TARGET - NEW PAYMENT SYSTEM FOR THE EURO AREA

Directory of Open Access Journals (Sweden)

ELENA VIOLETA DRĂGOI

2015-04-01

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

Refining Risk Adjustment for the Proposed CMS Surgical Hip and Femur Fracture Treatment Bundled Payment Program.

Science.gov (United States)

Cairns, Mark A; Ostrum, Robert F; Clement, R Carter

2018-02-21

The U.S. Centers for Medicare & Medicaid Services (CMS) has been considering the implementation of a mandatory bundled payment program, the Surgical Hip and Femur Fracture Treatment (SHFFT) model. However, bundled payments without appropriate risk adjustment may be inequitable to providers and may restrict access to care for certain patients. The SHFFT proposal includes adjustment using the Diagnosis-Related Group (DRG) and geographic location. The goal of the current study was to identify and quantify patient factors that could improve risk adjustment for SHFFT bundled payments. We retrospectively reviewed a 5% random sample of Medicare data from 2008 to 2012. A total of 27,898 patients were identified who met SHFFT inclusion criteria (DRG 480, 481, and 482). Reimbursement was determined for each patient over the bundle period (the surgical hospitalization and 90 days of post-discharge care). Multivariable regression was performed to test demographic factors, comorbidities, geographic location, and specific surgical procedures for associations with reimbursement. The average reimbursement was $23,632 ± $17,587. On average, reimbursements for male patients were $1,213 higher than for female patients (p payments; e.g., reimbursement for those ≥85 years of age averaged $2,282 ± $389 less than for those aged 65 to 69 (p reimbursement, but dementia was associated with lower payments, by an average of $2,354 ± $243 (p reimbursement ranging from $22,527 to $24,033. Less common procedures varied by >$20,000 in average reimbursement (p reimbursement (p reimbursed by an average of $10,421 ± $543 more than DRG 482. Payments varied significantly by state (p ≤ 0.01). Risk adjustment incorporating specific comorbidities demonstrated better performance than with use of DRG alone (r = 0.22 versus 0.15). Our results suggest that the proposed SHFFT bundled payment model should use more robust risk-adjustment methods to ensure that providers are reimbursed fairly and that

Relationship between risk assessment and payment models in Swedish Public Dental Service

DEFF Research Database (Denmark)

Petersson, Gunnel Hänsel; Twetman, Svante

2017-01-01

risk preferred the prepaid model while those in the higher risk categories selected fee-for-service. As more additional preventive care was delivered to patients in the subscribed care, oral health planners and decision makers should be aware of the fact that capitation payment models may enhance...

Risk Management for Third Party Payment Networks

NARCIS (Netherlands)

van Driel, W; Hernandez Ganan, C.; Lobbezoo, M; van Eeten, M.J.G.

2016-01-01

The payment industry has been characterized by a small number of players that operate the schemes for the facilitation of credit and debit card payments. Over the years, various initiatives have been taken in order to increase competition and hence cost efficiency within the industry. One of the

The Subject Analysis of Payment Systems Characteristics

Directory of Open Access Journals (Sweden)

Korobeynikova Olga Mikhaylovna

2015-09-01

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

Effect of Risk Acceptance for Bundled Care Payments on Clinical Outcomes in a High-Volume Total Joint Arthroplasty Practice After Implementation of a Standardized Clinical Pathway.

Science.gov (United States)

Kee, James R; Edwards, Paul K; Barnes, Charles L

2017-08-01

The Bundled Payments for Care Improvement (BPCI) initiative and the Arkansas Payment Improvement (API) initiative seek to incentivize reduced costs and improved outcomes compared with the previous fee-for-service model. Before participation, our practice initiated a standardized clinical pathway (CP) to reduce length of stay (LOS), readmissions, and discharge to postacute care facilities. This practice implemented a standardized CP focused on patient education, managing patient expectations, and maximizing cost outcomes. We retrospectively reviewed all primary total joint arthroplasty patients during the initial 2-year "at risk" period for both BPCI and API and determined discharge disposition, LOS, and readmission rate. During the "at risk" period, the average LOS decreased in our total joint arthroplasty patients and our patients discharged home >94%. Patients within the BPCI group had a decreased discharge to home and decreased readmission rates after total hip arthroplasty, but also tended to be older than both API and nonbundled payment patients. While participating in the BPCI and API, continued use of a standardized CP in a high-performing, high-volume total joint practice resulted in maintenance of a low-average LOS. In addition, BPCI patients had similar outcomes after total knee arthroplasty, but had decreased rates of discharge to home and readmission after total hip arthroplasty. Copyright © 2017 Elsevier Inc. All rights reserved.

75 FR 9141 - Reduced 2009 Estimated Income Tax Payments for Individuals With Small Business Income

Science.gov (United States)

2010-03-01

... Reduced 2009 Estimated Income Tax Payments for Individuals With Small Business Income AGENCY: Internal... issuing temporary regulations that provide guidance as to qualified individuals with small business income who certify that they satisfy the gross income requirement for purposes of claiming a reduction in...

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

Science.gov (United States)

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

1998-07-01

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

Diagnostic Risk Adjustment for Medicaid: The Disability Payment System

Science.gov (United States)

Kronick, Richard; Dreyfus, Tony; Lee, Lora; Zhou, Zhiyuan

1996-01-01

This article describes a system of diagnostic categories that Medicaid programs can use for adjusting capitation payments to health plans that enroll people with disability. Medicaid claims from Colorado, Michigan, Missouri, New York, and Ohio are analyzed to demonstrate that the greater predictability of costs among people with disabilities makes risk adjustment more feasible than for a general population and more critical to creating health systems for people with disability. The application of our diagnostic categories to State claims data is described, including estimated effects on subsequent-year costs of various diagnoses. The challenges of implementing adjustment by diagnosis are explored. PMID:10172665

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

Science.gov (United States)

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

2007-01-01

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

Causes of Payment Problems in the New Zealand Construction Industry

Directory of Open Access Journals (Sweden)

Thanuja Ramachandra

2015-03-01

Full Text Available Payment delays and losses persist in the construction industry and continue to be a key concern to industry practitioners. Therefore an exploration of the key causes of payment delays and losses is undertaken in this study with the ultimate objective of seeking mitigating solutions. The study adopted a survey approach using an online questionnaire, administered to practitioners from the New Zealand construction industry, comprising consultants, head contractors and subcontractors. The data obtained was analysed using inferential statistical techniques, including comparing means and factor analysis. Factor analysis enabled clustering of the inter-related causes of payment delays and losses in order to find reduced number of causes. Accordingly, the study found that payment problems mainly relate to contractual issues, financial strength of industry players, disputes, short-comings of payment processes and ‘domino effects’. Among them, the financial strength of critical industry players was considered central to payment problems. The study concludes that any solution to these problems must address these primary causes, as a rational starting point. Thus procuring a feasible form of financial security at the outset of a project, and the pre-qualification of the financial status of critical project participants, were found to be significant in the mitigation of construction payment risks. Paper Type: Research article

互联网支付风险及监管研究%Research on the Risk and Regulation of Internet Payment System

Institute of Scientific and Technical Information of China (English)

刘志洋

2016-01-01

Internet payment system developed early in China, and the related institutional arrangement has been established. Based on the risk analysis of internet payment system, this chapter argues that internet payment provider’s biggest risk is strategic risk— how to make consumers accept its services. At the same time, this chapter argues that because internet payment system does not involves capital allocation across periods, so risk regulation of internet payment system should focus on the internet payment provider’s themselves. Finally this chapter briefly reviews regulation of internet payment system and gives policy applications.%互联网支付在中国发展较早，相关风险监管措施建立的较为健全。在分析互联网支付风险基础上，本文认为在中国当前形势下，互联网支付企业的最大风险是战略风险，即如何让消费者接受企业的服务。同时，本文认为由于支付没有涉及到资金的跨期转移，因此针对互联网支付的风险监管是主要做好平台自身的风险管理体系建设。最后，本章对互联网支付平台的监管进行了简要回顾，并提出政策建议。

Can rent adjustment clauses reduce the income risk of farms?

OpenAIRE

Hotopp, Henning; Mußhoff, Oliver

2012-01-01

Risk management is gaining importance in agriculture. In addition to traditional instruments, new risk management instruments are increasingly being proposed. These proposals include the rent adjustment clauses (RACs), which seem to be an unusual instrument at first sight. In contrast with conventional instruments, RACs intentionally allow fixed-cost ‘rent payments’ to fluctuate. We investigate the whole-farm risk reduction potential of different types of RACs via a historical simulation....

Consumer’s and merchant’s confidence in internet payments

Directory of Open Access Journals (Sweden)

Franc Bračun

2003-01-01

Full Text Available Performing payment transactions over the Internet is becoming increasingly important. Whenever one interacts with others, he or she faces the problem of uncertainty because in interacting with others, one makes him or herself vulnerable, i.e. one can be betrayed. Thus, perceived risk and confidence are of fundamental importance in electronic payment transactions. A higher risk leads to greater hesitance about entering into a business relationship with a high degree of uncertainty; and therefore, to an increased need for confidence. This paper has two objectives. First, it aims to introduce and test a theoretical model that predicts consumer and merchant acceptance of the Internet payment solution by explaining the complex set of relationships among the key factors influencing confidence in electronic payment transactions. Second, the paper attempts to shed light on the complex interrelationship among confidence, control and perceived risk. An empirical study was conducted to test the proposed model using data from consumers and merchants in Slovenia. The results show how perceived risk dimensions and post-transaction control influence consumer’s and merchant’s confidence in electronic payment transactions, and the impact of confidence on the adoption of mass-market on-line payment solutions.

CONSIDERATIONS ON APPLYING THE ANALYSIS MATRIX METHODS OF THE RISKS WITHIN THE AUDIT OF THE PROCUREMENT-PAYMENT CYCLE

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Svetlana SLOBODEANU

2014-07-01

Full Text Available In the article hereby we analyse the matrix method of analysis of the risks for fraud and error at the level of the procurement-payments cycle. The risk of presentation of certain fraudulent information regarding the accounts of the procurement-payments cycle becomes more and more accentuated in the enhancement of the administration’s wish to present financial indicators of performance. In these conditions, the auditor is to necessarily quantify the involvement of this phenomenon for the report of audit. As a consequence, the auditor is to evaluate the risk for fraud and apply additional audit procedures for identifying all the possible indicators for „remaking” the financial situations on the side of the accounts of suppliers, activity, as a last consequence of which may be a qualified opinion on audit.

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

Science.gov (United States)

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

1996-01-01

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

Strategic behavior and marriage payments: theory and evidence from Senegal.

Science.gov (United States)

Gaspart, Frederic; Platteau, Jean-Philippe

2010-01-01

This article proposes an original theory of marriage payments based on insights gained from firsthand information collected in the Senegal River valley. This theory postulates that decisions about the bride-price, which are made by the bride's father, take into account the likely effects of the amount set on the risk of ill-treatment of the wife and the risk of marriage failure. Based on a sequential game with three players (the bride's father, the husband, and the wife) and a matching process, it leads to a number of important predictions that are tested against Senegalese data relating to bride-prices and various characteristics of women. The empirical results confirm that parents behave strategically by keeping bride-prices down so as to reduce the risk of marriage failure for their daughters. Other interesting effects on marriage payments and the probability of separation are also highlighted, stressing the role of the bride's bargaining power in her own family.

46 CFR 308.507 - Security for payment of premiums.

Science.gov (United States)

2010-10-01

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

Informal payments for health care in transition economies.

Science.gov (United States)

Ensor, Tim

2004-01-01

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

Customer-Specific Transaction Risk Management in E-Commerce

Science.gov (United States)

Ruch, Markus; Sackmann, Stefan

Increasing potential for turnover in e-commerce is inextricably linked with an increase in risk. Online retailers (e-tailers), aiming for a company-wide value orientation should manage this risk. However, current approaches to risk management either use average retail prices elevated by an overall risk premium or restrict the payment methods offered to customers. Thus, they neglect customer-specific value and risk attributes and leave turnover potentials unconsidered. To close this gap, an innovative valuation model is proposed in this contribution that integrates customer-specific risk and potential turnover. The approach presented evaluates different payment methods using their risk-turnover characteristic, provides a risk-adjusted decision basis for selecting payment methods and allows e-tailers to derive automated risk management decisions per customer and transaction without reducing turnover potential.

Alternative Payment Models Should Risk-Adjust for Conversion Total Hip Arthroplasty: A Propensity Score-Matched Study.

Science.gov (United States)

McLawhorn, Alexander S; Schairer, William W; Schwarzkopf, Ran; Halsey, David A; Iorio, Richard; Padgett, Douglas E

2017-12-06

For Medicare beneficiaries, hospital reimbursement for nonrevision hip arthroplasty is anchored to either diagnosis-related group code 469 or 470. Under alternative payment models, reimbursement for care episodes is not further risk-adjusted. This study's purpose was to compare outcomes of primary total hip arthroplasty (THA) vs conversion THA to explore the rationale for risk adjustment for conversion procedures. All primary and conversion THAs from 2007 to 2014, excluding acute hip fractures and cancer patients, were identified in the National Surgical Quality Improvement Program database. Conversion and primary THA patients were matched 1:1 using propensity scores, based on preoperative covariates. Multivariable logistic regressions evaluated associations between conversion THA and 30-day outcomes. A total of 2018 conversions were matched to 2018 primaries. There were no differences in preoperative covariates. Conversions had longer operative times (148 vs 95 minutes, P reimbursement models shift toward bundled payment paradigms, conversion THA appears to be a procedure for which risk adjustment is appropriate. Copyright © 2017 Elsevier Inc. All rights reserved.

US approaches to physician payment: the deconstruction of primary care.

Science.gov (United States)

Berenson, Robert A; Rich, Eugene C

2010-06-01

The purpose of this paper is to address why the three dominant alternatives to compensating physicians (fee-for-service, capitation, and salary) fall short of what is needed to support enhanced primary care in the patient-centered medical home, and the relevance of such payment reforms as pay-for-performance and episodes/bundling. The review illustrates why prevalent physician payment mechanisms in the US have failed to adequately support primary care and why innovative approaches to primary care payment play such a prominent role in the PCMH discussion. FFS payment for office visits has never effectively rewarded all the activities that comprise prototypical primary care and may contribute to the "hamster on a treadmill" problems in current medical practice. Capitation payments are associated with risk adjustment challenges and, perhaps, public perceptions of conflict with patients' best interests. Most payers don't employ and therefore cannot generally place physicians on salary; while in theory such salary payments might neutralize incentives, operationally, "time is money;" extra effort devoted to meeting the needs of a more complex patient will likely reduce the services available to others. Fee-for-service, the predominant physician payment scheme, has contributed to both the continuing decline in the primary care workforce and the capability to serve patients well. Yet, the conceptual alternative payment approaches, modified fee-for-service (including fee bundles), capitation, and salary, each have their own problems. Accordingly, new payment models will likely be required to support restoration of primary care to its proper role in the US health care system, and to promote and sustain the development of patient-centered medical homes.

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

Science.gov (United States)

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

2014-08-01

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

Episodic payments (bundling): PART I.

Science.gov (United States)

Jacofsky, D J

2017-10-01

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

Developing a framework for mobile payments integration

OpenAIRE

Carton, Fergal; Hedman, Jonas; Dennehy, Denis J.; Damsgaard, Jan; Tan, Kay-Ti; McCarthy, James B.

2012-01-01

This paper derives a theoretical framework for consideration of both the technologically driven dimensions of mobile payment solutions, and the associated value proposition for customers. Banks promote traditional payment instruments whose value proposition is the management of risk for both consumers and merchants. These instruments are centralised, costly and lack decision support functionality. The ubiquity of the mobile phone has provided a decentralised platform for managing payment proc...

A Speedier and More Efficient Payments System for Canada

OpenAIRE

Mati Dubrovinsky

2014-01-01

Canada needs a better and faster payments system, according to a report from the C.D. Howe Institute. In “A Speedier and More Efficient Payments System for Canada,” author Mati Dubrovinsky finds that the Canadian economy would benefit from an upgraded payments system that creates lower financial risk, lower payment-processing costs for businesses and, as a consequence, makes Canadian businesses more competitive globally.

Specialty Payment Model Opportunities and Assessment: Oncology Simulation Report.

Science.gov (United States)

White, Chapin; Chan, Chris; Huckfeldt, Peter J; Kofner, Aaron; Mulcahy, Andrew W; Pollak, Julia; Popescu, Ioana; Timbie, Justin W; Hussey, Peter S

2015-07-15

This article describes the results of a simulation analysis of a payment model for specialty oncology services that is being developed for possible testing by the Center for Medicare and Medicaid Innovation at the Centers for Medicare & Medicaid Services (CMS). CMS asked MITRE and RAND to conduct simulation analyses to preview some of the possible impacts of the payment model and to inform design decisions related to the model. The simulation analysis used an episode-level dataset based on Medicare fee-for-service (FFS) claims for historical oncology episodes provided to Medicare FFS beneficiaries in 2010. Under the proposed model, participating practices would continue to receive FFS payments, would also receive per-beneficiary per-month care management payments for episodes lasting up to six months, and would be eligible for performance-based payments based on per-episode spending for attributed episodes relative to a per-episode spending target. The simulation offers several insights into the proposed payment model for oncology: (1) The care management payments used in the simulation analysis-$960 total per six-month episode-represent only 4 percent of projected average total spending per episode (around $27,000 in 2016), but they are large relative to the FFS revenues of participating oncology practices, which are projected to be around $2,000 per oncology episode. By themselves, the care management payments would increase physician practices' Medicare revenues by roughly 50 percent on average. This represents a substantial new outlay for the Medicare program and a substantial new source of revenues for oncology practices. (2) For the Medicare program to break even, participating oncology practices would have to reduce utilization and intensity by roughly 4 percent. (3) The break-even point can be reduced if the care management payments are reduced or if the performance-based payments are reduced.

Catastrophic healthcare expenditure and poverty related to out-of-pocket payments for healthcare in Bangladesh-an estimation of financial risk protection of universal health coverage.

Science.gov (United States)

Khan, Jahangir A M; Ahmed, Sayem; Evans, Timothy G

2017-10-01

The Sustainable Development Goals target to achieve Universal Health Coverage (UHC), including financial risk protection (FRP) among other dimensions. There are four indicators of FRP, namely incidence of catastrophic health expenditure (CHE), mean positive catastrophic overshoot, incidence of impoverishment and increase in the depth of poverty occur for high out-of-pocket (OOP) healthcare spending. OOP spending is the major payment strategy for healthcare in most low-and-middle-income countries, such as Bangladesh. Large and unpredictable health payments can expose households to substantial financial risk and, at their most extreme, can result in poverty. The aim of this study was to estimate the impact of OOP spending on CHE and poverty, i.e. status of FRP for UHC in Bangladesh. A nationally representative Household Income and Expenditure Survey 2010 was used to determine household consumption expenditure and health-related spending in the last 30 days. Mean CHE headcount and its concentration indices (CI) were calculated. The propensity of facing CHE for households was predicted by demographic and socioeconomic characteristics. The poverty headcount was estimated using 'total household consumption expenditure' and such expenditure without OOP payments for health in comparison with the poverty-line measured by cost of basic need. In absolute values, a pro-rich distribution of OOP payment for healthcare was found in urban and rural Bangladesh. At the 10%-threshold level, in total 14.2% of households faced CHE with 1.9% overshoot. 16.5% of the poorest and 9.2% of the richest households faced CHE. An overall pro-poor distribution was found for CHE (CI = -0.064) in both urban and rural households, while the former had higher CHE incidences. The poverty headcount increased by 3.5% (5.1 million individuals) due to OOP payments. Reliance on OOP payments for healthcare in Bangladesh should be reduced for poverty alleviation in urban and rural Bangladesh in order to

Alternative Reimbursement Models: Bundled Payment and Beyond: AOA Critical Issues.

Science.gov (United States)

Greenwald, A Seth; Bassano, Amy; Wiggins, Stephen; Froimson, Mark I

2016-06-01

The Bundled Payments for Care Improvement (BPCI) initiative was begun in January 2013 by the U.S. Centers for Medicare & Medicaid Services (CMS) through its Innovation Center authority, which was created by the U.S. Patient Protection and Affordable Care Act (PPACA). The BPCI program seeks to improve health-care delivery and to ultimately reduce costs by allowing providers to enter into prenegotiated payment arrangements that include financial and performance accountability for a clinical episode in which a risk-and-reward calculus must be determined. BPCI is a contemporary 3-year experiment designed to test the applicability of episode-based payment models as a viable strategy to transform the CMS payment methodology while improving health outcomes. A summary of the 4 models being evaluated in the BPCI initiative is presented in addition to the awardee types and the number of awardees in each model. Data from one of the BPCI-designated pilot sites demonstrate that strategies do exist for successful implementation of an alternative payment model by keeping patients first while simultaneously improving coordination, alignment of care, and quality and reducing cost. Providers will need to embrace change and their areas of opportunity to gain a competitive advantage. Health-care providers, including orthopaedic surgeons, health-care professionals at post-acute care institutions, and product suppliers, all have a role in determining the strategies for success. Open dialogue between CMS and awardees should be encouraged to arrive at a solution that provides opportunity for gainsharing, as this program continues to gain traction and to evolve. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

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

Science.gov (United States)

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

2015-01-01

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

The Impact of Payment System Design on Tiering Incentives

OpenAIRE

Robert Arculus; Jennifer Hancock; Greg Moran

2012-01-01

Tiering occurs when an institution does not participate directly in the central payment system but instead settles its payments through an agent. A high level of tiering can be a significant issue for payment system regulators because of the increased credit and concentration risk. This paper explores the impact of payment system design on institutions' incentives to tier using simulation analysis. Some evidence is found to support the hypothesis that the liquidity-saving mechanisms in Austra...

Strategies Adopted by Romanian Banks to Reduce the Payment Incidents

Directory of Open Access Journals (Sweden)

Oana BĂRBULESCU SEITAN

2013-03-01

Full Text Available In the past few years, the lack of the market liquidity generated some difficulties in the process of recovering the claims from the partners. This has determined the banks to find solutions with which to protect their clients against the financial imbalances of their partners, imbalances that otherwise would directly affect their own business. However, the permanent changes of the banking regulations led to a continuous diversification of the relations between the bank and its customers. In this context, during January-February 2013, it was drawn up a qualitative marketing research, its main objective consisting in identifying and analyzing the main measures taken by banks to reduce the number and the value of payment incidents generated by the use of debt instruments. The study also considered the outline of potential measures that can be taken for adapting the regulations in the field to the needs of the Romanian business environment.

Effects of payment method on work control, work risk and work-related musculoskeletal health among sewing machine operators

Directory of Open Access Journals (Sweden)

R. Nawawi

2015-12-01

Full Text Available Effects of payment method on work control, work risk and work-related musculoskeletal health among sewing machine operators R. Nawawi1, B.M. Deros1*, D.D.I. Daruis2, A. Ramli3, R.M. Zein4 and L.H. Joseph3 1Dept. of Mechanical and Materials Engineering Faculty of Engineering & Built Environment Universiti Kebangsaan Malaysia, Malaysia *Email: hjbaba@ukm.edu.my 2Faculty of Engineering, Universiti Pertahanan Nasional Malaysia, Malaysia 3Department of Physiotherapy Faculty of Science, Lincoln University College, Malaysia 4Department of Consultation, Research & Development, National Institute of Occupational Safety and Health (NIOSH, Malaysia ABSTRACT This study aimed to identify payment method and its effects on work control, work risk and work-related musculoskeletal health among Malaysian sewing machine operators. The study sample comprised 337 sewing machine operators (male, n=122, female, n=215; aged between 18-54 years old; mean 30.74±8.44 from four different garment-making companies in Malaysia. They were being paid via time rate wages (n=246 and piece rate wages (n=91. Data was collected through Nordic Musculoskeletal Questionnaire and pen-and-paper assessment via Rapid Upper Limb Assessment (RULA. From the study, the piece rate wage group was found to take fewer breaks, had high work production demands, worked at a faster pace and experienced more exhaustion and pressure due to increasing work demands as compared to the time rate group. They were also observed working with higher physical exposure such as repetitive tasks, awkward static postures, awkward grips and hand movements, pulling, lifting and pushing as compared to those in the time rate wage group. The final RULA scores was also higher from the piece rate wage group (72.53% RULA score 7 which indicated higher work risks among them. The study found that the type of wage payment was significantly associated with work risks (p=0.036, df=1 and WRMSD at the shoulder, lower back

A Comparative Study of Current and Potential Users of Mobile Payment Services

Directory of Open Access Journals (Sweden)

Chanchai Phonthanukitithaworn

2016-11-01

Full Text Available Previous studies of mobile payment (m-payment services have primarily focused on a single group of adopters. This study identifies the factors that influence an individual’s intention to use m-payment services and compares groups of current users (adopters with potential users (non-adopters. A research model that reflects the behavioral intention to use m-payment services is developed and empirically tested using structural equation modeling on a data set consisting of 529 potential users and 256 current users of m-payment services in Thailand. The results show that the factors that influence current users’ intentions to use m-payment services are compatibility, subjective norms, perceived trust, and perceived cost. Subjective norms, compatibility, ease of use, and perceived risk influenced potential users’ intentions to use m-payment. Subjective norms and perceived risk had a stronger influence on potential users, while perceived cost had a stronger influence on current users, in terms of their intentions to use m-payment services. Discussions, limitations, and recommendations for future research are addressed.

Effect of Bundled Payments and Health Care Reform as Alternative Payment Models in Total Joint Arthroplasty: A Clinical Review.

Science.gov (United States)

Siddiqi, Ahmed; White, Peter B; Mistry, Jaydev B; Gwam, Chukwuweike U; Nace, James; Mont, Michael A; Delanois, Ronald E

2017-08-01

In an effort to control rising healthcare costs, healthcare reforms have developed initiatives to evaluate the efficacy of alternative payment models (APMs) for Medicare reimbursements. The Center for Medicare and Medicaid Services Innovation Center (CMMSIC) introduced the voluntary Bundled Payments for Care Improvement (BPCI) model experiment as a means to curtail Medicare cost by allotting a fixed payment for an episode of care. The purpose of this review is to (1) summarize the preliminary clinical results of the BPCI and (2) discuss how it has led to other healthcare reforms and alternative payment models. A literature search was performed using PubMed and the CMMSIC to explore different APMs and clinical results after implementation. All studies that were not in English or unrelated to the topic were excluded. Preliminary results of bundled payment models have shown reduced costs in total joint arthroplasty largely by reducing hospital length of stay, decreasing readmission rates, as well as reducing the number of patients sent to in-patient rehabilitation facilities. In order to refine episode of care bundles, CMMSIC has also developed other initiatives such as the Comprehensive Care for Joint Replacement (CJR) pathway and Surgical Hip and Femur Fracture (SHFFT). Despite the unknown future of the Affordable Care Act, BPCI, and CJR, preliminary results of alternative models have shown promise to reduce costs and improve quality of care. Moving into the future, surgeon control of the BPCI and CJR bundle should be investigated to further improve patient care and maximize financial compensation. Copyright © 2017 Elsevier Inc. All rights reserved.

Will Medicare Advantage payment reforms impact plan rebates and enrollment?

Science.gov (United States)

Nicholas, Lauren Hersch

2014-01-01

To assess the relationship between Medicare Advantage (MA) plan rebates and enrollment and simulate the effects of Affordable Care Act (ACA) payment reforms. First difference regressions of county-level MA payment and enrollment data from CMS from 2006 to 2010. A $10 decrease in the per member/per month rebate to MA plans was associated with a 0.20 percentage point (0.9%) decrease in MA penetration (P penetration and a 10% decrease in risk score. ACA reforms are predicted to reduce the level of rebates in lower-spending counties, leading to enrollment decreases of 1.7 to 1.9 percentage points in the lowest-spending counties. The simulation predicts that the disenrollment would come from MA enrollees with higher risk scores. MA enrollment responds to availability of supplemental benefits supported by rebates. ACA provisions designed to lower MA spending will predominantly affect Medicare beneficiaries living in counties where MA plans may be unable to offer a comparable product at a price similar to that of traditional Medicare.

CMS announces new payment model

Directory of Open Access Journals (Sweden)

Robbins RA

2018-01-01

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

The LUGPA Alternative Payment Model for Initial Therapy of Newly Diagnosed Patients With Organ-confined Prostate Cancer: Rationale and Development.

Science.gov (United States)

Kapoor, Deepak A; Shore, Neal D; Kirsh, Gary M; Henderson, Jonathan; Cohen, Todd D; Latino, Kathleen

2017-01-01

Over the past several decades, rapid expansion in healthcare expenditures has exposed the utilization incentives inherent in fee-for-service payment models. The passage of Medicare Access and CHIP Reauthorization Act of 2015 heralded a transition toward value-based care, creating incentives for practitioners to accept bidirectional risk linked to outcome and utilization metrics. At present, the limited availability of these vehicles excludes all but a handful of providers from participation in alternative payment models (APMs). The LUGPA APM supports the goals of the triple aim in improving the patient experience, enhancing population health and reducing expenditures. By requiring utilization of certified electronic health record technologies, tying payment to quality metrics, and requiring practices to bear more than nominal risk, the LUGPA APM qualifies as an advanced APM, thereby easing the reporting burden and creating opportunities for participating practices.

Association of Practice-Level Social and Medical Risk With Performance in the Medicare Physician Value-Based Payment Modifier Program.

Science.gov (United States)

Chen, Lena M; Epstein, Arnold M; Orav, E John; Filice, Clara E; Samson, Lok Wong; Joynt Maddox, Karen E

2017-08-01

Medicare recently launched the Physician Value-Based Payment Modifier (PVBM) Program, a mandatory pay-for-performance program for physician practices. Little is known about performance by practices that serve socially or medically high-risk patients. To compare performance in the PVBM Program by practice characteristics. Cross-sectional observational study using PVBM Program data for payments made in 2015 based on performance of large US physician practices caring for fee-for-service Medicare beneficiaries in 2013. High social risk (defined as practices in the top quartile of proportion of patients dually eligible for Medicare and Medicaid) and high medical risk (defined as practices in the top quartile of mean Hierarchical Condition Category risk score among fee-for-service beneficiaries). Quality and cost z scores based on a composite of individual measures. Higher z scores reflect better performance on quality; lower scores, better performance on costs. Among 899 physician practices with 5 189 880 beneficiaries, 547 practices were categorized as low risk (neither high social nor high medical risk) (mean, 7909 beneficiaries; mean, 320 clinicians), 128 were high medical risk only (mean, 3675 beneficiaries; mean, 370 clinicians), 102 were high social risk only (mean, 1635 beneficiaries; mean, 284 clinicians), and 122 were high medical and social risk (mean, 1858 beneficiaries; mean, 269 clinicians). Practices categorized as low risk performed the best on the composite quality score (z score, 0.18 [95% CI, 0.09 to 0.28]) compared with each of the practices categorized as high risk (high medical risk only: z score, -0.55 [95% CI, -0.77 to -0.32]; high social risk only: z score, -0.86 [95% CI, -1.17 to -0.54]; and high medical and social risk: -0.78 [95% CI, -1.04 to -0.51]) (P risk only performed the best on the composite cost score (z score, -0.52 [95% CI, -0.71 to -0.33]), low risk had the next best cost score (z score, -0.18 [95% CI, -0.25 to -0.10]), then

On the spillover of exchange rate risk into default risk

Directory of Open Access Journals (Sweden)

Božović Miloš

2009-01-01

Full Text Available In order to reduce the exchange-rate risk, banks in emerging markets are typically denominating their loans in foreign currencies. However, in the event of a substantial depreciation of the local currency, the payment ability of a foreign-currency borrower may be reduced significantly, exposing the lender to additional default risk. This paper analyses how the exchange-rate risk of foreign currency loans spills over into default risk. We show that in an economy where foreign currency loans are a dominant source of financing economic activity, depreciation of the local currency establishes a negative feedback mechanism that leads to higher default probabilities, reduced credit supply, and reduced growth. This finding has some important implications that may be of special interest for regulators and market participants in emerging economies.

The variance of length of stay and the optimal DRG outlier payments.

Science.gov (United States)

Felder, Stefan

2009-09-01

Prospective payment schemes in health care often include supply-side insurance for cost outliers. In hospital reimbursement, prospective payments for patient discharges, based on their classification into diagnosis related group (DRGs), are complemented by outlier payments for long stay patients. The outlier scheme fixes the length of stay (LOS) threshold, constraining the profit risk of the hospitals. In most DRG systems, this threshold increases with the standard deviation of the LOS distribution. The present paper addresses the adequacy of this DRG outlier threshold rule for risk-averse hospitals with preferences depending on the expected value and the variance of profits. It first shows that the optimal threshold solves the hospital's tradeoff between higher profit risk and lower premium loading payments. It then demonstrates for normally distributed truncated LOS that the optimal outlier threshold indeed decreases with an increase in the standard deviation.

77 FR 73117 - Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2014

Science.gov (United States)

2012-12-07

... Indian Health Service, an Indian Tribe, a Tribal Organization, or an Urban Indian Organization, or... behalf of a State, including the risk adjustment model, the payments and charges methodology, and the... York State, Urban Institute, March 2012. The provisions addressing SHOP Exchanges will reduce the...

NAMA 80/20 DEFERRED PAYMENT INITIATIVE PARTICIPATION FORM

OpenAIRE

2012-01-01

Brochure detailing the Deferred Payment Initiative key features and information on how to apply for the initiative: "NAMA has launched a Deferred Payment Initiative (the ‘Initiative’) on a pilot basis. The Initiative is aimed at potential owner-occupiers who are interested in purchasing residential property but are concerned at the risk of further price declines."

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

Science.gov (United States)

Conrad, Douglas A

2015-12-01

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

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

Science.gov (United States)

Hudson, Mark E

2015-10-01

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

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

Science.gov (United States)

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

2018-05-25

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

The new transnational payments law and global consumer trade : Online platforms as providers of private legal orders

NARCIS (Netherlands)

Janczuk, Agnieszka

2015-01-01

This article uses the example of one of the best-known global payment systems provided by an online platform, PayPal, to analyze the role of private legal orders in creating new markets beyond jurisdictional borders. It shows that a relatively uniform legal order reduces risks involved in

Solving Disparities Through Payment And Delivery System Reform: A Program To Achieve Health Equity.

Science.gov (United States)

DeMeester, Rachel H; Xu, Lucy J; Nocon, Robert S; Cook, Scott C; Ducas, Andrea M; Chin, Marshall H

2017-06-01

Payment systems generally do not directly encourage or support the reduction of health disparities. In 2013 the Finding Answers: Solving Disparities through Payment and Delivery System Reform program of the Robert Wood Johnson Foundation sought to understand how alternative payment models might intentionally incorporate a disparities-reduction component to promote health equity. A qualitative analysis of forty proposals to the program revealed that applicants generally did not link payment reform tightly to disparities reduction. Most proposed general pay-for-performance, global payment, or shared savings plans, combined with multicomponent system interventions. None of the applicants proposed making any financial payments contingent on having successfully reduced disparities. Most applicants did not address how they would optimize providers' intrinsic and extrinsic motivation to reduce disparities. A better understanding of how payment and care delivery models might be designed and implemented to reduce health disparities is essential. Project HOPE—The People-to-People Health Foundation, Inc.

14 CFR 198.13 - Premium insurance-payment of premiums.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Premium insurance-payment of premiums. 198... (CONTINUED) WAR RISK INSURANCE AVIATION INSURANCE § 198.13 Premium insurance—payment of premiums. The insured must pay the premium for insurance issued under this part within the stated period after receipt of...

Payment methods for outpatient care facilities

Science.gov (United States)

Yuan, Beibei; He, Li; Meng, Qingyue; Jia, Liying

2017-01-01

included 18 studies in this comparison, however we did not include five studies in the effects analysis due to high risk of bias. From the 13 studies, we found that the extra P4P incentives probably slightly improved the health professionals' use of some tests and treatments (adjusted RR median = 1.095, range 1.01 to 1.17; moderate-certainty evidence), and probably led to little or no difference in adherence to quality assurance criteria (adjusted percentage change median = -1.345%, range -8.49% to 5.8%; moderate-certainty evidence). We also found that P4P incentives may have led to little or no difference in patients' utilisation of health services (adjusted RR median = 1.01, range 0.96 to 1.15; low-certainty evidence) and may have led to little or no difference in the control of blood pressure or cholesterol (adjusted RR = 1.01, range 0.98 to 1.04; low-certainty evidence). 2) Capitation combined with P4P compared to fee-for-service (FFS) One study found that compared with FFS, a capitated budget combined with payment based on providers' performance on antibiotic prescriptions and patient satisfaction probably slightly reduced antibiotic prescriptions in primary health facilities (adjusted RR 0.84, 95% confidence interval 0.74 to 0.96; moderate-certainty evidence). 3) Capitation compared to FFS Two studies compared capitation to FFS in mental health centres in the United States. Based on these studies, the effects of capitation compared to FFS on the utilisation and costs of services were uncertain (very low-certainty evidence). Authors' conclusions Our review found that if policymakers intend to apply P4P incentives to pay health facilities providing outpatient services, this intervention will probably lead to a slight improvement in health professionals' use of tests or treatments, particularly for chronic diseases. However, it may lead to little or no improvement in patients' utilisation of health services or health outcomes. When considering using P4P to improve the

DOD TRAVEL IMPROPER PAYMENTS: Fiscal Year 2006 Reporting Was Incomplete and Planned Improvement Efforts Face Challenges

National Research Council Canada - National Science Library

WIlliams, McCoy

2007-01-01

... was incomplete because it understated the full extent of travel improper payments. The DOD travel payment data used to assess the program s risk of significant improper payments only included payments processed by the Defense Travel System (DTS...

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

Science.gov (United States)

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

2014-09-01

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

75 FR 9101 - Reduced 2009 Estimated Income Tax Payments for Individuals With Small Business Income

Science.gov (United States)

2010-03-01

... 2009 Estimated Income Tax Payments for Individuals With Small Business Income AGENCY: Internal Revenue... estimated income tax payments for qualified individuals with small business income for any taxable year... with small business income to certify that they satisfy the statutory gross income requirement for...

Internalizing Externalities through Payments for Environmental Services

Directory of Open Access Journals (Sweden)

Sudarsono Soedomo

2012-08-01

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

CASH-FLOW SENSITIVITY TO PAYMENTS FOR MATERIAL RESSOURCES

Directory of Open Access Journals (Sweden)

Lavinia Elena BRÎNDESCU OLARIU

2014-12-01

Full Text Available The financing decision is taken based on the expectations concerning the future cash-flows generated in the operating activity, which should provide coverage for the debt service and allow for an increase of the shareholders’ wealth. Still, the future cash-flows are affected by risk, which makes the sensitivity analysis a very important part of the decision process. The current research sets to evaluate the sensitivity of the payment capacity to variations of the payments for raw materials and consumables. The study employs 391 forecasted yearly cash-flow statements collected from 50 companies together with detailed information concerning the hypotheses of the forecasts. The results of the study allow for the establishment of benchmarks for the payment capacity’s sensitivity, the determination of the mechanisms through which the variation of payments for raw materials and consumables impacts the payment capacity, as well as the identification of the possible causes of such a variation.

Payment methods for outpatient care facilities.

Science.gov (United States)

Yuan, Beibei; He, Li; Meng, Qingyue; Jia, Liying

2017-03-03

analysis due to high risk of bias. From the 13 studies, we found that the extra P4P incentives probably slightly improved the health professionals' use of some tests and treatments (adjusted RR median = 1.095, range 1.01 to 1.17; moderate-certainty evidence), and probably led to little or no difference in adherence to quality assurance criteria (adjusted percentage change median = -1.345%, range -8.49% to 5.8%; moderate-certainty evidence). We also found that P4P incentives may have led to little or no difference in patients' utilisation of health services (adjusted RR median = 1.01, range 0.96 to 1.15; low-certainty evidence) and may have led to little or no difference in the control of blood pressure or cholesterol (adjusted RR = 1.01, range 0.98 to 1.04; low-certainty evidence). 2) Capitation combined with P4P compared to fee-for-service (FFS)One study found that compared with FFS, a capitated budget combined with payment based on providers' performance on antibiotic prescriptions and patient satisfaction probably slightly reduced antibiotic prescriptions in primary health facilities (adjusted RR 0.84, 95% confidence interval 0.74 to 0.96; moderate-certainty evidence). 3) Capitation compared to FFSTwo studies compared capitation to FFS in mental health centres in the United States. Based on these studies, the effects of capitation compared to FFS on the utilisation and costs of services were uncertain (very low-certainty evidence). Our review found that if policymakers intend to apply P4P incentives to pay health facilities providing outpatient services, this intervention will probably lead to a slight improvement in health professionals' use of tests or treatments, particularly for chronic diseases. However, it may lead to little or no improvement in patients' utilisation of health services or health outcomes. When considering using P4P to improve the performance of health facilities, policymakers should carefully consider each component of their P4P design, including

The impact of the Directive on Payment Services in the Internal Market on Danish and Belgium Legislation on Fraudulent Payment Transactions

DEFF Research Database (Denmark)

Henschel, Rene Franz; Steenot, Reinhard

2009-01-01

In December 2007, the European Directive on payment services in the internal market was published in the Official Journal. This Directive, which has to be transposed into national legislation before the 1st November 2009, contains many rules on payments, including rules on the allocation of liabi......In December 2007, the European Directive on payment services in the internal market was published in the Official Journal. This Directive, which has to be transposed into national legislation before the 1st November 2009, contains many rules on payments, including rules on the allocation...... and Belgian legislation. More specifically, we will examine how the rules incorporated in the European Directive, which is based on the principle of maximum harmonization, are implemented in Belgium and Denmark, whether the implementations are in accordance with the Directive and finally, whether...... the Directive and the implementations reduce or strengthen the protection of payment service users in the two countries and promotes the creation of a common internal market for payment services...

Payment Instrument Characteristics

DEFF Research Database (Denmark)

Holst, Jacques; Kjeldsen, Martin; Hedman, Jonas

2015-01-01

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

Distribution and Determinants of 90-Day Payments for Multilevel Posterior Lumbar Fusion: A Medicare Analysis.

Science.gov (United States)

Jain, Nikhil; Phillips, Frank M; Khan, Safdar N

2018-04-01

A retrospective, economic analysis. The objective of this article is to analyze the distribution of 90-day payments, sources of variation, and reimbursement for complications and readmissions for primary ≥3-level posterior lumbar fusion (PLF) from Medicare data. A secondary objective was to identify risk factors for complications. Bundled payments represent a single payment system to cover all costs associated with a single episode of care, typically over 90 days. The dollar amount spent on different health service providers and the variation in payments for ≥3-level PLF have not been analyzed from a bundled perspective. Administrative claims data were used to study 90-day Medicare (2005-2012) reimbursements for primary ≥3-level PLF for deformity and degenerative conditions of the lumbar spine. Distribution of payments, sources of variation, and reimbursements for managing complications were studied using linear regression models. Risk factors for complications were studied by stepwise multiple-variable logistic regression analysis. Hospital payments comprised 73.8% share of total 90-day payment. Adjusted analysis identified several factors for variation in index hospital payments. The average 90-day Medicare payment for all multilevel PLFs without complications was $35,878 per patient. The additional average cost of treating complications with/without revision surgery within 90 days period ranged from $17,284 to $68,963. A 90-day bundle for ≥3-level PLF with readmission ranges from $88,648 (3 levels) to $117,215 (8+ levels). Rates and risk factors for complications were also identified. The average 90-day payment per patient from Medicare was $35,878 with several factors such as levels of surgery, comorbidities, and development of complications influencing the cost. The study also identifies the risks and costs associated with complications and readmissions and emphasize the significant effect these would have on bundled payments (additional burden of up

Payment card rewards programs and consumer payment choice

OpenAIRE

Andrew Ching; Fumiko Hayashi

2006-01-01

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

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

Science.gov (United States)

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

2016-08-01

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

The Future of the Mobile Payment as Electronic Payment System

OpenAIRE

Bezovski, Zlatko

2016-01-01

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

Payment Instruments, Finance and Development

NARCIS (Netherlands)

Beck, T.H.L.; Pamuk, H.; Uras, R.B.; Ramrattan, R.

2018-01-01

This paper studies the effects of a payment technology innovation (mobile money) on entrepreneurship and economic development in a quantitative dynamic general equilibrium model. In the model mobile money dominates fiat money as a medium of exchange, since it avoids the risk of theft, but comes with

Payment instruments, finance and development

NARCIS (Netherlands)

Beck, Thorsten; Pamuk, Haki; Ramrattan, Ravindra; Uras, Burak R.

2018-01-01

This paper studies the effects of a payment technology innovation (mobile money) on entrepreneurship and economic development in a quantitative dynamic general equilibrium model. In the model mobile money dominates fiat money as a medium of exchange, since it avoids the risk of theft, but comes with

Reducing the risk of nuclear terrorism

International Nuclear Information System (INIS)

Hibbs, R.

2005-01-01

Full text: The March 2005 'International conference on nuclear security, global directions for the future' noted that nuclear terrorism is one of the greatest threats to society. Eminent members of a multi-national panel stated that there is no one principal activity to reduce the risk of nuclear terrorism and that a combination of activities is required. This paper seeks to identify those activities by analyzing the elements that comprise the risk of nuclear terrorism. For the purpose of the analysis, risk is the product of the probability of a terrorist attack (A p ), the success of a terrorist act (S p ) and the consequence (C) of the attack: R=A p * S p * C. The paper examines each of these three elements of risk with the objective of identifying what we are doing and what else we could be doing to reduce risk. It takes into consideration some historic catastrophes, examines how they might have been prevented or their consequences reduced, and if there are lessons that are applicable to reducing the risk of nuclear terrorism. The paper demonstrates that we have concentrated on only one of the three elements of risk and offer suggestions for diminishing the risk of nuclear terrorism by addressing all the elements. (author)

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

International Nuclear Information System (INIS)

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

2012-01-01

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

Equity in out-of-pocket payment in Chile.

Science.gov (United States)

Mondaca, Alicia Lorena Núñez; Chi, Chunhuei

2017-05-04

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

Pricing of payment cards, competition, and efficiency : A possible guide for SEPA

NARCIS (Netherlands)

Bolt, Wilko; Schmiedel, Heiko

2013-01-01

This paper analyzes equilibrium pricing of payment cards and welfare consequences of payment card competition. In particular, we model competition between debit and credit cards. The paper argues that optimal consumer and merchant fees must take safety, income uncertainty, default risk, and the

Effect of medicare payment on rural health care systems.

Science.gov (United States)

McBride, Timothy D; Mueller, Keith J

2002-01-01

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

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

Science.gov (United States)

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

2017-04-01

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

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

Science.gov (United States)

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

2018-05-01

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

Payment Platform

DEFF Research Database (Denmark)

Hjelholt, Morten; Damsgaard, Jan

2012-01-01

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

Taxonomy of Payments

DEFF Research Database (Denmark)

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

2017-01-01

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

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

Science.gov (United States)

2012-07-24

...) establishes National Average Payments for free, reduced price and paid afterschool snacks as part of the...--free lunch-- 303 cents, reduced price lunch--263 cents. Afterschool Snacks in Afterschool Care Programs--The payments are: Contiguous States--free snack--78 cents, reduced price snack--39 cents, paid snack...

75 FR 41796 - National School Lunch, Special Milk, and School Breakfast Programs, National Average Payments...

Science.gov (United States)

2010-07-19

... National Average Payments for free, reduced price and paid afterschool snacks as part of the National...; Hawaii--free lunch-- 288 cents, reduced price lunch--248 cents. Afterschool Snacks in Afterschool Care Programs--The payments are: Contiguous States--free snack--74 cents, reduced price snack--37 cents, paid...

76 FR 43256 - National School Lunch, Special Milk, and School Breakfast Programs, National Average Payments...

Science.gov (United States)

2011-07-20

... National Average Payments for free, reduced price and paid afterschool snacks as part of the National...; Hawaii--free lunch-- 294 cents, reduced price lunch--254 cents. Afterschool Snacks in Afterschool Care Programs--The payments are: Contiguous States--free snack--76 cents, reduced price snack--38 cents, paid...

Effects of revenue from tourism on Montenegro's balance of payments

Directory of Open Access Journals (Sweden)

Veličković Maja R.

2017-01-01

Full Text Available Tourism is one of the most important industries in Montenegro, having several multiplier effects. Direct contribution of tourism to economic growth and development of Montenegro became even more important in the period after the outbreak of the global economic crisis. Due to low export competitiveness and high dependence of its economy on import, Montenegro has been facing high deficit in foreign trade and balance of payments for years. The article aims to analyze the trend of revenue from foreign tourists and to assess the effects of such revenue on overall changes to the current account of Montenegro's balance of payment. The results of the study show that in the period from 2008 onwards, growth of tourism revenue has lead to increased deficit in balance of payments. Since needs of tourists cannot be met from own sources, Montenegro has increased import of goods and services in the same period, which reduced total effects of tourism. In the years after the outbreak of the global economic crisis, the direct influence of tourism on increased surplus on the services subaccount within the current account of the balance of payments becomes even more important. Growth of tourism revenue leads to significantly higher surplus in the services subaccount, and therefore reduces the balance of payments deficit. Negative effects of tourism on goods import have been significantly reduced over the period, which allowed for a higher degree of coverage of trade deficit by tourism revenue. Increased revenue from foreign tourists at the same time causes higher growth of revenues from transport services, which has indirect positive effect on general changes in the current account of Montenegro's balance of payments.

Comparative analysis of the current payment system for hospital services in Serbia and projected payments under diagnostic related groups system in urology.

Science.gov (United States)

Babić, Uroš; Soldatović, Ivan; Vuković, Dejana; Milićević, Milena Šantrić; Stjepanović, Mihailo; Kojić, Dejan; Argirović, Aleksandar; Vukotić, Vinka

2015-03-01

Global budget per calendar year is a traditional method of funding hospitals in Serbia. Diagnose related groups (DGR) is a method of hospital payment based on classification of patients into groups with clinically similar problems and similar utilization of hospital resources. The aim of this study was to compare current methods of hospital services payment with the projected costs by DRG payment method in urology. The data were obtained from the information system used in the Clinical Hospital Center "Dr. Dragiša Mišović"--Dedinje in Belgrade, Serbia. The implemented hospital information system was the main criterion for selection of healthcare institutions. The study included 994 randomly selected patients treated surgically and conservatively in 2012. Average costs under the current payment method were slightly higher than those projected by DRG, however, the variability was twice as high (54,111 ± 69,789 compared to 53,434 ± 32,509, p payment method as well as with the projected one by DRG was observed in relation to the number of days of hospitalization (ρ = 0.842, p payment system (β = 0.843, p payment system (β = 0.737, p payment method and the pro- jected DRG payment methods (β = 0.501, p Payment under the DRG system is administratively more complex because it requires detailed and standardized coding of diagnoses and procedures, as well as the information on the average consumption of resources (costs) per DRG. Given that aggregate costs of treatment under two hospital payment methods compared in the study are not significantly different, the focus on minor surgeries both under the current hospital payment method and under the introduced DRG system would be far more cost-effective for a hospital as great variations in treatment performance (reductions of days of hospitalization and complications), and consequently invoiced amounts would be reduced.

Payments for watershed services: opportunities and realities

Energy Technology Data Exchange (ETDEWEB)

Bond, Ivan

2007-08-15

Many nations have found that regulatory approaches to land and water management have limited impact. An alternative is to create incentives for sound management - under mechanisms known as payments for ecosystem services. It is a simple idea: people who look after ecosystems that benefit others should be recognised and rewarded. In the case of watersheds, downstream beneficiaries of wise upstream land and water use should compensate the stewards. To be effective these 'payments for watershed services' must cover the cost of watershed management. In developing countries, they might also aid local development and reduce poverty. But new research shows that the problems in watersheds are complex and not easily solved. Payments for watershed services do not guarantee poverty reduction and cannot replace the best aspects of regulation.

An Analysis of DOD Fraudulent Vendor Payments

National Research Council Canada - National Science Library

Jones-Oxendine, Shawn

1999-01-01

...) known DoD fraudulent vendor cases in light of their management control weaknesses. A high risk of fraudulent vendor payments were present in the DoD, pre-DFAS finance and accounting systems and the current DFAS configuration...

Mitigating delay and non-payment in the Malaysian construction industry

Science.gov (United States)

Mohamad, N.; Suman, A. S.; Harun, H.; Hashim, H.

2018-02-01

Construction industry is one of the industries that have contributed towards the rapid growth of development and economics in Malaysia. However, the industry is inundated with delay and non-payment issues between the two parties in contract that is the clients and contractors Even though there are contractual and administrative provisions in the standard forms of contract in Malaysia regarding payments, delay and non-payment issues still occur between them. The aim of the study is to develop measures to mitigate delay and non-payment issues between contractors and clients in the Malaysian construction industry. Questionnaire survey was conducted with clients and contractors in Klang Valley. Results from data analysis identified significant measures to mitigate delay and non-payment issues between contractors and clients which include contractors should submit their progress work invoicing with adequate documents; contractors should follow up constantly with client regarding payment; proper understanding of requirements with regards to payment; mutual discussion of problems with client to address problems in a timely manner and proper use of payment provisions in the standard form of contract. This study is significant to contractors and clients and to other construction players in order to reduce and minimise delay and non-payment issues for the growth of economy in the Malaysian construction industry.

Multiple Sources of Prescription Payment and Risky Opioid Therapy Among Veterans.

Science.gov (United States)

Becker, William C; Fenton, Brenda T; Brandt, Cynthia A; Doyle, Erin L; Francis, Joseph; Goulet, Joseph L; Moore, Brent A; Torrise, Virginia; Kerns, Robert D; Kreiner, Peter W

2017-07-01

Opioid overdose and other related harms are a major source of morbidity and mortality among US Veterans, in part due to high-risk opioid prescribing. We sought to determine whether having multiple sources of payment for opioids-as a marker for out-of-system access-is associated with risky opioid therapy among veterans. Cross-sectional study examining the association between multiple sources of payment and risky opioid therapy among all individuals with Veterans Health Administration (VHA) payment for opioid analgesic prescriptions in Kentucky during fiscal year 2014-2015. Source of payment categories: (1) VHA only source of payment (sole source); (2) sources of payment were VHA and at least 1 cash payment [VHA+cash payment(s)] whether or not there was a third source of payment; and (3) at least one other noncash source: Medicare, Medicaid, or private insurance [VHA+noncash source(s)]. Our outcomes were 2 risky opioid therapies: combination opioid/benzodiazepine therapy and high-dose opioid therapy, defined as morphine equivalent daily dose ≥90 mg. Of the 14,795 individuals in the analytic sample, there were 81.9% in the sole source category, 6.6% in the VHA+cash payment(s) category, and 11.5% in the VHA+noncash source(s) category. In logistic regression, controlling for age and sex, persons with multiple payment sources had significantly higher odds of each risky opioid therapy, with those in the VHA+cash having significantly higher odds than those in the VHA+noncash source(s) group. Prescribers should examine the prescription monitoring program as multiple payment sources increase the odds of risky opioid therapy.

Tradeoffs in the design of health plan payment systems: Fit, power and balance.

Science.gov (United States)

Geruso, Michael; McGuire, Thomas G

2016-05-01

In many markets, including the new U.S. Marketplaces, health insurance plans are paid by risk-adjusted capitation, sometimes combined with reinsurance and other payment mechanisms. This paper proposes a framework for evaluating the de facto insurer incentives embedded in these complex payment systems. We discuss fit, power and balance, each of which addresses a distinct market failure in health insurance. We implement empirical metrics of fit, power, and balance in a study of Marketplace payment systems. Using data similar to that used to develop the Marketplace risk adjustment scheme, we quantify tradeoffs among the three classes of incentives. We show that an essential tradeoff arises between the goals of limiting costs and limiting cream skimming because risk adjustment, which is aimed at discouraging cream-skimming, weakens cost control incentives in practice. A simple reinsurance system scores better on our measures of fit, power and balance than the risk adjustment scheme in use in the Marketplaces. Copyright © 2016 Elsevier B.V. All rights reserved.

Towards a framework for the evaluation of mobile payments integration

OpenAIRE

Carton, Fergal; Hedman, Jonas; Damsgaard, jan; Tan, Kay-Ti; McCarthy, JB

2011-01-01

This paper derives a theoretical framework for consideration of both the technologically driven dimensions of mobile payment solutions, and the associated value proposition for customers. Banks promote traditional payment instruments whose value proposition is the management of risk for both consumers and merchants. These instruments are centralised, costly and lack decision support functionality. The ubiquity of the mobile phone has provided a decentralised platform for managing ...

Informal Payments in the Health Care System - Research, Media and Policy

Directory of Open Access Journals (Sweden)

Răzvan Cherecheş

2011-02-01

Full Text Available Informal payments in the health system refer to any payment made outside the legal funding framework. The existence of the phenomenon in Central and Eastern European countries relates to the characteristics of the health systems in the communist period. The analysis is based on three types of data: a set of data gathered from literature review; a second set of data gathered from online media; and a third set of data collected from legislative and public policy. The analysis was pursued using the key words such as informal payment, under-the-table payment, out-of-pocket payment, envelope payment, healthcare corruption, under-the-counter payment. As reflected in the media reports and even publicly recognized by the officials of the Ministry of Health, informal payments are a serious problem of the Romanian healthcare system. Nevertheless, the studies pursued by local researchers are inconsistent with the actual magnitude of the problem. Besides that, there is a serious gap between the findings in this area and the policies intended to reduce the phenomenon.

The Effect of Green Payments on the Diffusion of Conservation Technologies

OpenAIRE

Hendricks, Nathan P.

2010-01-01

The benefits from green payments for the adoption of a conservation technology or practice are reduced if the technology would have eventually been adopted regardless of the green payment. This source of additionality is likely a significant concern for some technologies subsidized by EQIP.

Rethinking informal payments by patients in Europe: An institutional approach.

Science.gov (United States)

Williams, Colin C; Horodnic, Adrian V

2017-10-01

The aim of this paper is to explain informal payments by patients to healthcare professionals for the first time through the lens of institutional theory as arising when there are formal institutional imperfections and asymmetry between norms, values and practices and the codified formal laws and regulations. Reporting a 2013 Eurobarometer survey of the prevalence of informal payments by patients in 28 European countries, a strong association is revealed between the degree to which formal and informal institutions are unaligned and the propensity to make informal payments. The association between informal payments and formal institutional imperfections is then explored to evaluate which structural conditions might reduce this institutional asymmetry, and thus the propensity to make informal payments. The paper concludes by exploring the implications for tackling such informal practices. Copyright © 2017 Elsevier B.V. All rights reserved.

Risk Reducing Effect of AIS Implementation on Collision Risk

DEFF Research Database (Denmark)

Lützen, Marie; Friis-Hansen, Peter

2003-01-01

AIS (Automatic Identification System) is a transponder system developed for sea traffic purposes. The system sends and receives important ship information and other safety-related information between other ships and shore-based AIS stations. The implementation of AIS has now been initiated and......, as a result, the community will undoubtedly observe an increase in navigational safety. However, to the authors? knowledge, no study has so far rigorously quantified the risk reducing effect of using AIS as an integrated part of the navigational system. The objective of this study is to fill this gap....... The risk reducing effect of AIS is quantified by building a Bayesian network facilitating an evaluation of the effect of AIS on the navigational officer?s reaction ability in a potential, critical collision situation. The time-dependent change in the risk reducing effect on ship collisions is analysed...

Assessment of Conflicts of Interest in Robotic Surgical Studies: Validating Author's Declarations With the Open Payments Database.

Science.gov (United States)

Patel, Sunil V; Yu, David; Elsolh, Basheer; Goldacre, Ben M; Nash, Garrett M

2017-07-11

Accurate conflict of interest (COI) statements are important, as a known COI may invalidate study results due to the potential risk of bias. To determine the accuracy of self-declared COI statements in robotic studies and identify risk factors for undeclared payments. Robotic surgery studies were identified through EMBASE and MEDLINE and included if published in 2015 and had at least one American author. Undeclared COI were determined by comparing the author's declared COI with industry reported payments found in the "Open Payments" database for 2013 and 2014. Undeclared payments and discrepancies in the COI statement were determined. Risk factors were assessed for an association with undeclared payments at the author and study level. A total of 458 studies (2253 authors) were included. Approximately, 240 (52%) studies had 1 or more author receive undeclared payments and included 183 where "no COI" was explicitly declared, and 57 with no declaration statement present. Moreover, 21% of studies and 18% of authors with a COI declared it so in a COI statement. Studies that had undeclared payments from Intuitive were more likely to recommend robotic surgery compared with those that declared funding (odds ratio 4.29, 95% confidence interval 2.55-7.21). We found that it was common for payments from Intuitive to be undeclared in robotic surgery articles. Mechanisms for accountability in COI reporting need to be put into place by journals to achieve appropriate transparency to those reading the journal article.

The Physician Attrition Crisis: A Cross-Sectional Survey of the Risk Factors for Reduced Job Satisfaction Among US Surgeons.

Science.gov (United States)

Jackson, Theresa N; Pearcy, Chris P; Khorgami, Zhamak; Agrawal, Vaidehi; Taubman, Kevin E; Truitt, Michael S

2018-05-01

A physician shortage is on the horizon, and surgeons are particularly vulnerable due to attrition. Reduced job satisfaction leads to increased job turnover and earlier retirement. The purpose of this study is to delineate the risk factors that contribute to reduced job satisfaction. A cross-sectional survey of US surgeons was conducted from September 2016 to May 2017. Screening for job satisfaction was performed using the abridged Job in General scale. Respondents were grouped into more and less satisfied using the median split. Twenty-five potential risk factors were examined that included demographic, occupational, psychological, wellness, and work-environment variables. Overall, 993 respondents were grouped into more satisfied (n = 502) and less satisfied (n = 491) cohorts. Of the demographic variables, female gender and younger age were associated with decreased job satisfaction (p = 0.003 and p = 0.008). Most occupational variables (specialty, experience, academics, practice size, payment model) were not significant. However, increased average hours worked correlated with less satisfaction (p = 0.008). Posttraumatic stress disorder, burnout, wellness, all eight work-environment variables, and unhappiness with career choice were linked to reduced job satisfaction (p = 0.001). A surgeon shortage has serious implications for health care. Job satisfaction is associated with physician retention. Our results suggest women and younger surgeons may be at increased risk for job dissatisfaction. Targeted work-environment interventions to reduce work-hours, improve hospital culture, and provide adequate financial reimbursement may promote job satisfaction and wellness.

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

Science.gov (United States)

2010-07-01

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

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

Science.gov (United States)

2010-10-01

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

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

Science.gov (United States)

2010-04-01

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

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

Science.gov (United States)

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

2018-05-01

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

Electronic payment systems

OpenAIRE

Mláka, Michal

2010-01-01

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

38 CFR 21.7639 - Conditions which result in reduced rates or no payment.

Science.gov (United States)

2010-07-01

..., but does not have to lead to a standard college degree. (Authority: 10 U.S.C. 2131(b), 2136(b); sec... payments to a reservist. VA will not pay benefits to a reservist for pursuit of a course from which the...

Auctioning payment entitlements

DEFF Research Database (Denmark)

Nielsen, Kurt

2005-01-01

Payment entitlements is a new commodity that arises from the new European common agricultural policy. The agricultural subsidies are decoupled from the actual production and replaced by the so-called payment entitlements. A payment entitlement has a farm specific value and may be freely traded. T...

Use of Payment Technology

DEFF Research Database (Denmark)

Xiao, Xiao; Hedman, Jonas; Runnemark, Emma

2015-01-01

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

Factors affecting the informal payments in public and teaching hospitals.

Science.gov (United States)

Aboutorabi, Ali; Ghiasipour, Maryam; Rezapour, Aziz; Pourreza, Abolghasem; Sarabi Asiabar, Ali; Tanoomand, Asghar

2016-01-01

Informal payments in the health sector of many developing countries are considered as a major impediment to health care reforms. Informal payments are a form of systemic fraud and have adverse effects on the performance of the health system. In this study, the frequency and extent of informal payments as well as the determinants of these payments were investigated in general hospitals affiliated to Tehran University of Medical Sciences. In this cross-sectional study, 300 discharged patients were selected using multi-stage random sampling method. First, three hospitals were selected randomly; then, through a simple random sampling, we recruited 300 discharged patients from internal, surgery, emergency, ICU & CCU wards. All data were collected by structured telephone interviews and questionnaire. We analyzed data using Chi- square, Kruskal-Wallis and Mann-Whitney tests. The results indicated that 21% (n=63) of individuals paid informally to the staff. About 4% (n=12) of the participants were faced with informal payment requests from hospital staff. There was a significant relationship between frequency of informal payments with marital status of participants and type of hospitals. According to our findings, none of the respondents had informal payments to physicians. The most frequent informal payments were in cash and were made to the hospitals' housekeeping staff to ensure more and better services. There was no significant relationship between the informal payments with socio-demographic characteristics, residential area and insurance status. Our findings revealed that many strategies can be used for both controlling and reducing informal payments. These include training patients and hospitals' staff, increasing income levels of employees, improving the quantity and quality of health services and changing the entrenched beliefs that necessitate informal payments.

Payment - National

Data.gov (United States)

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

Informal payments for healthcare services and short-term effects of the introduction of visit fee on these payments in Hungary.

Science.gov (United States)

Baji, Petra; Pavlova, Milena; Gulácsi, László; Zsófia, Homolyáné Csete; Groot, Wim

2012-01-01

The objective of this paper is to study the short-term effects of the introduction of the visit fee in Hungary in 2007 on informal patient payments. We present the pattern of informal payments in primary, out-patient specialist and in in-patient care in the period before and shortly after the visit fee was introduced. We also analyse whether in the short run, the introduction of visit fee decreased the probability of paying informally. For the analysis, we use a dataset for a representative sample of 2500 respondents collected in 2007 shortly after the introduction of the visit fee, which contains data on informal payments for healthcare services. According to our results, 9% of the patients paid informally during their last visit to GP (2 Euros on average), 14% paid informally for specialist care (35 Euros on average) and 50% paid informally for hospitalisation (58 Euros on average). We find a significant reduction in the probability of paying informally only for elderly patients in case of in-patient care. Our results suggest that informal payments are widely spread in Hungary, especially in in-patient care. The short run potential of the introduction of the visit fee to reduce informal payments seems to be minor. Copyright © 2011 John Wiley & Sons, Ltd.

A model to determine payments associated with radiology procedures.

Science.gov (United States)

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

2017-12-01

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

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

OpenAIRE

Supardi, Azizan; Adnan, Hamimah

2011-01-01

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

Optimal Financing Order Decisions of a Supply Chain under the Retailer's Delayed Payment

Directory of Open Access Journals (Sweden)

Honglin Yang

2014-01-01

Full Text Available In real supply chain, a capital-constrained retailer has two typical payment choices: the up-front payment to receive a high discount price or the delayed payment to reduce capital pressure. We compare with the efficiency of optimal decisions of different participants, that is, supplier, retailer, and bank, under both types of payments based on a game equilibrium analysis. It shows that under the equilibrium, the delayed payment leads to a greater optimal order quantity from the retailer compared to the up-front payment and, thus, improves the whole benefit of the supply chain. The numerical simulation for the random demand following a uniform distribution further verifies our findings. This study provides novel evidence that a dominant supplier who actively offers trade credit helps enhance the whole efficiency of a supply chain.

Payment - State

Data.gov (United States)

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

Security Enhanced EMV-Based Mobile Payment Protocol

Directory of Open Access Journals (Sweden)

Ming-Hour Yang

2014-01-01

Full Text Available Near field communication has enabled customers to put their credit cards into a smartphone and use the phone for credit card transaction. But EMV contactless payment allows unauthorized readers to access credit cards. Besides, in offline transaction, a merchant’s reader cannot verify whether a card has been revoked. Therefore, we propose an EMV-compatible payment protocol to mitigate the transaction risk. And our modifications to the EMV standard are transparent to merchants and users. We also encrypt the communications between a card and a reader to prevent eavesdropping on sensitive data. The protocol is able to resist impersonation attacks and to avoid the security threats in EMV. In offline transactions, our scheme requires a user to apply for a temporary offline certificate in advance. With the certificate, banks no longer need to lower customer’s credits for risk control, and users can have online-equivalent credits in offline transactions.

Deterring Online Advertising Fraud through Optimal Payment in Arrears

Science.gov (United States)

Edelman, Benjamin

Online advertisers face substantial difficulty in selecting and supervising small advertising partners: Fraud can be well-hidden, and limited reputation systems reduce accountability. But partners are not paid until after their work is complete, and advertisers can extend this delay both to improve detection of improper partner practices and to punish partners who turn out to be rule-breakers. I capture these relationships in a screening model with delayed payments and probabilistic delayed observation of agents’ types. I derive conditions in which an advertising principal can set its payment delay to deter rogue agents and to attract solely or primarily good-type agents. Through the savings from excluding rogue agents, the principal can increase its profits while offering increased payments to good-type agents. I estimate that a leading affiliate network could have invoked an optimal payment delay to eliminate 71% of fraud without decreasing profit.

Variation in Bariatric Surgery Episode Costs in the Commercially Insured: Implications for Bundled Payments in the Private Sector.

Science.gov (United States)

Kelsall, Alexander C; Cassidy, Ruth; Ghaferi, Amir A

2017-08-01

To describe hospital-level variation in roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) in Michigan. Bariatric surgery is an increasingly prevalent elective surgical procedure that will likely be considered for future bundled payment programs, both public and private. Past research in the Medicare population found that the index hospitalization is responsible for the majority of payment variation among hospitals. However, this research largely excluded SG, now the most commonly performed bariatric surgery procedure nationally. We used data from a state-wide quality collaborative to calculate the average risk and price-adjusted 30-day episode payment for patients undergoing RYGB and SG procedures at Michigan hospitals between January 2009 and October 2014. We organized hospitals into quintiles and compared the variation in payments between highest and lowest-cost quintiles, and also the payment categories that drove this variation. We identified 9035 patients undergoing RYGB (n = 4194) or SG (n = 4841) procedures at 31 hospitals. The average price and risk-adjusted episode payment ranged from $11,874 in the lowest hospital quintile to $13,394 in the highest quintile, representing a difference of $1519 (12.8%). Payments for the index hospitalization accounted for the largest share of total episode costs for both procedure types. Despite representing 2.7% to 6.0% of payments across quintiles, postdischarge payments explained 22.6% of hospital variation in SG. Similarly, readmissions explained 24.5% of payment variation for SG episodes, despite representing between 1.2% and 4.4% of payments. Collectively, our findings suggest that there are previously underappreciated differences in episode payment variation between bariatric surgery procedures. SG may be more amenable to cost containment under bundled payment initiatives by virtue of the greater share of variation explained by readmission and postdischarge payments, components of episode payment more

42 CFR 422.310 - Risk adjustment data.

Science.gov (United States)

2010-10-01

... that are used in the development and application of a risk adjustment payment model. (b) Data... (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Payments to Medicare Advantage Organizations § 422... risk adjustment factors used to adjust payments, as required under §§ 422.304(a) and (c). CMS also may...

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

OpenAIRE

Wu, Chong

2016-01-01

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

Payment Cards

Directory of Open Access Journals (Sweden)

Kantnerová Liběna

2016-09-01

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

3 CFR 13520 - Executive Order 13520 of November 20, 2009. Reducing Improper Payments

Science.gov (United States)

2010-01-01

... forensic accounting and audits) agencies should take to more effectively tailor their methodologies for... recommendations to the Director of OMB designed to improve the effectiveness of single audits of State and local..., the effectiveness of single audits in identifying improper payments and opportunities to streamline or...

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

Science.gov (United States)

2010-07-01

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

The impact of the directive on payment services in the internal market on Danish and Belgian legislation on fraudulent payment transactions

DEFF Research Database (Denmark)

Henschel, Rene Franz; Steenot, Reinhard

2010-01-01

In December 2007, the European Directive on payment services in the internal market was published in the Official Journal of the European Union. This directive, which has to be transposed into national legislation. This directive, which has to be transposed into national legislation before 1...... out in what way the directive had or will have an impact on Danish and Belgian legislation. More specifically, we will examine how the rules incorporated in the European directive, which is based on the principle of maximum harmonisation, are implemented in Belgium and Denmark, whether...... the implementations are in accordance with the directive and, finally, whether the directive and the implementations reduce or strengthen the protection of payment service users in the two countries and promote the creation of a common internal market for payment services....

Comparative analysis of current payment system for hospital services in Serbia and projected payments under diagnostic related groups system in urology

Directory of Open Access Journals (Sweden)

Babić Uroš

2015-01-01

in the study are not significantly different, the focus on minor surgeries both under the current hospital payment method and under the introduced DRG system would be far more cost-effective for a hospital as great variations in treatment performance (reduction of days of hospitalization and complications, and consequently invoiced amounts would be reduced.

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

Science.gov (United States)

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

2015-05-08

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

Favorable Risk Selection in Medicare Advantage: Trends in Mortality and Plan Exits Among Nursing Home Beneficiaries

Science.gov (United States)

Goldberg, Elizabeth M.; Trivedi, Amal N.; Mor, Vincent; Jung, Hye-Young; Rahman, Momotazur

2016-01-01

The 2003 Medicare Modernization Act (MMA) increased payments to Medicare Advantage plans and instituted a new risk-adjustment payment model to reduce plans' incentives to enroll healthier Medicare beneficiaries and avoid those with higher costs. Whether the MMA reduced risk selection remains debatable. This study uses mortality differences, nursing home utilization, and switch rates to assess whether the MMA successfully decreased risk selection from 2000 to 2012. We found no decrease in the mortality difference or adjusted difference in nursing home use between plan beneficiaries pre- and post the MMA. Among beneficiaries with nursing home use, disenrollment from Medicare Advantage plans declined from 20% to 12%, but it remained 6 times higher than the switch rate from traditional Medicare to Medicare Advantage. These findings suggest that the MMA was not associated with reductions in favorable risk selection, as measured by mortality, nursing home use, and switch rates. PMID:27516452

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

Science.gov (United States)

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

2011-05-01

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

How to Hit a Home Run with Bundled Payments.

Science.gov (United States)

Kaldy, Joanne

2015-09-01

As health care payment reform continues to evolve, reimbursement increasingly is being linked to outcomes as well as to expenditures. Toward this end, the Centers for Medicare & Medicaid Services has established models for "bundled" payments to long-term care providers, using predetermined payments based on historical spending rates, in a new pay-for-performance landscape. The goal is to reward providers for quality and cost-effective care as well as penalize them for adverse patient outcomes and hospital readmissions based on the target spending rates. Pharmacists have a role in these new models of care, but need to broaden their partnerships and relationships with providers and be prepared to prove they are contributing both to quality care and to reducing costs.

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

Science.gov (United States)

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

2014-03-01

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

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

Science.gov (United States)

2010-10-01

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

Retail payments and economic growth

OpenAIRE

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

2012-01-01

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

Bundle Payment Program Initiative: Roles of a Nurse Navigator and Home Health Professionals.

Science.gov (United States)

Peiritsch, Heather

2017-06-01

With the passage of the Affordable Care Act, The Centers for Medicare and Medicaid (CMS) introduced a new value-based payment model, the Bundle Payment Care Initiative. The CMS Innovation (Innovation Center) authorized hospitals to participate in a pilot to test innovative payment and service delivery models that have a potential to reduce Medicare expenditures while maintaining or improving the quality of care for beneficiaries. A hospital-based home care agency, Abington Jefferson Health Home Care Department, led the initiative for the development and implementation of the Bundled Payment Program. This was a creative and innovative method to improve care along the continuum while testing a value-based care model.

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

Science.gov (United States)

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

2015-04-01

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

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

Science.gov (United States)

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

2015-07-01

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

New payment model for rural health services in Mongolia.

Science.gov (United States)

Hindle, Don; Khulan, Buyankhishig

2006-01-01

This article describes experiences in Mongolia in designing and implementing a new method of payment for rural health services. The new method involves using a formula that allocates 65% of available funding on the basis of risk-adjusted capitation, 20% on the basis of asset costs, 10% on the basis of variations in distance-related costs, and 5% on the basis of satisfactory attainment of quality of care targets. Rural populations have inferior health services in most countries, whether rich or poor. Their situation has deteriorated in most transition economies, including Mongolia since 1990. One factor has been the use of inappropriate methods of payment of care providers. Changes in payment methods have therefore been made in most transition economies with mixed success. One factor has been a tendency to over-simplify, for example, to introduce capitation without risk adjustment or to make per case payments that ignored casemix. In 2002, the Mongolian government decided that its crude funding formula for rural health services should be replaced. It had two main components. The first was payment of an annual grant by the local government from its general revenue on the basis of estimated service population, number of inpatient beds, and number of clinical staff. The second was an output-based payment per inpatient day from the National Health Insurance Fund. The model was administratively complicated, and widely believed to be unfair. The two funding agencies were giving conflicting types of financial incentives. Most important, the funding methods gave few incentives or rewards for service improvement. In some respects, the incentives were perverse (such as the encouragement of hospital admission by the National Health Insurance Fund). A new funding model was developed through statistical analysis of data from routine service reports and opinions questionnaires. As noted above, there are components relating to per capita needs for care, capital assets, distance

The 'polypill' to reduce cardiovascular risk

DEFF Research Database (Denmark)

Patel, Vinod; Pedersen, Oluf; Morrissey, John

2004-01-01

This article considers data from the Steno-2 multifactorial intervention study in type 2 diabetes to which are applied the United Kingdom Prospective Diabetes Study (UKPDS) risk engine. Mathematical analyses support the use of a 'polypill' to reduce cardiovascular risk in type 2 diabetes. It is s...

Benefits from reducing risk of death

Energy Technology Data Exchange (ETDEWEB)

Krupnick, A

1994-07-01

Of the categories of benefits to individuals, reductions in the risk of premature mortality are of central. concern to the public and environmental policy makers. These benefits can include those from reductions in own- risk, for example, an individual's valuation of reducing his or her own mortality risks; reductions in risk to an individual's family, friends, or co-workers (i.e., of people known to the individual); and reductions in risks to unknown individuals. The last type would be an example of altruistic value. The overall goal is to measure the welfare change from a change in the current and/or future probability of dying. The willingness to pay (WTP) reflects the amount of income taken from a person that would leave him or her indifferent to a decrease in risk, whenever it occurs. When this value is divided by the risk change, the resulting value is called the 'value of a statistical life'. Another relevant measure appearing in the literature is the value of life-years saved. A final issue concerns the type of premature mortality risks one is valuing when environmental pollution is at issue. While most effort has gone into estimating the welfare effects of a change in current probability of death of healthy workers on the job, this is more relevant for characterizing the benefits of reducing accidental death risks than death from environmental causes. Exposure to pollutants raises risks of developing cancer, chronic heart, respiratory, and other diseases that raise mortality risks in the future. Such exposure also may raise current death risks for the very old and the sick. But, surely the pollution effect that is analogous to occupational health risks-pollution exposures high enough to raise current risks of death for the healthy, prime-age person-is insignificant in the United States.

Benefits from reducing risk of death

International Nuclear Information System (INIS)

Krupnick, A.

1994-01-01

Of the categories of benefits to individuals, reductions in the risk of premature mortality are of central. concern to the public and environmental policy makers. These benefits can include those from reductions in own- risk, for example, an individual's valuation of reducing his or her own mortality risks; reductions in risk to an individual's family, friends, or co-workers (i.e., of people known to the individual); and reductions in risks to unknown individuals. The last type would be an example of altruistic value. The overall goal is to measure the welfare change from a change in the current and/or future probability of dying. The willingness to pay (WTP) reflects the amount of income taken from a person that would leave him or her indifferent to a decrease in risk, whenever it occurs. When this value is divided by the risk change, the resulting value is called the 'value of a statistical life'. Another relevant measure appearing in the literature is the value of life-years saved. A final issue concerns the type of premature mortality risks one is valuing when environmental pollution is at issue. While most effort has gone into estimating the welfare effects of a change in current probability of death of healthy workers on the job, this is more relevant for characterizing the benefits of reducing accidental death risks than death from environmental causes. Exposure to pollutants raises risks of developing cancer, chronic heart, respiratory, and other diseases that raise mortality risks in the future. Such exposure also may raise current death risks for the very old and the sick. But, surely the pollution effect that is analogous to occupational health risks-pollution exposures high enough to raise current risks of death for the healthy, prime-age person-is insignificant in the United States

Open Payments Data

Data.gov (United States)

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

[Payment mechanisms and financial resources management for consolidation of Ecuador's health system].

Science.gov (United States)

Villacrés, Tatiana; Mena, Ana Cristina

2017-06-08

Analyze the proposal by the Ministry of Public Health to reform the public financing model in Ecuador with regard to pooling of funds and payment mechanisms. A literature review was done of the financing model, the current legal framework, and the budgetary bases in Pubmed, SciELO, LILACS Ecuador, and regional LILACS using the key words health financing, health financing systems, capitation, pooling of funds, health system reform Ecuador, health system Ecuador, and health payment mechanisms. Books and other documents suggested by health systems experts were also included. Review of the financing model enabled identifying the historical segmentation of Ecuador's health system; out of this, the Ministry of Public Health conceived its proposal to reform the financing model. The Ministry's proposed solutions are pooling of funds and payment of services at the first level of care through payment per capita adjusted for socioeconomic and demographic risks. Progress made in reforming the financing model includes design of the proposals and their implementation mechanisms, and discussions with stakeholders. Implementation of these changes may produce improvements for the health system in efficiency, spreading of risks, incentives for meeting health objectives, as well as contribute to its sustainability and advance toward universal health coverage. Nevertheless, legal, political, and operational constraints are hampering their implementation.

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

Science.gov (United States)

2010-04-01

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

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

Science.gov (United States)

2010-10-01

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

The Direct Payments in the European Model of Agriculture

Directory of Open Access Journals (Sweden)

Věra Bečvářová

2008-01-01

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

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

Science.gov (United States)

2010-10-01

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

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

Science.gov (United States)

Maille, Peter; Collins, Alan R

2012-05-30

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

42 CFR 412.521 - Basis of payment.

Science.gov (United States)

2010-10-01

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

Family Physician Readiness for Value-Based Payments: Does Ownership Status Matter?

Science.gov (United States)

Robertson-Cooper, Heidy; Neaderhiser, Bradley; Happe, Laura E; Beveridge, Roy A

2017-10-01

Value-based payments are rapidly replacing fee-for-service arrangements, necessitating advancements in physician practice capabilities and functions. The objective of this study was to examine potential differences among family physicians who are owners versus employed with respect to their readiness for value-based payment models. The authors surveyed more than 550 family physicians from the American Academy of Family Physician's membership; nearly 75% had made changes to participate in value-based payments. However, owners were significantly more likely to report that their practices had made no changes in value-based payment capabilities than employed physicians (owners 35.2% vs. employed 18.1%, P value-based practice capabilities were not as advanced as the employed physician group: (1) quality improvement strategies, (2) human capital investment, and (3) identification of high-risk patients. Specifically, the employed physician group reported more quality improvement strategies, including quality measures, Plan-Do-Study-Act, root cause analysis, and Lean Six Sigma (P value-based payments, consideration of different population health management needs according to ownership status has the potential to support the adoption of value-based care delivery for family physicians.

24 CFR 206.19 - Payment options.

Science.gov (United States)

2010-04-01

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

Effects of payment changes on trends in post-acute care.

Science.gov (United States)

Buntin, Melinda Beeuwkes; Colla, Carrie Hoverman; Escarce, José J

2009-08-01

To test how the implementation of new Medicare post-acute payment systems affected the use of inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs), and home health agencies. Medicare acute hospital, IRF, and SNF claims; provider of services file; enrollment file; and Area Resource File data. We used multinomial logit models to measure realized access to post-acute care and to predict how access to alternative sites of care changed in response to prospective payment systems. A file was constructed linking data for elderly Medicare patients discharged from acute care facilities between 1996 and 2003 with a diagnosis of hip fracture, stroke, or lower extremity joint replacement. Although the effects of the payment systems on the use of post-acute care varied, most reduced the use of the site of care they directly affected and boosted the use of alternative sites of care. Payment system changes do not appear to have differentially affected the severely ill. Payment system incentives play a significant role in determining where Medicare beneficiaries receive their post-acute care. Changing these incentives results in shifting of patients between post-acute sites.

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

Science.gov (United States)

Zweifel, Peter; Frech, H E

2016-02-01

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

Relationship Between Perceived Risk of Falling and Adoption of Precautions to Reduce Fall Risk.

Science.gov (United States)

Blalock, Susan J; Gildner, Paula L; Jones, Jennifer L; Bowling, James M; Casteel, Carri H

2016-06-01

To better understand the relationship between perceived risk of falling and awareness and adoption of four specific precautions that older adults have taken to reduce this risk. Cross-sectional. Data were collected in in-person interviews conducted in the homes of study participants. Interviews conducted between March 2011 and September 2013 and lasted an average of 60-90 minutes. A stratified sampling strategy designed to enroll an equal number of homebound and nonhomebound participants was used. All participants (N = 164) were recruited from central North Carolina. Participants were asked about 1-year fall history, perceived risk of falling, restriction of activities because of fear of falling, awareness of four recommended fall prevention behaviors (exercise, annual medication review, bathroom grab bars, safe footwear), and current practice of these behaviors. In bivariate analyses, individuals who were aware of two behaviors recommended to reduce the risk of falling (exercise, use of safe footwear) and had adopted these behaviors perceived their risk of falling as lower than individuals who were aware of the recommended behaviors but had not adopted them. Moreover, in multivariate analyses, individuals who did not know that exercise is recommended to reduce the risk of falling perceived their risk of falling as lower than those who were aware of this recommendation and had adopted it. Individuals were least likely to be aware that medication reviews and exercise are recommended to reduce fall risk. Awareness of behaviors recommended to reduce fall risk appears necessary for adoption of these behaviors to reduce perceived risk. Fall-prevention campaigns should emphasize behaviors where awareness is low. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Automated patient and medication payment method for clinical trials

Directory of Open Access Journals (Sweden)

Yawn BP

2013-01-01

Full Text Available Barbara P Yawn,1 Suzanne Madison,1 Susan Bertram,1 Wilson D Pace,2 Anne Fuhlbrigge,3 Elliot Israel,3 Dawn Littlefield,1 Margary Kurland,1 Michael E Wechsler41Olmsted Medical Center, Department of Research, Rochester, MN, 2UCDHSC, Department of Family Medicine, University of Colorado Health Science Centre, Aurora, CO, 3Brigham and Women's Hospital, Pulmonary and Critical Care Division, Boston, MA, 4National Jewish Medical Center, Division of Pulmonology, Denver, CO, USABackground: Published reports and studies related to patient compensation for clinical trials focus primarily on the ethical issues related to appropriate amounts to reimburse for patient's time and risk burden. Little has been published regarding the method of payment for patient participation. As clinical trials move into widely dispersed community practices and more complex designs, the method of payment also becomes more complex. Here we review the decision process and payment method selected for a primary care-based randomized clinical trial of asthma management in Black Americans.Methods: The method selected is a credit card system designed specifically for clinical trials that allows both fixed and variable real-time payments. We operationalized the study design by providing each patient with two cards, one for reimbursement for study visits and one for payment of medication costs directly to the pharmacies.Results: Of the 1015 patients enrolled, only two refused use of the ClinCard, requesting cash payments for visits and only rarely a weekend or fill-in pharmacist refused to use the card system for payment directly to the pharmacy. Overall, the system has been well accepted by patients and local study teams. The ClinCard administrative system facilitates the fiscal accounting and medication adherence record-keeping by the central teams. Monthly fees are modest, and all 12 study institutional review boards approved use of the system without concern for patient

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

Directory of Open Access Journals (Sweden)

Ma Cecilia Catubig

2015-11-01

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

Framework for Mobile Payments Integration

DEFF Research Database (Denmark)

Carton, Fergal; Hedman, Jonas; Damsgaard, Jan

2012-01-01

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

Functional neural correlates of reduced physiological falls risk

Directory of Open Access Journals (Sweden)

Hsu Chun

2011-08-01

Full Text Available Abstract Background It is currently unclear whether the function of brain regions associated with executive cognitive processing are independently associated with reduced physiological falls risk. If these are related, it would suggest that the development of interventions targeted at improving executive neurocognitive function would be an effective new approach for reducing physiological falls risk in seniors. Methods We performed a secondary analysis of 73 community-dwelling senior women aged 65 to 75 years old who participated in a 12-month randomized controlled trial of resistance training. Functional MRI data were acquired while participants performed a modified Eriksen Flanker Task - a task of selective attention and conflict resolution. Brain volumes were obtained using MRI. Falls risk was assessed using the Physiological Profile Assessment (PPA. Results After accounting for baseline age, experimental group, baseline PPA score, and total baseline white matter brain volume, baseline activation in the left frontal orbital cortex extending towards the insula was negatively associated with reduced physiological falls risk over the 12-month period. In contrast, baseline activation in the paracingulate gyrus extending towards the anterior cingulate gyrus was positively associated with reduced physiological falls risk. Conclusions Baseline activation levels of brain regions underlying response inhibition and selective attention were independently associated with reduced physiological falls risk. This suggests that falls prevention strategies may be facilitated by incorporating intervention components - such as aerobic exercise - that are specifically designed to induce neurocognitive plasticity. Trial Registration ClinicalTrials.gov Identifier: NCT00426881

24 CFR 983.352 - Vacancy payment.

Science.gov (United States)

2010-04-01

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

Cash for carbon: A randomized trial of payments for ecosystem services to reduce deforestation.

Science.gov (United States)

Jayachandran, Seema; de Laat, Joost; Lambin, Eric F; Stanton, Charlotte Y; Audy, Robin; Thomas, Nancy E

2017-07-21

We evaluated a program of payments for ecosystem services in Uganda that offered forest-owning households annual payments of 70,000 Ugandan shillings per hectare if they conserved their forest. The program was implemented as a randomized controlled trial in 121 villages, 60 of which received the program for 2 years. The primary outcome was the change in land area covered by trees, measured by classifying high-resolution satellite imagery. We found that tree cover declined by 4.2% during the study period in treatment villages, compared to 9.1% in control villages. We found no evidence that enrollees shifted their deforestation to nearby land. We valued the delayed carbon dioxide emissions and found that this program benefit is 2.4 times as large as the program costs. Copyright © 2017 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

Does Metformin Reduce Cancer Risks? Methodologic Considerations.

Science.gov (United States)

Golozar, Asieh; Liu, Shuiqing; Lin, Joeseph A; Peairs, Kimberly; Yeh, Hsin-Chieh

2016-01-01

The substantial burden of cancer and diabetes and the association between the two conditions has been a motivation for researchers to look for targeted strategies that can simultaneously affect both diseases and reduce their overlapping burden. In the absence of randomized clinical trials, researchers have taken advantage of the availability and richness of administrative databases and electronic medical records to investigate the effects of drugs on cancer risk among diabetic individuals. The majority of these studies suggest that metformin could potentially reduce cancer risk. However, the validity of this purported reduction in cancer risk is limited by several methodological flaws either in the study design or in the analysis. Whether metformin use decreases cancer risk relies heavily on the availability of valid data sources with complete information on confounders, accurate assessment of drug use, appropriate study design, and robust analytical techniques. The majority of the observational studies assessing the association between metformin and cancer risk suffer from methodological shortcomings and efforts to address these issues have been incomplete. Future investigations on the association between metformin and cancer risk should clearly address the methodological issues due to confounding by indication, prevalent user bias, and time-related biases. Although the proposed strategies do not guarantee a bias-free estimate for the association between metformin and cancer, they will reduce synthesis of and reporting of erroneous results.

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

Science.gov (United States)

2010-10-01

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

PAYMENT CAPACITY SENSITIVITY FACTORS

Directory of Open Access Journals (Sweden)

Daniel BRÎNDESCU – OLARIU

2014-11-01

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

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

Science.gov (United States)

2010-10-01

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

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

Science.gov (United States)

Nalliah, R P

2017-01-13

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

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

Science.gov (United States)

2010-04-01

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

48 CFR 52.232-32 - Performance-Based Payments.

Science.gov (United States)

2010-10-01

... Contracting Officer, such excess shall be credited as a reduction in the unliquidated performance-based... adjustments. (e) Reduction or suspension of performance-based payments. The Contracting Officer may reduce or... sound and generally accepted accounting principles and practices: (i) Parts, materials, inventories, and...

The Costs of Decedents in the Medicare Program: Implications for Payments to Medicare+Choice Plans

Science.gov (United States)

Buntin, Melinda Beeuwkes; Garber, Alan M; McClellan, Mark; Newhouse, Joseph P

2004-01-01

Objective To discuss and quantify the incentives that Medicare managed care plans have to avoid (through selective enrollment or disenrollment) people who are at risk for very high costs, focusing on Medicare beneficiaries in the last year of life—a group that accounts for more than one-quarter of Medicare's annual expenditures. Data Source Medicare administrative claims for 1994 and 1995. Study Design We calculated the payment a plan would have received under three risk-adjustment systems for each beneficiary in our 1995 sample based on his or her age, gender, county of residence, original reason for Medicare entitlement, and principal inpatient diagnoses received during any hospital stays in 1994. We compared these amounts to the actual costs incurred by those beneficiaries. We then looked for clinical categories that were predictive of costs, including costs in a beneficiary's last year of life, not accounted for by the risk adjusters. Data Extraction Methods The analyses were conducted using claims for a 5 percent random sample of Medicare beneficiaries who died in 1995 and a matched group of survivors. Principal Findings Medicare is currently implementing the Principal Inpatient Diagnostic Cost Groups (PIP-DCG) risk adjustment payment system to address the problem of risk selection in the Medicare+Choice program. We quantify the strong financial disincentives to enroll terminally ill beneficiaries that plans still have under this risk adjustment system. We also show that up to one-third of the selection observed between Medicare HMOs and the traditional fee-for-service system could be due to differential enrollment of decedents. A risk adjustment system that incorporated more of the available diagnostic information would attenuate this disincentive; however, plans could still use clinical information (not included in the risk adjustment scheme) to identify beneficiaries whose expected costs exceed expected payments. Conclusions More disaggregated prospective

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

Science.gov (United States)

2010-04-01

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

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

Science.gov (United States)

2010-10-01

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

PAYMENT SYSTEMS AND THE ROLE OF THE CENTRAL BANK OF ROMANIA

Directory of Open Access Journals (Sweden)

MARIA VASILESCU

2014-05-01

Full Text Available The management of payment and settlement systems is one of the traditional functions of central banks that seeks to ensure financial stability. Similar to the case of other important function, that of lender of last resort, it is wise to ask ourselves whether the central bank is the best institution to manage payment systems. Also, considering the advances in the field, some questions arise: whether or not they contributed to the reduction of systemic risk?, do they bring extra liquidity and stability of the EMU scheme?.

Retail payments and the real economy

OpenAIRE

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

2013-01-01

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

Reducing cancer risk in rural communities through supermarket interventions.

Science.gov (United States)

McCool, Barent N; Lyford, Conrad P; Hensarling, Natalie; Pence, Barbara; McCool, Audrey C; Thapa, Janani; Belasco, Eric; Carter, Tyra M

2013-09-01

Cancer risk is high, and prevention efforts are often minimal in rural communities. Feasible means of encouraging lifestyles that will reduce cancer risk for residents of rural communities are needed. This project developed and tested a model that could be feasibly adopted by rural communities to reduce cancer risk. This model focuses on incorporating multi-faceted cancer risk education in the local supermarket. As the supermarket functions both as the primary food source and an information source in small rural communities, the supermarket focus encourages the development of a community environment supportive of lifestyles that should reduce residents' risk for cancer. The actions taken to implement the model and the challenges that communities would have in implementing the model are identified.

Paying for Payments

DEFF Research Database (Denmark)

Korsgaard, Søren

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

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

Science.gov (United States)

Ginsburg, Paul B

2012-09-01

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

Direct payments as an instrument of the environmental policy

Directory of Open Access Journals (Sweden)

Adrian Sadłowski

2011-01-01

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

A Capacity Payment Model for the Italian Electricity Market. Why It is Needed and How Can It Be Designed?

International Nuclear Information System (INIS)

Gelmini, A.; Benini, M.; Gallanti, M

2007-06-01

The capacity payment model proposed by the Regulatory Authority for the Italian electricity market has been described and its impact has been assessed by means of long-term dynamic simulations. By comparing the simulation results of scenarios with and without the proposed capacity payment models, as well as with a scenario characterized by a fixed-payment model, the following conclusions can be drawn: 1. the proposed capacity payment model is able to sufficiently incentivize investments, so that a satisfactory amount of generation capacity results available over time, keeping the reserve margin substantially over the reference lower limit; 2. the proposed capacity payment model allows to substantially reduce price peaks, thus reducing both the average electricity prices and their volatility; 3. specific costs of the proposed capacity payment model are in the range between 2.5 to 5.5 Euro/MWh along the simulation period; 4. savings in buying energy from the power exchange due to price reductions substantially compensate the 'premium' related costs in the long term: this means that, with the proposed capacity payment model, it is possible to guarantee a better adequacy of the electric system without additional costs; 5. the simulations confirmed that the dynamic behavior of the proposed capacity payment model results in a better timing in providing incentive to investments in new generation capacity when needed, w.r.t. a simple conventional fixed-payment model.

Informal payments and the quality of health care: Mechanisms revealed by Tanzanian health workers.

Science.gov (United States)

Mæstad, Ottar; Mwisongo, Aziza

2011-02-01

Informal payments for health services are common in many transitional and developing countries. The aim of this paper is to investigate the nature of informal payments in the health sector of Tanzania and to identify mechanisms through which informal payments may affect the quality of health care. Our focus is on the effect of informal payments on health worker behaviours, in particular the interpersonal dynamics among health workers at their workplaces. We organised eight focus groups with 58 health workers representing different cadres and levels of care in one rural and one urban district in Tanzania. We found that health workers at all levels receive informal payments in a number of different contexts. Health workers sometimes share the payments received, but only partially, and more rarely within the cadre than across cadres. Our findings indicate that health workers are involved in 'rent-seeking' activities, such as creating artificial shortages and deliberately lowering the quality of service, in order to extract extra payments from patients or to bargain for a higher share of the payments received by their colleagues. The discussions revealed that many health workers think that the distribution of informal payments is grossly unfair. The findings suggest that informal payments can impact negatively on the quality of health care through rent-seeking behaviours and through frustrations created by the unfair allocation of payments. Interestingly, the presence of corruption may also induce non-corrupt workers to reduce the quality of care. Positive impacts can occur because informal payments may induce health workers to increase their efforts, and maybe more so if there is competition among health workers about receiving the payments. Moreover, informal payments add to health workers' incomes and might thus contribute to retention of health workers within the health sector. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

32 CFR 750.9 - Claims: Payments.

Science.gov (United States)

2010-07-01

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

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

Science.gov (United States)

2010-04-01

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

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

Science.gov (United States)

2010-10-01

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

Adoption of Mobile Payment Platforms

DEFF Research Database (Denmark)

Staykova, Kalina Stefanova; Damsgaard, Jan

2016-01-01

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

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

Science.gov (United States)

Poulsen, Camilla Aavang

2014-07-01

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

Kuveyt Türk payment systems technology roadmap

OpenAIRE

Turan, Ayşe

2014-01-01

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

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

Science.gov (United States)

2010-10-01

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

Nutritional strategies to reduce falls risk in older people.

Science.gov (United States)

Nash, Louise; Bergin, Nick

2018-03-23

A literature review found an association between increased falls risk and malnutrition, sarcopenia, vitamin D deficiency and dehydration. Strategies to identify, prevent and treat these conditions can help to reduce falls risk in at-risk groups such as frail, older people. Nurses can reduce falls risk in older people by raising awareness of risk factors and embedding nutritional strategies in local falls reduction strategies. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

Investigating determinants of out-of-pocket spending and strategies for coping with payments for healthcare in southeast Nigeria

Directory of Open Access Journals (Sweden)

Okoronkwo Ijeoma

2010-03-01

Full Text Available Abstract Background Out-of-pocket spending (OOPS is the major payment strategy for healthcare in Nigeria. Hence, the paper assessed the determinants socio-economic status (SES of OOPS and strategies for coping with payments for healthcare in urban, semi-urban and rural areas of southeast Nigeria. This paper provides information that would be required to improve financial accessibility and equity in financing within the public health care system. Methods The study areas were three rural and three urban areas from Ebonyi and Enugu states in South-east Nigeria. Cross-sectional survey using interviewer-administered questionnaires to randomly selected householders was the study tool. A socio-economic status (SES index that was developed using principal components analysis was used to examine levels of inequity in OOPS and regression analysis was used to examine the determinants of use of OOPS. Results All the SES groups equally sought healthcare when they needed to. However, the poorest households were most likely to use low level and informal providers such as traditional healers, whilst the least poor households were more likely to use the services of higher level and formal providers such as health centres and hospitals. The better-off SES more than worse-off SES groups used OOPS to pay for healthcare. The use of own money was the commonest payment-coping mechanism in the three communities. The sales of movable household assets or land were not commonly used as payment-coping mechanisms. Decreasing SES was associated with increased sale of household assets to cope with payment for healthcare in one of the communities. Fee exemptions and subsidies were almost non-existent as coping mechanisms in this study Conclusions There is the need to reduce OOPS and channel and improve equity in healthcare financing by designing and implementing payment strategies that will assure financial risk protection of the poor such pre-payment mechanisms with

Does retirement reduce the risk of myocardial infarction?

DEFF Research Database (Denmark)

Olesen, Kasper; Rugulies, Reiner; Rod, Naja Hulvej

2014-01-01

BACKGROUND: Recent studies have suggested that retirement may have beneficial effects on health outcomes. In this study we examined whether the risk of myocardial infarction (MI) was reduced following retirement in a Danish population sample. METHODS: Participants were 617 511 Danish workers, born...... of 1.11 (95% confidence interval: 1.06, 1.16) when comparing retirees with active workers of the same age. CONCLUSIONS: This study does not support the hypothesis that retirement reduces risk of MI. On the contrary, we find that retirement is associated with a modestly increased risk of MI....

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

Science.gov (United States)

2010-12-16

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

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

Science.gov (United States)

2013-09-27

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

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

Science.gov (United States)

2010-10-01

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

20 CFR 435.22 - Payment.

Science.gov (United States)

2010-04-01

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

41 CFR 302-14.103 - What factors should we consider in determining the amount of a home marketing incentive payment?

Science.gov (United States)

2010-07-01

... intended to reduce your relocation costs. The amount of each home marketing incentive payment you make... consider in determining the amount of a home marketing incentive payment? 302-14.103 Section 302-14.103... TRANSACTION ALLOWANCES 14-HOME MARKETING INCENTIVE PAYMENTS Agency Responsibilities § 302-14.103 What factors...

Integrated care: achieving better coordination of care for the chronically ill. Lessons from The Netherlands bundled-payment initiative.

NARCIS (Netherlands)

Dijk, C. van; Raams, J.; Schut, E.; Baan, C.; Struijs, J.; Vrijhoef, B.; Wildt, J.E. de; Bakker, D. de

2013-01-01

Background: In 2010, a bundled payment system for diabetes care, COPD care and vascular risk management was introduced nationwide in The Netherlands. In the bundled payment system, are for thesepatients is organised by a care group that provides general and more specialised care for the specific

32 CFR 751.13 - Partial payments.

Science.gov (United States)

2010-07-01

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

10 CFR 603.805 - Payment methods.

Science.gov (United States)

2010-01-01

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

Study on payments through mobile phones

Directory of Open Access Journals (Sweden)

Anca Ioana ANDREESCU

2006-01-01

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

31 CFR 203.10 - Electronic payment methods.

Science.gov (United States)

2010-07-01

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

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

Science.gov (United States)

2010-04-01

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

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

Science.gov (United States)

2010-10-01

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

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

Science.gov (United States)

2010-10-04

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

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

Science.gov (United States)

2010-10-06

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

5 CFR 9701.361 - Special skills payments.

Science.gov (United States)

2010-01-01

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

12 CFR 412.11 - Payment guidelines.

Science.gov (United States)

2010-01-01

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

Incentives and provider payment methods.

Science.gov (United States)

Barnum, H; Kutzin, J; Saxenian, H

1995-01-01

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

42 CFR 484.205 - Basis of payment.

Science.gov (United States)

2010-10-01

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

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

Science.gov (United States)

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

2015-08-11

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

A Capacity Payment Model for the Italian Electricity Market. Why It is Needed and How Can It Be Designed?

Energy Technology Data Exchange (ETDEWEB)

Gelmini, A.; Benini, M.; Gallanti, M [CESI RICERCA S.p.A(Italy)

2007-06-15

The capacity payment model proposed by the Regulatory Authority for the Italian electricity market has been described and its impact has been assessed by means of long-term dynamic simulations. By comparing the simulation results of scenarios with and without the proposed capacity payment models, as well as with a scenario characterized by a fixed-payment model, the following conclusions can be drawn: 1. the proposed capacity payment model is able to sufficiently incentivize investments, so that a satisfactory amount of generation capacity results available over time, keeping the reserve margin substantially over the reference lower limit; 2. the proposed capacity payment model allows to substantially reduce price peaks, thus reducing both the average electricity prices and their volatility; 3. specific costs of the proposed capacity payment model are in the range between 2.5 to 5.5 Euro/MWh along the simulation period; 4. savings in buying energy from the power exchange due to price reductions substantially compensate the 'premium' related costs in the long term: this means that, with the proposed capacity payment model, it is possible to guarantee a better adequacy of the electric system without additional costs; 5. the simulations confirmed that the dynamic behavior of the proposed capacity payment model results in a better timing in providing incentive to investments in new generation capacity when needed, w.r.t. a simple conventional fixed-payment model.

7 CFR 1599.6 - Payments.

Science.gov (United States)

2010-01-01

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

7 CFR 1499.6 - Payments.

Science.gov (United States)

2010-01-01

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

Trends in out-of-pocket payments for health care in Kyrgyzstan, 2001-2007.

Science.gov (United States)

Falkingham, Jane; Akkazieva, Baktygul; Baschieri, Angela

2010-09-01

Within the countries of the former Soviet Union, the Kyrgyz Republic has been a pioneer in reforming the system of health care finance. Since the introduction of its compulsory health insurance fund in 1997, the country has gradually moved from subsidizing the supply of services to subsidizing the purchase of services through the 'single payer' of the health insurance fund. In 2002 the government introduced a new co-payment for inpatients along with a basic benefit package. A key objective of the reforms has been to replace the burgeoning system of unofficial informal payments for health care with a transparent official co-payment, thereby reducing the financial burden of health care spending for the poor. This article investigates trends in out-of-pocket payments for health care using the results of a series of nationally representative household surveys conducted over the period 2001-2007, when the reforms were being rolled out. The analysis shows that there has been a significant improvement in financial access to health care amongst the population. The proportion paying state providers for consultations fell between 2004 and 2007. As a result of the introduction of co-payments for hospital care, fewer inpatients report making payments to medical personnel, but when they are made, payments are high, especially to surgeons and anaesthetists. However, although financial access for outpatient care has improved, the burden of health care payments amongst the poor remains significant.

Impact of payment system change from per-case to per-diem on high severity patient's length of stay.

Science.gov (United States)

Jang, Sung-In; Nam, Chung Mo; Lee, Sang Gyu; Kim, Tae Hyun; Park, Sohee; Park, Eun-Cheol

2016-09-01

A new payment system, the diagnosis-related group (DRG) system, and Korean diagnosis procedure combination (KDPC, per-diem) payment system were officially introduced in 2002 and in 2012, respectively. We evaluated the impact of payment system change from per-case to per-diem on high severity patient's length of stay (LOS).Claim data was used. A total of 36,240 case admissions and 72,480 control admissions were included in the analysis. Segmented regression analysis of interrupted time series between cases and controls was conducted. Hospitals that consistently participated in the DRG payment system and changed to the KDPC payment system were defined as case hospitals. Hospitals that consistently participated in the DRG payment system were defined as control hospitals.LOS increased by 0.025 days per month (P = 0.0055) for 3 surgical diagnosis-related admissions due to the bundled payment system change. LOS among emergency admissions also increased and showed an increasing tendency under the KDPC. The LOS increase was observed specifically for complex procedure admissions and high severity cases (CCI 0, 1: 0.022, P = 0.0142; CCI 2, 3: 0.026, P = 0.0288; CCI ≥ 4: 0.055, P = 0.0003).Although both payment systems are optimized to decrease LOS, incentives to reduce LOS are stronger under the DRG system than under the KDPC system. It is worth noting that too strong incentive for reducing LOS is suitable to high severity cases.

Accelerating the Payment of PACE Assessments By Mark Zimring and Merrian Fulle

Energy Technology Data Exchange (ETDEWEB)

Zimring, Mark; Fuller, Merrian

2010-05-04

The 'acceleration' of land-secured assessments allows municipalities to declare the entire value (not just the late payments) of a property owner's outstanding balance payable if a default occurs. State laws vary on whether acceleration is required, permitted, or prohibited. Acceleration can be attractive to bond investors because it strips out non-performing assessments, and may avoid delays in debt service payments to investors. The risk that non-acceleration will negatively impact bond investors is a particular issue in states without a process for rapidly resolving defaults. However, acceleration may also increase the risk to mortgage holders, as the full amount of the outstanding assessment becomes due and traditionally has priority over other lien holders. Acceleration also places a greater burden on the property owner.

Breast cancer after bilateral risk-reducing mastectomy

DEFF Research Database (Denmark)

Skytte, A-B; Crüger, Dorthe Gylling; Gerster, M

2011-01-01

This study aims to evaluate the incidence of breast cancer after risk-reducing mastectomy (RRM) in healthy BRCA mutation carriers. This study is a long-term follow-up of 307 BRCA mutation carriers of whom 96 chose RRM. None of the study participants had a previous history of breast or ovarian...... cancer nor had they undergone RRM or risk-reducing bilateral salpingo-oophorectomy (BSO) prior to the time of BRCA testing. The annual incidence of post-mastectomy breast cancer was 0.8% compared with 1.7% in the non-operated group. Implications of these findings in relation to genetic counseling...

Impact of the Japanese Diagnosis Procedure Combination-based Payment System on cardiovascular medicine-related costs.

Science.gov (United States)

Yasunaga, Hideo; Ide, Hiroo; Imamura, Tomoaki; Ohe, Kazuhiko

2005-09-01

In 2003, a lump-sum payment system based on Diagnosis Procedure Combinations (DPC) was introduced to 82 specific function hospitals in Japan. While the US DRG/PPS system is a "per case payment" system, the DPC based payment system adopts a "per day payment." It is generally believed that the Japanese system provides as much of an incentive as the DRG/PPS system to shorten the average length of stay (LOS). We performed an empirical analysis of the effect of LOS shortening on hospital revenue and expenditure under the DPC-based payment system, particularly in cardiovascular diseases. We also point out fundamentally controversial aspects of the current system. A total 109 cases were selected from patients hospitalized at the University of Tokyo Hospital from May to July, 2003 and classified into one of three categories: (1) cardiac catheter interventions, (2) cardiac catheter examinations, and (3) other conservative treatments. We analyzed the changes in profit per day in cases of a reduction in average LOS and an increase in the number of cases. In category (1) profit increased significantly in conjunction with reduced LOS. In category (2) profit increased only minimally. In category (3), profit increased rarely and sometimes decreased. In cases of conservative treatment, profits sometimes decreased because an increase in material costs exceeded the increase in revenue. It therefore became clear that the DPC-based payment system does not decisively provide an economic incentive to reduce LOS in cardiovascular medicine.

Abrechnung mobiler Dienste im Mobile-Payment-Referenzmodell

OpenAIRE

Pousttchi, Key; Wiedemann, Dietmar Georg

2005-01-01

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

Paying for payments: free payments and optimal interchange fees

OpenAIRE

Korsgaard, Søren

2014-01-01

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

Breastfeeding Reduces Childhood Obesity Risks.

Science.gov (United States)

Wang, Liang; Collins, Candice; Ratliff, Melanie; Xie, Bin; Wang, Youfa

2017-06-01

The present study examined the effects of breastfeeding and its duration on the development of childhood obesity from 24 months through grade 6. U.S. longitudinal data collected from 1234 children were analyzed using logistic regression models and generalized estimating equation (GEE). Child height and weight were measured six times at ages of 24 months, 36 months, 54 months, grade 1, grade 3, and grade 6. During the early 1990s, prevalence of breastfeeding was low in the United States, 60% and 48% at 1 and 6 months, respectively. Nonsmoking, white, married mothers with both parents in the household, and with income above the poverty line, were more likely to breastfeed at 1 month of age of their babies. Obesity rate of the children increased with age from 24 months to grade 6. Logistic regression showed that breastfeeding at month 1 was associated with 53% (odds ratio [OR]: 0.47, 95% confidence interval [CI]: 0.30-0.73) and 47% (OR: 0.53, 95% CI: 0.36-0.78) decreased risks for childhood obesity at grades 1 and 6, respectively. GEE analysis showed that breastfeeding at 1 month reduced risk for childhood obesity by 36% (95% CI: 0.47-0.88) from ages 24 months through grade 6. Regarding breastfeeding duration, more than 6 months (vs. never) was associated with a decreased risk for childhood obesity by 42% (OR: 0.58, 95% CI: 0.36-0.94). Breastfeeding at 1 month and more than 6 months reduced the risk of childhood obesity. Rate of breastfeeding was low in the United States in the 1990s, which may have had long-term implications on children.

Heart Attack Payment - Hospital

Data.gov (United States)

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

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

Science.gov (United States)

Bell, Andrew; Zhang, Wei

2016-11-01

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

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

Science.gov (United States)

2010-04-01

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

Heart Attack Payment - National

Data.gov (United States)

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

Heart Attack Payment - State

Data.gov (United States)

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

Medicare payments to the neurology workforce in 2012.

Science.gov (United States)

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

2015-04-28

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

Alternative models for carbon payments to communities under REDD+: A comparison using the Polis model of actor inducements

NARCIS (Netherlands)

Skutsch, Margaret; Vickers, Ben; Georgiadou, P.Y.; McCall, M.K.

2011-01-01

Many tropical developing countries are considering using a form of Payments for Environmental Services (PES) to reward communities involved in Community Forest Management (CFM) for reducing carbon emissions and increasing carbon sequestration. Such payments would fall under the scope of national

7 CFR 760.209 - Livestock payment calculations.

Science.gov (United States)

2010-01-01

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

Social intervention and risk reduction - indirect countermeasures

International Nuclear Information System (INIS)

Higgins, N.A.; Morrey, M.

1996-01-01

An indirect countermeasure (IC) is an action which is intended to mitigate detrimental effects experienced by individuals or the community after an accident. Indirect countermeasures (ICs) achieve this, both by averting radiation risks arising from the accident, but by removing or reducing other risks and sources of stress or harm to which the community may be subject. ICs naturally fall into two categories: social action ICs, which range from introducing compensation payments to providing information centres; and risk reducing ICs which mitigate risks to which the population might be exposed, such as radon. By including a consideration of ICs in an assessment of the optimal response, it is likely that a decision maker will become aware of a greater range of harms and benefits that might result from the application of a countermeasure. The decision maker will then be in a better position to judge the appropriateness of any action. (author)

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

International Nuclear Information System (INIS)

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

2009-01-01

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

Higher Magnitude Cash Payments Improve Research Follow-up Rates Without Increasing Drug Use or Perceived Coercion

Science.gov (United States)

Festinger, David S.; Marlowe, Douglas B.; Dugosh, Karen L.; Croft, Jason R.; Arabia, Patricia L.

2008-01-01

In a prior study (Festinger et al., 2005) we found that neither the mode (cash vs. gift card) nor magnitude ($10, $40, or $70) of research follow-up payments increased rates of new drug use or perceptions of coercion. However, higher payments and payments in cash were associated with better follow-up attendance, reduced tracking efforts, and improved participant satisfaction with the study. The present study extended those findings to higher payment magnitudes. Participants from an urban outpatient substance abuse treatment program were randomly assigned to receive $70, $100, $130, or $160 in either cash or a gift card for completing a follow-up assessment at 6 months post-admission (n ≅ 50 per cell). Apart from the payment incentives, all participants received a standardized, minimal platform of follow-up efforts. Findings revealed that neither the magnitude nor mode of payment had a significant effect on new drug use or perceived coercion. Consistent with our previous findings, higher payments and cash payments resulted in significantly higher follow-up rates and fewer tracking calls. In addition participants receiving cash vs. gift cards were more likely to use their payments for essential, non-luxury purchases. Follow-up rates for participants receiving cash payments of $100, $130, and $160 approached or exceeded the FDA required minimum of 70% for studies to be considered in evaluations of new medications. This suggests that the use of higher magnitude payments and cash payments may be effective strategies for obtaining more representative follow-up samples without increasing new drug use or perceptions of coercion. PMID:18395365

Survey of electronic payment methods and systems

NARCIS (Netherlands)

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

1996-01-01

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

Health-Based Capitation Risk Adjustment in Minnesota Public Health Care Programs

Science.gov (United States)

Gifford, Gregory A.; Edwards, Kevan R.; Knutson, David J.

2004-01-01

This article documents the history and implementation of health-based capitation risk adjustment in Minnesota public health care programs, and identifies key implementation issues. Capitation payments in these programs are risk adjusted using an historical, health plan risk score, based on concurrent risk assessment. Phased implementation of capitation risk adjustment for these programs began January 1, 2000. Minnesota's experience with capitation risk adjustment suggests that: (1) implementation can accelerate encounter data submission, (2) administrative decisions made during implementation can create issues that impact payment model performance, and (3) changes in diagnosis data management during implementation may require changes to the payment model. PMID:25372356

Proof of payment for all reimbursement claims

CERN Multimedia

HR Department

2006-01-01

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

Reducing cardiovascular risk : protecting the kidney

NARCIS (Netherlands)

Dobre, Daniela; Lambers Heerspink, Hiddo J.; de Zeeuw, Dick

2009-01-01

Progressive decline of renal function in chronic kidney disease (CKD), measured by a reduced glomerular filtration rate or albuminuria, is linked to an increased risk of cardiovascular (CV) disease. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs), most

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

Science.gov (United States)

Chen, Wen-Yi; Lin, Yu-Hui

2008-06-01

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

Third-party online payment solutions in China

OpenAIRE

Yang, Qian

2017-01-01

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

Specialty Payment Model Opportunities and Assessment

Science.gov (United States)

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

2015-01-01

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

Shifting Away From Fee-For-Service: Alternative Approaches to Payment in Gastroenterology.

Science.gov (United States)

Patel, Kavita; Presser, Elise; George, Meaghan; McClellan, Mark

2016-04-01

Fee-for-service payments encourage high-volume services rather than high-quality care. Alternative payment models (APMs) aim to realign financing to support high-value services. The 2 main components of gastroenterologic care, procedures and chronic care management, call for a range of APMs. The first step for gastroenterologists is to identify the most important conditions and opportunities to improve care and reduce waste that do not require financial support. We describe examples of delivery reforms and emerging APMs to accomplish these care improvements. A bundled payment for an episode of care, in which a provider is given a lump sum payment to cover the cost of services provided during the defined episode, can support better care for a discrete procedure such as a colonoscopy. Improved management of chronic conditions can be supported through a per-member, per-month (PMPM) payment to offer extended services and care coordination. For complex chronic conditions such as inflammatory bowel disease, in which the gastroenterologist is the principal care coordinator, the PMPM payment could be given to a gastroenterology medical home. For conditions in which the gastroenterologist acts primarily as a consultant for primary care, such as noncomplex gastroesophageal reflux or hepatitis C, a PMPM payment can support effective care coordination in a medical neighborhood delivery model. Each APM can be supplemented with a shared savings component. Gastroenterologists must engage with and be early leaders of these redesign discussions to be prepared for a time when APMs may be more prevalent and no longer voluntary. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

28 CFR 74.12 - Order of payment.

Science.gov (United States)

2010-07-01

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

Model Checking a Client-Side Micro Payment Protocol

NARCIS (Netherlands)

Chaudhary, Kaylash; Fehnker, Ansgar

2016-01-01

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

Online Behavior and Loyalty Program Participation-parameters Influencing the Acceptance of Contactless Payment Devices

OpenAIRE

Martin Fiedler; Ali Öztüren

2014-01-01

This study explores the central perceptions of consumers influencing the decision to use contactless payment instruments. Aim is to define a customer core group narrowed down by several variables and to find a basis for a purposeful communication of advantages of the new payment process, as investment into this technology bears the risk of total loss if the customer group is declining acceptance and the image of a company might be excessively damaged. External variables in context with the us...

Self-reported illness and household strategies for coping with health-care payments in Bangladesh

Science.gov (United States)

Gilmour, Stuart; Saito, Eiko; Sultana, Papia; Shibuya, Kenji

2013-01-01

Abstract Objective To investigate self-reported illness and household strategies for coping with payments for health care in a city in Bangladesh. Methods A cluster-sampled probability survey of 1593 households in the city of Rajshahi, Bangladesh, was conducted in 2011. Multilevel logistic regression – with adjustment for any clustering within households – was used to examine the risk of self-reported illness in the previous 30 days. A multilevel Poisson regression model, with adjustment for clustering within households and individuals, was used to explore factors potentially associated with the risk of health-care-related “distress” financing (e.g. paying for health care by borrowing, selling, reducing food expenditure, removing children from school or performing additional paid work). Findings According to the interviewees, about 45% of the surveyed individuals had suffered at least one episode of illness in the previous 30 days. The most frequently reported illnesses among children younger than 5 years and adults were common tropical infections and noncommunicable diseases, respectively. The risks of self-reported illness in the previous 30 days were relatively high for adults older than 44 years, women and members of households in the poorest quintile. Distress financing, which had been implemented to cover health-care payments associated with 13% of the reported episodes, was significantly associated with heart and liver disease, asthma, typhoid, inpatient care, the use of public outpatient facilities, and poverty at the household level. Conclusion Despite the subsidization of public health services in Bangladesh, high prevalences of distress financing – and illness – were detected in the surveyed, urban households. PMID:24052682

46 CFR 282.30 - Payment of subsidy.

Science.gov (United States)

2010-10-01

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

46 CFR 252.40 - Payment of subsidy.

Science.gov (United States)

2010-10-01

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

Bundled payment and enhanced recovery after surgery.

Science.gov (United States)

Huang, Jeffrey

2015-01-01

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

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

Directory of Open Access Journals (Sweden)

Czyżewski Andrzej

2016-12-01

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

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

International Nuclear Information System (INIS)

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

2017-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2017-11-01

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

Payments to the Lab

Science.gov (United States)

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

20 CFR 627.430 - Grant payments.

Science.gov (United States)

2010-04-01

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

42 CFR 408.65 - Payment options.

Science.gov (United States)

2010-10-01

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

47 CFR 27.1186 - Payment issues.

Science.gov (United States)

2010-10-01

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

Business risks, functions, methods of assessment and ways to reduce risk

Directory of Open Access Journals (Sweden)

A.V. Mihalchuk

2015-06-01

Full Text Available For successful existence in a market economy entrepreneur have to take bold actions, and this increases the risk. The article describes the concept of entrepreneurship and business risk, positive and negative aspects of functions of risk in business. Therefore, it is necessary to assess the risk properly and be able to manage it to achieve the most effective results in the market. In market conditions the problem of assessing and accounting market becomes independent theoretical and practical significance as an important component of the theory and practice of management. Risk - a key element of business activities. Development of risk situations can lead to both the occurrence of adverse effects (losses, lost profits, and positive results for a company in the form of increased profit. This article describes: the concept of entrepreneurship, risk and business risks, characteristic of positive and negative aspects of risk functions in business, methods of assessment and risk reduction, shows formulae and examples you can use to assess risk in an enterprise. Analyzing already established methods of risk assessment a number of rules were proposed in order to reduce business risk.

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

Science.gov (United States)

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

2013-12-01

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

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

OpenAIRE

Heng, Stefan

2007-01-01

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

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

Science.gov (United States)

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

2018-06-01

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

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

Science.gov (United States)

Hanning, Brian W T

2005-02-01

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

42 CFR 460.182 - Medicaid payment.

Science.gov (United States)

2010-10-01

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

5 CFR 1655.14 - Loan payments.

Science.gov (United States)

2010-01-01

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

Characteristics of Mobile Payment Procedures

OpenAIRE

Kreyer, Nina; Pousttchi, Key; Turowski, Klaus

2002-01-01

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

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

Science.gov (United States)

2010-10-01

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

Cash and Payments Management Data

Data.gov (United States)

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

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

OpenAIRE

Singh Sambhy, Gurpreet

2014-01-01

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

Periodontal disease with treatment reduces subsequent cancer risks.

Science.gov (United States)

Hwang, Ing-Ming; Sun, Li-Min; Lin, Cheng-Li; Lee, Chun-Feng; Kao, Chia-Hung

2014-10-01

The aim of our study was to evaluate the relationship between routine treatment of periodontal disease (PD) and the subsequent risks for cancers in Taiwan. Study participants were selected from the Taiwan National Health Insurance (NHI) system database. The PD with a routine treatment cohort contained 38 902 patients. For each treatment cohort participant, two age- and sex-matched comparison (control) cohort participants were randomly selected. Cox's proportional hazards regression analysis was used to estimate the effects of PD with treatment on the subsequent risk of cancer. The overall risk of developing cancer was significantly lower in the treatment cohort than in the patients without treatment (adjusted Hazard ratio = 0.72, 95% confidence interval = 0.68-0.76). The risks of developing most gastrointestinal tract, lung, gynecological and brain malignancies were significantly lower in the treatment cohort than in the comparison cohort. In contrast, the risks of prostate and thyroid cancers were significantly higher in the treatment cohort than in the comparison cohort. Our findings suggest that PD with treatment is associated with a significantly reduced overall risk of cancer and reduced risks of certain types of cancers. © The Author 2014. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The Impact of New Payment Models on Quality of Diabetes Care and Outcomes.

Science.gov (United States)

McGinley, Erin L; Gabbay, Robert A

2016-06-01

Historic changes in healthcare reimbursement and payment models due to the Affordable Care Act in the United States have the potential to transform how providers care for chronic diseases such as diabetes. Payment experimentation has provided insights into how changing incentives for primary care providers can yield improvements in the triple aim: improving patient experience, improving the health of populations, and reducing costs of healthcare. Much of this has involved leveraging widespread adoption of the patient-centered medical home (PCMH) with diabetes often the focus. While evidence is mounting that the PCMH can improve diabetes outcomes, some PCMH demonstrations have displayed mixed results. One of the first large-scale PCMH demonstrations developed around diabetes was conducted by the Commonwealth of Pennsylvania. Different payment models were employed across a series of staggered regional rollouts that provided a case study for the influence of innovative payment models. These learning laboratories provide insights into the role of reimbursement models and changes in how practice transformation is implemented. Ultimately, evolving payment systems focused on the total cost of care, such as Accountable Care Organizations, hold promise to transform diabetes care and produce significant cost savings through the prevention of complications.

41 CFR 51-5.7 - Payments.

Science.gov (United States)

2010-07-01

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

20 CFR 410.501 - Payment periods.

Science.gov (United States)

2010-04-01

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

5 CFR 1620.35 - Loan payments.

Science.gov (United States)

2010-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2016-01-01

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

Medicare Provider Payment Data - Home Health Agencies

Data.gov (United States)

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

An Investigation of Digital Payment Platform Designs

DEFF Research Database (Denmark)

Kazan, Erol; Damsgaard, Jan

2014-01-01

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

Regional impacts of abolishing direct payments

DEFF Research Database (Denmark)

Uthes, Sandra; Priorr, Annette; Zander, Peter

2011-01-01

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

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

OpenAIRE

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

2011-01-01

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

Informal Patient Payments and Bought and Brought Goods in the Western Balkans – A Scoping Review

Directory of Open Access Journals (Sweden)

Sofie Buch Mejsner

2017-11-01

Full Text Available Introduction Informal patient payments for healthcare are common in the Western Balkans, negatively affecting public health and healthcare. Aim To identify literature from the Western Balkans on what is known about informal patient payments and bought and brought goods, to examine their effects on healthcare and to determine what actions can be taken to tackle these payments. Methods After conducting a scoping review that involved searching websites and databases and filtering with eligibility criteria and quality assessment tools, 24 relevant studies were revealed. The data were synthesized using a narrative approach that identified key concepts, types of evidence, and research gaps. Results The number of studies of informal patient payments increased between 2002 and 2015, but evidence regarding the issues of concern is scattered across various countries. Research has reported incidents of informal patient payments on a wide scale and has described various patterns and characteristics of these payments. Although these payments have typically been small – particularly to providers in common areas of specialized medicine – evidence regarding bought and brought goods remains limited, indicating that such practices are likely even more common, of greater magnitude and perhaps more problematic than informal patient payments. Only scant research has examined the measures that are used to tackle informal patient payments. The evidence indicates that legalizing informal patient payments, introducing performance-based payment systems, strengthening reporting, changing mentalities and involving the media and the European Union (EU or religious organizations in anti-corruption campaigns are understood as some of the possible remedies that might help reduce informal patient payments. Conclusion Despite comprehensive evidence regarding informal patient payments, data remain scattered and contradictory, implying that informal patient payments are a

45 CFR 34.7 - Payment procedures.

Science.gov (United States)

2010-10-01

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

7 CFR 920.112 - Late payments.

Science.gov (United States)

2010-01-01

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

Medicaid Disproportionate Share Hospital Payments

Data.gov (United States)

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

The efficiency of asset management strategies to reduce urban flood risk.

Science.gov (United States)

ten Veldhuis, J A E; Clemens, F H L R

2011-01-01

In this study, three asset management strategies were compared with respect to their efficiency to reduce flood risk. Data from call centres at two municipalities were used to quantify urban flood risks associated with three causes of urban flooding: gully pot blockage, sewer pipe blockage and sewer overloading. The efficiency of three flood reduction strategies was assessed based on their effect on the causes contributing to flood risk. The sensitivity of the results to uncertainty in the data source, citizens' calls, was analysed through incorporation of uncertainty ranges taken from customer complaint literature. Based on the available data it could be shown that increasing gully pot blockage is the most efficient action to reduce flood risk, given data uncertainty. If differences between cause incidences are large, as in the presented case study, call data are sufficient to decide how flood risk can be most efficiently reduced. According to the results of this analysis, enlargement of sewer pipes is not an efficient strategy to reduce flood risk, because flood risk associated with sewer overloading is small compared to other failure mechanisms.

Genesis and Evolution of Digital Payment Platforms

DEFF Research Database (Denmark)

Hjelholt, Morten; Damsgaard, Jan

2012-01-01

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

24 CFR 2002.15 - Advance payments.

Science.gov (United States)

2010-04-01

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

14 CFR 1206.704 - Advance payments.

Science.gov (United States)

2010-01-01

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

Evaluating shielding effectiveness for reducing space radiation cancer risks

International Nuclear Information System (INIS)

Cucinotta, Francis A.; Kim, Myung-Hee Y.; Ren, Lei

2006-01-01

We discuss calculations of probability distribution functions (PDF) representing uncertainties in projecting fatal cancer risk from galactic cosmic rays (GCR) and solar particle events (SPE). The PDFs are used in significance tests for evaluating the effectiveness of potential radiation shielding approaches. Uncertainties in risk coefficients determined from epidemiology data, dose and dose-rate reduction factors, quality factors, and physics models of radiation environments are considered in models of cancer risk PDFs. Competing mortality risks and functional correlations in radiation quality factor uncertainties are included in the calculations. We show that the cancer risk uncertainty, defined as the ratio of the upper value of 95% confidence interval (CI) to the point estimate is about 4-fold for lunar and Mars mission risk projections. For short-stay lunar missions ( 180d) or Mars missions, GCR risks may exceed radiation risk limits that are based on acceptable levels of risk. For example, the upper 95% CI exceeding 10% fatal risk for males and females on a Mars mission. For reducing GCR cancer risks, shielding materials are marginally effective because of the penetrating nature of GCR and secondary radiation produced in tissue by relativistic particles. At the present time, polyethylene or carbon composite shielding cannot be shown to significantly reduce risk compared to aluminum shielding based on a significance test that accounts for radiobiology uncertainties in GCR risk projection

32 CFR 756.7 - Payment.

Science.gov (United States)

2010-07-01

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

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

Science.gov (United States)

2010-04-01

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

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

Science.gov (United States)

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

2006-10-14

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

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

OpenAIRE

Yang, Ning

2016-01-01

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

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

Science.gov (United States)

2010-11-24

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

Financial Technologies: A Note on Mobile Payment

Directory of Open Access Journals (Sweden)

Song Yee Leng

2018-02-01

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

Financial Technologies: A Note on Mobile Payment

Directory of Open Access Journals (Sweden)

Song Yee Leng

2018-02-01

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

Retail payments in the Netherlands : Facts and theory

NARCIS (Netherlands)

Bolt, Wilko

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

Risk-reducing mastectomy for the prevention of primary breast cancer.

Science.gov (United States)

Carbine, Nora E; Lostumbo, Liz; Wallace, Judi; Ko, Henry

2018-04-05

Recent progress in understanding the genetic basis of breast cancer and widely publicized reports of celebrities undergoing risk-reducing mastectomy (RRM) have increased interest in RRM as a method of preventing breast cancer. This is an update of a Cochrane Review first published in 2004 and previously updated in 2006 and 2010. (i) To determine whether risk-reducing mastectomy reduces death rates from any cause in women who have never had breast cancer and in women who have a history of breast cancer in one breast, and (ii) to examine the effect of risk-reducing mastectomy on other endpoints, including breast cancer incidence, breast cancer mortality, disease-free survival, physical morbidity, and psychosocial outcomes. For this Review update, we searched Cochrane Breast Cancer's Specialized Register, MEDLINE, Embase and the WHO International Clinical Trials Registry Platform (ICTRP) on 9 July 2016. We included studies in English. Participants included women at risk for breast cancer in at least one breast. Interventions included all types of mastectomy performed for the purpose of preventing breast cancer. At least two review authors independently abstracted data from each report. We summarized data descriptively; quantitative meta-analysis was not feasible due to heterogeneity of study designs and insufficient reporting. We analyzed data separately for bilateral risk-reducing mastectomy (BRRM) and contralateral risk-reducing mastectomy (CRRM). Four review authors assessed the methodological quality to determine whether or not the methods used sufficiently minimized selection bias, performance bias, detection bias, and attrition bias. All 61 included studies were observational studies with some methodological limitations; randomized trials were absent. The studies presented data on 15,077 women with a wide range of risk factors for breast cancer, who underwent RRM.Twenty-one BRRM studies looking at the incidence of breast cancer or disease-specific mortality, or

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

Science.gov (United States)

2011-06-09

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

Dynamic Rule Encryption for Mobile Payment

Directory of Open Access Journals (Sweden)

Emir Husni

2017-01-01

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

ELECTRONIC PAYMENT SYSTEM AND ITS PROTECTION

Directory of Open Access Journals (Sweden)

Miroslav Milutinovic

2015-01-01

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

[Strategies for reducing risks in smoking: opportunity or threat].

Science.gov (United States)

Córdoba, Rodrigo; Nerín, Isabel

2009-12-01

The smoking control policies recommended by the World Health Organisation have achieved a slight decrease in smoking prevalence in the developed countries, although associated mortality is still very high. The use of tobacco products other than cigarettes and even medicinal nicotine (known as nicotine replacement therapy (NRT)) has been proposed as a risk reduction strategy. Among the tobacco products with less individual risk than cigarettes would be any type of tobacco without smoke (smokeless) with a low content in nitrosamines and modified cigarettes; both forms included under the PREP (Potentially Reduced Exposure Products) concept. The idea would be to promote these products among those who cannot quit smoking or wish to reduce their risk without giving up nicotine intake. The possible effects of risk reduction strategies, including PREP, on the decreased prevalence and morbidity and mortality are reviewed, and the possible implications that this measure could have in our country are analysed. Tobacco control measures in Spain are recent and still insufficient. Therefore, the current priority in Spain is the development of policies of control that have shown to more than effective. The marketing and advertising of new tobacco products, even with reduced potential risk, seems more a serious threat than an opportunity for the development of smoking control policies.

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

Science.gov (United States)

2016-11-04

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

Congestion and cascades in payment systems

Science.gov (United States)

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

2007-10-01

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

Health and safety implications of recruitment payments in migrant construction workers

Science.gov (United States)

Hassan, H. A.

2014-01-01

Background The Middle East construction sector is heavily reliant on a migrant workforce that predominantly originates from South Asia. It is common practice for migrant construction workers to pay a local labour recruiter the equivalent of one or more years’ prospective overseas salary to secure employment, work and travel permits and transportation. The occupational health and safety implications of these financial arrangements remain unexplored. Aims To examine associations between payment to a labour recruiter, perceived general health and worksite accidents among migrant construction workers in the Middle East. Methods A questionnaire was completed by a convenience sample of predominantly Indian migrant construction workers drawn from a large construction project. The relationship between payment and risk of poor health and workplace accidents was assessed using multivariate logistic regression models (crude and adjusted for socio-demographic and occupational factors). Results There were 651 participants. The majority (58%) of migrant construction workers had paid a labour recruiter and ~40% had experienced a worksite accident. Between 3% (labourers) and 9% (foremen) perceived their health to be poor. Labourers and skilled workers who had paid a labour recruiter were significantly more likely to have experienced a worksite accident in the previous 12 months. Skilled workers, but not labourers and foremen, who had paid a labour recruiter were at increased risk of poor health. Conclusions The mechanisms linking labour recruiter payments to adverse safety and health outcomes warrant investigation with a view to developing interventions to erode these links. PMID:24668316

Payment Reform to Enhance Collaboration of Primary Care and Cardiology: A Review.

Science.gov (United States)

Farmer, Steven A; Casale, Paul N; Gillam, Linda D; Rumsfeld, John S; Erickson, Shari; Kirschner, Neil M; de Regnier, Kevin; Williams, Bruce R; Martin, R Shawn; McClellan, Mark B

2018-01-01

The US health care system faces an unsustainable trajectory of high costs and inconsistent outcomes. The fee-for-service payment model has contributed to inefficiency, and new payment methods are a promising approach to improving value. Health reforms are needed to increase patient access, reduce costs, and improve health care quality, and the landmark Medicare Access and CHIP Reauthorization Act presents a roadmap for reform. The product of a collaboration between primary care and cardiology clinicians, this review describes a conceptual approach to delivery and payment reforms that aim to better support primary care-cardiology comanagement of chronic cardiovascular disease (CVD). Few existing alternative payment models specifically address long-term management of CVD. Primary care medical homes and accountable care organizations come closest, but both emphasize primary care, and cardiologists have often not been well engaged. A collaborative care framework should articulate distinct roles and responsibilities for primary care and cardiology in CVD comanagement. Finally, a series of payment models aim to better support clinicians in providing accountable, seamless, and patient-centered cardiac care. Clinical leadership is essential during this time of change in the health care system. Patients often struggle to navigate a fragmented and expensive system, whereas clinicians often practice with incomplete information about tests, treatments, and recommendations by their colleagues. The payment models described in this review offer an opportunity to create more satisfying approaches to patient care while improving value. These models have potential to support more effective coordination and to facilitate broader health care system transformation.

38 CFR 10.51 - Payments to minor child.

Science.gov (United States)

2010-07-01

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

Reducing the Risk of Methadone Overdose

Centers for Disease Control (CDC) Podcasts

2012-07-03

This podcast is based on the July 2012 CDC Vital Signs report. Approximately 14 people die every day of overdoses related to methadone. Listen to learn how to reduce your risk of an overdose.  Created: 7/3/2012 by Centers for Disease Control and Prevention (CDC).   Date Released: 7/3/2012.

M-Payments Issues and Concepts

Directory of Open Access Journals (Sweden)

Cristian TOMA

2012-01-01

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

Communication in reducing facility siting risk

International Nuclear Information System (INIS)

Bisconti, A.S.

1992-01-01

Today, social considerations are as important as technical ones in siting new nuclear facilities. Siting any industrial facility has become extremely difficult in this era of not in my backyard (NIMBY). Even if NIMBY does not arise locally, well-organized national opposition groups can be counted on to step in to fan the flames, especially when the industrial facility has to do with anything nuclear. It is now generally recognized that the greatest risk of failure for new nuclear facilities is not technical but social. Applying lessons gained from past experience and social science research can help reduce that risk. From these lessons, six principles for public interaction and communication stand out: (1) create goodwill now; (2) involve the community early; (3) establish the need; (4) communicate controls, not risk; (5) avoid jargon; (6) understand your public

45 CFR 35.7 - Payment of approved claims.

Science.gov (United States)

2010-10-01

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

40 CFR 10.7 - Payment of approved claim.

Science.gov (United States)

2010-07-01

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

24 CFR 206.26 - Change in payment option.

Science.gov (United States)

2010-04-01

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

42 CFR 102.83 - Payment of all benefits.

Science.gov (United States)

2010-10-01

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

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

Science.gov (United States)

2010-07-19

...] Lunch and Centers Breakfast supper \\1\\ Snack Contingous States: Paid 0.26 0.26 0.06 Reduced Price 1.18 2... adjustments to the national average payment rates for meals and snacks served in child care centers, outside... payment rates for meals and snacks served in day care homes; and the administrative reimbursement rates...

76 FR 41929 - Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors and...

Science.gov (United States)

2011-07-15

... adjustment model, in an annually updated Federal notice of benefit and payment parameters. In addition to the... uncertainty of insurance risk in the individual market by making payments for high- cost cases. The temporary... program is intended to provide adequate payments to health insurance issuers that attract high-risk...

34 CFR 35.7 - Payment of approved claims.

Science.gov (United States)

2010-07-01

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

12 CFR 793.7 - Payment of approved claims.

Science.gov (United States)

2010-01-01

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

34 CFR 5.62 - Advance payment of fees.

Science.gov (United States)

2010-07-01

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

20 CFR 404.1055 - Payments for agricultural labor.

Science.gov (United States)

2010-04-01

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

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

NARCIS (Netherlands)

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

2016-01-01

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

A surety engineering framework to reduce cognitive systems risks.

Energy Technology Data Exchange (ETDEWEB)

Caudell, Thomas P. (University of New Mexico, Albuquerque, NM); Peercy, David Eugene; Caldera, Eva O. (University of New Mexico, Albuquerque, NM); Shaneyfelt, Wendy L.

2008-12-01

Cognitive science research investigates the advancement of human cognition and neuroscience capabilities. Addressing risks associated with these advancements can counter potential program failures, legal and ethical issues, constraints to scientific research, and product vulnerabilities. Survey results, focus group discussions, cognitive science experts, and surety researchers concur technical risks exist that could impact cognitive science research in areas such as medicine, privacy, human enhancement, law and policy, military applications, and national security (SAND2006-6895). This SAND report documents a surety engineering framework and a process for identifying cognitive system technical, ethical, legal and societal risks and applying appropriate surety methods to reduce such risks. The framework consists of several models: Specification, Design, Evaluation, Risk, and Maturity. Two detailed case studies are included to illustrate the use of the process and framework. Several Appendices provide detailed information on existing cognitive system architectures; ethical, legal, and societal risk research; surety methods and technologies; and educing information research with a case study vignette. The process and framework provide a model for how cognitive systems research and full-scale product development can apply surety engineering to reduce perceived and actual risks.

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

Science.gov (United States)

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

2017-06-01

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

Build Your Own Payment Model.

Science.gov (United States)

Berlin, Joey

2017-07-01

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

28 CFR 70.22 - Payment.

Science.gov (United States)

2010-07-01

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

15 CFR 14.22 - Payment.

Science.gov (United States)

2010-01-01

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

Informal payments in the Greek health sector amid the financial crisis: old habits die last...

Science.gov (United States)

Souliotis, Kyriakos; Golna, Christina; Tountas, Yannis; Siskou, Olga; Kaitelidou, Daphne; Liaropoulos, Lycourgos

2016-03-01

Under-the-table informal payments are commonplace as reimbursements for health care services in Greece. As the country faces a severe financial crisis, the need to investigate the extent of such payments, their incidence and their impact on household income is pressing. A survey of 2,741 persons from across the country was conducted between December 2011 and February 2012. The sample was defined via a multistage selection process using a quota for municipality of residence, sex and age. The maximum error margin was 2.41% with a confidence interval of 95%. The survey reports under-the-table payments for approximately 32.4% of public hospital admissions. Private clinics, which display the bulk of out-of-pocket payments, naturally display the lowest under-the-table payments. The highest percentage of under-the-table payments in the private sector appears at visits to private practitioners and dentists (36%). Informal payments are most frequently made upon request, prior to service provision, to facilitate access to care and to reduce waiting times, and at a much lower percentage, to post-service provision, and out of gratitude. This survey reveals that, due to severe financial pressure, there is a growing unwillingness of citizens to pay informally and an increasing demand for these payments as a prerequisite for access to services or to redeem services provided. This "hidden" financial burden of at least 27% impacts negatively on the living conditions of households and is not reported as purchasing ability or cost of living.

48 CFR 32.007 - Contract financing payments.

Science.gov (United States)

2010-10-01

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

The 5 Clinical Pillars of Value for Total Joint Arthroplasty in a Bundled Payment Paradigm.

Science.gov (United States)

Kim, Kelvin; Iorio, Richard

2017-06-01

Our large, urban, tertiary, university-based institution reflects on its 4-year experience with Bundled Payments for Care Improvement. We will describe the importance of 5 clinical pillars that have contributed to the early success of our bundled payment initiative. We are convinced that value-based care delivered through bundled payment initiatives is the best method to optimize patient outcomes while rewarding surgeons and hospitals for adapting to the evolving healthcare reforms. We summarize a number of experiences and lessons learned since the implementation of Bundled Payments for Care Improvement at our institution. Our experience has led to the development of more refined clinical pathways and coordination of care through evidence-based approaches. We have established that the success of the bundled payment program rests on the following 5 main clinical pillars: (1) optimizing patient selection and comorbidities; (2) optimizing care coordination, patient education, shared decision making, and patient expectations; (3) using a multimodal pain management protocol and minimizing narcotic use to facilitate rapid rehabilitation; (4) optimizing blood management, and standardizing venous thromboembolic disease prophylaxis treatment by risk standardizing patients and minimizing the use of aggressive anticoagulation; and (5) minimizing post-acute facility and resource utilization, and maximizing home resources for patient recovery. From our extensive experience with bundled payment models, we have established 5 clinical pillars of value for bundled payments. Our hope is that these principles will help ease the transition to value-based care for less-experienced healthcare systems. Copyright © 2017 Elsevier Inc. All rights reserved.

Payment Procedures for Electronic Government Services

OpenAIRE

Pousttchi, Key; Wiedemann, Dietmar Georg

2005-01-01

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

7 CFR 760.3 - Indemnity payments on milk.

Science.gov (United States)

2010-01-01

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

Electronic Payments Profitability Extent Model

Directory of Open Access Journals (Sweden)

Rudolf Vohnout

2016-12-01

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

Design, monitoring and evaluation of a direct payments approach for an ecotourism strategy to reduce illegal hunting and trade of wildlife in Lao PDR

Science.gov (United States)

Johnson, Arlyne; Duangdala, Sivilay; Hansel, Troy

2018-01-01

Ecotourism as a strategy for achieving biodiversity conservation often results in limited conservation impact relative to its investment and revenue return. In cases where an ecotourism strategy has been used, projects are frequently criticized for not providing sufficient evidence on how the strategy has reduced threats or improved the status of the biodiversity it purports to protect. In Lao PDR, revenue from ecotourism has not been directly linked to or dependent on improvements in biodiversity and there is no evidence that ecotourism enterprises have contributed to conservation. In other developing countries, direct payments through explicit contracts in return for ecosystem services have been proposed as a more cost-effective means for achieving conservation, although further research is needed to evaluate the impact of this approach. To address this need, a new model was tested in the Nam Et-Phou Louey National Protected Area (NPA) in Lao PDR using a direct payments approach to create ecotourism incentives for villagers to increase wildlife populations. Over a four-year period, we monitored along a theory of change to evaluate assumptions about the linkages between intermediate results and biological outcomes. Preliminary results show a negative correlation between ecotourism benefits and hunting infractions in target villages; no increase in hunting sign in the ecotourism sector of the NPA relative to a three-fold increase in hunting sign across the NPA’s non-tourism sectors; and an overall increase in wildlife sightings. This case provides key lessons on the design of a direct payments approach for an ecotourism strategy, including how to combine threat monitoring and data on wildlife sightings to evaluate strategy effectiveness, on setting rates for wildlife sightings and village fees, and the utility of the approach for protecting very rare species. PMID:29489821

Design, monitoring and evaluation of a direct payments approach for an ecotourism strategy to reduce illegal hunting and trade of wildlife in Lao PDR.

Science.gov (United States)

Eshoo, Paul Frederick; Johnson, Arlyne; Duangdala, Sivilay; Hansel, Troy

2018-01-01

Ecotourism as a strategy for achieving biodiversity conservation often results in limited conservation impact relative to its investment and revenue return. In cases where an ecotourism strategy has been used, projects are frequently criticized for not providing sufficient evidence on how the strategy has reduced threats or improved the status of the biodiversity it purports to protect. In Lao PDR, revenue from ecotourism has not been directly linked to or dependent on improvements in biodiversity and there is no evidence that ecotourism enterprises have contributed to conservation. In other developing countries, direct payments through explicit contracts in return for ecosystem services have been proposed as a more cost-effective means for achieving conservation, although further research is needed to evaluate the impact of this approach. To address this need, a new model was tested in the Nam Et-Phou Louey National Protected Area (NPA) in Lao PDR using a direct payments approach to create ecotourism incentives for villagers to increase wildlife populations. Over a four-year period, we monitored along a theory of change to evaluate assumptions about the linkages between intermediate results and biological outcomes. Preliminary results show a negative correlation between ecotourism benefits and hunting infractions in target villages; no increase in hunting sign in the ecotourism sector of the NPA relative to a three-fold increase in hunting sign across the NPA's non-tourism sectors; and an overall increase in wildlife sightings. This case provides key lessons on the design of a direct payments approach for an ecotourism strategy, including how to combine threat monitoring and data on wildlife sightings to evaluate strategy effectiveness, on setting rates for wildlife sightings and village fees, and the utility of the approach for protecting very rare species.

Evolving provider payment models and patient access to innovative medical technology.

Science.gov (United States)

Long, Genia; Mortimer, Richard; Sanzenbacher, Geoffrey

2014-12-01

Abstract Objective: To investigate the evolving use and expected impact of pay-for-performance (P4P) and risk-based provider reimbursement on patient access to innovative medical technology. Structured interviews with leading private payers representing over 110 million commercially-insured lives exploring current and planned use of P4P provider payment models, evidence requirements for technology assessment and new technology coverage, and the evolving relationship between the two topics. Respondents reported rapid increases in the use of P4P and risk-sharing programs, with roughly half of commercial lives affected 3 years ago, just under two-thirds today, and an expected three-quarters in 3 years. All reported well-established systems for evaluating new technology coverage. Five of nine reported becoming more selective in the past 3 years in approving new technologies; four anticipated that in the next 3 years there will be a higher evidence requirement for new technology access. Similarly, four expected it will become more difficult for clinically appropriate but costly technologies to gain coverage. All reported planning to rely more on these types of provider payment incentives to control costs, but didn't see them as a substitute for payer technology reviews and coverage limitations; they each have a role to play. Interviews limited to nine leading payers with models in place; self-reported data. Likely implications include a more uncertain payment environment for providers, and indirectly for innovative medical technology and future investment, greater reliance on quality and financial metrics, and increased evidence requirements for favorable coverage and utilization decisions. Increasing provider financial risk may challenge the traditional technology adoption paradigm, where payers assumed a 'gatekeeping' role and providers a countervailing patient advocacy role with regard to access to new technology. Increased provider financial risk may result in an

Out-of-Pocket and Informal Payment Before and After the Health Transformation Plan in Iran: Evidence from Hospitals Located in Kurdistan, Iran

Directory of Open Access Journals (Sweden)

Bakhtiar Piroozi

2017-10-01

Full Text Available Background One of the objectives of the health transformation plan (HTP in Iran is to reduce out-of-pocket (OOP payments for inpatient services and eradicate informal payments. The HTP has three phases: the first phase (launched in May 5, 2014 is focused on reducing OOP payments for inpatient services; the second phase (launched in May 22, 2014 is focused on primary healthcare (PHC and the third phase utilizes an updated relative value units for health services (launched in September 29, 2014 and is focused on the elimination of informal payments. This aim of this study was to determine the OOP payments and the frequency of informal cash payments to physicians for inpatient services before and after the HTP in Kurdistan province, Iran. Methods This quasi-experimental study used multistage sampling method to select and evaluate 265 patients discharged from hospitals in Kurdistan province. The study covered 3 phases (before the HTP, after the first, and third phases of the HTP. Part of the data was collected using a hospital information system form and the rest were collected using a questionnaire. Data were analyzed using Fisher exact test, logistic regression, and independent samples ttest. Results The mean OOP payments before the HTP and after the first and third phases, respectively, were US$59.4, US$17.6, and US$14.3 in hospital affiliated to the Ministry of Health and Medical Education (MoHME, US$39.6, US$33.7, and US$13.7 in hospitals affiliated to Social Security Organization (SSO, and US$153.3, US$188.7, and US$66.4 in private hospitals. In hospitals affiliated to SSO and MoHME there was a significant difference between the mean OOP payments before the HTP and after the third phase (P < .05. The percentage of informal payments to physicians in hospitals affiliated to MoHME, SSO, and private sector, respectively, were 4.5%, 8.1%, and 12.5% before the HTP, and 0.0%, 7.1%, and 10.0% after the first phase. Contrary to the time before the HTP

Permissible Delay in Payments

Directory of Open Access Journals (Sweden)

Yung-Fu Huang

2007-01-01

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

7 CFR 714.46 - Certification for payment.

Science.gov (United States)

2010-01-01

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

48 CFR 49.112-2 - Final payment.

Science.gov (United States)

2010-10-01

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

The Race to Dominate the Mobile Payments Platform

DEFF Research Database (Denmark)

Staykova, Kalina Stefanova; Damsgaard, Jan

2015-01-01

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

45 CFR 2543.22 - Payment.

Science.gov (United States)

2010-10-01

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

Charging of mobile services by mobile payment reference model

OpenAIRE

Pousttchi, Key; Wiedemann, Dietmar Georg

2005-01-01

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

Design and implementation of Bluetooth beacon in mobile payment system

Science.gov (United States)

Han, Tiantian; Ding, Lei

2017-08-01

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

Reducing the Risks for Contrast-Induced Nephropathy

International Nuclear Information System (INIS)

Stacul, Fulvio

2005-01-01

Contrast-induced nephropathy (CIN) is one of the most serious adverse events associated with the use of contrast media (CM). Patients who develop this complication can have increased morbidity, higher rates of mortality, lengthy hospital stays, and poor long-term outcomes. Although CIN cannot be eliminated, the chances of developing this condition can be reduced by using appropriate prevention strategies. An important first step to reduce the chance of CIN is to identify risk factors associated with this condition. Patients with a previously elevated serum creatinine level, especially when secondary to diabetic nephropathy, are at great risk for developing CIN. Other patient-related risk factors include concurrent use of nephrotoxic medications, dehydration, congestive heart failure, age greater than 70 years, and probably the presence of diabetes mellitus even if serum creatinine is normal. Adequate hydration is widely accepted as an important prophylactic measure for preventing CIN, but the optimal hydration regimen is still debatable. The risk of CIN increases with greater doses of CM, as well as with the type of CM used. A high-osmolar CM poses a greater risk of CIN than does a low-osmolar CM and, as recent but limited data suggest, the use of an iso-osmolar CM is less nephrotoxic than a low-osmolar CM in patients with renal impairment following intra-arterial procedures, although this finding needs to be verified in future clinical studies. Pharmacologic agents such as calcium channel blockers, dopamine, atrial natriuretic peptide, fenoldopam, prostaglandin E1, and endothelin receptor antagonist have not been proven effective against CIN development. Controversies still exist on the possible effectiveness of theophylline and N-acetylcysteine. Simple strategies for the prevention of CIN in at-risk patients are reviewed and unproven interventions are discussed

Towards A Framework of Digital Payment Platform Design

DEFF Research Database (Denmark)

Kazan, Erol; Damsgaard, Jan

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

Contemporary approaches to reducing the risks of central counterparties based on the use of marginal contributions

Directory of Open Access Journals (Sweden)

Utkin Viktor Sergeyevich

2012-07-01

Full Text Available To protect their own interests central counterparties has developed a number of procedures, including payment of guarantee margin by trading members as a means to ensure their positions. This article discusses a number of approaches, which attempt to simulate the risks of the Central Committee, as well as calculating the amount of margin and other resources in the event of insolvency. These approaches are based on the simulation of the three main types: (a statistical modeling; (b optimization modeling, and (c model of option pricing. The author incorporates the basic provisions of models.

40 CFR 66.74 - Payment or reimbursement.

Science.gov (United States)

2010-07-01

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

29 CFR 4.168 - Wage payments-deductions from wages paid.

Science.gov (United States)

2010-07-01

... 29 Labor 1 2010-07-01 2010-07-01 true Wage payments-deductions from wages paid. 4.168 Section 4... Standards Compliance with Compensation Standards § 4.168 Wage payments—deductions from wages paid. (a) The wage requirements of the Act will not be met where unauthorized deductions, rebates, or refunds reduce...

Equal Access to Justice Act Payments

Data.gov (United States)

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

7 CFR 3430.51 - Payment.

Science.gov (United States)

2010-01-01

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

20 CFR 437.21 - Payment.

Science.gov (United States)

2010-04-01

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

Empirical Studies on Cash Payments

NARCIS (Netherlands)

J. Kippers (Jeanine)

2004-01-01

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

Performance Based Supplementary Payment System at University Hospitals in Turkey

Directory of Open Access Journals (Sweden)

Vahit YÝÐÝT

2017-06-01

Results: The result of the analysis has revealed that PBSP system encourage physicians who would like to receive financial incentives. PBSP system supports the individual performance, reduces waiting times in patients, increases revenues and decreases expenditures and increases in efficiency of department. However, this payment system increases work load, number of examinations and provokes the conflict among personals. Conclusions: University hospitals are academic institutions that perform important missions such as research, medical education and health services provision. Therefore, PBSP system should be revised so as to encourage performing these missions at university hospitals. There is also shortage of financial resources at the university hospitals. This situation leads to less additional payments to physicians. [J Contemp Med 2017; 7(2.000: 126-131

THE ADVANTAGES AND DISADVANTAGES OF BITCOIN PAYMENTS IN THE NEW ECONOMY

Directory of Open Access Journals (Sweden)

CARINA-ELENA STEGĂROIU

2018-02-01

Full Text Available In the Internet economy, with the help of cryptography, a branch of mathematics dealing with the security of information, as well as authentication and restriction of access to a computer system, a new digital coin as an alternative to national currencies appeared. In accomplishing this, using both mathematical methods (taking advantage of, for example, the difficulty of factorizing very large numbers, and quantum encryption methods. Throughout the world, information technology companies are focusing on information protection, inventing day-to-day methods with greater durability. In the horizon of Information Security, Quantum Cryptography has emerged, generating new possibilities in that field, hoping that data will be better protected and that the digital currency will resist over time and eventually evolve in the future, although Kurzweil, Bitcoin's pioneering technology is unlikely to be used in this respect. The idea of virtual alternatives to national currencies is not new, with advantages and disadvantages. The advantages of this coin are high payment freedom, transparency of information, high security, reduced risks for traders. Among the disadvantages we highlight the risk and volatility, the lack of notification and understanding, with incomplete functions, but which are developing, so Bitcoin is not perfect.

42 CFR 413.172 - Principles of prospective payment.

Science.gov (United States)

2010-10-01

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

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

NARCIS (Netherlands)

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

2015-01-01

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

Equity in out-of-pocket payments for hospital care: evidence from India.

Science.gov (United States)

Roy, Kakoli; Howard, David Hill

2007-02-01

The lack of formal health insurance and inadequate social safety nets cause families in most low-income countries to finance health spending through out-of-pocket (OOP) payments, leaving poor families unable to insure their consumption during periods of major illnesses. To examine how well the Indian healthcare system protects households of differing living standards against the financial consequences of unanticipated health shocks. The data are drawn from the 52nd round of National Sample Survey, a nationally representative socioeconomic and health survey conducted in 1995-1996. The sample comprises 24,379 (3.84%) households where a member was hospitalized during the 1-year reference period. We estimate, using ordinary least squares, the relationship between household consumption (proxy for ability to pay) and OOP payments for hospitalization. We also estimate the relationship between consumption and OOP share in consumption. Our results indicate that both utilization (payments) and the consequent financial burden (payment share) increases with increasing ability to pay (ATP). While this relationship is retained across the different subgroups (e.g., gender, social code, region, etc.), comparisons across groups indicate horizontal inequities including differences in both degrees of progressivity and the redistributive effect. The finding that OOP payments do not decline with ATP could be an indication of: (1) the lack of insurance which implies that the better-off must pay from OOP to secure quality health care and (2) the absence of risk-pooling or prepayments mechanisms which poses financial impediments to the consumption of health care by the poor.

7 CFR 634.27 - Cost-share payment.

Science.gov (United States)

2010-01-01

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

32 CFR 701.49 - Payment of fees.

Science.gov (United States)

2010-07-01

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

42 CFR 417.536 - Cost payment principles.

Science.gov (United States)

2010-10-01

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

Reducing the harms associated with risk assessments

International Nuclear Information System (INIS)

Montague, Peter

2004-01-01

Risk assessments are the intellectual products of dedicated public health and environmental professionals. Like many other products, risk assessments carry with them the potential for both good and harm. This paper briefly examines some of the harms to which risk assessments have contributed, and then suggests that the legal 'duty to warn' doctrine offers a logical and practical way to reduce some of these harms. The paper suggests concepts that could be incorporated into warnings accompanying every formal risk assessment as routine 'boiler plate' addenda, just as other potentially harmful products, such as lawn mowers and cook stoves, are accompanied by warnings. Finally, the paper briefly examines the 'Code of Ethics and Standards of Practice for Environmental Professionals' (promulgated by the National Association of Environmental Professionals) and shows that the suggested warnings are consistent with recommended practices for environmental professionals

A Secure Operational Model for Mobile Payments

Directory of Open Access Journals (Sweden)

Tao-Ku Chang

2014-01-01

Full Text Available Instead of paying by cash, check, or credit cards, customers can now also use their mobile devices to pay for a wide range of services and both digital and physical goods. However, customers’ security concerns are a major barrier to the broad adoption and use of mobile payments. In this paper we present the design of a secure operational model for mobile payments in which access control is based on a service-oriented architecture. A customer uses his/her mobile device to get authorization from a remote server and generate a two-dimensional barcode as the payment certificate. This payment certificate has a time limit and can be used once only. The system also provides the ability to remotely lock and disable the mobile payment service.

Mitigating flood exposure: Reducing disaster risk and trauma signature.

Science.gov (United States)

Shultz, James M; McLean, Andrew; Herberman Mash, Holly B; Rosen, Alexa; Kelly, Fiona; Solo-Gabriele, Helena M; Youngs, Georgia A; Jensen, Jessica; Bernal, Oscar; Neria, Yuval

2013-01-01

Introduction. In 2011, following heavy winter snowfall, two cities bordering two rivers in North Dakota, USA faced major flood threats. Flooding was foreseeable and predictable although the extent of risk was uncertain. One community, Fargo, situated in a shallow river basin, successfully mitigated and prevented flooding. For the other community, Minot, located in a deep river valley, prevention was not possible and downtown businesses and one-quarter of the homes were inundated, in the city's worst flood on record. We aimed at contrasting the respective hazards, vulnerabilities, stressors, psychological risk factors, psychosocial consequences, and disaster risk reduction strategies under conditions where flood prevention was, and was not, possible. Methods . We applied the "trauma signature analysis" (TSIG) approach to compare the hazard profiles, identify salient disaster stressors, document the key components of disaster risk reduction response, and examine indicators of community resilience. Results . Two demographically-comparable communities, Fargo and Minot, faced challenging river flood threats and exhibited effective coordination across community sectors. We examined the implementation of disaster risk reduction strategies in situations where coordinated citizen action was able to prevent disaster impact (hazard avoidance) compared to the more common scenario when unpreventable disaster strikes, causing destruction, harm, and distress. Across a range of indicators, it is clear that successful mitigation diminishes both physical and psychological impact, thereby reducing the trauma signature of the event. Conclusion . In contrast to experience of historic flooding in Minot, the city of Fargo succeeded in reducing the trauma signature by way of reducing risk through mitigation.

Regulations as a Tool to Increase Consumer Protection on the European Retail Payment Market

Directory of Open Access Journals (Sweden)

Janina Harasim

2018-03-01

Full Text Available Aim/purpose - The purpose of the paper is to identify the main areas of customers' threats concerning using financial services and the in-depth review of European industry- -specific consumer regulations concerning current accounts and payments. Design/methodology/approach - Desk research including in-depth analysis of industry- specific consumer regulations referring to current accounts and payment services having the character of EU directives and regulations, European Commission reports, and documents. Findings - The paper shows that consumers' interests are threatened even when they use basic financial services as current account and combined payment instruments. The analysis based on of desk resources has revealed that the regulations give effect to customer protection only if they strictly correspond to defined areas of threats and particular types of risks. Research implications/limitations - The experience of the recent financial crisis proved that the asymmetry of knowledge and information was one of the crucial reasons disrupting customers' position on financial markets. Research findings will help to identify gaps in regulations and develop the quality of further initiatives aimed on informing customers about the implementation of regulations and improving their financial literacy level. Originality/value/contribution - The payment products are rarely discussed in the literature in the context of consumers' protection and financial regulations. This paper contributes to the debate by providing an overview of financial consumer protection issues concerning retail payments.(original abstract

36 CFR 1207.21 - Payment.

Science.gov (United States)

2010-07-01

.... (e) Working capital advances. If a grantee cannot meet the criteria for advance payments described in... because the grantee lacks sufficient working capital, the awarding agency may provide cash or a working.... The working capital advance method of payment shall not be used by grantees or subgrantees if the...

38 CFR 43.21 - Payment.

Science.gov (United States)

2010-07-01

.... (e) Working capital advances. If a grantee cannot meet the criteria for advance payments described in... because the grantee lacks sufficient working capital, the awarding agency may provide cash or a working.... The working capital advance method of payment shall not be used by grantees or subgrantees if the...

40 CFR 31.21 - Payment.

Science.gov (United States)

2010-07-01

.... (e) Working capital advances. If a grantee cannot meet the criteria for advance payments described in... because the grantee lacks sufficient working capital, the awarding agency may provide cash or a working.... The working capital advance method of payment shall not be used by grantees or subgrantees if the...

43 CFR 12.61 - Payment.

Science.gov (United States)

2010-10-01

.... (e) Working capital advances. If a grantee cannot meet the criteria for advance payments described in... because the grantee lacks sufficient working capital, the awarding agency may provide cash or a working.... The working capital advance method of payment shall not be used by grantees or subgrantees if the...

32 CFR 33.21 - Payment.

Science.gov (United States)

2010-07-01

.... (e) Working capital advances. If a grantee cannot meet the criteria for advance payments described in... because the grantee lacks sufficient working capital, the awarding agency may provide cash or a working.... The working capital advance method of payment shall not be used by grantees or subgrantees if the...

40 CFR 35.6280 - Payments.

Science.gov (United States)

2010-07-01

... EPA shall advance cash to the recipient to cover its estimated disbursement needs for an initial... following requirements, the recipient must comply with the requirements regarding payment described in 40 CFR 31.21 (f) through (h). (1) Assignment of payment. The recipient cannot assign the right to receive...

30 CFR 281.26 - Payments.

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Payments. 281.26 Section 281.26 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR OFFSHORE LEASING OF MINERALS OTHER THAN OIL, GAS, AND SULPHUR IN THE OUTER CONTINENTAL SHELF Financial Considerations § 281.26 Payments. (a...

CRADA Payment Options | NCI Technology Transfer Center | TTC

Science.gov (United States)

NCI TTC CRADA PAYMENT OPTIONS: Electronic Payments by Wire Transfer via Fedwire, Mail a check to the Institute or Center, or Automated Clearing House (ACH)/Electronic Funds Transfer (ETF) payments via Pay.gov (NCI ONLY).

Gifts, bribes and solicitions: print media and the social construction of informal payments to doctors in Taiwan.

Science.gov (United States)

Chiu, Yu-Chan; Smith, Katherine Clegg; Morlock, Laura; Wissow, Lawrence

2007-02-01

The Taiwanese practice of patients giving informal payments to physicians to secure services is deeply rooted in social and cultural factors. This study examines the portrayal of informal payments by Taiwanese print news media over a period of 12 years-from prior to until after the implementation of national health insurance (NHI) in Taiwan in 1995. The goal of the study was to examine how the advent of NHI changed the rationale for and use of informal payments. Both before and after the introduction of NHI, Taiwanese newspapers portrayed informal payments as appropriate means to secure access to better health care. Newspaper accounts established that, although NHI reduced patients' financial barriers to care, it did not change deeply held cultural beliefs that good care depended on the development of a reciprocal sense of obligation between patients and physicians. Physicians may have also encouraged the ongoing use of informal payments to make up revenue lost when NHI standardized fees and limited income from dispensing medications. In 2002, seven years after the implementation of NHI, the use of informal payments, though illegal, was still being justified in the print media through allusions to its role in traditional Taiwanese culture.

7 CFR 240.7 - Payments to States.

Science.gov (United States)

2010-01-01

... designated State Officials of a Payment Voucher on Letter of Credit (Treasury Form GFO 7578) in accordance... 7 Agriculture 4 2010-01-01 2010-01-01 false Payments to States. 240.7 Section 240.7 Agriculture... CHILD NUTRITION PROGRAMS CASH IN LIEU OF DONATED FOODS § 240.7 Payments to States. (a) Funds to be paid...

32 CFR 34.12 - Payment.

Science.gov (United States)

2010-07-01

... Program Management § 34.12 Payment. (a) Methods available. Payment methods for awards with for-profit... Administration Services Components,” DLAH 4105.4, which can be obtained from either: Defense Logistics Agency...-6220; or the Defense Contract Management Command home page at http://www.dcmc.dcrb.dla.mil. 2 See...

28 CFR 104.51 - Payments to eligible individuals.

Science.gov (United States)

2010-07-01

... COMPENSATION FUND OF 2001 Payment of Claims § 104.51 Payments to eligible individuals. Not later than 20 days... compensation due a claimant under the Fund, the Special Master shall authorize payment to such claimant of the...

THE BASIS OF THE MARKET REGULATION OF PAYMENT CARDS

Directory of Open Access Journals (Sweden)

Khetagurov G. V.

2017-06-01

Full Text Available The article is devoted to basics and the regulation problems of the modern payment cards market. In particular, it addresses the key participants in a payment system, which include the Central Bank, credit organizations, settlement and clearing centers. The paper explores the basic functions of the participants. The author analyzes approaches of card payment systems to development and implementation monitoring of standards and regulations relative to the technology: hardware and software, communication channels, etc. The article contains analysis of information exchange in the framework of payment cards market and specific features of the design and development of a payment infrastructure. It discusses the economic model of the payment cards market, which is based on commission payments. The paper describes the key fees. At the final stage of the study, the author examines the role of different global regulators in the payment card market, conducts an analysis of the foundations of the Russian legislation regulating this market.

Risk sharing between competing health plans and sponsors

NARCIS (Netherlands)

E.M. van Barneveld (Erik); W.P.M.M. van de Ven (Wynand); R.C.J.A. van Vliet (René)

2001-01-01

textabstractIn many countries, competing health plans receive capitation payments from a sponsor, whether government or a private employer. All capitation payment methods are far from perfect and have raised concerns about risk selection. Paying health plans partly on the basis

Co-payments for general practitioners in Denmark

DEFF Research Database (Denmark)

Hansen, Camilla; Andrioti, Despena

2017-01-01

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

Reducing risks, protecting people. A harmonized approach

International Nuclear Information System (INIS)

Foster, R.B.

2000-01-01

Risk training, education and communication usually refer to the responsibilities of those who generate risk (e.g. operators of nuclear power plants) towards those who are exposed to the risk (e.g. employees working in the plants and those living in the vicinity). In this context training, education and communication are intended to transfer information from risk professionals to a largely uninformed audience, with a view to improving standards or providing reassurance. However, with the growth of media such as the Internet those to whom such training, education and communication have traditionally been directed are now much better informed. In addition, increasing prosperity affects expectations and prompts questions, not only about the adequacy of the control measures intended to address specific hazards, but also about whether the hazardous activity is justified at all. Within the UK (and Europe) this is very evident for nuclear power, other applications of ionizing radiation, and in other areas such as genetically modified food. In consequence regulators of hazardous activities face considerable new challenges. Of course, regulators still have to formulate standards, communicate them to those responsible for risk reduction and see that the necessary controls are in place. But in addition regulators also have to be able to answer questions such as: - why is this hazardous activity (e.g. a nuclear power plant) allowed at all? - what level of risk is unacceptable? - is the approach to risk reduction sufficiently precautionary? - why shouldn't the risk be reduced further? - why are the risks from certain activities (e.g. those from ionizing radiation) controlled to much lower levels than those from other work activities? - how are decisions made, what criteria are applied and how are the stake holders involves? All this does not make life easy for regulators! The full paper will describe how the Health and Safety Executive (HSE) has responded to these challenges by

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

Directory of Open Access Journals (Sweden)

Ahmed Shoukry Rashad

2015-11-01

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

Designing internet-based payment system: guidelines and empirical basis

NARCIS (Netherlands)

Abrazhevich, D.; Markopoulos, P.; Rauterberg, G.W.M.

2009-01-01

This article describes research into online electronic payment systems, focusing on the aspects of payment systems that are critical for their acceptance by end users. Based on our earlier research and a diary study of payments with an online payment system and with online banking systems of a

Managing Risk, Reducing Vulnerability and Enhancing Productivity ...

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

Managing Risk, Reducing Vulnerability and Enhancing Productivity under a Changing Climate. The countries of the Greater Horn of Africa are particularly vulnerable to drought, exacerbated by widespread poverty and dependence on rainfed agriculture. Even with normal rainfall, the region does not produce enough food to ...

Evaluating Industry Payments Among Dermatology Clinical Practice Guidelines Authors.

Science.gov (United States)

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

2017-12-01

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

75 FR 47236 - Golden Parachute and Indemnification Payments

Science.gov (United States)

2010-08-05

... golden parachute, severance, indemnification or other agreement. Claims for employee welfare benefits or... legitimate employee severance payments and improper golden parachute payments. DATES: Comments must be... FICUs with greater clarity on the distinction between legitimate employee severance payments and...

5 CFR 1653.5 - Payment.

Science.gov (United States)

2010-01-01

... letter. This is intended to permit the payee sufficient time to consider decisions about tax withholding... time. A series of payments will not be made, even if the court order provides for such a method of.... (k) If a court ordered payment is returned as undeliverable, the TSP record keeper will attempt to...

A Discussion of a Risk-Sharing Pension Plan

Directory of Open Access Journals (Sweden)

Catherine Donnelly

2017-02-01

Full Text Available I show that risk-sharing pension plans can reduce some of the shortcomings of defined benefit and defined contributions plans. The risk-sharing pension plan presented aims to improve the stability of benefits paid to generations of members, while allowing them to enjoy the expected advantages of a risky investment strategy. The plan does this by adjusting the investment strategy and benefits in response to a changing funding level, motivated by the with-profits contract proposed by Goecke (2013. He suggests a mean-reverting log reserve (or funding ratio, where mean reversion occurs through adjustments to the investment strategy and declared bonuses. To measure the robustness of the plan to human factors, I introduce a measurement of disappointment, where disappointment is high when there are many consecutive years over which benefit payments are declining. Another measure introduced is devastation, where devastation occurs when benefit payments are zero. The motivation is that members of a pension plan who are easily disappointed or likely to get no benefit, are more likely to exit the plan. I find that the risk-sharing plan offers more disappointment than a defined contribution plan, but it eliminates the devastation possible in a plan that tries to accumulate contributions at a steadily increasing rate. The proposed risk-sharing plan can give a narrower range of benefits than in a defined contribution plan. Thus it can offer a stable benefit to members without the risk of running out of money.

MACRA, MIPS, and the New Medicare Quality Payment Program: An Update for Radiologists.

Science.gov (United States)

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

2017-03-01

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 advances the goal of tying Medicare payments to quality and value. In April 2016, CMS published an initial proposed rule for MACRA, renaming it the Quality Payment Program (QPP). Under QPP, clinicians receive payments through either advanced alternative payment models or the Merit-Based Incentive Payment System (MIPS), a consolidation of existing federal performance programs that applies positive or negative adjustments to fee-for-service payments. Most physicians will participate in MIPS. This review highlights implications of the QPP and MIPS for radiologists. Although MIPS incorporates radiology-specific quality measures, radiologists will also be required to participate in other practice improvement activities, including patient engagement. Recognizing physicians' unique practice patterns, MIPS will provide special considerations in performance evaluation for physicians with limited face-to-face patient interaction. Although such considerations will affect radiologists' likelihood of success under QPP, many practitioners will be ineligible for the considerations under currently proposed criteria. Reporting using qualified clinical data registries will benefit radiologists' performance by allowing expanded arrays of MIPS and non-MIPS specialty-specific measures. A group practice reporting option will substantially reduce administrative burden but introduce new challenges by requiring uniform determination of patient-facing status and performance measurement for all of the group's physicians (diagnostic radiologists, interventional radiologists, and nonradiologists) under the same taxpayer identification number. Given that the initial MIPS performance period begins in 2017, radiologists must begin preparing for QPP and taking actions to ensure their future success under this new quality-based payment system. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights

36 CFR 1009.4 - Payment of claims.

Science.gov (United States)

2010-07-01

... TORT CLAIMS ACT § 1009.4 Payment of claims. (a) When an award of $2,500 or less is made, the voucher signed by the claimant shall be transmitted for payment to the Presidio Trust. When an award over $2,500... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Payment of claims. 1009.4...

Pengaruh Sistem Pembayaran Listrik Online (Payment Point Online Bank Terhadap Pengendalian Internal Kas Pada PT. PLN (Persero DJBB

Directory of Open Access Journals (Sweden)

Maulana Yusup

2012-04-01

Full Text Available The company has its own way in the benefit and boost profits from year to year. Gains usually obtained sourced from a network perusahaan.System activities related procedures in a comprehensive series to carry out an enterprise activity. Therefore, the service strategy very big influence on the activities of the company. With the waiters are good, it is expected there will be no diversion of the company The research objective was to determine the effect of electricity online payment system (payment points online bank to internal control of cash at PT.PLN (Persero Distribution West Java and Banten Distribution Office. Conventional payment systems that rely on physical cash as a payment instrument has been shifted due to advances in technology can replace conventional ways of containing the risk of endangering safety. Based on research data on the PT. PLN (Persero Distribution West Java and Banten and discussion based on the theory, it can be concluded that the system of online payment of electricity was instrumental in supporting the effectiveness of internal control of cash, it can be seen from (1 The presence of general controls and application controls are adequate. Customers make payment through bank online payment points, (2 Reconciliation of receipt of funds receipt and bookkeeping is done regularly and directed accordingly (2 Process Online Payment System Electrical PPOB (Payment Point Online Bank is an electricity bill payment service and other bills online real -Time. For it can be suggested that understanding is not uniform (the existence of different viewpoints of employees with regard to the value and effect of the application of the company's progress PPOB can be removed and can eliminate the old paradigm of doing business processes PLN and increased knowledge of the mechanism of action of the system so as to improve performance and ultimately increase customer satisfaction and loyalty.

Reducing Risk for the Next Generation Nuclear Plant

Energy Technology Data Exchange (ETDEWEB)

John M. Beck II; Harold J. Heydt; Emmanuel O. Opare; Kyle B. Oswald

2010-07-01

The Next Generation Nuclear Plant (NGNP) Project, managed by the Idaho National Laboratory (INL), is directed by the Energy Policy Act of 2005, to research, develop, design, construct, and operate a prototype forth generation nuclear reactor to meet the needs of the 21st Century. As with all large projects developing and deploying new technologies, the NGNP has numerous risks that need to be identified, tracked, mitigated, and reduced in order for successful project completion. A Risk Management Plan (RMP) was created to outline the process the INL is using to manage the risks and reduction strategies for the NGNP Project. Integral to the RMP is the development and use of a Risk Management System (RMS). The RMS is a tool that supports management and monitoring of the project risks. The RMS does not only contain a risk register, but other functionality that allows decision makers, engineering staff, and technology researchers to review and monitor the risks as the project matures.

Reducing Risk for the Next Generation Nuclear Plant

International Nuclear Information System (INIS)

Beck, John M. II; Heydt, Harold J.; Opare, Emmanuel O.; Oswald, Kyle B.

2010-01-01

The Next Generation Nuclear Plant (NGNP) Project, managed by the Idaho National Laboratory (INL), is directed by the Energy Policy Act of 2005, to research, develop, design, construct, and operate a prototype forth generation nuclear reactor to meet the needs of the 21st Century. As with all large projects developing and deploying new technologies, the NGNP has numerous risks that need to be identified, tracked, mitigated, and reduced in order for successful project completion. A Risk Management Plan (RMP) was created to outline the process the INL is using to manage the risks and reduction strategies for the NGNP Project. Integral to the RMP is the development and use of a Risk Management System (RMS). The RMS is a tool that supports management and monitoring of the project risks. The RMS does not only contain a risk register, but other functionality that allows decision makers, engineering staff, and technology researchers to review and monitor the risks as the project matures.

42 CFR 86.15 - Payments.

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Payments. 86.15 Section 86.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES GRANTS FOR EDUCATION PROGRAMS IN OCCUPATIONAL SAFETY AND HEALTH Occupational Safety and Health Training Grants § 86.15 Payments....

42 CFR 86.35 - Payments.

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Payments. 86.35 Section 86.35 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES GRANTS FOR EDUCATION PROGRAMS IN OCCUPATIONAL SAFETY AND HEALTH Occupational Safety and Health Direct Traineeships § 86.35 Payment...

24 CFR 983.353 - Tenant rent; payment to owner.

Science.gov (United States)

2010-04-01

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

12 CFR 622.60 - Payment of civil money penalty.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Payment of civil money penalty. 622.60 Section... Rules and Procedures for Assessment and Collection of Civil Money Penalties § 622.60 Payment of civil money penalty. (a) Payment date. Generally, the date designated in the notice of assessment for payment...

42 CFR 413.74 - Payment to a foreign hospital.

Science.gov (United States)

2010-10-01

... chapter. (d) Exchange rate. Payment to the hospital will be subject to the official exchange rate on the... 42 Public Health 2 2010-10-01 2010-10-01 false Payment to a foreign hospital. 413.74 Section 413...; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Payments to Providers § 413...

31 CFR 256.52 - How does FMS issue a payment?

Science.gov (United States)

2010-07-01

... requirement for payment by EFT is appropriate, FMS will issue a payment by check. The Voucher for Payment must... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false How does FMS issue a payment? 256.52... SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE OBTAINING PAYMENTS FROM THE JUDGMENT FUND...

7 CFR 3.45 - USDA payment authorizing agency offset of pro rata share of payments due entity in which debtor...

Science.gov (United States)

2010-01-01

... Secretary of Agriculture DEBT MANAGEMENT Administrative Offset § 3.45 USDA payment authorizing agency offset... ownership of, or changed in some other manner the operation of, for the purpose of avoiding payment on the claim or debt, as determined by the creditor agency or the payment authorizing agency. (b) Prior to...

25 CFR 163.23 - Advance payment for timber products.

Science.gov (United States)

2010-04-01

... contracts. However, no advance payment will be required that would make the sum of such payment and of... required, advance payments will operate the same as provided for in § 163.23(a) of this part. ... 25 Indians 1 2010-04-01 2010-04-01 false Advance payment for timber products. 163.23 Section 163...

24 CFR 982.451 - Housing assistance payments contract.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Housing assistance payments... URBAN DEVELOPMENT SECTION 8 TENANT BASED ASSISTANCE: HOUSING CHOICE VOUCHER PROGRAM Housing Assistance Payments Contract and Owner Responsibility § 982.451 Housing assistance payments contract. (a)(1) The HAP...

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

Science.gov (United States)

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

2016-09-01

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

Medicaid prospective payment: Case-mix increase

Science.gov (United States)

Baker, Samuel L.; Kronenfeld, Jennie J.

1990-01-01

South Carolina Medicaid implemented prospective payment by diagnosis-related group (DRG) for inpatient care. The rate of complications among newborns and deliveries doubled immediately. The case-mix index for newborns increased 66.6 percent, which increased the total Medicaid hospital expenditure 5.5 percent. Outlier payments increased total expenditure further. DRG distribution change among newborns has a large impact on spending because newborn complication DRGs have high weights. States adopting a DRG-based payment system for Medicaid should anticipate a greater increase in case mix than Medicare experienced. PMID:10113463

Making Value-Based Payment Work for Academic Health Centers.

Science.gov (United States)

Miller, Harold D

2015-10-01

Under fee-for-service payment systems, physicians and hospitals can be financially harmed by delivering higher-quality, more efficient care. The author describes how current "value-based purchasing" initiatives fail to address the underlying problems in fee-for-service payment and can be particularly problematic for academic health centers (AHCs). Bundled payments, warranties, and condition-based payments can correct the problems with fee-for-service payments and enable physicians and hospitals to redesign care delivery without causing financial problems for themselves. However, the author explains several specific actions that are needed to ensure that payment reforms can be a "win-win-win" for patients, purchasers, and AHCs: (1) disconnecting funding for teaching and research from payment for service delivery, (2) providing predictable payment for essential hospital services, (3) improving the quality and efficiency of care at AHCs, and (4) supporting collaborative relationships between AHCs and community providers by allowing each to focus on their unique strengths and by paying AHC specialists to assist community providers in diagnosis and treatment. With appropriate payment reforms and a commitment by AHCs to redesign care delivery, medical education, and research, AHCs could provide the leadership needed to improve care for patients, lower costs for health care purchasers, and maintain the financial viability of both AHCs and community providers.

The determining trends of the retail payment market

OpenAIRE

BERGQVIST, CHRISTIAN; PETTERSSON, ERIK

2016-01-01

The retail payment market can be seen as a high velocity market, where the rate of change is high. The future for the retail payment market is uncertain to a large extent. A relatively new phenomenon is the entrance of third party payment providers (hereafter; TPP) who are utilizing the incumbent banks account infrastructure in order access information or initiate payments. A legislation named PSD2 will increase the TPP’s possibilities to utilize the bank’s infrastructure. This makes it possi...

Acid-reducing vagotomy is associated with reduced risk of subsequent ischemic heart disease in complicated peptic ulcer

Science.gov (United States)

Wu, Shih-Chi; Fang, Chu-Wen; Chen, William Tzu-Liang; Muo, Chih-Hsin

2016-01-01

Abstract Persistent exacerbation of a peptic ulcer may lead to a complicated peptic ulcer (perforation or/and bleeding). The management of complicated peptic ulcers has shifted from acid-reducing vagotomy, drainage, and gastrectomy to simple local suture or non-operative (endoscopic/angiographic) hemostasis. We were interested in the long-term effects of this trend change. In this study, complicated peptic ulcer patients who received acid-reducing vagotomy were compared with those who received simple suture/hemostasis to determine the risk of ischemic heart disease (IHD). This retrospective cohort study analyzed 335,680 peptic ulcer patients recorded from 2000 to 2006 versus 335,680 age-, sex-, comorbidity-, and index-year matched comparisons. Patients with Helicobacter pylori (HP) infection were excluded. In order to identify the effect of vagus nerve severance, patients who received gastrectomy or antrectomy were also excluded. The incidence of IHD in both cohorts, and in the complicated peptic ulcer patients who received acid-reducing vagotomy versus those who received simple suture or hemostasis was evaluated. The overall incidence of IHD was higher in patients with peptic ulcer than those without peptic ulcer (17.00 vs 12.06 per 1000 person-years), with an adjusted hazard ratio (aHR) of 1.46 based on multivariable Cox proportional hazards regression analysis controlling for age, sex, Charlson's comorbidity index, and death (competing risk). While comparing peptic ulcer patients with acid-reducing vagotomy to those with simple suture/hemostasis or those without surgical treatment, the aHR (0.58) was the lowest in the acid-reducing vagotomy group. Patients with peptic ulcer have an elevated risk of IHD. However, complicated peptic ulcer patients who received acid-reducing vagotomy were associated with reduced risk of developing IHD. PMID:27977613

48 CFR 728.105-1 - Advance payment bonds.

Science.gov (United States)

2010-10-01

... GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Bonds 728.105-1 Advance payment bonds. (a) Generally, advance payment bonds will not be required in connection with USAID contracts containing an advance... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Advance payment bonds. 728...

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

Science.gov (United States)

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

2016-01-01

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

Child Benefit Payments and Household Wealth Accumulation

OpenAIRE

Melvin Stephens Jr.; Takashi Unayama

2014-01-01

Using the life-cycle/permanent income hypothesis, we theoretically and empirically assess the impact of child benefit payments on household wealth accumulation. Consistent with the predictions of the model, we find that higher cumulative benefits received increase current assets, higher future benefit payments lower asset holding, and that these effects systematically vary over the life-cycle. We find different wealth responses to child benefit payments for liquidity constrained and unconstra...

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

Science.gov (United States)

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

2017-02-06

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

48 CFR 532.905 - Payment documentation and process.

Science.gov (United States)

2010-10-01

... payments. The contracting officer or designee must review the processing of invoices or vouchers before... approval of any payment on (or attached to) the invoice or voucher submitted by the contractor and forward... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Payment documentation and...

Can an ethical work climate influence payment discipline?

Directory of Open Access Journals (Sweden)

Tanja Salamon

2016-02-01

Full Text Available Purpose: All European companies are faced with the lack of payment discipline, which often affects even their survival. One of the key reasons for the lack of payment discipline is poor business ethics, which is primarily introduced with the subject of ethical climate in the literature. For this reason, we wanted to determine whether a company's ethical climate influences its payment discipline.Design/methodology/approach: In the research, we used Arnaud's measurement instrument (2010 that helped us to identify six dimensions of ethical climate. The data about a company’s ethical climate were later compared with the data about its payment discipline, calculated using the Dun & Bradstreet rating agency methodology. We included in the sample 273 Slovenian companies, which represented 9.1% of all companies invited to take part in the survey (2978 Slovenian enterprises with 10 or more employees.Findings: We established that (among the six dimensions of the ethical climate the dimension “moral sensitivity – the lack of norms of empathetic concern” had statistically significant influence on the average delay of payment, and the more significant for the company the lack of norms of empathetic concern was, the longer the delay of the payment to suppliers would be. Our conclusion is that the appropriate forms of the incorporation of training and education on ethical subjects into business studies may increase the payment discipline of companies.Originality/value: The present study represents an important contribution to understanding the causes of payment defaults. The study also includes non-financial antecedents of payment discipline, which represents a new, important contribution of the research.

Can an ethical work climate influence payment discipline?

Energy Technology Data Exchange (ETDEWEB)

Salamon, T.; Mesko, M.

2016-07-01

Purpose: All European companies are faced with the lack of payment discipline, which often affects even their survival. One of the key reasons for the lack of payment discipline is poor business ethics, which is primarily introduced with the subject of ethical climate in the literature. For this reason, we wanted to determine whether a company’s ethical climate influences its payment discipline. Design/methodology/approach: In the research, we used Arnaud’s measurement instrument (2010) that helped us to identify six dimensions of ethical climate. The data about a company’s ethical climate were later compared with the data about its payment discipline, calculated using the Dun & Bradstreet rating agency methodology. We included in the sample 273 Slovenian companies, which represented 9.1% of all companies invited to take part in the survey (2978 Slovenian enterprises with 10 or more employees). Findings: We established that (among the six dimensions of the ethical climate) the dimension “moral sensitivity – the lack of norms of empathetic concern” had statistically significant influence on the average delay of payment, and the more significant for the company the lack of norms of empathetic concern was, the longer the delay of the payment to suppliers would be. Our conclusion is that the appropriate forms of the incorporation of training and education on ethical subjects into business studies may increase the payment discipline of companies. Originality/value: The present study represents an important contribution to understanding the causes of payment defaults. The study also includes non-financial antecedents of payment discipline, which represents a new, important contribution of the research. (Author)

12 CFR 219.6 - Payment procedures.

Science.gov (United States)

2010-01-01

... obtain payment of costs incurred prior to the time the financial institution receives this notice. [Reg... PROVIDING FINANCIAL RECORDS; RECORDKEEPING REQUIREMENTS FOR CERTAIN FINANCIAL RECORDS (REGULATION S) Reimbursement to Financial Institutions for Providing Financial Records § 219.6 Payment procedures. (a) Notice...

42 CFR 493.1809 - Limitation on Medicaid payment.

Science.gov (United States)

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Limitation on Medicaid payment. 493.1809 Section 493.1809 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Limitation on Medicaid payment. As provided in section 1902(a)(9)(C) of the Act, payment for laboratory...

45 CFR 302.38 - Payments to the family.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Payments to the family. 302.38 Section 302.38... ENFORCEMENT PROGRAM), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES STATE PLAN REQUIREMENTS § 302.38 Payments to the family. The State plan shall provide that any payment...

26 CFR 25.2701-4 - Accumulated qualified payments.

Science.gov (United States)

2010-04-01

... compound interest from the due date of the payment at a rate not less than the appropriate discount rate is... retained interest conferring a distribution right that was previously valued as a qualified payment right (a “qualified payment interest”), the taxable estate or taxable gifts of the individual holding the...

Social Determinants of Health in Managed Care Payment Formulas.

Science.gov (United States)

Ash, Arlene S; Mick, Eric O; Ellis, Randall P; Kiefe, Catarina I; Allison, Jeroan J; Clark, Melissa A

2017-10-01

Managed care payment formulas commonly allocate more money for medically complex populations, but ignore most social determinants of health (SDH). To add SDH variables to a diagnosis-based payment formula that allocates funds to managed care plans and accountable care organizations. Using data from MassHealth, the Massachusetts Medicaid and Children's Health Insurance Program, we estimated regression models predicting Medicaid spending using a diagnosis-based and SDH-expanded model, and compared the accuracy of their cost predictions overall and for vulnerable populations. MassHealth members enrolled for at least 6 months in 2013 in fee-for-service (FFS) programs (n = 357 660) or managed care organizations (MCOs) (n = 524 607). We built cost prediction models from a fee-for-service program. Predictors in the diagnosis-based model are age, sex, and diagnoses from claims. The SDH model adds predictors describing housing instability, behavioral health issues, disability, and neighborhood-level stressors. Overall model explanatory power and overpayments and underpayments for subgroups of interest for all Medicaid-reimbursable expenditures excepting long-term support services (mean annual cost = $5590 per member). We studied 357 660 people who were FFS participants and 524 607 enrolled in MCOs with a combined 806 889 person-years of experience. The FFS program experience included more men (49.6% vs 43.6%), older patients (mean age of 26.1 years vs 21.6 years), and sicker patients (mean morbidity score of 1.16 vs 0.89) than MCOs. Overall, the SDH model performed well, but only slightly better than the diagnosis-based model, explaining most of the spending variation in the managed care population (validated R2 = 62.4) and reducing underpayments for several vulnerable populations. For example, raw costs for the quintile of people living in the most stressed neighborhoods were 9.6% ($537 per member per year) higher than average. Since greater

Exploring the Industry-Dermatologist Financial Relationship: Insight From the Open Payment Data.

Science.gov (United States)

Feng, Hao; Wu, Paula; Leger, Marie

2016-12-01

Significant ties exist between clinicians and industry. Little is known about the characteristics of industry payments to dermatologists. To analyze the nature and extent of industry payments to dermatologists. This was a retrospective review using the publicly available Centers for Medicare and Medicaid Services (CMS) Sunshine Act Open Payment database. Data were downloaded from the publically available CMS website under General Payment and Research Payment data sets. All payments to dermatologists from companies making products reimbursed by a government-run health program were reviewed. Mean, median, and range of payments made, including quantity and total sum of payments, per clinician. Total payments and number of transactions per category of payment, geographic region, and payment source were also assessed. A total of 8333 dermatologists received 208 613 payments totaling more than $34 million. The median total payment per dermatologist was $298 with an interquartile range of $99 to $844. The top 10% of dermatologists (n = 833) received more than $31.2 million, 90% of the total payments. The top 1% each (n = 83) received at least $93 622 and accounted for 44% of total payments. While 83% of payment entries were for food and beverage, they accounted for only 13% of total amount of payments. Speaker fees (31.7%), consulting fees (21.6%), and research payments (16.5%) comprised 69.8% of total payment amount. The top 15 companies were all pharmaceutical manufacturers and paid dermatologists $28.7 million, representing 81% of total disbursement. Dermatologists received substantial payments from the pharmaceutical industry. The nature and amount of payments varied widely. The impact of the data on patient care, physicians practice patterns, and patient perception of physicians is unclear.

Invoicing, Payments Info

Science.gov (United States)

Goals Recycling Green Purchasing Pollution Prevention Reusing Water Resources Environmental Management Vendors Invoicing, Payments Info Bidding Opportunities Code of Conduct regarding holiday gifts Business

Coopetitive Service Innovation in Mobile Payment Ecosystems

OpenAIRE

Zhong, Junying

2015-01-01

Mobile payments are a new way to pay in the digital era. The emerging mobile payment platforms and services enable viable businesses through exchanges of value between consumers and collaborating actors in a real-time and context-specific way. However, business interactions in mobile payment markets are reected in a highly dynamic market structure that requires coopetition (simultaneous competition and collaboration) between the participants in the markets. This dissertation studies how mo...

The effect of health payment reforms on cost containment in Taiwan hospitals: the agency theory perspective.

Science.gov (United States)

Chang, Li

2011-01-01

This study aims to determine whether the Taiwanese government's implementation of new health care payment reforms (the National Health Insurance with fee-for-service (NHI-FFS) and global budget (NHI-GB)) has resulted in better cost containment. Also, the question arises under the agency theory whether the monitoring system is effective in reducing the risk of information asymmetry. This study uses panel data analysis with fixed effects model to investigate changes in cost containment at Taipei municipal hospitals before and after adopting reforms from 1989 to 2004. The results show that the monitoring system does not reduce information asymmetry to improve cost containment under the NHI-FFS. In addition, after adopting the NHI-GB system, health care costs are controlled based on an improved monitoring system in the policymaker's point of view. This may suggest that the NHI's fee-for-services system actually causes health care resource waste. The GB may solve the problems of controlling health care costs only on the macro side.

Attitudes towards industry capitation payments for entering patients into clinical trials

International Nuclear Information System (INIS)

Shimm, David S.

1997-01-01

PURPOSE: Pharmaceutical companies commonly pay a clinical investigator (CI) for entering patients into a clinical trial. These payments average $3500-$5000, and can be as high as $50,000 per patient, and are rarely disclosed to the clinical research subject (CRS). Capitation payments exceeding direct and indirect expenses present a conflict of interest by posing a temptation for CIs to ignore their fiduciary duty to patients. Since CIs commonly accept such payments, either they do not see, they ignore, or they otherwise manage the conflict of interest posed by accepting this money. This study surveys attitudes towards this practice among students and staff at a university medical center. MATERIALS and METHODS: The survey examined factors which might affect a CI's decision to enroll CRSs into a clinical trial, and attitudes towards financial arrangements between the CI and a study sponsor. Two hundred twenty nine surveys were sent to 75 medical students, 80 housestaff, and 74 attending staff, chosen randomly from personnel rosters. Questionnaires were returned anonymously to conceal the identity of the responder. RESULTS: Eighteen medical students (24%), 13 housestaff (16%), and 24 attending staff (32%) returned questionnaires (overall response rate 24%). Responding MDs represented 13 departments and included 13 primary care MDs. Nineteen (79%) attending staff and 7 (46%) housestaff had conducted clinical research. Responders cited the purpose of the study, potential benefit to the CRS, potential benefit to others, and risk to the CRS as the most important factors that would affect their decision to enter a CRS into a study. Eighteen (75%) attending staff, 12 (92%) housestaff, and 14 (78%) students favored telling CRSs the source of a study's funding. Twenty one (88%) attending staff, all housestaff, and 16 (89%) students favored telling CRSs whether the CI owned stock in the sponsoring company. Sixteen (67%) attendings, all housestaff, and 14 (78%) students favored

20 CFR 211.13 - Payments made after death.

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Payments made after death. 211.13 Section 211... CREDITABLE RAILROAD COMPENSATION § 211.13 Payments made after death. Payments made by an employer with respect to a deceased employee but paid after the calendar year of the employee's death to the employee's...

48 CFR 1632.770 - Contingency reserve payments.

Science.gov (United States)

2010-10-01

... FINANCING Contract Funding 1632.770 Contingency reserve payments. (a) Payments from the contingency reserve... advise the carrier of its decision. However, OPM shall not unreasonably withhold approval for amounts...

Meta-analysis: Does garlic intake reduce risk of gastric cancer?

Science.gov (United States)

Kodali, R T; Eslick, Guy D

2015-01-01

In the past 2 decades, various epidemiological studies investigated whether garlic can positively modify the risk of gastric cancer. Garlic contains numerous sulfide compounds, including diallyl trisulfide, which have anticarcinogenic properties. We conducted a meta-analysis to determine if garlic intake reduces the risk of gastric cancer. An electronic search of MEDLINE, PubMed, and EMBASE to June 2014 was completed. There were 14 case control studies, 2 randomized controlled studies, and 1 cohort study that fulfilled our inclusion criteria. We used a random effects model to calculate pooled odds ratios (OR) and 95% confidence intervals (CIs) for risk of gastric cancer with garlic consumption. Meta-analysis of a total of 8,621 cases and 14,889 controls was conducted. Significant variability in duration of garlic intake and reference categories for amount of intake was noted. High, low, and any garlic intake were all associated with reduced risk of gastric cancer. High intake had the most significant risk reduction, OR = 0.49 (95% CI: 0.38-0.62). Heterogeneity was low (I² = 30.85, P = 0.17). A more modest risk reduction was associated with low intake, OR = 0.75 (95% CI: 0.58-0.97). Half of the studies did not separate garlic intake into high or low amounts, intake was only noted as consumption vs. non-consumption. Any amount of consumption still showed a risk reduction similar to low intake, OR = 0.77 (95% CI: 0.60-1.00). Low and any amount of consumption showed moderate heterogeneity (58% and 45%, respectively). Garlic intake appears to be associated with reduced risk of gastric cancer. Further high quality studies are required to confirm this finding and to assess the amount of garlic that needs to be consumed for protective effect.

New Technologies in the Payment System Industries: The SEPA Project

OpenAIRE

Armando Calabrese; Massimo Gastaldi; Irene Iacovelli; Nathan L. Ghiron

2010-01-01

Problem statement: The Single Euro Payments Area (SEPA) project plans to establish an integrated market for extending European integration to retail payments; it aims to provide incentives for using payment systems instead of cash for all micro payments, in order to improve both efficiency and competition in the Euro area. In this study we described the SEPA and its effects on competition and innovation in the payment systems. Moreover, we will discuss the main technologic...

42 CFR 418.306 - Determination of payment rates.

Science.gov (United States)

2010-10-01

...) of the Act. (b) Payment rates. The payment rates for routine home care and other services included in... October 21, 1990, through December 31, 1990, the payment rates for routine home care and other services... December 31, 1990: Routine home care $75.80 Continuous home care: Full rate for 24 hours 442.40 Hourly rate...

25 CFR 227.16 - Crediting advance annual payments.

Science.gov (United States)

2010-04-01

... equal such advance payment; nor will any part of the moneys so paid be refunded to the lessee because of... 25 Indians 1 2010-04-01 2010-04-01 false Crediting advance annual payments. 227.16 Section 227.16... Crediting advance annual payments. In the event of discovery of minerals in paying quantities all advance...

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

NARCIS (Netherlands)

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

2014-01-01

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

42 CFR 424.555 - Payment liability.

Science.gov (United States)

2010-10-01

... covered items or services furnished to a Medicare beneficiary by a provider or supplier if the billing... Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Billing Privileges § 424.555 Payment liability. (a) No payment may be made for otherwise Medicare covered...

47 CFR 27.1170 - Payment Issues.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Payment Issues. 27.1170 Section 27.1170 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS... Microwave Relocation from the 2110-2150 Mhz and 2160-2200 Mhz Bands § 27.1170 Payment Issues. Prior to...

Security Assessment of Payment Systems under PCI DSS Incompatibilities

OpenAIRE

Bahtiyar , Şerif; Gür , Gürkan; Altay , Levent

2014-01-01

Part 9: Malicious Behavior and Fraud; International audience; With the ubiquitous proliferation of electronic payment systems, data and application security has become more critical for financial operations. The Payment Card Industry Data Security Standard (PCI DSS) has been developed by the payment industry to provide a widely-applicable and definitive security compliance among all components in electronic payment infrastructure. However, the security impact of PCI DSS incompatibilities and ...

Evolution of a 90-day model of care for bundled episodic payments for congestive heart failure in home care.

Science.gov (United States)

Feld, April; Madden-Baer, Rose; McCorkle, Ruth

2016-01-01

The Centers for Medicare and Medicaid Services Innovation Center's Episode-Based Payment initiatives propose a large opportunity to reduce cost from waste and variation and stand to align hospitals, physicians, and postacute providers in the redesign of care that achieves savings and improve quality. Community-based organizations are at the forefront of this care redesign through innovative models of care aimed at bridging gaps in care coordination and reducing hospital readmissions. This article describes a community-based provider's approach to participation under the Bundled Payments for Care Improvement initiative and a 90-day model of care for congestive heart failure in home care.

Full-Automatic Parking registration and payment

DEFF Research Database (Denmark)

Agerholm, Niels; Lahrmann, Harry; Jørgensen, Brian

2014-01-01

As part of ITS Platform North Denmark, a full-automatic GNSS-based parking payment (PP) system was developed (PP app). On the basis of the parking position and parking time, the PP app can determine the price of parking and collect the amount from the car owner’s bank account. The driver...... is informed about any initiation of PP via SMS message. If the driver finds the payment erroneous, it can be cancelled via SMS message. Parking attendants can check if the car in question has an ongoing payment for parking. To handle the problems with GNSS-based positioning in densely built-up areas......, an advanced map matching algorithm was integrated in the PP app. 24 of the participating vehicles used the PP app, and 58 parking payments were carried out without errors. In a few cases, the wrong parking area was selected. This was due to lack of information in the map rather than errors in the map matching...

Annuity payments can increase patient access to innovative cell and gene therapies under England's net budget impact test.

Science.gov (United States)

Jørgensen, Jesper; Kefalas, Panos

2017-01-01

Background: Cell and gene therapies have the potential to provide therapeutic breakthroughs, but the high costs of researching, developing, manufacturing and delivering them translate into prices that may challenge healthcare budgets. Various measures exist that aim to address the affordability challenge, including reducing price, limiting patient numbers and/or linking remuneration to product performance. Objective: To explore how the net budget impact test recently introduced in England can affect patient access to high-value, one-off cell and gene therapies, and how managed entry agreements can improve access. Methods: We use a hypothetical example where a new high-value, one-off therapy launches in an indication where it displaces a relatively low cost chronic treatment. We calculate the number of patients that can be treated without exceeding the £20 million net budget impact threshold, and compare results for scenarios where a full upfront payment is used, and where annuity-based payments are used. Results : Charging a full upfront payment at the time of treatment can lead to suboptimal patient access. Conclusion: Annuity-based payments in combination with an outcomes-based remuneration scheme reduce consequences of decision uncertainty and can increase patient access, without exceeding the net budget impact test.

Traditional Payment Models in Radiology: Historical Context for Ongoing Reform.

Science.gov (United States)

Silva, Ezequiel; McGinty, Geraldine B; Hughes, Danny R; Duszak, Richard

2016-10-01

The passage of the Medicare Access and CHIP Reauthorization Act (MACRA) replaces the sustainable growth rate with a payment system based on quality and alternative payment model participation. The general structure of payment under MACRA is included in the statute, but the rules and regulations defining its implementation are yet to be formalized. It is imperative that the radiology profession inform policymakers on their role in health care under MACRA. This will require a detailed understanding of prior legislative and nonlegislative actions that helped shape MACRA. To that end, the authors provide a detailed historical context for payment reform, focusing on the payment quality initiatives and alternative payment model demonstrations that helped provide the foundation of future MACRA-driven payment reform. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

42 CFR 412.525 - Adjustments to the Federal prospective payment.

Science.gov (United States)

2010-10-01

... HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Long-Term Care Hospitals § 412.525 Adjustments to the Federal prospective payment. (a... its estimated costs for a patient exceed the adjusted LTC-MS-DRG payment plus a fixed-loss amount. For...

Video-assisted thoracic surgery lobectomy cost variability: implications for a bundled payment era.

Science.gov (United States)

Medbery, Rachel L; Perez, Sebastian D; Force, Seth D; Gillespie, Theresa W; Pickens, Allan; Miller, Daniel L; Fernandez, Felix G

2014-05-01

In 2013, the Centers for Medicare and Medicaid Services began its Bundled Payments for Care Improvement Initiative. If payments are to be bundled, surgeons must be able to predict which patients are at risk for more costly care. We aim to identify factors driving variability in hospital costs after video-assisted thoracic surgery (VATS) lobectomy for lung cancer. Our institutional Society of Thoracic Surgeons data were queried for patients undergoing VATS lobectomy for lung cancer during fiscal years 2010 to 2011. Clinical outcomes data were linked with hospital financial data to determine operative and postoperative costs. Linear regression models were created to identify the impact of preoperative risk factors and perioperative outcomes on cost. One hundred forty-nine VATS lobectomies for lung cancer were reviewed. The majority of patients had clinical stage IA lung cancer (67.8%). Median length of stay was 4 days, with 30-day mortality and morbidity rates of 0.7% and 37.6%, respectively. Mean operative and postoperative costs per case were $8,492.31 (±$2,238.76) and $10,145.50 (±$7,004.71), respectively, resulting in an average overall hospital cost of $18,637.81 (±$8,244.12) per patient. Patients with chronic obstructive pulmonary disease and coronary artery disease, as well as postoperative urinary tract infections and blood transfusions, were associated with statistically significant variability in cost. Variability in cost associated with VATS lobectomy is driven by assorted patient and clinical variables. Awareness of such factors can help surgeons implement quality improvement initiatives and focus resource utilization. Understanding risk-adjusted clinical-financial data is critical to designing payment arrangements that include financial and performance accountability, and thus ultimately increasing the value of health care. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

29 CFR 100.610 - Written demand for payment.

Science.gov (United States)

2010-07-01

... Procedures § 100.610 Written demand for payment. (a) The NLRB will promptly make written demand upon the debtor for payment of money or the return of specific property. The written demand for payment will be... late charges will be 60 days from the date that the demand letter is mailed or hand-delivered. (b) The...

25 CFR 213.19 - Crediting advance annual payments.

Science.gov (United States)

2010-04-01

... been made. No refund of such advance payments made under any lease will be allowed in the event the royalty on production is not sufficient to equal such advance payment; nor will any part of the moneys so... 25 Indians 1 2010-04-01 2010-04-01 false Crediting advance annual payments. 213.19 Section 213.19...

5 CFR 1315.13 - Commodity Credit Corporation payments.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Commodity Credit Corporation payments... PAYMENT § 1315.13 Commodity Credit Corporation payments. As provided in § 1315.1(d), the provisions of... Credit Corporation (CCC) pursuant to Section 4(h) of the Act of June 29, 1948 (15 U.S.C. 714b(h)) (“CCC...

Methodic of payment determination for environment pollution. Chapter 2

International Nuclear Information System (INIS)

1997-01-01

In the chapter 2 the methodic for determination of payments for environmental impacts from coal thermal power plant including the specifications of enterprises payments for harmful gases discharges into atmosphere and payments for solid wastes disposition is presented

Reducing sequence risk using trend following and the CAPE ratio

OpenAIRE

Clare, A.; Thomas, S.; Smith, P. N.; Seaton, J.

2017-01-01

The risk of experiencing bad investment outcomes at the wrong time, or sequence risk, is a poorly understood, but crucial aspect of the risk faced by investors, in particular those in the decumulation phase of their savings journey, typically over the period of retirement financed by a defined contributions pension scheme. Using US equity return data from 1872-2014 we show how this risk can be significantly reduced by applying trend-following investment strategies. We also demonstrate that kn...

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

Science.gov (United States)

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

2010-01-01

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

Effects of the per diem prospective payment system with DRG-like grouping system (DPC/PDPS) on resource usage and healthcare quality in Japan.

Science.gov (United States)

Hamada, Hironori; Sekimoto, Miho; Imanaka, Yuichi

2012-10-01

In 2003, Japan introduced the prospective payment system (PPS) with diagnosis-related groups (DRG) rearranged grouping system called the diagnostic procedure combination/per-diem payment system (DPC/PDPS). Even after eight years, little is known about the effects of DPC/PDPS. The purpose of this study was to examine the effects of DPC/PDPS on resource usage and healthcare quality. Using 2001-2009 (fiscal year) administrative data of acute myocardial infarction patients, four indices, including inpatient total accumulated medical charges, length of stay (LOS), mortality rate, and readmission rate, were compared between patients reimbursed by DPC/PDPS or by fee-for-service. DPC/PDPS significantly reduced total accumulated medical charges by $1061 (95% confidence interval [CI], -2007, -116) and LOS by 2.29 days (95% CI, -3.71, -0.88) after risk adjustment. However, mortality rate (Odds ratio [OR], 0.94; 95% CI, 0.73, 1.21) was unchanged. Furthermore, DPC/PDPS increased the readmission rate (OR, 1.37; 95% CI, 1.03, 1.82). This study showed that DPC/PDPS was associated with reduced resource usage, but not improved healthcare quality, as with DRG/PPSs in other countries. To achieve successful healthcare reform, further discussion on additional motives will be required. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.