. However, it turns out that research...... collaboration is associated with a higher number of citations than single authorship which may present the author with two opposing incentives for research collaboration....

  15. Incentives and Prosocial Behavior