Medicare's post-acute care payment: a review of the issues and policy proposals.

Science.gov (United States)

Linehan, Kathryn

2012-12-07

Medicare spending on post-acute care provided by skilled nursing facility providers, home health providers, inpatient rehabilitation facility providers, and long-term care hospitals has grown rapidly in the past several years. The Medicare Payment Advisory Commission and others have noted several long-standing problems with the payment systems for post-acute care and have suggested refinements to Medicare's post-acute care payment systems that are intended to encourage the delivery of appropriate care in the right setting for a patient's condition. The Patient Protection and Affordable Care Act of 2010 contained several provisions that affect the Medicare program's post-acute care payment systems and also includes broader payment reforms, such as bundled payment models. This issue brief describes Medicare's payment systems for post-acute care providers, evidence of problems that have been identified with the payment systems, and policies that have been proposed or enacted to remedy those problems.

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.

Integrated Payment and Delivery Models Offer Opportunities and Challenges for Residential Care Facilities

OpenAIRE

Grabowski, David C.; Caudry, Daryl J.; Dean, Katie M.; Stevenson, David G.

2015-01-01

Under health care reform, a series of new financing and delivery models are being piloted to integrate health and long-term care services for older adults. To date, these programs have not encompassed residential care facilities, with most programs focusing on long-term care recipients in the community or the nursing home. Our analyses indicate that individuals living in residential care facilities have similarly high rates of chronic illness and Medicare utilization when compared with simila...

Assessing Residential Customer Satisfaction for Large Electric Utilities

OpenAIRE

Lea Kosnik; L. Douglas Smith; Satish Nayak; Maureen Karig; Mark Konya; Kristy Lovett; Zhennan Liu; Harrison Luvai

2015-01-01

Electric utilities, like other service organizations, rely on customer surveys to assess the quality of their services and customer relations. With responses to an in-depth survey of 2,216 residential customers, complementary data from geo-coded public sources, aggregate assessments of performance by J.D. Power & Associates from their independent surveys, historical records of individual customer usage and bill payments, streams of published media content and records of actual service deliver...

Exploring the market for third-party-owned residential photovoltaic systems: insights from lease and power-purchase agreement contract structures and costs in California

International Nuclear Information System (INIS)

Davidson, Carolyn; Steinberg, Daniel; Margolis, Robert

2015-01-01

Over the past several years, third-party-ownership (TPO) structures for residential photovoltaic (PV) systems have become the predominant ownership model in the US residential market. Under a TPO contract, the PV system host typically makes payments to the third-party owner of the system. Anecdotal evidence suggests that the total TPO contract payments made by the customer can differ significantly from payments in which the system host directly purchases the system. Furthermore, payments can vary depending on TPO contract structure. To date, a paucity of data on TPO contracts has precluded studies evaluating trends in TPO contract cost. This study relies on a sample of 1113 contracts for residential PV systems installed in 2010–2012 under the California Solar Initiative to evaluate how the timing of payments under a TPO contract impacts the ultimate cost of the system to the customer. Furthermore, we evaluate how the total cost of TPO systems to customers has changed through time, and the degree to which contract costs have tracked trends in the installed costs of a PV system. We find that the structure of the contract and the timing of the payments have financial implications for the customer: (1) power-purchase contracts, on average, cost more than leases, (2) no-money-down contracts are more costly than prepaid contracts, assuming a customer’s discount rate is lower than 17% and (3) contracts that include escalator clauses cost more, for both power-purchase agreements and leases, at most plausible discount rates. In addition, all contract costs exhibit a wide range, and do not parallel trends in installed costs over time. (letter)

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

Science.gov (United States)

2012-08-31

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

From Disparity to Harmonisation of Construction Industry Payment Legislation in Australia: A Proposal for a Dual Process of Adjudication based upon Size of Progress Payment Claim

Directory of Open Access Journals (Sweden)

Jeremy Coggins

2011-06-01

Full Text Available Since the introduction of the Building and Construction Industry Security of Payment Act into New South Wales in 1999, construction industry payment legislation has progressively been enacted on a jurisdiction-by-jurisdiction basis throughout Australia. Of the eight Australian Acts, two distinct legislative models can be discerned – what have been termed the ‘East Coast’ and ‘West Coast’ models. This article compares the two models with respect to their payment systems and adjudication schemes, procedural justice afforded, incursion upon freedom of contract, uptake rates and efficiency. From this comparison, the strengths and weaknesses of the two models are identified. Finally, a dual process of adjudication based on progress payment claim size is proposed for a harmonised model, developed from previous proposals put forward by other authors, which aims to combine the strengths of the two existing models.

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.

Assessing the engineering performance of affordable net-zero energy housing

Science.gov (United States)

Wallpe, Jordan P.

The purpose of this research was to evaluate affordable technologies that are capable of providing attractive, cost-effective energy savings to the housing industry. The research did so by investigating the 2011 Solar Decathlon competition, with additional insight from the Purdue INhome. Insight from the Purdue INhome verified the importance of using a three step design process to design a net-zero energy building. In addition, energy consumption values of the INhome were used to compare and contrast different systems used in other houses. Evaluation of unbiased competition contests gave a better understanding of how a house can realistically reach net-zero. Upon comparison, off-the-shelf engineering systems such as super-efficient HVAC units, heat pump hot water heaters, and properly designed photovoltaic arrays can affordably enable a house to become net-zero. These important and applicable technologies realized from the Solar Decathlon will reduce the 22 percent of all energy consumed through the residential sector in the United States. In conclusion, affordable net-zero energy buildings can be built today with commitment from design professionals, manufacturers, and home owners.

Affordable housing as a niche product: The case of the Danish “SocialHousing Plus”

DEFF Research Database (Denmark)

Jensen, Jesper Ole; Stensgaard, Anne Gro

Establishing affordable housing is a growing demand in many larger cities there is however a number of challenges related to establishing affordable housing, as well as many different approaches. This paper presents a case-study of an affordable housing concept in the Danish social housing sector......, the “SocialHousing Plus” (“AlmenBolig+”) which is based on lowering production costs as well as operation costs including residential self-management, large-scale production of pre-fab housing units, low-energy solutions and other innovative approaches. The concept was developed in 2007, and has so far...... resulted in the production of more than 1.500 dwellings. The paper will discuss the results of the concept, and the various challenges related to it. Based on the theory of Technological Transition (Geels, 2002) it will discuss the options and limitations of providing affordable housing through developing...

The affordances of broken affordances

DEFF Research Database (Denmark)

Grünbaum, Martin Gielsgaard; Simonsen, Jakob Grue

2015-01-01

We consider the use of physical and virtual objects having one or more affordances associated to simple interactions with them. Based on Kaptelinin and Nardi’s notion of instrumental affordance, we investigate what it means to break an affordance, and the two ensuing questions we deem most import...

Out-of-pocket payments for health care services in Bulgaria: financial burden and barrier to access.

Science.gov (United States)

Atanasova, Elka; Pavlova, Milena; Moutafova, Emanuela; Rechel, Bernd; Groot, Wim

2013-12-01

In recent years, Bulgaria has increasingly relied on out-of-pocket payments as one of the main sources of health care financing. However, it is largely unknown whether the official patient charges, combined with informal payments, are affordable for the population. Our study aimed to explore the scale of out-of-pocket payments for health care services and their affordability. Data were collected in two nationally representative surveys, conducted in Bulgaria in 2010 and 2011, using face-to-face interviews based on a standardized questionnaire. To select respondents, a multi-stage random probability method was used. The questionnaire included questions on the out-of-pocket payments for health care services used by the respondent during the preceding 12 months. In total, 75.7% (2010) and 84.0% (2011) of outpatient service users reported to have paid out-of-pocket, with 12.6% (2010) and 9.7% (2011) of users reporting informal payments. Of those who had used inpatient services, 66.5% (2010) and 63.1% (2011) reported to have made out-of-pocket payments, with 31.8% (2010) and 18.3% (2011) reporting to have paid informally. We found large inability to pay indicated by the need to borrow money and/or forego services. Regression analysis showed that the inability to pay is especially pronounced among those with poor health status and chronic diseases and those on low household incomes. The high level of both formal and informal out-of-pocket payments for health care services in Bulgaria poses a considerable burden for households and undermines access to health services for poorer parts of the population.

Affordable Hybrid Heat Pump Clothes Dryer

Energy Technology Data Exchange (ETDEWEB)

TeGrotenhuis, Ward E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Butterfield, Andrew [Jabil, St. Petersburg, FL (United States); Caldwell, Dustin D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Crook, Alexander [Jabil, St. Petersburg, FL (United States)

2016-06-30

This project was successful in demonstrating the feasibility of a step change in residential clothes dryer energy efficiency by demonstrating heat pump technology capable of 50% energy savings over conventional standard-size electric dryers with comparable drying times. A prototype system was designed from off-the-shelf components that can meet the project’s efficiency goals and are affordable. An experimental prototype system was built based on the design that reached 50% energy savings. Improvements have been identified that will reduce drying times of over 60 minutes to reach the goal of 40 minutes. Nevertheless, the prototype represents a step change in efficiency over heat pump dryers recently introduced to the U.S. market, with 30% improvement in energy efficiency at comparable drying times.

Perceived affordability of health insurance and medical financial burdens five years in to Massachusetts health reform.

Science.gov (United States)

Zallman, Leah; Nardin, Rachel; Sayah, Assaad; McCormick, Danny

2015-10-29

Under the Massachusetts health reform, low income residents (those with incomes below 150 % of the Federal Poverty Level [FPL]) were eligible for Medicaid and health insurance exchange-based plans with minimal cost-sharing and no premiums. Those with slightly higher incomes (150 %-300 % FPL) were eligible for exchange-based plans that required cost-sharing and premium payments. We conducted face to face surveys in four languages with a convenience sample of 976 patients seeking care at three hospital emergency departments five years after Massachusetts reform. We compared perceived affordability of insurance, financial burden, and satisfaction among low cost sharing plan recipients (recipients of Medicaid and insurance exchange-based plans with minimal cost-sharing and no premiums), high cost sharing plan recipients (recipients of exchange-based plans that required cost-sharing and premium payments) and the commercially insured. We found that despite having higher incomes, higher cost-sharing plan recipients were less satisfied with their insurance plans and perceived more difficulty affording their insurance than those with low cost-sharing plans. Higher cost-sharing plan recipients also reported more difficulty affording medical and non-medical health care as well as insurance premiums than those with commercial insurance. In contrast, patients with low cost-sharing public plans reported higher plan satisfaction and less financial concern than the commercially insured. Policy makers with responsibility for the benefit design of public insurance available under health care reforms in the U.S. should calibrate cost-sharing to income level so as to minimize difficulty affording care and financial burdens.

Episode-Based Payment and Direct Employer Purchasing of Healthcare Services: Recent Bundled Payment Innovations and the Geisinger Health System Experience.

Science.gov (United States)

Slotkin, Jonathan R; Ross, Olivia A; Newman, Eric D; Comrey, Janet L; Watson, Victoria; Lee, Rachel V; Brosious, Megan M; Gerrity, Gloria; Davis, Scott M; Paul, Jacquelyn; Miller, E Lynn; Feinberg, David T; Toms, Steven A

2017-04-01

One significant driver of the disjointed healthcare often observed in the United States is the traditional fee-for-service payment model which financially incentivizes the volume of care delivered over the quality and coordination of care. This problem is compounded by the wide, often unwarranted variation in healthcare charges that purchasers of health services encounter for substantially similar episodes of care. The last 10 years have seen many stakeholder organizations begin to experiment with novel financial payment models that strive to obviate many of the challenges inherent in customary quantity-based cost paradigms. The Patient Protection and Affordable Care Act has allowed many care delivery systems to partner with Medicare in episode-based payment programs such as the Bundled Payments for Care Improvement (BPCI) initiative, and in patient-based models such as the Medicare Shared Savings Program. Several employer purchasers of healthcare services are experimenting with innovative payment models to include episode-based bundled rate destination centers of excellence programs and the direct purchasing of accountable care organization services. The Geisinger Health System has over 10 years of experience with episode-based payment bundling coupled with the care delivery reengineering which is integral to its ProvenCare® program. Recent experiences at Geisinger have included participation in BPCI and also partnership with employer-purchasers of healthcare through the Pacific Business Group on Health (representing Walmart, Lowe's, and JetBlue Airways). As the shift towards value-focused care delivery and patient experience progresses forward, bundled payment arrangements and direct purchasing of healthcare will be critical financial drivers in effecting change. Copyright © 2017 by the Congress of Neurological Surgeons.

Post-acute care and vertical integration after the Patient Protection and Affordable Care Act.

Science.gov (United States)

Shay, Patrick D; Mick, Stephen S

2013-01-01

The anticipated changes resulting from the passage of the Patient Protection and Affordable Care Act-including the proposed adoption of bundled payment systems and the promotion of accountable care organizations-have generated considerable controversy as U.S. healthcare industry observers debate whether such changes will motivate vertical integration activity. Using examples of accountable care organizations and bundled payment systems in the American post-acute healthcare sector, this article applies economic and sociological perspectives from organization theory to predict that as acute care organizations vary in the degree to which they experience environmental uncertainty, asset specificity, and network embeddedness, their motivation to integrate post-acute care services will also vary, resulting in a spectrum of integrative behavior.

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

Affordability for sustainable energy development products

International Nuclear Information System (INIS)

Riley, Paul H.

2014-01-01

Highlights: • Clean cookstoves that also generate electricity improve affordability. • Excel spreadsheet model to assist stakeholders to choose optimum technology. • Presents views for each stakeholder villager, village and country. • By adding certain capital costs, affordability and sustainability are improved. • Affordability is highly dependent on carbon credits and social understandings. - Abstract: Clean burning products, for example cooking stoves, can reduce household air pollution (HAP), which prematurely kills 3.5 million people each year. By careful selection of components into a product package with micro-finance used for the capital payment, barriers to large-scale uptake of products that remove HAP are reduced. Such products reduce smoke from cooking and the lighting from electricity produced, eliminates smoke from kerosene lamps. A bottom-up financial model, that is cognisant of end user social needs, has been developed to compare different products for use in rural areas of developing countries. The model is freely available for use by researchers and has the ability to assist in the analysis of changing assumptions. Business views of an individual villager, the village itself and a country view are presented. The model shows that affordability (defined as the effect on household expenses as a result of a product purchase) and recognition of end-user social needs are as important as product cost. The effects of large-scale deployment (greater that 10 million per year) are described together with level of subsidy required by the poorest people. With the assumptions given, the model shows that pico-hydro is the most cost effective, but not generally available, one thermo-acoustic technology option does not require subsidy, but it is only at technology readiness level 2 (NASA definition) therefore costs are predicted and very large investment in manufacturing capability is needed to meet the cost target. Thermo-electric is currently the only

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.

Can poor consumers pay for energy and water? An affordability analysis for transition countries

International Nuclear Information System (INIS)

Frankhauser, S.; Sladjana Tepic

2007-01-01

Low-income households spend a substantial share of their income on utility services such as electricity, heating and water. The difficulty of these socially vulnerable consumers to absorb further price increases is often used as an argument against tariff reform. However, detailed quantitative information on the affordability of tariff adjustments for low-income consumers is actually quite scarce. Much of the available information is based on households. This paper takes a more detailed look at the affordability of electricity, district heating and water for low-income consumers in transition countries. While the available data are incomplete, the paper finds that affordability is a problem for low-income consumers in most countries, in particular in the water sector and in the Commonwealth of Independent States (CIS). The affordability consequences of tariff reform ultimately depend on the speed of tariff adjustments relative to the growth in household income, the level of tariffs needed for cost recovery, the level of effective tariffs at the outset (tariffs adjusted for non-payment) and the demand response to the tariff increase. The paper finds that delaying tariff reform by a few years makes little difference to affordability constraints, and may therefore not be an effective way to mitigate the social impact of utility reform. (author)

Can poor consumers pay for energy and water? An affordability analysis for transition countries

International Nuclear Information System (INIS)

Fankhauser, Samuel; Tepic, Sladjana

2007-01-01

Low-income households spend a substantial share of their income on utility services such as electricity, heating and water. The difficulty of these socially vulnerable consumers to absorb further price increases is often used as an argument against tariff reform. However, detailed quantitative information on the affordability of tariff adjustments for low-income consumers is actually quite scarce. Much of the available information is based on households. This paper takes a more detailed look at the affordability of electricity, district heating and water for low-income consumers in transition countries. While the available data are incomplete, the paper finds that affordability is a problem for low-income consumers in most countries, in particular in the water sector and in the Commonwealth of Independent States (CIS). The affordability consequences of tariff reform ultimately depend on the speed of tariff adjustments relative to the growth in household income, the level of tariffs needed for cost recovery, the level of effective tariffs at the outset (tariffs adjusted for non-payment) and the demand response to the tariff increase. The paper finds that delaying tariff reform by a few years makes little difference to affordability constraints, and may therefore not be an effective way to mitigate the social impact of utility reform

Public Awareness of and Contact With Physicians Who Receive Industry Payments: A National Survey.

Science.gov (United States)

Pham-Kanter, Genevieve; Mello, Michelle M; Lehmann, Lisa Soleymani; Campbell, Eric G; Carpenter, Daniel

2017-07-01

The Physician Payments Sunshine Act, part of the Affordable Care Act, requires pharmaceutical and medical device firms to report payments they make to physicians and, through its Open Payments program, makes this information publicly available. To establish estimates of the exposure of the American patient population to physicians who accept industry payments, to compare these population-based estimates to physician-based estimates of industry contact, and to investigate Americans' awareness of industry payments. Cross-sectional survey conducted in late September and early October 2014, with data linkage of respondents' physicians to Open Payments data. A total of 3542 adults drawn from a large, nationally representative household panel. Respondents' contact with physicians reported in Open Payments to have received industry payments; respondents' awareness that physicians receive payments from industry and that payment information is publicly available; respondents' knowledge of whether their own physician received industry payments. Among the 1987 respondents who could be matched to a specific physician, 65% saw a physician who had received an industry payment during the previous 12 months. This population-based estimate of exposure to industry contact is much higher than physician-based estimates from the same period, which indicate that 41% of physicians received an industry payment. Across the six most frequently visited specialties, patient contact with physicians who had received an industry payment ranged from 60 to 85%; the percentage of physicians with industry contact in these specialties was much lower (35-56%). Only 12% of survey respondents knew that payment information was publicly available, and only 5% knew whether their own doctor had received payments. Patients' contact with physicians who receive industry payments is more prevalent than physician-based measures of industry contact would suggest. Very few Americans know whether their own doctor

Impact of universal medical insurance system on the accessibility of medical service supply and affordability of patients in China

Science.gov (United States)

Zhang, Zhiguo; Ren, Jing; Zhang, Jie; Pan, Xiaoyun; Zhang, Liang; Jin, Si

2018-01-01

Background China’s universal medical insurance system (UMIS) is designed to promote social fairness through improving access to medical services and reducing out-of-pocket (OOP) costs for all Chinese. However, it is still not known whether UMIS has a significant impact on the accessibility of medical service supply and the affordability, as well as the seeking-care choice, of patients in China. Methods Segmented time-series regression analysis, as a powerful statistical method of interrupted time series design, was used to estimate the changes in the quantity and quality of medical service supply before and after the implementation of UMIS. The rates of catastrophic payments and seeking-care choices for UMIS beneficiaries were selected to measure the affordability and medical service flow of patients after the implementation of UMIS. Results China’s UMIS was established in 2008. After that, the trending increase of the expenditure of the UMIS was higher than that of increase in revenue compared to previous years. Up to 2014, the UMIS had covered 97.5% of the entire population in China. After introduction of the UMIS, there were significant increases in licensed physicians, nurses, and hospital beds per 1000 individuals. In addition, hospital outpatient visits and inpatient visits per year increased compared to the pre-UMIS period. The average fatality rate of inpatients in the overall hospital and general hospital and the average fatality rate due to acute myocardial infarction (AMI) in general hospitals was significantly decreased. In contrast, no significant and prospective changes were observed in rural physicians per 1000 individuals, inpatient visits and inpatient fatality rate in the community centers and township hospitals compared to the pre-UMIS period. After 2008, the rates of catastrophic payments for UMIS inpatients at different income levels were declining at three levels of hospitals. Whichever income level, the rate of catastrophic payments for

Development Of Economic Techniques For Residential Thermography

Science.gov (United States)

Allen, Lee R.; Allen, Sharon

1983-03-01

Infrared thermography has proven to be a valuable tool in the detection of heat loss in both commercial and residential buildings. The field of residential thermography has needed a simple method with which to report the deficiencies found during an infrared scan. Two major obstacles hindering the cost effectiveness of residential thermography have been 1) the ability to quickly transport some high resolution imaging system equipment from job site to job site without having to totally dismount the instruments at each area, and 2) the lack of a standard form with which to report the findings of the survey to the customer. Since the industry has yet to provide us with either, we believed it necessary to develop our own. Through trial and error, we have come up with a system that makes interior residential thermography a profitable venture at a price the homeowner can afford. Insulation voids, or defects can be instantly spotted with the use of a thermal imaging system under the proper conditions. A special hand-held device was developed that enables the thermographer to carry the equipment from house to house without the need to dismantle and set up at each stop. All the necessary components are attached for a total weight of about 40 pounds. The findings are then conveyed to a form we have developed. The form is simple enough that the client without special training in thermography can understand. The client is then able to locate the problems and take corrective measures or give it to a con-tractor to do the work.

American surgery and the Affordable Care Act.

Science.gov (United States)

Stain, Steven C; Hoyt, David B; Hunter, John G; Joyce, Geoffrey; Hiatt, Jonathan R

2014-09-01

The Affordable Care Act (ACA) attempts to change the way we finance and deliver health care by coordinating the delivery of primary, specialty, and hospital services in accountable care organizations. The ways in which accountable care organizations will develop and evolve is unclear; however, the effects on surgeons and their patients will be substantial. High-value care in the ACA emphasizes quality, safety, resource use and appropriateness, and the patient's experience of care. Payment will be linked to these principles. Department chairs overseeing a clinical enterprise in academic medical centers now must add financial and quality measures to the traditional missions of education, research, and clinical service. At a time when surgical training is in dramatic evolution, with work hour limitations for residents and an emphasis on quality, productivity, and increasing oversight of trainees for faculty, residency programs will need to meet the increasing demands of an aging population and newly insured patients under the ACA. The American College of Surgeons, with its century-long commitment to quality improvement, research-based standards, and performance measurement and verification, has begun its Inspiring Quality Campaign, is developing new educational tools, and is preparing proposals for payment reform based on surgeons' participation in quality programs.

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

Science.gov (United States)

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

2011-01-01

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

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.

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

Science.gov (United States)

2015-08-17

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

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

Science.gov (United States)

Balabanova, Dina; McKee, Martin

2002-12-01

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

Paying for Cures: How Can We Afford It? Managed Care Pharmacy Stakeholder Perceptions of Policy Options to Address Affordability of Prescription Drugs.

Science.gov (United States)

Yeung, Kai; Suh, Kangho; Basu, Anirban; Garrison, Louis P; Bansal, Aasthaa; Carlson, Josh J

2017-10-01

High-priced medications with curative potential, such as the newer hepatitis C therapies, have contributed to the recent growth in pharmaceutical expenditure. Despite the obvious benefits, health care decision makers are just beginning to grapple with questions of how to value and pay for curative therapies that may feature large upfront cost, followed by health benefits that are reaped over a patient's lifespan. Alternative policy options have been proposed to promote high value and financially sustainable use of these therapies. It is unclear which policy options would be most acceptable to health care payer and biomedical manufacturer stakeholders. To (a) briefly review pharmaceutical policy options to address health system affordability and (b) assess the acceptability of alternative policy options to health care payers and biomedical manufacturers before and after an Academy of Managed Care Pharmacy (AMCP) continuing pharmacy education (CPE) session. We searched MEDLINE and Cochran databases for pharmaceutical policy options addressing affordability. With input from a focus group of managed care professionals, we developed CPE session content and an 8-question survey focusing on the most promising policy options. We fielded the survey before and after the CPE session, which occurred as part of the 2016 AMCP Annual Meeting. We first conducted a chi-squared goodness-of-fit test to assess response distributions. Next, we tested how responses differed before and after by using an ordered logit and a multinomial logit to model Likert scale and unordered responses, respectively. Although risk-sharing payments over time remained the most favorable choice before (37%) and after (35%) the CPE session, this choice was closely followed by HealthCoin after the session, which increased in favorability from 4% to 33% of responses (P = 0.001). About half of the respondents (54%) indicated that legislative change is the most significant barrier to the implementation of any

Homeowner attitudes and practices towards residential landscape management in Ohio, USA.

Science.gov (United States)

Blaine, Thomas W; Clayton, Susan; Robbins, Paul; Grewal, Parwinder S

2012-08-01

This study describes the results of a survey of 432 homeowners in Ohio, USA concerning their perceptions and practices regarding management of residential landscapes. The results reveal that outdoor residential environments are extremely important to homeowners, who tend to view their yards as serving multiple functions: a place to observe nature and to socialize as well as a place of beauty and recreation. Use of a lawn care company to apply chemicals is reported by 22 % of respondents, while 40 % either apply chemicals themselves or have someone other than a lawn care company do it. Logistic regressions reveal that factors influencing a homeowner's decision to employ a lawn care company or to apply chemicals themselves include: household income (+), perceived impacts on the environment (-), whether the next door neighbor does it (+), and type of residential environment (rural -, suburban and urban +). A theme that emerges throughout the study is the perceived importance of the role of the lawn in residents' sense of social status or acceptance in the neighborhood. This perception can be viewed as a positive in ensuring that residential environments are well maintained, but also as a negative resulting in environmental degradation or presenting a barrier to creativity in the development of alternative residential environments. Specific policy implications of these findings are that efforts aimed at educating homeowners about the environmental impacts of their lawn care choices are likely to have more success if they are directed at neighborhood groups rather than individuals, show that alternatives are easy to adopt, affordable, and can produce the characteristics of lawns that homeowners seek.

Design and impact of bundled payment for detox and follow-up care.

Science.gov (United States)

Quinn, Amity E; Hodgkin, Dominic; Perloff, Jennifer N; Stewart, Maureen T; Brolin, Mary; Lane, Nancy; Horgan, Constance M

2017-11-01

Recent payment reforms promote movement from fee-for-service to alternative payment models that shift financial risk from payers to providers, incentivizing providers to manage patients' utilization. Bundled payment, an episode-based fixed payment that includes the prices of a group of services that would typically treat an episode of care, is expanding in the United States. Bundled payment has been recommended as a way to pay for comprehensive SUD treatment and has the potential to improve treatment engagement after detox, which could reduce detox readmissions, improve health outcomes, and reduce medical care costs. However, if moving to bundled payment creates large losses for some providers, it may not be sustainable. The objective of this study was to design the first bundled payment for detox and follow-up care and to estimate its impact on provider revenues. Massachusetts Medicaid beneficiaries' behavioral health, medical, and pharmacy claims from July 2010-April 2013 were used to build and test a detox bundled payment for continuously enrolled adults (N=5521). A risk adjustment model was developed using general linear modeling to predict beneficiaries' episode costs. The projected payments to each provider from the risk adjustment analysis were compared to the observed baseline costs to determine the potential impact of a detox bundled payment reform on organizational revenues. This was modeled in two ways: first assuming no change in behavior and then assuming a supply-side cost sharing behavioral response of a 10% reduction in detox readmissions and an increase of one individual counseling and one group counseling session. The mean total 90-day detox episode cost was $3743. Nearly 70% of the total mean cost consists of the index detox, psychiatric inpatient care, and short-term residential care. Risk mitigation, including risk adjustment, substantially reduced the variation of the mean episode cost. There are opportunities for organizations to gain revenue

Impact of higher energy efficiency standards on housing affordability in Alberta

International Nuclear Information System (INIS)

2010-07-01

As a result of changes to provincial and national building and energy costs, the impact of increasing energy efficiency standards on housing affordability has been questioned. Determining housing affordability is a complicated process. This report presented the results of a costing analysis completed for upgrades of EnerGuide 80 levels of energy efficiency in homes in Calgary and Edmonton, Alberta. The elements of residential construction were identified. In order to better understand the cost impact of energy efficiency upgrades on a home, pricing data was obtained. Costing elements that were examined included housing price indexes; construction material price indexes; unionized trade wages; and land value. Specifically, the report presented the new housing price index analysis using material and labour costs. An analysis of energy efficiency improvement was then presented in terms of lifecycle costs (capital costs and life cycle costing results). It was concluded that although the price of labour and materials is increasing, the value of land is the primary driver for rising house prices. The price of housing is strongly correlated to the price of land and not the price of labour or materials. In addition, moving to EnerGuide 80 levels of energy efficiency for housing in Alberta made homes more affordable for homebuyers by lowering their total monthly housing costs. 4 tabs., 3 figs., 3 appendices.

Medical Device Innovation in the Era of the Affordable Care Act: The End of Sexy.

Science.gov (United States)

Mattke, Soeren; Liu, Hangsheng; Orr, Patrick

2016-06-20

In this article, the authors explore why medical device innovation has traditionally been geared so thoroughly toward improving performance, with little regard to cost. They argue that the changing incentives in the health care sector and the move to value-based payment models, accelerated by the implementation of the Affordable Care Act, will force device manufacturers to redirect investments from the spectacular toward the prudent, which they dub "the end of sexy." The authors explore consequences for manufacturers, investors, and policymakers.

Game-Theoretic Energy Management for Residential Users with Dischargeable Plug-in Electric Vehicles

Directory of Open Access Journals (Sweden)

Bingtuan Gao

2014-11-01

Full Text Available The plug-in electric vehicle (PEV has attracted more and more attention because of the energy crisis and environmental pollution, which is also the main shiftable load of the residential users’ demand side management (DSM system in the future smart grid (SG. In this paper, we employ game theory to provide an autonomous energy management system among residential users considering selling energy back to the utility company by discharging the PEV’s battery. By assuming all users are equipped with smart meters to execute automatic energy consumption scheduling (ECS and the energy company can adopt adequate pricing tariffs relating to time and level of energy usage, we formulate an energy management game, where the players are the residential users and the strategies are their daily schedules of household appliance use. We will show that the Nash equilibrium of the formulated energy management game can guarantee the global optimization in terms of minimizing the energy costs, where the depreciation cost of PEV’s battery because of discharging and selling energy back is also considered. Simulation results verify that the proposed game-theoretic approach can reduce the total energy cost and individual daily electricity payment. Moreover, since plug-in electric bicycles (PEBs are currently widely used in China, simulation results of residential users owing household appliances and bidirectional energy trading of PEBs are also provided and discussed.

Accessibility, affordability and use of health services in an urban area in South Africa.

Science.gov (United States)

Stellenberg, Ethelwynn L

2015-03-10

Inequalities in healthcare between population groups of South Africa existed during the apartheid era and continue to exist both between and within many population groups. Accessibility and affordability of healthcare is a human right. The aim of the study was to explore and describe accessibility, affordability and the use of health services by the mixed race (coloured) population in the Western Cape, South Africa. A cross-sectional descriptive, non-experimental study with a quantitative approach was applied. A purposive convenient sample of 353 participants (0.6%) was drawn from a population of 63 004 economically-active people who lived in the residential areas as defined for the purpose of the study. All social classes were represented. The hypothesis set was that there is a positive relationship between accessibility, affordability and the use of health services. A pilot study was conducted which also supported the reliability and validity of the study. Ethics approval was obtained from the University of Stellenbosch and informed consent from respondents. A questionnaire was used to collect the data. The hypothesis was accepted. The statistical association between affordability (p = < 0.01), accessibility (p = < 0.01) and the use of health services was found to be significant using the Chi-square (χ²) test. The study has shown how affordability and accessibility may influence the use of healthcare services. Accessibility is not only the distance an individual must travel to reach the health service point but more so the utilisation of these services. Continuous Quality Management should be a priority in healthcare services, which should be user-friendly.

Historicizing affordance theory

DEFF Research Database (Denmark)

Pedersen, Sofie; Bang, Jytte Susanne

2017-01-01

The aim of this article is to discuss how mutually enriching points from both affordance theory and cultural-historical activity theory can promote theoretical ideas which may prove useful as analytical tools for the study of human life and human development. There are two issues that need...... to be overcome in order to explore the potentials of James Gibson’s affordance theory: it does not sufficiently theorize (a) development and (b) society. We claim that Gibson’s affordance theory still needs to be brought beyond “the axiom of immediacy.” Ambivalences in Gibson’s affordance theory...... societal character of affordance theory....

Affordability Challenges to Value-Based Pricing: Mass Diseases, Orphan Diseases, and Cures.

Science.gov (United States)

Danzon, Patricia M

2018-03-01

To analyze how value-based pricing (VBP), which grounds the price paid for pharmaceuticals in their value, can manage "affordability" challenges, defined as drugs that meet cost-effectiveness thresholds but are "unaffordable" within the short-run budget. Three specific contexts are examined, drawing on recent experience. First, an effective new treatment for a chronic, progressive disease, such as hepatitis C, creates a budget spike that is transitory because initial prevalence is high, relative to current incidence. Second, "cures" that potentially provide lifetime benefits may claim abnormally high VBP prices, with high immediate budget impact potentially/partially offset by deferred cost savings. Third, although orphan drugs in principle target rare diseases, in aggregate they pose affordability concerns because of the growing number of orphan indications and increasingly high prices. For mass diseases, the transitory budget impact of treating the accumulated patient stock can be managed by stratified rollout that delays treatment of stable patients and prioritizes patients at high risk of deterioration. Delay spreads the budget impact and permits potential savings from launch of competing treatments. For cures, installment payments contingent on outcomes could align payment flows and appropriately shift risk to producers. This approach, however, entails high administrative and incentive costs, especially if applied across multiple payers in the United States. For orphan drugs, the available evidence on research and development trends and returns argues against the need for a higher VBP threshold to incentivize research and development in orphan drugs, given existing statutory benefits under orphan drug legislation. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

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.

Network Affordances

DEFF Research Database (Denmark)

Samson, Audrey; Soon, Winnie

2015-01-01

This paper examines the notion of network affordance within the context of network art. Building on Gibson's theory (Gibson, 1979) we understand affordance as the perceived and actual parameters of a thing. We expand on Gaver's affordance of predictability (Gaver, 1996) to include ecological...... and computational parameters of unpredictability. We illustrate the notion of unpredictability by considering four specific works that were included in a network art exhibiton, SPEED SHOW [2.0] Hong Kong. The paper discusses how the artworks are contingent upon the parameteric relations (Parisi, 2013......), of the network. We introduce network affordance as a dynamic framework that could articulate the experienced tension arising from the (visible) symbolic representation of computational processes and its hidden occurrences. We base our proposal on the experience of both organising the SPEED SHOW and participating...

Rethinking Space Design Standards Toward Quality Affordable Housing In Malaysia

Directory of Open Access Journals (Sweden)

Ishak Nor Haniza

2016-01-01

Full Text Available Provision of affordable housing is important to low- and middle-income population. A fit form of house will not only fulfil a basic human need for shelter, but it also contributes to physical and psychological well-being of the occupants. Excellent quality and affordable housing is an indication of a high quality of life. While writings exist on various aspects of the quality of affordable housing in Malaysia, discussion regarding space and design standards has scarcely been given any serious academic attention. Standards concerning residential development usually cover different aspects or stages of the development process. They can include planning standards, design standards, space standards and technical construction standards. The main concern of this paper is on space and design standards specifically. Space standard can be defined as a set of framework which dictates fixed internal space minimums. Meanwhile, design standard indicates design guidelines to ensure the functionality, comfortability and habitability of the house. This paper is concerned exclusively with indoor spaces of a house excluding external circulation spaces and service facilities (in case of strata housing. Its interest is in internal space as an aspect of housing quality. It can be concluded that one of the way forward will be to find the balance between providing adequate minimum spaces for resident satisfactions and having economic values for housing developers. This paper may be used as a valuable reference for authorities and policy makers to better address the best housing space design standards that would benefit not only the occupants, but also the local government and developers alike.

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.

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

Science.gov (United States)

2011-11-28

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

Residential landscapes and house societies of the late prehistoric Society Islands

International Nuclear Information System (INIS)

Kahn, J.G.; Kirch, P.V.

2013-01-01

We extend the 'house society' perspective to one of the most complex Eastern Polynesian chiefdoms, the Society Islands. Employing a landscape approach, we argue that competing elites used the flexibility of the 'house society' structure and its landed estates to promulgate and manipulate status differences. Our study documents how the social hierarchy and its ideological underpinnings were materialised in archaeologically visible ways, including investments in residential landscapes, site proxemics, and construction sequences. While communal investments in the landed material estate were staged over a few centuries, investments in the house's ideology and corporate identity were established early on. Differences in house rank afforded some houses greater access to essential resources and facilitated their abilities to maintain and extend their corporate group, while affording them greater access to labor and continued wealth production over time. Our case study exemplifies the significant role that small-scale relations - quotidian interactions within neighborhoods - played as sources of social power. (author). 105 refs., 9 figs., 3 tabs.

Residential building codes, affordability, and health protection: a risk-tradeoff approach.

Science.gov (United States)

Hammitt, J K; Belsky, E S; Levy, J I; Graham, J D

1999-12-01

Residential building codes intended to promote health and safety may produce unintended countervailing risks by adding to the cost of construction. Higher construction costs increase the price of new homes and may increase health and safety risks through "income" and "stock" effects. The income effect arises because households that purchase a new home have less income remaining for spending on other goods that contribute to health and safety. The stock effect arises because suppression of new-home construction leads to slower replacement of less safe housing units. These countervailing risks are not presently considered in code debates. We demonstrate the feasibility of estimating the approximate magnitude of countervailing risks by combining the income effect with three relatively well understood and significant home-health risks. We estimate that a code change that increases the nationwide cost of constructing and maintaining homes by $150 (0.1% of the average cost to build a single-family home) would induce offsetting risks yielding between 2 and 60 premature fatalities or, including morbidity effects, between 20 and 800 lost quality-adjusted life years (both discounted at 3%) each year the code provision remains in effect. To provide a net health benefit, the code change would need to reduce risk by at least this amount. Future research should refine these estimates, incorporate quantitative uncertainty analysis, and apply a full risk-tradeoff approach to real-world case studies of proposed code changes.

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...

77 FR 28519 - Test Procedure Guidance for Room Air Conditioners, Residential Dishwashers, and Residential...

Science.gov (United States)

2012-05-15

... Guidance for Room Air Conditioners, Residential Dishwashers, and Residential Clothes Washers: Public... procedures for room air conditioners, residential dishwashers, and residential clothes washers. DATES: DOE...'s existing test procedures for residential room air conditioners, residential dishwashers, and...

Payment Instrument Characteristics

DEFF Research Database (Denmark)

Holst, Jacques; Kjeldsen, Martin; Hedman, Jonas

2015-01-01

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

Payment card rewards programs and consumer payment choice

OpenAIRE

Andrew Ching; Fumiko Hayashi

2006-01-01

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

Accessibility, affordability and use of health services in an urban area in South Africa

Directory of Open Access Journals (Sweden)

Ethelwynn L. Stellenberg

2015-03-01

Full Text Available Background: Inequalities in healthcare between population groups of South Africa existed during the apartheid era and continue to exist both between and within many population groups. Accessibility and affordability of healthcare is a human right. Objectives: The aim of the study was to explore and describe accessibility, affordability and the use of health services by the mixed race (coloured population in the Western Cape, South Africa. Method: A cross-sectional descriptive, non-experimental study with a quantitative approach was applied. A purposive convenient sample of 353 participants (0.6% was drawn from a population of 63 004 economically-active people who lived in the residential areas as defined for the purpose of the study. All social classes were represented. The hypothesis set was that there is a positive relationship between accessibility, affordability and the use of health services. A pilot study was conducted which also supported the reliability and validity of the study. Ethics approval was obtained from the University of Stellenbosch and informed consent from respondents. A questionnaire was used to collect the data. Results: The hypothesis was accepted. The statistical association between affordability (p = < 0.01, accessibility (p = < 0.01 and the use of health services was found to be significant using the Chi-square (χ² test. Conclusion: The study has shown how affordability and accessibility may influence the use of healthcare services. Accessibility is not only the distance an individual must travel to reach the health service point but more so the utilisation of these services. Continuous Quality Management should be a priority in healthcare services, which should be user-friendly.

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...

Design and Evaluation of a Net Zero Energy Low-Income Residential Housing Development in Lafayette, Colorado

Energy Technology Data Exchange (ETDEWEB)

Dean, J.; VanGeet, O.; Simkus, S.; Eastment, M.

2012-03-01

This report outlines the lessons learned and sub-metered energy performance of an ultra low energy single family ranch home and duplex unit, called the Paradigm Pilot Project and presents the final design recommendations for a 153-unit net zero energy residential development called the Josephine Commons Project. Affordable housing development authorities throughout the United States continually struggle to find the most cost-effective pathway to provide quality, durable, and sustainable housing. The challenge for these authorities is to achieve the mission of delivering affordable housing at the lowest cost per square foot in environments that may be rural, urban, suburban, or within a designated redevelopment district. With the challenges the U.S. faces regarding energy, the environmental impacts of consumer use of fossil fuels and the increased focus on reducing greenhouse gas emissions, housing authorities are pursuing the goal of constructing affordable, energy efficient and sustainable housing at the lowest life-cycle cost of ownership. This report outlines the lessons learned and sub-metered energy performance of an ultra-low-energy single family ranch home and duplex unit, called the Paradigm Pilot Project and presents the final design recommendations for a 153-unit net zero energy residential development called the Josephine Commons Project. In addition to describing the results of the performance monitoring from the pilot project, this paper describes the recommended design process of (1) setting performance goals for energy efficiency and renewable energy on a life-cycle cost basis, (2) using an integrated, whole building design approach, and (3) incorporating systems-built housing, a green jobs training program, and renewable energy technologies into a replicable high performance, low-income housing project development model.

Solar Energy Systems for Ohioan Residential Homeowners

Science.gov (United States)

Luckett, Rickey D.

Dwindling nonrenewable energy resources and rising energy costs have forced the United States to develop alternative renewable energy sources. The United States' solar energy industry has seen an upsurge in recent years, and photovoltaic holds considerable promise as a renewable energy technology. The purpose of this case study was to explore homeowner's awareness of the benefits of solar energy. Disruptive-innovation theory was used to explore marketing strategies for conveying information to homeowners about access to new solar energy products and services. Twenty residential homeowners were interviewed face-to-face to explore (a) perceived benefits of solar energy in their county in Ohio, and (b) perceptions on the rationale behind the marketing strategy of solar energy systems sold for residential use. The study findings used inductive analyses and coding interpretation to explore the participants' responses that revealed 3 themes: the existence of environmental benefits for using solar energy systems, the expensive cost of equipment associated with government incentives, and the lack of marketing information that is available for consumer use. The implications for positive social change include the potential to enable corporate leaders, small business owners, and entrepreneurs to develop marketing strategies for renewable energy systems. These strategies may promote use of solar energy systems as a clean, renewable, and affordable alternative electricity energy source for the 21st century.

Low-carbon-oriented dynamic optimization of residential energy pricing in China

International Nuclear Information System (INIS)

He, Yongxiu; Liu, Yangyang; Wang, Jianhui; Xia, Tian; Zhao, Yushan

2014-01-01

In China, the energy pricing mechanism has an insufficient linkage with other energy prices. As a result of the unreasonable price level, it is impossible to exploit fully the substitution elasticity among energy resources and there is a negative impact on achieving energy conservation and energy efficiency. This paper proposes an optimized mechanism for residential energy prices in China, which maximizes the total social surplus subject to some related constraints. Three types of energy pricing mechanisms are designed based on China's low-carbon targets and the optimization of residential energy price policies through the dynamic CGE model. Compared with the energy price linkage method, the results show that the market netback value mechanism has a greater impact on the total social surplus. In order to achieve further low-carbon targets, the proportion of second and third tier residents can be expanded, while the energy prices could be deregulated to some degree. In addition, considering residential affordability, the government may take into account different electricity pricing mechanisms for different tiers of residents. Electricity pricing for the first tier, the second tier and the third tier should be based respectively on cost, the integration of energy price linkage and the market netback value mechanism. - Highlights: • Residential energy price mechanisms can be considered in the D-CGE model. • The maximization of total social surplus is the optimized objective. • The market netback value mechanism has a greater impact on the total social surplus. • Production cost and energy price conduction should be considered in price mechanisms. • Government should take the energy system as a whole to optimize energy prices

Achieving a deeper understanding of the implemented provisions of the Affordable Care Act.

Science.gov (United States)

Zhang, Shuang Qin; Polite, Blase N

2014-01-01

The Patient Protection and Affordable Care Act (ACA) was signed into law by President Barack Obama on March 23, 2010. Since that time, numerous regulations have been promulgated, legal battles continue to be fought and the major provisions of the law are being implemented. In the following article, we outline components of the ACA that are relevant to cancer health care, review current implementation of the new health care reform law, and identify challenges that may lie ahead in the post-ACA era. Specifically, among the things we explore are Medicaid expansion, health insurance exchanges, essential health benefits and preventive services, subsidies, access to clinical trials, the Medicare Part D donut hole, and physician quality payment reform.

Putting out the welcome mat-targeting outreach efforts under the Affordable Care Act: Evidence from the Minnesota Community Application Agent Program.

Science.gov (United States)

Dybdal, Kristin; Blewett, Lynn A; Pintor, Jessie Kemmick; Johnson, Kelli

2015-01-01

An evaluation of the Minnesota Community Application Agent (MNCAA) Program was conducted for the MN Minnesota Department of Human Services and funded by the Health Resources and Services Administration's State Health Access Program grant. The MNCAA evaluation assessed effectiveness in reaching disparate populations, explored overall program value, and sought lessons applicable to the Navigator programs required under the Affordable Care Act. Mixed-methods approach using quantitative analysis of tracking and payment data and interviews with key informants to elicit "lessons learned" about the MNCAA program. The MNCAA program offers incentive payments and technical assistance to community partner organizations that assist individuals in applying for public health care coverage. A total of 140 unique community organizations participated in the MNCAA program in 2008 to 2012. Outreach staff and directors from participating MNCAAs and state/local government officials were interviewed. The article highlights a strategy for targeting outreach to individuals eligible for Medicaid coverage or subsidies under the Affordable Care Act by presenting evaluation findings from a unique outreach program to increase access to care for vulnerable populations in Minnesota. Almost two-thirds of applicants were successfully enrolled but lengthy waiting periods persisted. Seventy percent of applications came from health care organizations. Only 13% of applicants assisted by MNCAAs were new to public health care programs. Most MNCAAs believed that the incentive payment-$25 per successful enrollee-was insufficient. Significant expertise in enrolling individuals in public health care programs exists within a core group of community organizations. Incentives to leverage the capacity of community organizations must be accompanied by recruiting and training. Outreach providers and navigators also need timely access to client information. More investment in financial incentives will be required.

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

Science.gov (United States)

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

2017-10-01

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

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.

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.

Actant affordances: a brief history of affordance theory and a ...

African Journals Online (AJOL)

Affordance theory provides a useful lens to explore the action opportunities that arise between users and technology, especially in education. However developments in the theory have resulted both in confusion and misapplication, due partly to issues related to affordance theory's ontology. This paper outlines two ...

55 Actant affordances: a brief history of affordance theory and a ...

African Journals Online (AJOL)

He combined affordances and perceptual information in a simple matrix, as shown in figure ... Secondly it shows up cases of False Affordances that appear to be useful ..... Distributed Cognitions: Psychological and Educational Considerations.

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...

Medicare and Medicaid programs; CY 2015 Home Health Prospective Payment System rate update; Home Health Quality Reporting Requirements; and survey and enforcement requirements for home health agencies. Final rule.

Science.gov (United States)

2014-11-06

This final rule updates Home Health Prospective Payment System (HH PPS) rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor under the Medicare prospective payment system for home health agencies (HHAs), effective for episodes ending on or after January 1, 2015. As required by the Affordable Care Act, this rule implements the second year of the four-year phase-in of the rebasing adjustments to the HH PPS payment rates. This rule provides information on our efforts to monitor the potential impacts of the rebasing adjustments and the Affordable Care Act mandated face-to-face encounter requirement. This rule also implements: Changes to simplify the face-to-face encounter regulatory requirements; changes to the HH PPS case-mix weights; changes to the home health quality reporting program requirements; changes to simplify the therapy reassessment timeframes; a revision to the Speech-Language Pathology (SLP) personnel qualifications; minor technical regulations text changes; and limitations on the reviewability of the civil monetary penalty provisions. Finally, this rule also discusses Medicare coverage of insulin injections under the HH PPS, the delay in the implementation of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), and a HH value-based purchasing (HH VBP) model.

Little Evidence Exists To Support The Expectation That Providers Would Consolidate To Enter New Payment Models.

Science.gov (United States)

Neprash, Hannah T; Chernew, Michael E; McWilliams, J Michael

2017-02-01

Provider consolidation has been associated with higher health care prices and spending. The prevailing wisdom is that payment reform will accelerate consolidation, especially between physicians and hospitals and among physician groups, as providers position themselves to bear financial risk for the full continuum of patient care. Drawing on data from a number of sources from 2008 onward, we examined the relationship between Medicare's accountable care organization (ACO) programs and provider consolidation. We found that consolidation was under way in the period 2008-10, before the Affordable Care Act (ACA) established the ACO programs. While the number of hospital mergers and the size of specialty-oriented physician groups increased after the ACA was passed, we found minimal evidence that consolidation was associated with ACO penetration at the market level or with physicians' participation in ACOs within markets. We conclude that payment reform has been associated with little acceleration in consolidation in addition to trends already under way, but there is evidence of potential defensive consolidation in response to new payment models. Project HOPE—The People-to-People Health Foundation, Inc.

Income Trends of Residential PV Adopters: An analysis of household-level income estimates [PowerPoint presentation

Energy Technology Data Exchange (ETDEWEB)

Barbose, Galen L.; Darghouth, Naim R.; Hoen, Ben; Wiser, Ryan H.

2018-04-09

The residential photovoltaic (PV) market has expanded rapidly over the past decade, but questions exist about how equitably that growth has occurred across income groups. Prior studies have investigated this question but are often limited by narrow geographic study regions, now-dated analysis timeframes, or coarse estimates of PV-adopter incomes. At the same time, a spate of new programs and initiatives, as well as innovations in business models and product design, have emerged in recent years with the aim of making solar more accessible and affordable to broader segments of the population. Yet, many of those efforts are proceeding without robust underlying information about the income characteristics of recent residential PV adopters. This work aims to establish basic factual information about income trends among U.S. residential solar adopters, with some emphasis on low- and moderate-income (LMI) households. The analysis is unique in its relatively extensive coverage of the U.S. solar market, relying on Berkeley Lab’s Tracking the Sun dataset, which contains project-level data for the vast majority of all residential PV systems in the country (a subset of which are ultimately included in the analysis sample). This analysis is also unique in its use of household-level income estimates that provide a more-precise characterization of PV-adopter incomes than in most prior studies.

Assuring Access to Affordable Coverage

Data.gov (United States)

U.S. Department of Health & Human Services — Under the Affordable Care Act, millions of uninsured Americans will gain access to affordable coverage through Affordable Insurance Exchanges and improvements in...

Association of the Affordable Care Act Dependent Coverage Provision With Prenatal Care Use and Birth Outcomes.

Science.gov (United States)

Daw, Jamie R; Sommers, Benjamin D

2018-02-13

The effect of the Affordable Care Act (ACA) dependent coverage provision on pregnancy-related health care and health outcomes is unknown. To determine whether the dependent coverage provision was associated with changes in payment for birth, prenatal care, and birth outcomes. Retrospective cohort study, using a differences-in-differences analysis of individual-level birth certificate data comparing live births among US women aged 24 to 25 years (exposure group) and women aged 27 to 28 years (control group) before (2009) and after (2011-2013) enactment of the dependent coverage provision. Results were stratified by marital status. The dependent coverage provision of the ACA, which allowed young adults to stay on their parent's health insurance until age 26 years. Primary outcomes were payment source for birth, early prenatal care (first visit in first trimester), and adequate prenatal care (a first trimester visit and 80% of expected visits). Secondary outcomes were cesarean delivery, premature birth, low birth weight, and infant neonatal intensive care unit (NICU) admission. The study population included 1 379 005 births among women aged 24-25 years (exposure group; 299 024 in 2009; 1 079 981 in 2011-2013), and 1 551 192 births among women aged 27-28 years (control group; 325 564 in 2009; 1 225 628 in 2011-2013). From 2011-2013, compared with 2009, private insurance payment for births increased in the exposure group (36.9% to 35.9% [difference, -1.0%]) compared with the control group (52.4% to 51.1% [difference, -1.3%]), adjusted difference-in-differences, 1.9 percentage points (95% CI, 1.6 to 2.1). Medicaid payment decreased in the exposure group (51.6% to 53.6% [difference, 2.0%]) compared with the control group (37.4% to 39.4% [difference, 1.9%]), adjusted difference-in-differences, -1.4 percentage points (95% CI, -1.7 to -1.2). Self-payment for births decreased in the exposure group (5.2% to 4.3% [difference, -0.9%]) compared with the

Achieving Challenge Home in Affordable Housing in the Hot-Humid Climate

Energy Technology Data Exchange (ETDEWEB)

Beal, D. [Building America Partnership for Improved Residential Construction, Cocoa, FL (United States); McIlvaine, J. [Building America Partnership for Improved Residential Construction, Cocoa, FL (United States); Winter, B. [Building America Partnership for Improved Residential Construction, Cocoa, FL (United States); Allnutt, R. [Building America Partnership for Improved Residential Construction, Cocoa, FL (United States)

2014-08-01

The Building America Partnership for Improved Residential Construction (BA-PIRC), one of the Building America research team leads, has partnered with two builders as they work through the Challenge Home certification process (now Zero Energy Ready Home) in one test home each. The builder partners participating in this cost-shared research are Southeast Volusia County Habitat for Humanity near Daytona, Florida and Manatee County Habitat for Humanity near Tampa, Florida. Both are affiliates of Habitat for Humanity International, a non-profit affordable housing organization. This research serves to identify viable technical pathways to meeting the CH criteria for other builders in the region. A further objective of this research is to identify gaps and barriers in the marketplace related to product availability, labor force capability, code issues, cost effectiveness, and business case issues that hinder or prevent broader adoption on a production scale.

Achieving Challenge Home in Affordable Housing in the Hot-Humid Climate

Energy Technology Data Exchange (ETDEWEB)

Beal, D.; McIlvaine, J.; Winter, B.; Allnutt, R.

2014-08-01

The Building America Partnership for Improved Residential Construction (BA-PIRC), one of the Building America research team leads, has partnered with two builders as they work through the Challenge Home certification process in one test home each. The builder partners participating in this cost-shared research are Southeast Volusia County Habitat for Humanity near Daytona, Florida and Manatee County Habitat for Humanity near Tampa, Florida. Both are affiliates of Habitat for Humanity International, a non-profit affordable housing organization. This research serves to identify viable technical pathways to meeting the CH criteria for other builders in the region. A further objective of this research is to identify gaps and barriers in the marketplace related to product availability, labor force capability, code issues, cost effectiveness, and business case issues that hinder or prevent broader adoption on a production scale.

78 FR 66653 - Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2014...

Science.gov (United States)

2013-11-06

... Essential Health Benefits, we inadvertently included the incorrect section reference to the Affordable Care... inadvertently omitted references to paragraphs (f) and (g) of this section. On page 15540, in the regulation... 553(b) of the Administrative Procedure Act (APA) (5 U.S.C. 553(b)). However, we can waive this notice...

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

Is quality affordable?

Directory of Open Access Journals (Sweden)

Robert Lindfield

2008-12-01

Full Text Available The question “Is quality affordable?” is loaded with dynamite!Can a person who lives on less than US $1 per day afford a high-quality cataract operation? If the answer is ‘No’, then do we offer that person poor or low-quality services? Do people living in poverty have a ‘right’ to high-quality eye or health care? If the answer is ‘Yes’, then at what price and who should pay? Should we ignore quality and focus on affordability? Or should we provide high-quality services in the hope that someone else will pay?These are difficult questions, which policy makers, managers, and clinicians must face and try to answer.

Affordable Care Act (ACA)

Data.gov (United States)

Social Security Administration — The Affordable Care Act (ACA) is a federal statute enacted with a goal of increasing the quality and affordability of health insurance. Through a web service, CMS...

Changes in health expenditures in China in 2000s: has the health system reform improved affordability.

Science.gov (United States)

Long, Qian; Xu, Ling; Bekedam, Henk; Tang, Shenglan

2013-06-13

China's health system reform launched in early 2000s has achieved better coverage of health insurance and significantly increased the use of healthcare for vast majority of Chinese population. This study was to examine changes in the structure of total health expenditures in China in 2000-2011, and to investigate the financial burden of healthcare placed on its population, particularly between urban and rural areas and across different socio-economic development regions. Health expenditures data came from the China National Health Accounts study in 1990-2011, and other data used to calculate the financial burden of healthcare were from China Statistical Yearbook and China Population Statistical Yearbook. Total health expenditures were divided into government and social expenditure, and out-of-pocket payment. The financial burden of healthcare was estimated as out-of-pocket payment per capita as a percentage of annual household living consumption expenditure per capita. Between 2000 and 2011, total health expenditures in China increased from Chinese yuan 319 to 1888 (United States dollars 51 to 305), with average annual increase of 17.4%. Government and social health expenditure increased rapidly being 22.9% and 18.8% of average annual growth rate, respectively. The share of out-of-pocket payment in total health expenditure for the urban population declined from 53% in 2005 to 36% in 2011, but had only a slight decrease for the rural population from 53% to 50%. Out-of-pocket payment, as a percentage of annual household living consumption, has continued to rise, particularly in the rural population from the less developed region (6.1% in 2000 to 8.8% in 2011). The rapid increase of public funding to subsidize health insurance in China, as part of the reform strategy, did not mitigate the out-of-pocket payment for healthcare over the past decade. Financial burden of healthcare on the rural population increased. Affordability among the rural households with sick

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...

Marketing Residential Treatment Programs for Eating Disorders: A Call for Transparency.

Science.gov (United States)

Attia, Evelyn; Blackwood, Kristy L; Guarda, Angela S; Marcus, Marsha D; Rothman, David J

2016-06-01

Residential behavioral treatment is a growing sector of the health care industry and is used by a large proportion of adolescent and adult patients with eating disorders. These programs and the organizations that own them have developed extensive marketing strategies that target clinicians and include promotional gifts, meals, travel reimbursement, and continuing education credit. Legislation and policy changes have limited these types of activities when conducted by the pharmaceutical industry, and awareness of conflicts of interest associated with clinician-targeted advertising of drugs and devices has increased. However, similar practices by the behavioral health care industry have evolved without oversight. The authors urge clinicians to consider how marketing strategies by treatment facilities may influence their referral behaviors and call for improved transparency regarding gifts and payments from treatment facilities.

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...

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...

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.

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...

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

Youth residential situation in the transition to adulthood: The case of Serbia (an exploratory approach

Directory of Open Access Journals (Sweden)

Milić Jelena

2015-01-01

Full Text Available Research undertaken on housing and youth to date primarily focus on those at the very bottom of the social ladder. Nonetheless, a large percentage of youth population around the world is facing a crisis in terms of achieving residential autonomy. This paper attempts to illustrate the possibilities and obstacles that prevent youth from achieving residential independence in Serbia. The data collected in this exploratory study conducted in 2014, on a sample of 312 respondents, is used to analyze some of the most important structural factors (job market, education, financial situation and access to the housing market in order to assess both current situation and the possible prospects of the youth housing issue in the country. Serbia, as most Southern European countries, has a 'Mediterranean' model of transition to adulthood, which is characterized by great reliance on the family of origin. It has been observed by respondents to this study that the most represented living arrangement was living with parents and that even older cohorts (30 to 35 years old in most cases continued living with their family of origin to date. As our findings indicate, youth from the sample perceived this residential arrangement more as a consequence of poor financial situation and lack of cheap housing, rather than a desirable choice. It is difficult to predict if there will be significant improvements in the housing affordability or job market situation for youth, therefore the prospect of achieving residential independency for generations to come will remain tremendously challenging. Investigating existing and defining new strategies, in both the family and broader society contexts, is an important task for future research on accessibility of housing and youth residential situation advancement given the importance of this factor in the transition to adulthood.

Payment - National

Data.gov (United States)

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

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

OpenAIRE

Supardi, Azizan; Adnan, Hamimah

2011-01-01

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

Payment - State

Data.gov (United States)

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

Physician payment 2008 for interventionalists: current state of health care policy.

Science.gov (United States)

Manchikanti, Laxmaiah; Giordano, James

2007-09-01

Physicians in the United States have been affected by significant changes in the pattern(s) of medical practice evolving over the last several decades. These changes include new measures to 1) curb increasing costs, 2) increase access to patient care, 3) improve quality of healthcare, and 4) pay for prescription drugs. Escalating healthcare costs have focused concerns about the financial solvency of Medicare and this in turn has fostered a renewed interest in the economic basis of interventional pain management practices. The provision and systemization of healthcare in North America and several European countries are difficult enterprises to manage irrespective of whether these provisions and systems are privatized (as in the United States) or nationalized or seminationalized (as in Great Britain, Canada, Australia and France). Consequently, while many management options have been put forth, none seem to be optimally geared toward affording healthcare as a maximized individual and social good, and none have been completely enacted. The current physician fee schedule (released on July 12, 2007) includes a 9.9% cut in payment rate. Since the Medicare program was created in 1965, several methods have been used to determine physicians' rate(s) for each covered service. The sustained growth rate (SGR) system, established in 1998, has evoked negative consequences on physician payment(s). Based on the current Medicare expenditure index, practice expenses are projected to increase by 34.5% from 2002 to 2016, whereas, if actual practice inflation is considered, this increase will be 90%. This is in contrast to projected physician payment cuts that are depicted to be 51%. No doubt, this scenario will be devastating to many practices and the US medical community at large. Resolutions to this problem have been offered by MedPAC, the Government Accountability Office, physician organizations, economists, and various other interested groups. In the past, temporary measures have

Affordances theory in multilingualism studies

Directory of Open Access Journals (Sweden)

Larissa Aronin

2012-10-01

Full Text Available The concept of affordances originating in Gibson’s work (Gibson, 1977 is gaining ground in multilingualism studies (cf. Aronin and Singleton, 2010; Singleton and Aronin, 2007; Dewaele, 2010. Nevertheless, studies investigating affordances in respect of teaching, learning or using languages are still somewhat rare and tend to treat isolated aspects of multilingualism. This is despite the fact that the theory of affordances can actually provide a valuable, supplementary, up-to-date framework within which a clearer, sharper description and explication of the intriguing range of attributes of multilingual communities, educational institutions and individuals, as well as teaching practices, become feasible. It is important that not only researchers and practitioners (teachers, educators, parents, community and political actors but also language users and learners themselves should be aware of how to identify or, if necessary, design new affordances for language acquisition and learning. The aim of this article is to adapt the concept of affordances to multilingualism studies and additional language teaching, and in so doing advance theoretical understanding in this context. To this end the article contains a brief summary of the findings so far available. The article also goes further into defining the ways of how affordances work in relation to multilingualism and second language teaching and puts forward an integrated model of affordances.

Re-thinking residential mobility

Science.gov (United States)

van Ham, Maarten; Findlay, Allan M.

2015-01-01

While researchers are increasingly re-conceptualizing international migration, far less attention has been devoted to re-thinking short-distance residential mobility and immobility. In this paper we harness the life course approach to propose a new conceptual framework for residential mobility research. We contend that residential mobility and immobility should be re-conceptualized as relational practices that link lives through time and space while connecting people to structural conditions. Re-thinking and re-assessing residential mobility by exploiting new developments in longitudinal analysis will allow geographers to understand, critique and address pressing societal challenges. PMID:27330243

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...

Information Processing and Creative Thinking Abilities of Residential and Non-Residential School Children

Directory of Open Access Journals (Sweden)

Atasi Mohanty

2015-10-01

Full Text Available This study attempts to assess and compare the residential and non-residential schoolchildren in information-processing skills and creative thinking abilities. A sample of 80 children from Classes 5 and 7 were selected from two types of schools, residential/ashram (02 and non-residential/formal schools (02 in Bolpur subdivision of West Bengal in India where the medium of instruction is Bengali language/mother-tongue. All the children were individually administered the PASS (Planning, Attention, Simultaneous, Successive, Stroop, Matching Familiar Figure Test (MFFT-20, and creative thinking tasks. The residential school children were found to perform better both in information processing and creative thinking tasks. The developmental trend could not be clearly observed due to small sample size, but with increasing age, children were using better processing strategies. Due to ashram environment, creative pedagogy, and various co-curricular activities, the residential school children were found to be more creative than their formal school counterparts. Moreover, some significant positive correlations were found among information processing skills and creative thinking dimensions.

Payment Cards

Directory of Open Access Journals (Sweden)

Kantnerová Liběna

2016-09-01

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

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

Science.gov (United States)

2010-07-01

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

Residential care : Dutch and Italian residents of residential care facilities compared

NARCIS (Netherlands)

de Heer-Wunderink, Charlotte; Caro-Nienhuis, Annemarie D.; Sytema, Sjoerd; Wiersma, Durk

2008-01-01

Aims - Characteristics of patients living in residential care facilities and the availability of mental hospital- and residential beds in Italy and The Netherlands were compared to assess whether differences in the process of deinstitutionalisation have influenced the composition of their

Dynamic properties of energy affordability measures

International Nuclear Information System (INIS)

Heindl, Peter; Schuessler, Rudolf

2015-01-01

Measures of affordability and of fuel poverty are applied in practice to assess the affordability of energy services, for example, or of water or housing. The extensive body of literature on affordability measures has little overlap with the existing literature on poverty measurement. A comprehensive assessment of the response of affordability measures as a result of changes in the distribution of income or expenditure (the dynamic properties) is missing. This paper aims to fill this gap by providing a conceptual discussion on the ‘dynamics’ of both energy affordability measures and fuel poverty measures. Several types of measures are examined in a microsimulation framework. Our results indicate that some measures exhibit odd dynamic behavior. This includes measures used in practice, such as the low income/high cost measure and the double median of expenditure share indicator. Odd dynamic behavior causes the risk of drawing false policy recommendations from the measures. Thus, an appropriate response of affordability measures to changes in relevant variables is a prerequisite for defining meaningful measures that inform about affordability or deprivation in certain domains of consumption. - Highlights: • We investigate changes in fuel poverty measures as result from changes in income and expenditure. • More generally, we investigate dynamic behavior of affordability measures using microsimulation. • We propose axioms regarding dynamic behavior of affordability measures. • Some measures which are used in practice show unintuitive dynamic behavior. • Inappropriate dynamic behavior causes a risk of false policy implications.

Understanding Residential Polarization in a Globalizing City

Directory of Open Access Journals (Sweden)

Ibrahim Rotimi Aliu

2013-12-01

Full Text Available This study examines the spatial polarization that characterizes the dwellings in the African leading megacity of Lagos. Data were collected through an extensive housing survey carried out on 1,485 household residences in 56 wards within 12 administrative units in Lagos megacity. The spatial dimension of residential density in the city generates three unique residential patterns which are low residential density (LRD, medium residential density (MRD, and high residential density (HRD areas. Descriptive and multivariate inferential statistics were used to render explanations for the spatial variations in the residential quality variables in the study area. Findings indicated that a clear difference exists in the residential quality within the three residential density areas of Lagos. High correlations exist among the residential quality indicators and housing type. The principal component analysis shows that residential polarizations that occur in the LRD, MRD, and HRD are based on the location, dwelling facility, interior and exterior quality, neighborhood integrity, social bond, barrier to entry, and security. The practical implications of residential polarizations along the residential density areas are explicitly expressed.

Making the connection. The relationship between fuel poverty, electricity disconnection, and prepayment metering

International Nuclear Information System (INIS)

O'Sullivan, Kimberley C.; Howden-Chapman, Philippa L.; Fougere, Geoff

2011-01-01

Fuel poverty, or inability to afford adequate heating for a reasonable outlay of expenditure, is a significant and under-researched problem in New Zealand. The connection between fuel poverty, and electricity disconnection or 'self-disconnection' is analysed for four cities using prepayment metering to pay for electricity. A price comparison analysis on a government-sponsored website showed that prepayment metering was more expensive than other payment options. This website analysis was supplemented by qualitative data from older people with chronic respiratory disease expressing their views about electricity disconnection and prepayment metering. We show that prepayment metering for electricity is more expensive than other payment methods in New Zealand and that older people's insights provide valuable context to these issues. Under the present payment schedule, the use of prepayment metering to pay for electricity is not a suitable policy instrument to address fuel poverty, which remains problematic. The deregulated electricity market continues to lead to increases in the real price of residential electricity and in the number of people in fuel poverty. We offer policy suggestions for reducing fuel poverty in New Zealand. (author)

Affordance

DEFF Research Database (Denmark)

Olesen, Mogens

2016-01-01

This entry presents the concept of affordances as part of an ecological approach to understanding how agents interact with objects in their environment. It examines some of the central developments of the concept, from J. J. Gibson’s original definition within psychology and Donald Norman’s design...

Residential Waste

DEFF Research Database (Denmark)

Christensen, Thomas Højlund; Fruergaard, Thilde; Matsufuji, Y.

2011-01-01

are discussed in this chapter. Characterizing residential waste is faced with the problem that many residences already divert some waste away from the official collection systems, for example performing home composting of vegetable waste and garden waste, having their bundled newspaper picked up by the scouts...... twice a year or bringing their used furniture to the flea markets organized by charity clubs. Thus, much of the data available on residential waste represents collected waste and not necessarily all generated waste. The latter can only be characterized by careful studies directly at the source......, but such studies are very expensive if fair representation of both spatial and temporal variations should be obtained. In addition, onsite studies may affect the waste generation in the residence because of the increased focus on the issue. Residential waste is defined in different ways in different countries...

Conceptual provisions of the implementation of energy saving measures in the residential facilities

Directory of Open Access Journals (Sweden)

Meshcheryakova Tatiana

2017-01-01

Full Text Available Research purpose is identification of sales problems of energy saving actions for residential sector of economy, including with use of the power service contract. The choice of the object of the study is related to the general issues on energy saving of residential facilities and increasing the number of unresolved problems. Unfortunately, the efficiency of energy consumption of housing stock is extremely low that directly leads to an increase in citizens’ payments for public utilities (housing and communal services. There are many problems associated with the aging of fixed assets: it becomes especially evident in winter seasons. The level of quality of delivery, distribution and consumption of expensive heat resources that has the greatest impact on a residence comfort and sometimes human life and health, is very low. Our population faces to year overheating or freezing, to leakages through worn pipes and the subsequent disconnection of water and heat. Despite the public declaration of the of the active processes of modernization of the housing municipal economy in the Russian Federation, the implementation of the necessary energy-saving elements in the housing sector is evolving very slowly. The article presents conceptual positions, which will bring the issues related to energy saving and efficiency to a new level.

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...

Collaborative Affordances of Medical Records

DEFF Research Database (Denmark)

Bardram, Jakob Eyvind; Houben, Steven

2017-01-01

by Sellen and Harper (2003) on the affordances of physical paper. Sellen and Harper describe how the physical properties of paper affords easy reading, navigation, mark-up, and writing, but focuses, we argue, mainly on individual use of paper and digital technology. As an extension to this, Collaborative...... Affordances; being portable across patient wards and the entire hospital, by providing collocated access, by providing a shared overview of medical data, and by giving clinicians ways to maintain mutual awareness. We then discuss how the concept of Collaborative Affordances can be used in the design of new...... technology by providing a design study of a ‘Hybrid Patient Record’ (HyPR), which is designed to seamlessly blend and integrate paper-based with electronic patient records....

What's at Stake in U.S. Health Reform: A Guide to the Affordable Care Act and Value-Based Care.

Science.gov (United States)

Rambur, Betty A

2017-05-01

The U.S. presidential election of 2016 accentuated the divided perspectives on the Patient Protection and Affordable Care Act of 2010, commonly known as Obamacare. The perspectives included a pledge from then candidate Donald J. Trump to "repeal and replace on day one"; Republican congressional leaders' more temperate suggestions in the first weeks of the Trump administration to "repair" the Affordable Care Act (ACA); and President Trump's February 5, 2017 statement-16 days after inauguration-that a Republican replacement for the ACA may not be ready until late 2017 or 2018. The swirling rhetoric, media attention, and the dizzying rate of U.S. health and payment reforms both within and outside of the ACA makes it difficult for nurses, both United States and globally, to discern which health policy issues are grounded in the ACA and which aspects reflect payer-driven "volume to value" reimbursement changes. Moreover, popular and controversial elements of the ACA-for example, the clause that prohibits insurance carriers to deny coverage to those with preexisting health conditions and the more controversial individual mandate that bears Supreme Court support as a constitutional provision-are paired in ways that might be unclear to those unfamiliar with nuances of insurance rate determination. To support nurses' capacity to maximize their impact on health policy, this overview distills the 906-page ACA into major themes and describes payment reform legislation and initiatives that are external to the ACA. Understanding the political and societal forces that affect health care policy and delivery is necessary for nurses to effectively lead and advocate for the best interests of their patients.

Indirect medical education and disproportionate share adjustments to Medicare inpatient payment rates.

Science.gov (United States)

Nguyen, Nguyen Xuan; Sheingold, Steven H

2011-11-04

The indirect medical education (IME) and disproportionate share hospital (DSH) adjustments to Medicare's prospective payment rates for inpatient services are generally intended to compensate hospitals for patient care costs related to teaching activities and care of low income populations. These adjustments were originally established based on the statistical relationships between IME and DSH and hospital costs. Due to a variety of policy considerations, the legislated levels of these adjustments may have deviated over time from these "empirically justified levels," or simply, "empirical levels." In this paper, we estimate the empirical levels of IME and DSH using 2006 hospital data and 2009 Medicare final payment rules. Our analyses suggest that the empirical level for IME would be much smaller than under current law-about one-third to one-half. Our analyses also support the DSH adjustment prescribed by the Affordable Care Act of 2010 (ACA)--about one-quarter of the pre-ACA level. For IME, the estimates imply an increase in costs of 1.88% for each 10% increase in teaching intensity. For DSH, the estimates imply that costs would rise by 0.52% for each 10% increase in the low-income patient share for large urban hospitals. Public Domain.

Family ties and residential locations

NARCIS (Netherlands)

Mulder, C.H.; Cooke, T.J.

2009-01-01

In this paper, and in the Special Issue it introduces, the focus is on the role of family ties in residential location choice and, conversely, the role of residential locations in maintaining family ties. Not only do events in the nuclear family trigger residential relocations, but nearby family

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...

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...

Modelling the affordability and distributional implications of future health care financing options in South Africa.

Science.gov (United States)

McIntyre, Di; Ataguba, John E

2012-03-01

South Africa is considering introducing a universal health care system. A key concern for policy-makers and the general public is whether or not this reform is affordable. Modelling the resource and revenue generation requirements of alternative reform options is critical to inform decision-making. This paper considers three reform scenarios: universal coverage funded by increased allocations to health from general tax and additional dedicated taxes; an alternative reform option of extending private health insurance coverage to all formal sector workers and their dependents with the remainder using tax-funded services; and maintaining the status quo. Each scenario was modelled over a 15-year period using a spreadsheet model. Statistical analyses were also undertaken to evaluate the impact of options on the distribution of health care financing burden and benefits from using health services across socio-economic groups. Universal coverage would result in total health care spending levels equivalent to 8.6% of gross domestic product (GDP), which is comparable to current spending levels. It is lower than the status quo option (9.5% of GDP) and far lower than the option of expanding private insurance cover (over 13% of GDP). However, public funding of health services would have to increase substantially. Despite this, universal coverage would result in the most progressive financing system if the additional public funding requirements are generated through a surcharge on taxable income (but not if VAT is increased). The extended private insurance scheme option would be the least progressive and would impose a very high payment burden; total health care payments on average would be 10.7% of household consumption expenditure compared with the universal coverage (6.7%) and status quo (7.5%) options. The least pro-rich distribution of service benefits would be achieved under universal coverage. Universal coverage is affordable and would promote health system equity, but

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...

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...

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...

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...

The Impact of Medicaid Disproportionate Share Hospital Payment on Provision of Hospital Uncompensated Care

Science.gov (United States)

Hsieh, Hui-Min; Bazzoli, Gloria J.

2012-01-01

This study examines the association between hospital uncompensated care (UC) and reductions in Medicaid Disproportionate Share Hospital (DSH) payments resulting from the 1997 Balanced Budget Act. Data on California hospitals from 1996 to 2003 were examined using two-stage least squares with a first-differencing model to control for potential feedback effects. Our findings suggest that not-for-profit hospitals did reduce UC provision in response to reductions in Medicaid DSH, but the response was inelastic in value. Policy makers need to continue to monitor how UC changes as sources of support for indigent care change with the Patient Protection and Affordable Care Act (PPACA). PMID:23230705

Framework for Mobile Payments Integration

DEFF Research Database (Denmark)

Carton, Fergal; Hedman, Jonas; Damsgaard, Jan

2012-01-01

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

24 CFR 983.352 - Vacancy payment.

Science.gov (United States)

2010-04-01

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

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...

Social affordances and the possibility of ecological linguistics.

Science.gov (United States)

Kono, Tetsuya

2009-12-01

This paper includes an effort to extend the notion of affordance from a philosophical point of view the importance of ecological approach for social psychology, ethics, and linguistics. Affordances are not always merely physical but also interpersonal and social. I will conceptualize affordance in general and social affordance in particular, and will elucidate the relation between intentional action and affordances, and that between affordances and free will. I will also focus on the relation between social institution and affordance. An extended theory of affordances can provide a way to analyze in concrete ways how social institution works as an implicit background of interpersonal interactions. Ecological approach considers social institution as the producer and maintainer of affordances. Social institutions construct the niches for human beings. Finally, I will argue the possibility of the ecological linguistics. Language is a social institution. The system of signs is the way to articulate and differentiate interpersonal affordances. Language acquires its meaning, i.e. communicative power in the interpersonal interactions, and interpersonal interactions, in turn, develop and are elaborated through the usage of signs. Communication is seen as never aimed to transmit inner ideas to others, but to guide and adjust the behaviors of others thorough articulating the affordance of responsible-ness.

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.

Patterns in Health Care Access and Affordability Among Cancer Survivors During Implementation of the Affordable Care Act.

Science.gov (United States)

Nipp, Ryan D; Shui, Amy M; Perez, Giselle K; Kirchhoff, Anne C; Peppercorn, Jeffrey M; Moy, Beverly; Kuhlthau, Karen; Park, Elyse R

2018-03-29

Cancer survivors face ongoing health issues and need access to affordable health care, yet studies examining health care access and affordability in this population are lacking. To evaluate health care access and affordability in a national sample of cancer survivors compared with adults without cancer and to evaluate temporal trends during implementation of the Affordable Care Act. We used data from the National Health Interview Survey from 2010 through 2016 to conduct a population-based study of 30 364 participants aged 18 years or older. We grouped participants as cancer survivors (n = 15 182) and those with no reported history of cancer, whom we refer to as control respondents (n = 15 182), matched on age. We excluded individuals reporting a cancer diagnosis prior to age 18 years and those with nonmelanoma skin cancers. We compared issues with health care access (eg, delayed or forgone care) and affordability (eg, unable to afford medications or health care services) between cancer survivors and control respondents. We also explored trends over time in the proportion of cancer survivors reporting these difficulties. Of the 30 364 participants, 18 356 (57.4%) were women. The mean (SD) age was 63.5 (23.5) years. Cancer survivors were more likely to be insured (14 412 [94.8%] vs 13 978 [92.2%], P care (odds ratio [OR], 1.38; 95% CI, 1.16-1.63), forgone medical care (OR, 1.76; 95% CI, 1.45-2.12), and/or inability to afford medications (OR, 1.77; 95% CI, 1.46-2.14) and health care services (OR, 1.46; 95% CI, 1.27-1.68) (P care decreased each year (B = 0.47; P = .047), and the proportion of those needing and not getting medical care also decreased each year (B = 0.35; P = .04). In addition, the proportion of cancer survivors who reported being unable to afford prescription medication decreased each year (B=0.66; P = .004) and the proportion of those unable to afford at least 1 of 6 services decreased each year (B = 0

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...

Residential environmental evaluation of local cities considering regional characteristic and personal residential preference-a case study of Saga City,Japan

Institute of Scientific and Technical Information of China (English)

GE Jian; HOKAO Kazunori

2004-01-01

Questionnaire surveys and subjective evaluations on residential environment were performed in order to grasp the main factors of residential environment of small local cities. The suitable evaluation index system was established, and the regional residential environment characteristics and personal residential preference types were analyzed, so that their influence on residential environment evaluation could be grasped. The results can be applied to the residential environment planning, construction and monitoring of local cities.

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...

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

Science.gov (United States)

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

2015-10-01

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

Out-of-pocket healthcare payments on chronic conditions impoverish urban poor in Bangalore, India

Directory of Open Access Journals (Sweden)

Bhojani Upendra

2012-11-01

Full Text Available Abstract Background The burden of chronic conditions is on the rise in India, necessitating long-term support from healthcare services. Healthcare, in India, is primarily financed through out-of-pocket payments by households. Considering scarce evidence available from India, our study investigates whether and how out-of-pocket payments for outpatient care affect individuals with chronic conditions. Methods A large census covering 9299 households was conducted in Bangalore, India. Of these, 3202 households that reported presence of chronic condition were further analysed. Data was collected using a structured household-level questionnaire. Out-of-pocket payments, catastrophic healthcare expenditure, and the resultant impoverishment were measured using a standard technique. Results The response rate for the census was 98.5%. Overall, 69.6% (95%CI=68.0-71.2 of households made out-of-pocket payments for outpatient care spending a median of 3.2% (95%CI=3.0-3.4 of their total income. Overall, 16% (95%CI=14.8-17.3 of households suffered financial catastrophe by spending more than 10% of household income on outpatient care. Occurrence and intensity of financial catastrophe were inequitably high among poor. Low household income, use of referral hospitals as place for consultation, and small household size were associated with a greater likelihood of incurring financial catastrophe. The out-of-pocket spending on chronic conditions doubled the number of people living below the poverty line in one month, with further deepening of their poverty. In order to cope, households borrowed money (4.2% instances, and sold or mortgaged their assets (0.4% instances. Conclusions This study provides evidence from India that the out-of-pocket payment for chronic conditions, even for outpatient care, pushes people into poverty. Our findings suggest that improving availability of affordable medications and diagnostics for chronic conditions, as well as strengthening the

Out-of-pocket healthcare payments on chronic conditions impoverish urban poor in Bangalore, India.

Science.gov (United States)

Bhojani, Upendra; Thriveni, Bs; Devadasan, Roopa; Munegowda, Cm; Devadasan, Narayanan; Kolsteren, Patrick; Criel, Bart

2012-11-16

The burden of chronic conditions is on the rise in India, necessitating long-term support from healthcare services. Healthcare, in India, is primarily financed through out-of-pocket payments by households. Considering scarce evidence available from India, our study investigates whether and how out-of-pocket payments for outpatient care affect individuals with chronic conditions. A large census covering 9299 households was conducted in Bangalore, India. Of these, 3202 households that reported presence of chronic condition were further analysed. Data was collected using a structured household-level questionnaire. Out-of-pocket payments, catastrophic healthcare expenditure, and the resultant impoverishment were measured using a standard technique. The response rate for the census was 98.5%. Overall, 69.6% (95%CI=68.0-71.2) of households made out-of-pocket payments for outpatient care spending a median of 3.2% (95%CI=3.0-3.4) of their total income. Overall, 16% (95%CI=14.8-17.3) of households suffered financial catastrophe by spending more than 10% of household income on outpatient care. Occurrence and intensity of financial catastrophe were inequitably high among poor. Low household income, use of referral hospitals as place for consultation, and small household size were associated with a greater likelihood of incurring financial catastrophe.The out-of-pocket spending on chronic conditions doubled the number of people living below the poverty line in one month, with further deepening of their poverty. In order to cope, households borrowed money (4.2% instances), and sold or mortgaged their assets (0.4% instances). This study provides evidence from India that the out-of-pocket payment for chronic conditions, even for outpatient care, pushes people into poverty. Our findings suggest that improving availability of affordable medications and diagnostics for chronic conditions, as well as strengthening the gate keeping function of the primary care services are important

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...

Vital affordances, occupying niches

DEFF Research Database (Denmark)

Dokumaci, Arseli

2017-01-01

This article proposes a new conceptual approach to disability and performance through a contribution that comes entirely from outside the disciplines; a re-theorisation of Gibson’s [1979. The Ecological Approach to Visual Perception. Hillsdale: Lawrence Erlbaum Associates] theory of affordances....... Drawing on three visual ethnographies with differently disabled individuals, and building upon my previous consideration of performance as ‘affordance creation’ in itself [Dokumaci, A. 2013. “On Falling Ill.” Performance Research 18 (4): 107–115], the article conceptualises affordances as a form of micro......-activism–one that can allow us to unpack the entanglements of disability, performance, and matter. Putting Gibson’s theory in conversation with Canguilhem’s philosophy of life, it proposes the concept ‘vital affordances’ as a new way to think through this micro-activism, and the way disabled individuals might transform...

At first glance, informal payments experience on track: why accept or refuse? Patients' perceive in cardiac surgery department of public hospitals, northeast of Iran 2013.

Science.gov (United States)

Vafaei Najar, Ali; Ebrahimipour, Hossein; Pourtaleb, Arefeh; Esmaily, Habibollah; Jafari, Mehdi; Nejatzadegan, Zohre; Taleghani, Yasamin Molavi

2017-03-14

Patient's Informal payments is among the main source of health care financing in some countries. This paper aimed at determining the patient informal payments and relative factors in Cardiac Surgery Departments (CSD) in hospitals affiliated to Mashhad University of Medical Sciences (MUMS) in 2013. In this cross-sectional study, 316 discharged patients were selected using multi-stage sampling. Data gathering tool was a questionnaire which was filled by structured telephone interviews. We used quantitative content analysis for open-ended questions besides descriptive statistics and nonparametric tests by SPSS 16 at 0.05 Sig level. Sixteen (5.93%) patients made voluntary informal payments. The purpose of payment was: "gratitude" (43.75%), satisfaction with health services provided" (31.25%) and (18.75%) for better quality of services. About 75% of the payments were occurred during receiving health care services. The main causes were "no request for informal payments" (98.14%), "not affording to pay for informal payments" (73.33%) and "paying the hospital expenses by taking out a loan" (55.91%). Responders said they would pay informally in demand situation (51.85%) just for patient's health priority, 40.71% would also "search for other alternative solutions" and 27.33% "accepted the demand as a kind of gratitude culture". Twenty four patients (8.9%) had experienced mandatory informal payments during the last 6 months. The minimum amount of payment was 62.5$ and the maximum was 3125$. There was a significant relationship between the way of referring to medical centers and informal patient's payment (P ≤0.05). Despite the widespread prevalent belief about informal payments in public hospitals -particularly to the well-known physicians - such judgment cannot be generalized. The main reasons for the low informal payments in the current study were the personality characteristics of the physicians and hospital staff, their moral conscience and commitment to professional

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...

Potential market-size for renewables in the residential sector of Pakistan

International Nuclear Information System (INIS)

Athar, G.R; Imtiaz, M.

2005-01-01

electricity, by the year 2024-25, which can be supplied through renewables, depending upon resource endowment of the area. Theoretically, all the thermal energy-needs of residential sector for cooking, water heating and space heating can be met by renewables. However, natural gas, followed by LPG and kerosene, according to availability of fuels and afford ability by consumers, are preferred fuels for thermal uses. These commercial fuels can meet only 11 MTOE of thermal energy-requirements for cooking, water heating and space heating. The resultant shortfall of about 25 MTOE, by year 2024-25, will be a potential market for renewable-energy sources in addition to the renewable-electricity market of 3 to 5 Twh. (author)

The Transformation of Ergonomic Affordances into Cultural Affordances: The Case of the Alnuset System

Science.gov (United States)

Chiappini, Giampaolo

2012-01-01

Is it possible to study the ergonomic affordances offered by a system designed for educational aims and their transformation into cultural affordances? To this purpose, what references can we adopt? This work describes the theoretical framework used to realise this study referring to AlNuSet, a system realised within the EC ReMath project to…

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...

12 CFR 541.23 - Residential real estate.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Residential real estate. 541.23 Section 541.23... AFFECTING FEDERAL SAVINGS ASSOCIATIONS § 541.23 Residential real estate. The terms residential real estate... home used in part for business); (c) Other real estate used for primarily residential purposes other...

Affordances Theory in Multilingualism Studies

Science.gov (United States)

Aronin, Larissa; Singleton, David

2012-01-01

The concept of affordances originating in Gibson's work (Gibson, 1977) is gaining ground in multilingualism studies (cf. Aronin and Singleton, 2010; Singleton and Aronin, 2007; Dewaele, 2010). Nevertheless, studies investigating affordances in respect of teaching, learning or using languages are still somewhat rare and tend to treat isolated…

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.

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...

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...

Combined Regional Investments Could Substantially Enhance Health System Performance And Be Financially Affordable.

Science.gov (United States)

Homer, Jack; Milstein, Bobby; Hirsch, Gary B; Fisher, Elliott S

2016-08-01

Leaders across the United States face a difficult challenge choosing among possible approaches to transform health system performance in their regions. The ReThink Health Dynamics Model simulates how alternative scenarios could unfold through 2040. This article compares the likely consequences if four interventions were enacted in layered combinations in a prototypical midsize US city. We estimated the effects of efforts to deliver higher-value care; reinvest savings and expand global payment; enable healthier behaviors; and expand socioeconomic opportunities. Results suggest that there may be an effective and affordable way to unlock much greater health and economic potential, ultimately reducing severe illness by 20 percent, lowering health care costs by 14 percent, and improving economic productivity by 9 percent. This would require combined investments in clinical and population-level initiatives, coupled with financial agreements that reduce incentives for costly care and reinvest a share of the savings to ensure adequate long-term financing. Project HOPE—The People-to-People Health Foundation, Inc.

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

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

Science.gov (United States)

2010-12-16

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

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

Science.gov (United States)

2013-09-27

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

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

Science.gov (United States)

2010-10-01

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

20 CFR 435.22 - Payment.

Science.gov (United States)

2010-04-01

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

32 CFR 751.13 - Partial payments.

Science.gov (United States)

2010-07-01

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

10 CFR 603.805 - Payment methods.

Science.gov (United States)

2010-01-01

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

Study on payments through mobile phones

Directory of Open Access Journals (Sweden)

Anca Ioana ANDREESCU

2006-01-01

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

31 CFR 203.10 - Electronic payment methods.

Science.gov (United States)

2010-07-01

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

24 CFR 40.2 - Definition of “residential structure”.

Science.gov (United States)

2010-04-01

... OWNED RESIDENTIAL STRUCTURES § 40.2 Definition of “residential structure”. (a) As used in this part, the term residential structure means a residential structure (other than a privately owned residential structure and a residential structure on a military reservation): (1) Constructed or altered by or on behalf...

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...

Three key affordances for serendipity

DEFF Research Database (Denmark)

Björneborn, Lennart

2017-01-01

Purpose Serendipity is an interesting phenomenon to study in information science as it plays a fundamental – but perhaps underestimated – role in how we discover, explore, and learn in all fields of life. The purpose of this paper is to operationalize the concept of serendipity by providing termi...... terminological “building blocks” for understanding connections between environmental and personal factors in serendipitous encounters. Understanding these connections is essential when designing affordances in physical and digital environments that can facilitate serendipity. Design....../methodology/approach In this paper, serendipity is defined as what happens when we, in unplanned ways, encounter resources (information, things, people, etc.) that we find interesting. In the outlined framework, serendipity is understood as an affordance, i.e., a usage potential when environmental and personal factors correspond...... the three key affordances and three key personal serendipity factors: curiosity, mobility, and sensitivity. Ten sub-affordances for serendipity and ten coupled personal sub-factors are also briefly outlined. Related research is compared with and mapped into the framework aiming at a theoretical validation...

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...

Imagined Affordance: Reconstructing a Keyword for Communication Theory

Directory of Open Access Journals (Sweden)

Peter Nagy

2015-09-01

Full Text Available In this essay, we reconstruct a keyword for communication—affordance. Affordance, adopted from ecological psychology, is now widely used in technology studies, yet the term lacks a clear definition. This is especially problematic for scholars grappling with how to theorize the relationship between technology and sociality for complex socio-technical systems such as machine-learning algorithms, pervasive computing, the Internet of Things, and other such “smart” innovations. Within technology studies, emerging theories of materiality, affect, and mediation all necessitate a richer and more nuanced definition for affordance than the field currently uses. To solve this, we develop the concept of imagined affordance. Imagined affordances emerge between users’ perceptions, attitudes, and expectations; between the materiality and functionality of technologies; and between the intentions and perceptions of designers. We use imagined affordance to evoke the importance of imagination in affordances—expectations for technology that are not fully realized in conscious, rational knowledge. We also use imagined affordance to distinguish our process-oriented, socio-technical definition of affordance from the “imagined” consensus of the field around a flimsier use of the term. We also use it in order to better capture the importance of mediation, materiality, and affect. We suggest that imagined affordance helps to theorize the duality of materiality and communication technology: namely, that people shape their media environments, perceive them, and have agency within them because of imagined affordances.

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.

Affording Sustainability: Adopting a Theory of Affordances as a Guiding Heuristic for Environmental Policy

Directory of Open Access Journals (Sweden)

Roope O. Kaaronen

2017-11-01

Full Text Available Human behavior is an underlying cause for many of the ecological crises faced in the 21st century, and there is no escaping from the fact that widespread behavior change is necessary for socio-ecological systems to take a sustainable turn. Whilst making people and communities behave sustainably is a fundamental objective for environmental policy, behavior change interventions and policies are often implemented from a very limited non-systemic perspective. Environmental policy-makers and psychologists alike often reduce cognition ‘to the brain,’ focusing only to a minor extent on how everyday environments systemically afford pro-environmental behavior. Symptomatic of this are the widely prevalent attitude–action, value–action or knowledge–action gaps, understood in this paper as the gulfs lying between sustainable thinking and behavior due to lack of affordances. I suggest that by adopting a theory of affordances as a guiding heuristic, environmental policy-makers are better equipped to promote policies that translate sustainable thinking into sustainable behavior, often self-reinforcingly, and have better conceptual tools to nudge our socio–ecological system toward a sustainable turn. Affordance theory, which studies the relations between abilities to perceive and act and environmental features, is shown to provide a systemic framework for analyzing environmental policies and the ecology of human behavior. This facilitates the location and activation of leverage points for systemic policy interventions, which can help socio–ecological systems to learn to adapt to more sustainable habits. Affordance theory is presented to be applicable and pertinent to technically all nested levels of socio–ecological systems from the studies of sustainable objects and households to sustainable urban environments, making it an immensely versatile conceptual policy tool. Finally, affordance theory is also discussed from a participatory perspective

Affording Sustainability: Adopting a Theory of Affordances as a Guiding Heuristic for Environmental Policy.

Science.gov (United States)

Kaaronen, Roope O

2017-01-01

Human behavior is an underlying cause for many of the ecological crises faced in the 21st century, and there is no escaping from the fact that widespread behavior change is necessary for socio-ecological systems to take a sustainable turn. Whilst making people and communities behave sustainably is a fundamental objective for environmental policy, behavior change interventions and policies are often implemented from a very limited non-systemic perspective. Environmental policy-makers and psychologists alike often reduce cognition 'to the brain,' focusing only to a minor extent on how everyday environments systemically afford pro-environmental behavior. Symptomatic of this are the widely prevalent attitude-action, value-action or knowledge-action gaps, understood in this paper as the gulfs lying between sustainable thinking and behavior due to lack of affordances. I suggest that by adopting a theory of affordances as a guiding heuristic, environmental policy-makers are better equipped to promote policies that translate sustainable thinking into sustainable behavior, often self-reinforcingly, and have better conceptual tools to nudge our socio-ecological system toward a sustainable turn. Affordance theory, which studies the relations between abilities to perceive and act and environmental features, is shown to provide a systemic framework for analyzing environmental policies and the ecology of human behavior. This facilitates the location and activation of leverage points for systemic policy interventions, which can help socio-ecological systems to learn to adapt to more sustainable habits. Affordance theory is presented to be applicable and pertinent to technically all nested levels of socio-ecological systems from the studies of sustainable objects and households to sustainable urban environments, making it an immensely versatile conceptual policy tool. Finally, affordance theory is also discussed from a participatory perspective. Increasing the fit between local

Affording Sustainability: Adopting a Theory of Affordances as a Guiding Heuristic for Environmental Policy

Science.gov (United States)

Kaaronen, Roope O.

2017-01-01

Human behavior is an underlying cause for many of the ecological crises faced in the 21st century, and there is no escaping from the fact that widespread behavior change is necessary for socio-ecological systems to take a sustainable turn. Whilst making people and communities behave sustainably is a fundamental objective for environmental policy, behavior change interventions and policies are often implemented from a very limited non-systemic perspective. Environmental policy-makers and psychologists alike often reduce cognition ‘to the brain,’ focusing only to a minor extent on how everyday environments systemically afford pro-environmental behavior. Symptomatic of this are the widely prevalent attitude–action, value–action or knowledge–action gaps, understood in this paper as the gulfs lying between sustainable thinking and behavior due to lack of affordances. I suggest that by adopting a theory of affordances as a guiding heuristic, environmental policy-makers are better equipped to promote policies that translate sustainable thinking into sustainable behavior, often self-reinforcingly, and have better conceptual tools to nudge our socio–ecological system toward a sustainable turn. Affordance theory, which studies the relations between abilities to perceive and act and environmental features, is shown to provide a systemic framework for analyzing environmental policies and the ecology of human behavior. This facilitates the location and activation of leverage points for systemic policy interventions, which can help socio–ecological systems to learn to adapt to more sustainable habits. Affordance theory is presented to be applicable and pertinent to technically all nested levels of socio–ecological systems from the studies of sustainable objects and households to sustainable urban environments, making it an immensely versatile conceptual policy tool. Finally, affordance theory is also discussed from a participatory perspective. Increasing the fit

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...

Experiments on affordance in the journal "ecological psychology"

DEFF Research Database (Denmark)

Trettvik, Johan

2009-01-01

There are two general aims: 1) to review how the concept of affordance is construed, in theory as well as in practice/experiments, and 2) to review the experiments on affordances.......There are two general aims: 1) to review how the concept of affordance is construed, in theory as well as in practice/experiments, and 2) to review the experiments on affordances....

Out-of-pocket payments, health care access and utilisation in south-eastern Nigeria: a gender perspective.

Science.gov (United States)

Onah, Michael N; Govender, Veloshnee

2014-01-01

Out-of-pocket (OOP) payments have severe consequences for health care access and utilisation and are especially catastrophic for the poor. Although women comprise the majority of the poor in Nigeria and globally, the implications of OOP payments for health care access from a gender perspective have received little attention. This study seeks to fill this gap by using a combination of quantitative and qualitative analysis to investigate the gendered impact of OOPs on healthcare utilisation in south-eastern Nigeria. 411 households were surveyed and six single-sex Focus Group Discussions conducted. This study confirmed the socioeconomic and demographic vulnerability of female-headed households (FHHs), which contributed to gender-based inter-household differences in healthcare access, cost burden, choices of healthcare providers, methods of funding healthcare and coping strategies. FHHs had higher cost burdens from seeking care and untreated morbidity than male-headed households (MHHs) with affordability as a reason for not seeking care. There is also a high utilisation of patent medicine vendors (PMVs) by both households (PMVs are drug vendors that are unregulated, likely to offer very low-quality treatment and do not have trained personnel). OOP payment was predominantly the means of healthcare payment for both households, and households spoke of the difficulties associated with repaying health-related debt with implications for the medical poverty trap. It is recommended that the removal of user fees, introduction of prepayment schemes, and regulating PMVs be considered to improve access and provide protection against debt for FHHs and MHHs. The vulnerability of widows is of special concern and efforts to improve their healthcare access and broader efforts to empower should be encouraged for them and other poor households.

Using the cost distribution report in estimating private sector payments: what adjustments should researchers make?

Science.gov (United States)

Nugent, Gary; Grippen, Glen; Parris, Y C; Mitchell, Mary

2003-06-01

To reapportion Veterans Health Administration (VA) annual expenditures into benefit categories for comparison with estimated payments by private sector providers. Total expenditures for six VA medical centers for federal fiscal year 1999 were reapportioned by benefit category using the cost distribution report (CDR). Health benefit categories were based on those of health care insurers. Cost reapportionment was based on CDR data and reviews of source accounting and payroll documents. Actual expenditures for many benefits can be accurately identified and reapportioned using CDR data, but other expenditures were not identifiable in the CDR and required inspection of source documents. Inpatient expenditures amounting to $75,110,094 US dollars and outpatient expenditures amounting to $73,594,284 US dollars were reapportioned into other benefit categories, primarily professional fees. Expenditures for some VA benefits could not be identified because of differences in accounting and clinical practice between the VA and the community. Revisions to bring the CDR more in line with private sector payment categories would improve effectiveness for internal VA analyses and external expenditure comparisons. CDR revisions would require changes in recording some clinical workload (eg, rehabilitation and extended care) and classifying residential and domiciliary programs separate from inpatient care. Benefits that were not assigned expenditures for comparison with payments represent a potential liability if the VA were to purchase health care services in the marketplace. Variation among hospitals on expenditures not clearly identified in the CDR was significant and raises questions about the effectiveness of capitated budget methodologies using either the CDR or the decision support system.

Correlates of housing affordability stress among older Australians.

Science.gov (United States)

Temple, Jeromey B

2008-03-01

The purpose of this study was to examine the prevalence and correlates of housing affordability stress among community-dwelling older Australians. The 2002 ABS General Social Survey was used to measure the prevalence of housing affordability stress. Rare event logistic regression was used to measure the potential correlates of housing affordability stress. Almost 5% of Australians aged 55 years and older, and 20% of those younger than 55 years, are estimated to experience housing affordability stress. Men and women living alone are more likely to experience affordability stress when compared to couples. Low-income earners, those with a consumer debt or who do not hold assets, are at a heightened risk of such stress. Home ownership, regardless of income, is the strongest buffer against housing affordability problems in old age. Although the prevalence of housing affordability stress is low among older Australians when compared to the younger population, a definite social gradient exists in those at risk.

Energy efficiency and economic value in affordable housing

International Nuclear Information System (INIS)

Chegut, Andrea; Eichholtz, Piet; Holtermans, Rogier

2016-01-01

Strong rental protection in the affordable housing market often prohibits landlords from charging rental premiums for energy-efficient dwellings. This may impede (re)development of energy efficient affordable housing. In the Netherlands, affordable housing institutions regularly sell dwellings from their housing stock to individual households. If they can sell energy efficient dwellings at a premium, this may stimulate investments in the environmental performance of homes. We analyze the value effects of energy efficiency in the affordable housing market, by using a sample of 17,835 homes sold by Dutch affordable housing institutions in the period between 2008 and 2013. We use Energy Performance Certificates to determine the value of energy efficiency in these transactions. We document that dwellings with high energy efficiency sell for 2.0–6.3% more compared to otherwise similar dwellings with low energy efficiency. This implies a premium of some EUR 3,000 to EUR 9,700 for highly energy efficient affordable housing. - Highlights: • Dutch affordable housing suppliers recoup sustainability investment by selling dwellings. • Energy-efficient affordable dwellings sell at a premium. • A-labeled dwellings are 6.3% – 9,300 euros – more valuable than C-labeled ones. • The combined value effect of refurbishing an affordable housing dwelling, including improving the energy efficiency, of 20% would more than pay for the retrofit.

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...

Bootstrapping Relational Affordances of Object Pairs using Transfer

DEFF Research Database (Denmark)

Fichtl, Severin; Kraft, Dirk; Krüger, Norbert

2018-01-01

leverage past knowledge to accelerate current learning (which we call bootstrapping). We learn Random Forest based affordance predictors from visual inputs and demonstrate two approaches to knowledge transfer for bootstrapping. In the first approach (direct bootstrapping), the state-space for a new...... affordance predictor is augmented with the output of previously learnt affordances. In the second approach (category based bootstrapping), we form categories that capture underlying commonalities of a pair of existing affordances and augment the state-space with this category classifier’s output. In addition......, we introduce a novel heuristic, which suggests how a large set of potential affordance categories can be pruned to leave only those categories which are most promising for bootstrapping future affordances. Our results show that both bootstrapping approaches outperform learning without bootstrapping...

Estimating length of stay in publicly-funded residential and nursing care homes: a retrospective analysis using linked administrative data sets.

Science.gov (United States)

Steventon, Adam; Roberts, Adam

2012-10-31

Information about how long people stay in care homes is needed to plan services, as length of stay is a determinant of future demand for care. As length of stay is proportional to cost, estimates are also needed to inform analysis of the long-term cost effectiveness of interventions aimed at preventing admissions to care homes. But estimates are rarely available due to the cost of repeatedly surveying individuals. We used administrative data from three local authorities in England to estimate the length of publicly-funded care homes stays beginning in 2005 and 2006. Stays were classified into nursing home, permanent residential and temporary residential. We aggregated successive placements in different care home providers and, by linking to health data, across periods in hospital. The largest group of stays (38.9%) were those intended to be temporary, such as for rehabilitation, and typically lasted 4 weeks. For people admitted to permanent residential care, median length of stay was 17.9 months. Women stayed longer than men, while stays were shorter if preceded by other forms of social care. There was significant variation in length of stay between the three local authorities. The typical person admitted to a permanent residential care home will cost a local authority over £38,000, less payments due from individuals under the means test. These figures are not apparent from existing data sets. The large cost of care home placements suggests significant scope for preventive approaches. The administrative data revealed complexity in patterns of service use, which should be further explored as it may challenge the assumptions that are often made.

Estimating length of stay in publicly-funded residential and nursing care homes: a retrospective analysis using linked administrative data sets

Directory of Open Access Journals (Sweden)

Steventon Adam

2012-10-01

Full Text Available Abstract Background Information about how long people stay in care homes is needed to plan services, as length of stay is a determinant of future demand for care. As length of stay is proportional to cost, estimates are also needed to inform analysis of the long-term cost effectiveness of interventions aimed at preventing admissions to care homes. But estimates are rarely available due to the cost of repeatedly surveying individuals. Methods We used administrative data from three local authorities in England to estimate the length of publicly-funded care homes stays beginning in 2005 and 2006. Stays were classified into nursing home, permanent residential and temporary residential. We aggregated successive placements in different care home providers and, by linking to health data, across periods in hospital. Results The largest group of stays (38.9% were those intended to be temporary, such as for rehabilitation, and typically lasted 4 weeks. For people admitted to permanent residential care, median length of stay was 17.9 months. Women stayed longer than men, while stays were shorter if preceded by other forms of social care. There was significant variation in length of stay between the three local authorities. The typical person admitted to a permanent residential care home will cost a local authority over £38,000, less payments due from individuals under the means test. Conclusions These figures are not apparent from existing data sets. The large cost of care home placements suggests significant scope for preventive approaches. The administrative data revealed complexity in patterns of service use, which should be further explored as it may challenge the assumptions that are often made.

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.

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.

12 CFR 541.16 - Improved residential real estate.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Improved residential real estate. 541.16... REGULATIONS AFFECTING FEDERAL SAVINGS ASSOCIATIONS § 541.16 Improved residential real estate. The term improved residential real estate means residential real estate containing offsite or other improvements...

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...

Heart Attack Payment - Hospital

Data.gov (United States)

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

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

Science.gov (United States)

2010-04-01

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

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

Science.gov (United States)

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

2014-08-01

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

The relation between residential property and its surroundings and day- and night-time residential burglary

NARCIS (Netherlands)

Montoya, Lorena; Junger, Marianne; Ongena, Yfke

This article examines how residential property and its surroundings influence day- and night-time residential burglary. Crime Prevention Through Environmental Design (CPTED) principles of territoriality, surveillance, access control, target hardening, image maintenance, and activity support underpin

The Relation Between Residential Property and its Surroundings and Day- and Night-Time Residential Burglary

NARCIS (Netherlands)

Montoya, L.; Junger, Marianne; Ongena, Yfke

This article examines how residential property and its surroundings influence day- and night-time residential burglary. Crime Prevention Through Environmental Design (CPTED) principles of territoriality, surveillance, access control, target hardening, image maintenance, and activity support underpin

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

Science.gov (United States)

2014-08-22

We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems. Some of these changes implement certain statutory provisions contained in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act), the Protecting Access to Medicare Act of 2014, and other legislation. These changes are applicable to discharges occurring on or after October 1, 2014, unless otherwise specified in this final rule. We also are updating the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. The updated rate-of-increase limits are effective for cost reporting periods beginning on or after October 1, 2014. We also are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) and implementing certain statutory changes to the LTCH PPS under the Affordable Care Act and the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2013 and the Protecting Access to Medicare Act of 2014. In addition, we discuss our proposals on the interruption of stay policy for LTCHs and on retiring the "5 percent" payment adjustment for collocated LTCHs. While many of the statutory mandates of the Pathway for SGR Reform Act apply to discharges occurring on or after October 1, 2014, others will not begin to apply until 2016 and beyond. In addition, we are making a number of changes relating to direct graduate medical education (GME) and indirect medical education (IME) payments. We are establishing new requirements or revising requirements for quality reporting by specific providers (acute care hospitals, PPS-exempt cancer hospitals, and LTCHs) that

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.

Affordances of agricultural systems analysis tools

NARCIS (Netherlands)

Ditzler, Lenora; Klerkx, Laurens; Chan-Dentoni, Jacqueline; Posthumus, Helena; Krupnik, Timothy J.; Ridaura, Santiago López; Andersson, Jens A.; Baudron, Frédéric; Groot, Jeroen C.J.

2018-01-01

The increasingly complex challenges facing agricultural systems require problem-solving processes and systems analysis (SA) tools that engage multiple actors across disciplines. In this article, we employ the theory of affordances to unravel what tools may furnish users, and how those affordances

Benefits of High-Intensity Intensive Care Unit Physician Staffing under the Affordable Care Act

Directory of Open Access Journals (Sweden)

Sachin Logani

2011-01-01

Full Text Available The Affordable Care Act signed into law by President Obama, with its value-based purchasing program, is designed to link payment to quality processes and outcomes. Treatment of critically ill patients represents nearly 1% of the gross domestic product and 25% of a typical hospital budget. Data suggest that high-intensity staffing patterns in the intensive care unit (ICU are associated with cost savings and improved outcomes. We evaluate the literature investigating the cost-effectiveness and clinical outcomes of high-intensity ICU physician staffing as recommended by The Leapfrog Group (a consortium of companies that purchase health care for their employees and identify ways to overcome barriers to nationwide implementation of these standards. Hospitals that have implemented the Leapfrog initiative have demonstrated reductions in mortality and length of stay and increased cost savings. High-intensity staffing models appear to be an immediate cost-effective way for hospitals to meet the challenges of health care reform.

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...

24 CFR 572.120 - Affordability standards.

Science.gov (United States)

2010-04-01

... by homeowners in the eligible property. Financing that would impair the continued affordability of... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Affordability standards. 572.120 Section 572.120 Housing and Urban Development Regulations Relating to Housing and Urban Development...

Critical Care Implications of the Affordable Care Act.

Science.gov (United States)

Dogra, Anjali P; Dorman, Todd

2016-03-01

To provide an overview of key elements of the Affordable Care Act. To evaluate ways in which the Affordable Care Act will likely impact the practice of critical care medicine. To describe strategies that may help health systems and providers effectively adapt to changes brought about by the Affordable Care Act. Data sources for this concise review include search results from the PubMed and Embase databases, as well as sources relevant to public policy such as the text of the Patient Protection and Affordable Care Act and reports of the Congressional Budget Office. As all of the Affordable Care Act's provisions will not be fully implemented until 2019, we also drew upon cost, population, and utilization projections, as well as the experience of existing state-based healthcare reforms. The Affordable Care Act represents the furthest reaching regulatory changes in the U.S. healthcare system since the 1965 Medicare and Medicaid provisions of the Social Security Act. The Affordable Care Act aims to expand health insurance coverage to millions of Americans and place an emphasis on quality and cost-effectiveness of care. From models which link pay and performance to those which center on episodic care, the Affordable Care Act outlines sweeping changes to health systems, reimbursement structures, and the delivery of critical care. Staffing models that include daily rounding by an intensivist, palliative care integration, and expansion of the role of telemedicine in areas where intensivists are inaccessible are potential strategies that may improve quality and profitability of ICU care in the post-Affordable Care Act era.

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

Differences between Residential and Non-Residential Fathers on Sexual Socialisation of African American Youth

Science.gov (United States)

Sneed, Carl D.; Willis, Leigh A.

2016-01-01

This study investigated differences between residential and non-residential fathers on topics discussed during father-child sex communication and factors associated with child sexual socialisation. Young people (N = 159, 53% female) provided self-reports using computer surveys on the role of their fathers on father-child sex communication, general…

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 ...

Factors Influencing the Usage of Compact Fluorescent Lamps in Existing Residential Buildings in Lagos, Nigeria

Directory of Open Access Journals (Sweden)

Olusola Olugbemileke Johnson

2012-01-01

Full Text Available Nigeria as a developing nation is facing increasing demand for electricity especially in the residential areas. The use of compact fluorescent lamps (CFLs is one of the several measures towards reducing the demand. However, in Nigeria, the use of CFLs is low. The present study was designed to investigate some factors responsible for the low usage of CFLs in Lagos, Nigeria. Questionnaires were administered by hand on 984 households, selected through systematic random sampling techniques from 5 local government areas in Lagos State. The first building along the major street in each of the local government was selected randomly and every tenth building constituted the sample. A household head was surveyed in each of the building selected, and was asked to rate some factors that might have influenced the usage of CFLs. The data generated from the questionnaire were analysed using ranking method. The findings show that inability to measure the saving benefits of CFLs on electricity bills, lack of affordability and high initial cost of acquisition and installation were the most important factors which influence the use of the CFLs. The study concludes by providing some recommendations on how to achieve sustainable energy management in the Lagos and beyond through more efficient residential house lighting.

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.

Growing community : rooftop gardens for affordable housing

Energy Technology Data Exchange (ETDEWEB)

Weeks, K.N. [California Univ., Berkeley, CA (United States)

2007-07-01

This paper reviewed the processes used in recently designed affordable housing roof garden projects in California, Montana and Georgia. Gardens create a sense of community through shared space and social interactions. As such, roof gardens can give residents of affordable housing the opportunity to experience the community-fostering benefits of gardening, with the added advantages of potentially lower energy bills and wastewater fees. The factors that should be considered in planning, design, construction and maintenance of roof gardens for affordable housing were also outlined. As places of refuge, gardens help people relax and promote healing, which is particularly important for physical, emotional, social and economic well-being. For the many residents of affordable housing who earn less than 50 per cent of the area median income, gardens offer a venue for establishing relationships with neighbours, many of whom they might otherwise never meet. They also offer a means to improved nutrition and food security, education and positive recreation for youth, and better aesthetic surroundings. While motivations for choosing green roofs varied widely across the projects, affordability was linked to 3 main areas, namely saving costs in design, construction and operations; getting the roof to generate funding; and, improving the quality of life in affordable housing. 17 refs., 12 figs.

No Role for Motor Affordances in Visual Working Memory

Science.gov (United States)

Pecher, Diane

2013-01-01

Motor affordances have been shown to play a role in visual object identification and categorization. The present study explored whether working memory is likewise supported by motor affordances. Use of motor affordances should be disrupted by motor interference, and this effect should be larger for objects that have motor affordances than for…

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

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.

Life-cycle energy of residential buildings in China

International Nuclear Information System (INIS)

Chang, Yuan; Ries, Robert J.; Wang, Yaowu

2013-01-01

In the context of rapid urbanization and new construction in rural China, residential building energy consumption has the potential to increase with the expected increase in demand. A process-based hybrid life-cycle assessment model is used to quantify the life-cycle energy use for both urban and rural residential buildings in China and determine the energy use characteristics of each life cycle phase. An input–output model for the pre-use phases is based on 2007 Chinese economic benchmark data. A process-based life-cycle assessment model for estimating the operation and demolition phases uses historical energy-intensity data. Results show that operation energy in both urban and rural residential buildings is dominant and varies from 75% to 86% of life cycle energy respectively. Gaps in living standards as well as differences in building structure and materials result in a life-cycle energy intensity of urban residential buildings that is 20% higher than that of rural residential buildings. The life-cycle energy of urban residential buildings is most sensitive to the reduction of operational energy intensity excluding heating energy which depends on both the occupants' energy-saving behavior as well as the performance of the building itself. -- Highlights: •We developed a hybrid LCA model to quantify the life-cycle energy for urban and rural residential buildings in China. •Operation energy in urban and rural residential buildings is dominant, varying from 75% to 86% of life cycle energy respectively. •Compared with rural residential buildings, the life-cycle energy intensity of urban residential buildings is 20% higher. •The life-cycle energy of urban residential buildings is most sensitive to the reduction of daily activity energy

Out-of-pocket payments, health care access and utilisation in south-eastern Nigeria: a gender perspective.

Directory of Open Access Journals (Sweden)

Michael N Onah

Full Text Available Out-of-pocket (OOP payments have severe consequences for health care access and utilisation and are especially catastrophic for the poor. Although women comprise the majority of the poor in Nigeria and globally, the implications of OOP payments for health care access from a gender perspective have received little attention. This study seeks to fill this gap by using a combination of quantitative and qualitative analysis to investigate the gendered impact of OOPs on healthcare utilisation in south-eastern Nigeria. 411 households were surveyed and six single-sex Focus Group Discussions conducted. This study confirmed the socioeconomic and demographic vulnerability of female-headed households (FHHs, which contributed to gender-based inter-household differences in healthcare access, cost burden, choices of healthcare providers, methods of funding healthcare and coping strategies. FHHs had higher cost burdens from seeking care and untreated morbidity than male-headed households (MHHs with affordability as a reason for not seeking care. There is also a high utilisation of patent medicine vendors (PMVs by both households (PMVs are drug vendors that are unregulated, likely to offer very low-quality treatment and do not have trained personnel. OOP payment was predominantly the means of healthcare payment for both households, and households spoke of the difficulties associated with repaying health-related debt with implications for the medical poverty trap. It is recommended that the removal of user fees, introduction of prepayment schemes, and regulating PMVs be considered to improve access and provide protection against debt for FHHs and MHHs. The vulnerability of widows is of special concern and efforts to improve their healthcare access and broader efforts to empower should be encouraged for them and other poor households.

46 CFR 282.30 - Payment of subsidy.

Science.gov (United States)

2010-10-01

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

46 CFR 252.40 - Payment of subsidy.

Science.gov (United States)

2010-10-01

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

Bundled payment and enhanced recovery after surgery.

Science.gov (United States)

Huang, Jeffrey

2015-01-01

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

Payments to the Lab

Science.gov (United States)

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

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

Science.gov (United States)

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

2018-05-25

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

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...

Steering Angle Function Algorithm of Morphing of Residential Area

Directory of Open Access Journals (Sweden)

XIE Tian

2015-07-01

Full Text Available A residential area feature morphing method based on steering angle function is presented. To residential area with the same representation under two different scales,transforming the representation of the residential area polygon from vector coordinates to steering angle function,then using the steering angle function to match,and finding out the similarity and the differences between the residential areas under different scale to get the steering angle function of the the residential areas under any middle scale,the final,transforming the middle scale steering angle function to vector coordinates form,and get the middle shape interpolation of the the residential area polygon.Experimental results show:the residential area morphing method by using steering angle function presented can realize the continuous multi-scale representation under the premise of keeping in shape for the residential area with the rectangular boundary features.

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...

What is an affordance? 40 years later.

Science.gov (United States)

Osiurak, François; Rossetti, Yves; Badets, Arnaud

2017-06-01

About 40 years ago, James J. Gibson coined the term "affordance" to describe the action possibilities offered to an animal by the environment with reference to the animal's action capabilities. Since then, this notion has acquired a multitude of meanings, generating confusion in the literature. Here, we offer a clear operationalization of the concept of affordances and related concepts in the field of tool use. Our operationalization is organized around the distinction between the physical (what is objectively observable) and neurocognitive (what is subjectively experienced) levels. This leads us to propose that motor control (dorso-dorsal system), mechanical knowledge (ventro-dorsal system) and function knowledge (ventral system) could be neurocognitive systems respectively involved in the perception of affordances, the understanding of mechanical actions and the storage of contextual relationships (three action-system model; 3AS). We end by turning to two key issues that can be addressed within 3AS. These issues concern the link between affordances and tool incorporation, and the constraints posed by affordances for tool use. Copyright © 2017 Elsevier Ltd. All rights reserved.

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...

Residential energy demand in Brazil

International Nuclear Information System (INIS)

Arouca, M.; Gomes, F.M.; Rosa, L.P.

1981-01-01

The energy demand in Brazilian residential sector is studied, discussing the methodology for analyzing this demand from some ideas suggested, for developing an adequate method to brazilian characteristics. The residential energy consumption of several fuels in Brazil is also presented, including a comparative evaluation with the United States and France. (author)

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...

Persistent problems of access to appropriate, affordable TB services in rural China: experiences of different socio-economic groups.

Science.gov (United States)

Zhang, Tuohong; Tang, Shenglan; Jun, Gao; Whitehead, Margaret

2007-02-08

Large-scale Tuberculosis (TB) control programmes in China have been hailed a success. Concerns remain, however, about whether the programme is reaching all sections of the population, particularly poorer groups within rural communities, and whether there are hidden costs. This study takes a household perspective to investigate receipt of appropriate care and affordability of services for different socio-economic groups with TB symptoms in rural China. Secondary analysis of Chinese National Household Health Survey for 2003: 40,000 rural households containing 143,991 individuals, 2,308 identified as TB suspects. use of services and expenditure of TB suspects, by gender and socio-economic position, indicated by household income, education, material assets, and insurance status. 37% of TB suspects did not seek any professional care, with low-income groups less likely to seek care than more affluent counterparts. Of those seeking care, only 35% received any of the recommended diagnostic tests. Of the 182 patients with a confirmed TB diagnosis, 104 (57%) received treatment at the recommended level, less likely if lacking health insurance or material assets. The burden of payment for services amounted to 45% of annual household income for the low-income group, 16% for the high-income group. Access to appropriate, affordable TB services is still problematic in some rural areas of China, and receipt of care and affordability declines with declining socio-economic position. These findings highlight the current shortcomings of the national TB control programme in China and the formidable challenge it faces if it is to reach all sections of the population, including the poor with the highest burden of disease.

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...

To be an affordable healthy house, case study Medan

Science.gov (United States)

Silitonga, Shanty

2018-03-01

House has a paramount meaning in human life. Provision of adequate housing will be able to improve the quality of life. Provision of an affordable house is a major step to fulfilling the needs of houses in the big city. Medan has built a lot of affordable houses, and mostly it takes place in the suburbs. Although the affordable house is for low-income people, it must be worthy of its physical condition, affordable in the budget and healthy for its users. House often saw only as physical alone, the provision of a house only to achieve solely in quantity regardless its quality. This study aims to examine the condition of affordable houses in the suburbs of Medan. The research method used qualitative descriptive, using indicator according to affordable healthy house standard according to the regulation in Indonesia and other related theories. This study took place in Medan by taking three areas in the suburbs of Medan. The results show that most affordable houses in the suburbs of Medan are unhealthy. There are several design recommendations for the houses to meet the affordable healthy house category; the most important is the addition of ventilation and window holes.

The quasi-market for adult residential care in the UK: Do for-profit, not-for-profit or public sector residential care and nursing homes provide better quality care?

Science.gov (United States)

Barron, David N; West, Elizabeth

2017-04-01

There has been a radical transformation in the provision of adult residential and nursing home care in England over the past four decades. Up to the 1980s, over 80% of adult residential care was provided by the public sector, but today public sector facilities account for only 8% of the available places, with the rest being provided by a mixture of for-profit firms (74%) and non-profit charities (18%). The public sector's role is often now that of purchaser (paying the fees of people unable to afford them) and regulator. While the idea that private companies may play a bigger role in the future provision of health care is highly contentious in the UK, the transformation of the residential and nursing home care has attracted little comment. Concerns about the quality of care do emerge from time to time, often stimulated by high profile media investigations, scandals or criminal prosecutions, but there is little or no evidence about whether or not the transformation of the sector from largely public to private provision has had a beneficial effect on those who need the service. This study asks whether there are differences in the quality of care provided by public, non-profit or for-profit facilities in England. We use data on care quality for over 15,000 homes that are provided by the industry regulator in England: the Care Quality Commission (CQC). These data are the results of inspections carried out between April 2011 and October 2015. Controlling for a range of facility characteristics such as age and size, proportional odds logistic regression showed that for-profit facilities have lower CQC quality ratings than public and non-profit providers over a range of measures, including safety, effectiveness, respect, meeting needs and leadership. We discuss the implications of these results for the ongoing debates about the role of for-profit providers of health and social care. Copyright © 2017 Elsevier Ltd. All rights reserved.

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.

Creating Affordable Housing through self-management:

DEFF Research Database (Denmark)

Jensen, Jesper Ole; Stensgaard, Anne Gro

The paper presents a case on self-management in the Danish social housing sector as a way of providing affordable housing. It is based on an evaluation of a Danish concept for affordable housing, Social Housing Plus (“AlmenBolig+”). The concept was introduced in 2007, and so far app 1.400 housing...

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...

Organizational Media Affordances : Operationalization and Associations with Media Use

OpenAIRE

Rice, Ronald E.; Evans, Sandra K.; Pearce, Katy E.; Sivunen, Anu; Vitak, Jessica; Treem, Jeffrey W.

2017-01-01

The concept of affordances has been increasingly applied to the study of information and communication technologies (ICTs) in organizational contexts. However, almost no research operationalizes affordances, limiting comparisons and programmatic research. This article briefly reviews conceptualizations and possibilities of affordances in general and for media, then introduces the concept of organizational media affordances as organizational resources. Analysis of survey data from a large Nord...

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...

Residential Care

Science.gov (United States)

... Kids For Teens For Parents & Teachers Resolving Family Conflicts The Holidays and Alzheimer's Glossary Virtual Library Online ... longer an option Costs Choosing a care setting Types of residential care A good long-term care ...

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 ...

Affordances and the musically extended mind.

Science.gov (United States)

Krueger, Joel

2014-01-06

I defend a model of the musically extended mind. I consider how acts of "musicking" grant access to novel emotional experiences otherwise inaccessible. First, I discuss the idea of "musical affordances" and specify both what musical affordances are and how they invite different forms of entrainment. Next, I argue that musical affordances - via soliciting different forms of entrainment - enhance the functionality of various endogenous, emotion-granting regulative processes, drawing novel experiences out of us with an expanded complexity and phenomenal character. I argue that music therefore ought to be thought of as part of the vehicle needed to realize these emotional experiences. I appeal to different sources of empirical work to develop this idea.

Malaysian Affordability Housing Policies Revisited

Directory of Open Access Journals (Sweden)

Samad Diwa

2016-01-01

Full Text Available Housing has always been a significant aspiration of family expression and distinctly priciest investment by household. It plays a momentous role in the country’s economy and so central to the societal well-being that is emplaced in the United Nation Universal declaration of Human rights. Yet in developed and developing world alike, cities struggle to provide decent housing for lower and middle income population. The provision of affordable housing is a major policy concern around the world with Malaysia being no exception; rising income hardly keep pace with price hike of housing unit and housing interventions has majorly concentrated on demand side leading to a non-responsive supply sector. Therefore, this paper highlights affordable housing issues pertaining Malaysia. It formulates Malaysian Map of affordability and conducts an evaluation of global housing schemes to better identify policy priorities for Malaysia. It’s significant to harmonize supply and demand side factors in the housing market to ensure that housing supply fits the needs of citizens based on the location, price and target group. In case of Malaysia supply oriented initiative are of urgency in short and medium run. This must be supported by long term demand side schemes in parallel. Convergence of these two factors is essential for a balanced equilibrium and obtaining affordability.

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...

Development of Residential SOFC Cogeneration System

International Nuclear Information System (INIS)

Ono, Takashi; Miyachi, Itaru; Suzuki, Minoru; Higaki, Katsuki

2011-01-01

Since 2001 Kyocera has been developing 1kW class Solid Oxide Fuel Cell (SOFC) for power generation system. We have developed a cell, stack, module and system. Since 2004, Kyocera and Osaka Gas Co., Ltd. have been developed SOFC residential co-generation system. From 2007, we took part in the 'Demonstrative Research on Solid Oxide Fuel Cells' Project conducted by New Energy Foundation (NEF). Total 57 units of 0.7kW class SOFC cogeneration systems had been installed at residential houses. In spite of residential small power demand, the actual electric efficiency was about 40%(netAC,LHV), and high CO2 reduction performance was achieved by these systems. Hereafter, new joint development, Osaka Gas, Toyota Motors, Kyocera and Aisin Seiki, aims early commercialization of residential SOFC CHP system.

Development of Residential SOFC Cogeneration System

Science.gov (United States)

Ono, Takashi; Miyachi, Itaru; Suzuki, Minoru; Higaki, Katsuki

2011-06-01

Since 2001 Kyocera has been developing 1kW class Solid Oxide Fuel Cell (SOFC) for power generation system. We have developed a cell, stack, module and system. Since 2004, Kyocera and Osaka Gas Co., Ltd. have been developed SOFC residential co-generation system. From 2007, we took part in the "Demonstrative Research on Solid Oxide Fuel Cells" Project conducted by New Energy Foundation (NEF). Total 57 units of 0.7kW class SOFC cogeneration systems had been installed at residential houses. In spite of residential small power demand, the actual electric efficiency was about 40%(netAC,LHV), and high CO2 reduction performance was achieved by these systems. Hereafter, new joint development, Osaka Gas, Toyota Motors, Kyocera and Aisin Seiki, aims early commercialization of residential SOFC CHP system.

Therapeutic Residential Care for Children and Youth:

DEFF Research Database (Denmark)

Whittaker, James K.; Holmes, Lisa; del Valle, Jorge F.

2016-01-01

so in closer collaboration with their families and in closer proximity to their home communities; and, (3) with the hope of reducing the high costs often associated with group residential provision. In some jurisdictions, efforts to reduce residential care resources in the absence of sufficient...... alternatives to serve high-resource needing youth has had unintended and negative consequences. It is within this context that a working group international experts representing research, policy, service delivery and families (International Work Group for Therapeutic Residential Care) convened at the Centre...... for Child and Family Research, Loughborough University in the U.K. for a Summit meeting on therapeutic residential care for children and youth funded by the Sir Halley Stewart Trust (UK). The focus centered on what is known about therapeutic residential care and what key questions should inform a priority...

The concept of a structural affordance

Directory of Open Access Journals (Sweden)

Adrian Alsmith

2012-12-01

Full Text Available I provide an analysis of the concept of an “affordance” that enables one to conceive of “structural affordance” as a kind of affordance relation that might hold between an agent and its body. I then review research in the science of humanoid bodily movement to indicate the empirical reality of structural affordance.

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.

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 …

Retailing residential electricity : A concept that makes sense?

International Nuclear Information System (INIS)

MacDonald, C.

2003-07-01

A heated debate centres around the deregulation of the electricity industry and the retailing of residential electricity. An assessment of the current situation in the industry was provided in this paper to provide a basis for discussion. The experience gained both in Alberta and Texas in residential retail was examined. The main issue of concern is whether residential customers will benefit from deregulation of the electricity sector. The Retail Energy Deregulation (RED) Index provides a benchmark for those jurisdictions considering the residential options. Deregulation has not led to significant benefits to residential customers in most jurisdictions. The electricity industry will always require a central dispatch/market process that will have to designed, governed, regulated, modified regularly. The benefits to residential consumers are not expected for a very long time. Standard market design is an issue that will require attention. refs., 7 figs

Medicare and Medicaid Programs; CY 2016 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.

Science.gov (United States)

2015-11-05

This final rule will update Home Health Prospective Payment System (HH PPS) rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor under the Medicare prospective payment system for home health agencies (HHAs), effective for episodes ending on or after January 1, 2016. As required by the Affordable Care Act, this rule implements the 3rd year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates. This rule updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking and provides a clarification regarding the use of the "initial encounter'' seventh character applicable to certain ICD-10-CM code categories. This final rule will also finalize reductions to the national, standardized 60-day episode payment rate in CY 2016, CY 2017, and CY 2018 of 0.97 percent in each year to account for estimated case-mix growth unrelated to increases in patient acuity (nominal case-mix growth) between CY 2012 and CY 2014. In addition, this rule implements a HH value-based purchasing (HHVBP) model, beginning January 1, 2016, in which all Medicare-certified HHAs in selected states will be required to participate. Finally, this rule finalizes minor changes to the home health quality reporting program and minor technical regulations text changes.

Main challenges of residential areas

Directory of Open Access Journals (Sweden)

Oana Luca

2017-06-01

Full Text Available The present article is a position paper aiming to initiate a professional debate related to the aspects related to the urban dysfunctions leading to the wear of the residential areas. The paper proposes a definition of the wear process, identify the main causes leading to its occurrence and propose a number of solutions to neutralise the dysfunctions. The three wearing phases of residential areas components are emphasized, exploring their lifecycle. In order to perform the study of urban wear, the status of the residential areas components can be established and monitored, and also the variables of the function that can mathematically model the specific wear process may be considered. The paper is considered a first step for the model adjustment, to be tested and validated in the following steps. Based on the mathematical method and model, there can be created, in a potential future research, the possibility of determining the precarity degree for residential areas/neighbourhoods and cities, by minimising the subjective component of the analyses preceding the decision for renovation or regeneration.

Patient Protection and Affordable Care Act; exchange and insurance market standards for 2015 and beyond. Final rule.

Science.gov (United States)

2014-05-27

This final rule addresses various requirements applicable to health insurance issuers, Affordable Insurance Exchanges (``Exchanges''), Navigators, non-Navigator assistance personnel, and other entities under the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). Specifically, the rule establishes standards related to product discontinuation and renewal, quality reporting, non-discrimination standards, minimum certification standards and responsibilities of qualified health plan (QHP) issuers, the Small Business Health Options Program, and enforcement remedies in Federally-facilitated Exchanges. It also finalizes: A modification of HHS's allocation of reinsurance collections if those collections do not meet our projections; certain changes to allowable administrative expenses in the risk corridors calculation; modifications to the way we calculate the annual limit on cost sharing so that we round this parameter down to the nearest $50 increment; an approach to index the required contribution used to determine eligibility for an exemption from the shared responsibility payment under section 5000A of the Internal Revenue Code; grounds for imposing civil money penalties on persons who provide false or fraudulent information to the Exchange and on persons who improperly use or disclose information; updated standards for the consumer assistance programs; standards related to the opt-out provisions for self-funded, non-Federal governmental plans and related to the individual market provisions under the Health Insurance Portability and Accountability Act of 1996 including excepted benefits; standards regarding how enrollees may request access to non-formulary drugs under exigent circumstances; amendments to Exchange appeals standards and coverage enrollment and termination standards; and time-limited adjustments to the standards relating to the medical loss ratio

Genesis and Evolution of Digital Payment Platforms

DEFF Research Database (Denmark)

Hjelholt, Morten; Damsgaard, Jan

2012-01-01

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

24 CFR 2002.15 - Advance payments.

Science.gov (United States)

2010-04-01

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

14 CFR 1206.704 - Advance payments.

Science.gov (United States)

2010-01-01

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

32 CFR 756.7 - Payment.

Science.gov (United States)

2010-07-01

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

What are the affordances of information and communication technologies?

Directory of Open Access Journals (Sweden)

Grainne Conole

2004-12-01

Full Text Available The paper examines the notion that Information and Communication Technologies (ICT have affordances that epitomize the features of our late modern age (Giddens, 1991 and explores whether these affordances (Salomon, 1993, p. 51 can be used to facilitate particular approaches to educational practice. It argues that a clear articulation of these affordances would enable us to understand how these technologies can be most effectively used to support learning and teaching. We believe that any one affordance can be considered to have both positive and negative connotations and the paper draws on social and educational theory to provide an initial taxonomy of these affordances.

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...

Targeting energy justice: Exploring spatial, racial/ethnic and socioeconomic disparities in urban residential heating energy efficiency

International Nuclear Information System (INIS)

Reames, Tony Gerard

2016-01-01

Fuel poverty, the inability of households to afford adequate energy services, such as heating, is a major energy justice concern. Increasing residential energy efficiency is a strategic fuel poverty intervention. However, the absence of easily accessible household energy data impedes effective targeting of energy efficiency programs. This paper uses publicly available data, bottom-up modeling and small-area estimation techniques to predict the mean census block group residential heating energy use intensity (EUI), an energy efficiency proxy, in Kansas City, Missouri. Results mapped using geographic information systems (GIS) and statistical analysis, show disparities in the relationship between heating EUI and spatial, racial/ethnic, and socioeconomic block group characteristics. Block groups with lower median incomes, a greater percentage of households below poverty, a greater percentage of racial/ethnic minority headed-households, and a larger percentage of adults with less than a high school education were, on average, less energy efficient (higher EUIs). Results also imply that racial segregation, which continues to influence urban housing choices, exposes Black and Hispanic households to increased fuel poverty vulnerability. Lastly, the spatial concentration and demographics of vulnerable block groups suggest proactive, area- and community-based targeting of energy efficiency assistance programs may be more effective than existing self-referral approaches. - Highlights: • Develops statistical model to predict block group (BG) residential heating energy use intensity (EUI), an energy efficiency proxy. • Bivariate and multivariate analyses explore racial/ethnic and socioeconomic relationships with heating EUI. • BGs with more racial/ethnic minority households had higher heating EUI. • BGs with lower socioeconomics had higher heating EUI. • Mapping heating EUI can facilitate effective energy efficiency intervention targeting.

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...

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

Has the free maternal health policy eliminated out of pocket payments for maternal health services? Views of women, health providers and insurance managers in Northern Ghana.

Directory of Open Access Journals (Sweden)

Philip Ayizem Dalinjong

Full Text Available The free maternal health policy was implemented in Ghana in 2008 under the National Health Insurance Scheme (NHIS. The policy sought to eliminate out of pocket (OOP payments and enhance the utilisation of maternal health services. It is unclear whether the policy had altered OOP payments for services. The study explored views on costs and actual OOP payments during pregnancy. The source of funding for payments was also explored.A convergent parallel mixed methods design, involving quantitative and qualitative data collection approaches. The study was set in the Kassena-Nankana municipality, a rural area in Ghana. Women (n = 406 who utilised services during pregnancy were surveyed. Also, 10 focus groups discussions (FGDs were held with women who used services during pregnancy as well as 28 in-depth interviews (IDIs with midwives/nurses (n = 25 and insurance managers/directors (n = 3. The survey was analysed using descriptive statistics, focussing on costs from the women's perspective. Qualitative data were audio recorded, transcribed and translated verbatim into English where necessary. The transcripts were read and coded into themes and sub-themes.The NHIS did not cover all expenses in relation to maternal health services. The overall mean for OOP cost during pregnancy was GH¢17.50 (US$8.60. Both FGDs and IDIs showed that women especially paid for drugs and ultrasound scan services. Sixty-five percent of the women used savings, whilst twenty-two percent sold assets to meet the OOP cost. Some women were unable to afford payments due to poverty and had to forgo treatment. Participants called for payments to be eliminated and for the NHIS to absorb the cost of emergency referrals. All participants admitted the benefits of the policy.Women needed to make payments despite the policy. Measures should be put in place to eliminate payments to enable all women to receive services and promote universal health coverage.

The Independent Payment Advisory Board.

Science.gov (United States)

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

2011-01-01

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

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...

Family events and the residential mobility of couples

NARCIS (Netherlands)

Michielin, F.; Mulder, C.H.

2008-01-01

Using data from retrospective surveys carried out in the Netherlands during the early 1990s, we describe how the residential mobility of couples—that is, short-distance moves—is affected by family events and how fertility is affected by residential mobility. The results show that residential moves

An Affordability Comparison Tool (ACT) for Space Transportation

Science.gov (United States)

McCleskey, C. M.; Bollo, T. R.; Garcia, J. L.

2012-01-01

NASA bas recently emphasized the importance of affordability for Commercial Crew Development Program (CCDP), Space Launch Systems (SLS) and Multi-Purpose Crew Vehicle (MPCV). System architects and designers are challenged to come up with architectures and designs that do not bust the budget. This paper describes the Affordability Comparison Tool (ACT) analyzes different systems or architecture configurations for affordability that allows for a comparison of: total life cycle cost; annual recurring costs, affordability figures-of-merit, such as cost per pound, cost per seat, and cost per flight, as well as productivity measures, such as payload throughput. Although ACT is not a deterministic model, the paper develops algorithms and parametric factors that use characteristics of the architectures or systems being compared to produce important system outcomes (figures-of-merit). Example applications of outcome figures-of-merit are also documented to provide the designer with information on the relative affordability and productivity of different space transportation applications.

Dynamic Rule Encryption for Mobile Payment

Directory of Open Access Journals (Sweden)

Emir Husni

2017-01-01

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

ELECTRONIC PAYMENT SYSTEM AND ITS PROTECTION

Directory of Open Access Journals (Sweden)

Miroslav Milutinovic

2015-01-01

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

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

Science.gov (United States)

2016-11-04

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

Garden greenery and the health of older people in residential care facilities: a multi-level cross-sectional study.

Science.gov (United States)

Dahlkvist, Eva; Hartig, Terry; Nilsson, Annika; Högberg, Hans; Skovdahl, Kirsti; Engström, Maria

2016-09-01

To test the relationship between greenery in gardens at residential facilities for older people and the self-perceived health of residents, mediated by experiences of being away and fascination when in the garden and the frequency of visitation there. To examine how these indirect effects vary with the number of physical barriers to visiting the garden. Many older people in residential facilities suffer from complex health problems. Access to a green outdoor environment may enable psychological distance, engage effortless attention, encourage more frequent visitation and promote resident health. A multi-level, cross-sectional, correlational design. Questionnaires were administered June-August, 2011 to convenience samples of residents at 72 facilities for older people with complex healthcare needs. One to 10 eligible residents were sampled during self-motivated garden visits at each facility (n = 290). They reported on their garden experiences and health. Facility staff reported on objective garden characteristics and barriers to access. A serial mediation model was tested with multiple linear regression analysis. The total indirect effect of greenery on self-perceived health was positive and significant. Garden greenery appears to affect health by enhancing a sense of being away, affording possibilities to experience the outdoor environment as interesting and encouraging visitation. Among residents in homes with multiple barriers, only fascination mediated the relationship between greenery and self-perceived health. Ample greenery in outdoor space at residential facilities for older people appears to promote experiences of being away and fascination, more frequent visitation and better health. © 2016 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.

Congestion and cascades in payment systems

Science.gov (United States)

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

2007-10-01

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

38 CFR 10.51 - Payments to minor child.

Science.gov (United States)

2010-07-01

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

M-Payments Issues and Concepts

Directory of Open Access Journals (Sweden)

Cristian TOMA

2012-01-01

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

Affordances for robots: a brief survey

Directory of Open Access Journals (Sweden)

Thomas E. Horton

2012-12-01

Full Text Available In this paper, we consider the influence of Gibson's affordance theory on the design of robotic agents. Affordance theory (and the ecological approach to agent design in general has in many cases contributed to the development of successful robotic systems; we provide a brief survey of AI research in this area. However, there remain significant issues that complicate discussions on this topic, particularly in the exchange of ideas between researchers in artificial intelligence and ecological psychology. We identify some of these issues, specifically the lack of a generally accepted definition of "affordance" and fundamental differences in the current approaches taken in AI and ecological psychology. While we consider reconciliation between these fields to be possible and mutually beneficial, it will require some flexibility on the issue of direct perception.

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...

What Does Electronic Conferencing Afford Distance Education?

Science.gov (United States)

Barnes, Sally

2000-01-01

Discusses the use of technology for distance learning in higher education and examines the similarities and differences between face-to-face seminars and online discussions. Considers the concept of affordance in relation to information and communication technologies and distance education; and examines affordances of electronic conferencing and…

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

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.

Dissociating Simon and affordance compatibility effects: silhouettes and photographs.

Science.gov (United States)

Pappas, Zissis

2014-12-01

When a graspable object's handle is oriented to the same side as the response hand, responses are quicker and more accurate than when it is oriented to the opposite side. This effect has been attributed to the affordance of the object's handle (Tucker & Ellis, 1998). Recent findings suggest this effect results instead from an abstract spatial response code (i.e., Simon effect; Cho & Proctor, 2010). However, the stimuli used in these previous studies differ in the amount of object and environmental depth information they contain, which may be critical to conveying an affordance. This information could explain these disparate findings as well as dissociate Simon and affordance compatibility effects. Four experiments demonstrate that the Simon effect results from the absence of this information, as in a silhouette, and the affordance effect results from its presence, as in a photograph. A fifth experiment confirmed that modifying information associated with the affordance, rather than the modification itself, produced the effects observed in the previous experiments. These findings support the following: (a) the internal details of an object and environmental depth can dissociate Simon and affordance compatibility effects, (b) this information is necessary to convey the object's graspable affordance, and (c) the outer shape of the object is not sufficient to elicit an affordance effect. These findings are discussed in relation to the theory of embodied cognition. Copyright © 2014 Elsevier B.V. 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...

48 CFR 32.007 - Contract financing payments.

Science.gov (United States)

2010-10-01

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

Payment Procedures for Electronic Government Services

OpenAIRE

Pousttchi, Key; Wiedemann, Dietmar Georg

2005-01-01

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

7 CFR 760.3 - Indemnity payments on milk.

Science.gov (United States)

2010-01-01

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

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.

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.

An Activity Theory Approach to Affordance

DEFF Research Database (Denmark)

Bærentsen, Klaus B.; Trettvik, Johan

2002-01-01

We present an analysis of the concept of affordance as it was originally introduced by J. J. Gibson, and elaborate on this concept, acknowledging, that the general theoretical landscape in psychology is in fundamental ways different from the situation in which Gibson found himself when he crafted...... the notion. Specifically we will suggest the inclusion of the ecological theory of perception in the paradigm of cultural historical psychology and activity theory developed in the former Soviet Union by most notably Lev Vygotsky, S. L. Rubinshtein, A. N. Leontjev and others. It will be suggested, that much...... of the confusion in HCI concerning the concept of affordance is a consequence of the attempt of using it inside a theoretical paradigm that is unable to capture and encompass one of the most essential aspect of Gibsons concept of affordance, that is its foundation in activity...

Suggestions on Strengthening Greening Construction of Ecological Residential Areas

OpenAIRE

Li, Peng

2013-01-01

Greening construction is an important part of the construction of ecological residential areas, but there exist some misunderstandings in greening construction of ecological residential districts at present. Based on the description of functions of green space in ecological residential areas, the summarization of principles of greening design, and the discussion of questions in greening construction of ecological residential districts, some suggestions as well as specific measures for strengt...

Application of an almost ideal demand system (AIDS) to Ethiopian rural residential energy use: Panel data evidence

International Nuclear Information System (INIS)

Guta, Dawit Diriba

2012-01-01

It is well known that poor rural households in low-income economies are reliant on traditional fuels to meet basic domestic energy needs, but little is known about the specific underlying socio-economic drivers of residential fuel choices in Ethiopia. I used the linear approximation almost ideal demand system (LAAIDS) with normalized prices to compute expenditure elasticity and a multinomial logit model (MLM) to examine household fuel use. The LAAIDS model result showed that expenditure was elastic for modern fuels, but inelastic for traditional fuels. Regression results from the MLM indicated that fuel choice behaviour of rural households could be more accurately described as ‘fuel stacking’ behaviour as opposed to the ‘energy ladder’ hypothesis. In rural areas household fuel choice may be constrained by limited access to commercial fuels and efficient cook stoves, supply dependency and affordability, consumer preferences and a web of other intricate factors. Rural households had less incentive for fuel switching due to underlying factors and the availability of fuel wood without direct financial cost. With continued deforestation and receding forests, households are expected to develop inter fuel substitution and switching behaviour conditional on access to modern energy technologies. - Highlights: ► Two step LAAIDS model and MLM were applied to analysis of residential fuel use. ► I examined issues of ‘energy ladder’ versus ‘fuel stacking’ behavior of households. ► Controlling other factors increase in welfare increases demand for modern fuel. ► Traditional fuels are income inelastic but not necessarily cheaper. ► Residential fuel choice is determined by intricate web of socio-economic factors.

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.

Learning outcomes afforded by self-assessed, segmented video–print combinations

OpenAIRE

Jack Koumi

2015-01-01

Learning affordances of video and print are examined in order to assess the learning outcomes afforded by hybrid video–print learning packages. The affordances discussed for print are: navigability, surveyability and legibility. Those discussed for video are: design for constructive reflection, provision of realistic experiences, presentational attributes, motivational influences and teacher personalisation. The video affordances are examined through a framework of pedagogic design principles...

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....

Affordances and the musically extended mind

OpenAIRE

Joel eKrueger

2014-01-01

I defend a model of the musically extended mind. I consider how acts of “musicking” grant access to novel emotional experiences otherwise inaccessible. First, I discuss the idea of “musical affordances” and specify both what musical affordances are and how they invite different forms of entrainment. Next, I argue that musical affordances – via soliciting different forms of entrainment – enhance the functionality of various endogenous, emotion-granting regulative processes, drawing novel exper...

Affordances in Mobile Augmented Reality Applications

OpenAIRE

Gjøsæter, Tor

2014-01-01

This paper explores the affordances of augmented reality content in a mobile augmented reality application. A user study was conducted by performing a multi-camera video recording of seven think aloud sessions. The think aloud sessions consisted of individual users performing tasks, exploring and experiencing a mobile augmented reality (MAR) application we developed for the iOS platform named ARad. We discuss the instrumental affordances we observed when users interacted with augmented realit...

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...

Aligning incentives in the management of inguinal hernia: the impact of the payment model.

Science.gov (United States)

Devarajan, Karthik; Rogers, Loni; Smith, Paul; Schwaitzberg, Steven D

2012-09-01

The Affordable Care Act has stimulated discussion to find feasible, alternate payment models. Adopting a global payment (GP) mechanism may dampen the high number of procedures incentivized by the fee-for-service (FFS) system. The evolving payment mechanism should reflect collaboration between surgeon and system goals. Our aim was to model and perform simulation of a GP system for hernia care and its impact on cost, revenue, and physician reimbursement in an integrated health care system. The results of the 2006 Watchful Waiting (WW) vs Repair of Inguinal Hernia in Minimally Symptomatic Men trial was used as a clinical model for the natural history and progression of inguinal hernia disease Simulations were built using 2009 financial and clinical data from the Cambridge Health Alliance to model costs and revenues in managing care for a 4-year cohort of inguinal hernia patients; FFS, FFS-WW, and the GP-WW were modeled. To build this GP model, surgeons were paid a constant $500 per patient whether herniorrhaphy was performed or not. Compared with the actual combined physician and hospital revenue under the current FFS model ($308,820), implementing the FFS-WW system for 4 years for 139 hernia patients decreased hospital and physician revenues by $93,846 and $19,308, respectively. This resulted in a total savings of $113,154 for the payors only. In contrast, when using WW methodology within a GP model, system savings of $69,174 were observed after 4 years, with preservation of physician and hospital income. Collaboration to achieve shared savings can be accomplished by pooling physician and hospital revenue in order to meet the goals of all parties. Copyright © 2012 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

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

A hybrid society model for simulating residential electricity consumption

International Nuclear Information System (INIS)

Xu, Minjie; Hu, Zhaoguang; Wu, Junyong; Zhou, Yuhui

2008-01-01

In this paper, a hybrid social model of econometric model and social influence model is proposed for evaluating the influence of pricing policy and public education policy on residential habit of electricity using in power resources management. And, a hybrid society simulation platform based on the proposed model, called residential electricity consumption multi-agent systems (RECMAS), is designed for simulating residential electricity consumption by multi-agent system. RECMAS is composed of consumer agent, power supplier agent, and policy maker agent. It provides the policy makers with a useful tool to evaluate power price policies and public education campaigns in different scenarios. According to an influenced diffusion mechanism, RECMAS can simulate the residential electricity demand-supply chain and analyze impacts of the factors on residential electricity consumption. Finally, the proposed method is used to simulate urban residential electricity consumption in China. (author)

A hybrid society model for simulating residential electricity consumption

Energy Technology Data Exchange (ETDEWEB)

Xu, Minjie [School of Electrical Engineering, Beijing Jiaotong University, Beijing (China); State Power Economic Research Institute, Beijing (China); Hu, Zhaoguang [State Power Economic Research Institute, Beijing (China); Wu, Junyong; Zhou, Yuhui [School of Electrical Engineering, Beijing Jiaotong University, Beijing (China)

2008-12-15

In this paper, a hybrid social model of econometric model and social influence model is proposed for evaluating the influence of pricing policy and public education policy on residential habit of electricity using in power resources management. And, a hybrid society simulation platform based on the proposed model, called residential electricity consumption multi-agent systems (RECMAS), is designed for simulating residential electricity consumption by multi-agent system. RECMAS is composed of consumer agent, power supplier agent, and policy maker agent. It provides the policy makers with a useful tool to evaluate power price policies and public education campaigns in different scenarios. According to an influenced diffusion mechanism, RECMAS can simulate the residential electricity demand-supply chain and analyze impacts of the factors on residential electricity consumption. Finally, the proposed method is used to simulate urban residential electricity consumption in China. (author)

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...

Affordability Funding Models for Early Childhood Services

Science.gov (United States)

Purcal, Christiane; Fisher, Karen

2006-01-01

This paper presents a model of the approaches open to government to ensure that early childhood services are affordable to families. We derived the model from a comparative literature review of affordability approaches taken by government, both in Australia and internationally. The model adds significantly to the literature by proposing a means to…

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...

PRN 2011-1: Residential Exposure Joint Venture

Science.gov (United States)

This PR Notice is to advise registrants of an industry-wide joint venture, titled the Residential Exposure Joint Venture (REJV), which has developed a national survey regarding residential consumer use/usage data for pesticides.

Integrated Management of Residential Energy Resources

Directory of Open Access Journals (Sweden)

Antunes C. H.

2012-10-01

Full Text Available The increasing deployment of distributed generation systems based on renewables in the residential sector, the development of information and communication technologies and the expected evolution of traditional power systems towards smart grids are inducing changes in the passive role of end-users, namely with stimuli to change residential demand patterns. The residential user should be able to make decisions and efficiently manage his energy resources by taking advantages from his flexibility in load usage with the aim to minimize the electricity bill without depreciating the quality of energy services provided. The aim of this paper is characterizing electricity consumption in the residential sector and categorizing the different loads according to their typical usage, working cycles, technical constraints and possible degree of control. This categorization of end-use loads contributes to ascertain the availability of controllable loads to be managed as well as the different direct management actions that can be implemented. The ability to implement different management actions over diverse end-use load will increase the responsiveness of demand and potentially raises the willingness of end-users to accept such activities. The impacts on the aggregated national demand of large-scale dissemination of management systems that would help the end-user to make decisions regarding electricity consumption are predicted using a simulator that generates the aggregated residential sector electricity consumption under variable prices.

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.

Technical Problems of Residential Construction

Science.gov (United States)

Nowogońska, Beata; Cibis, Jerzy

2017-10-01

Beauty, utility, durability - these are the features of good architecture and should also be the distinguishing qualities of every residential building. But do beauty and utility remain along with the passing of time? Performance characteristics are an indicator of both, the technical as well as aesthetic state of buildings. Aesthetic needs are in disagreement with the merciless aging process. The beauty of a city is formed not only by the original forms of new residential buildings, but also by existing tenement housing; thus preserving their aesthetics becomes a necessity. Time is continuously passing and along with it, aging intensifies. The aging process is a natural phenomenon for every material. The life expectancy of building materials is also limited. Along with the passing of time, the technical state of residential buildings continuously deteriorates. With the passing of time, the aesthetic values and preferences of users of flats change and the usability of the building decreases. The permanence of buildings, including residential buildings, is shaped not only by the forces of nature but also by activities of humans. A long lifespan is ensured by carrying out ongoing, systematic renovation-repair works. It is thanks to them that buildings derived from past centuries are still being used, and their market attractiveness is not decreasing.

Evaluation of advanced technologies for residential appliances and residential and commercial lighting

Energy Technology Data Exchange (ETDEWEB)

Turiel, I.; Atkinson, B.; Boghosian, S.; Chan, P.; Jennings, J.; Lutz, J.; McMahon, J.; Rosenquist, G.

1995-01-01

Section 127 of the Energy Policy Act requires that the Department of Energy (DOE) prepare a report to Congress on the potential for the development and commercialization of appliances that substantially exceed the present federal or state efficiency standards. Candidate high-efficiency appliances must meet several criteria including: the potential exists for substantial improvement (beyond the minimum established in law) of the appliance`s energy efficiency; electric, water, or gas utilities are prepared to support and promote the commercialization of such appliances; manufacturers are unlikely to undertake development and commercialization of such appliances on their own, or development and production would be substantially accelerated by support to manufacturers. This report describes options to improve the efficiency of residential appliances, including water heaters, clothes washers and dryers, refrigerator/freezers, dishwashers, space heating and cooling devices, as well as residential and commercial lighting products. Data from this report (particularly Appendix 1)were used to prepare the report to Congress mentioned previously. For the residential sector, national energy savings are calculated using the LBL Residential Energy Model. This model projects the number of households and appliance saturations over time. First, end-use consumption is calculated for a base case where models that only meet the standard replace existing models as these reach the end of their lifetime. Second, models with efficiencies equal to the technology under consideration replace existing models that reach the end of their lifetime. For the commercial sector, the COMMEND model was utilized to project national energy savings from new technologies. In this report, energy savings are shown for the period 1988 to 2015.

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).

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...

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.

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...

Housing Affordability And Children's Cognitive Achievement.

Science.gov (United States)

Newman, Sandra; Holupka, C Scott

2016-11-01

Housing cost burden-the fraction of income spent on housing-is the most prevalent housing problem affecting the healthy development of millions of low- and moderate-income children. By affecting disposable income, a high burden affects parents' expenditures on both necessities for and enrichment of their children, as well as investments in their children. Reducing those expenditures and investments, in turn, can affect children's development, including their cognitive skills and physical, social, and emotional health. This article summarizes the first empirical evidence of the effects of housing affordability on children's cognitive achievement and on one factor that appears to contribute to these effects: the larger expenditures on child enrichment by families in affordable housing. We found that housing cost burden has the same relationship to both children's cognitive achievement and enrichment spending on children, exhibiting an inverted U shape in both cases. The maximum benefit occurs when housing cost burden is near 30 percent of income-the long-standing rule-of-thumb definition of affordable housing. The effect of the burden is stronger on children's math ability than on their reading comprehension and is more pronounced with burdens above the 30 percent standard. For enrichment spending, the curve is "shallower" (meaning the effect of optimal affordability is less pronounced) but still significant. Project HOPE—The People-to-People Health Foundation, Inc.

Diabetes and the Affordable Care Act.

Science.gov (United States)

Burge, Mark R; Schade, David S

2014-07-01

The Affordable Care Act--"Obamacare"--is the most important federal medical legislation to be enacted since Medicare. Although the goal of the Affordable Care Act is to improve healthcare coverage, access, and quality for all Americans, people with diabetes are especially poised to benefit from the comprehensive reforms included in the act. Signed into law in 2010, this massive legislation will slowly be enacted over the next 10 years. In the making for at least a decade, it will affect every person in the United States, either directly or indirectly. In this review, we discuss the major changes in healthcare that will take place in the next several years, including (1) who needs to purchase insurance on the Web-based exchange, (2) the cost to individuals and the rebates that they may expect, (3) the rules and regulations for purchasing insurance, (4) the characteristics of the different "metallic" insurance plans that are available, and (5) the states that have agreed to participate. With both tables and figures, we have tried to make the Affordable Care Act both understandable and appreciated. The goal of this comprehensive review is to highlight aspects of the Affordable Care Act that are of importance to practitioners who care for people with diabetes by discussing both the positive and the potentially negative aspects of the program as they relate to diabetes care.

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.

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...

Learning Grasp Affordance Densities

DEFF Research Database (Denmark)

Detry, Renaud; Kraft, Dirk; Kroemer, Oliver

2011-01-01

and relies on kernel density estimation to provide a continuous model. Grasp densities are learned and refined from exploration, by letting a robot “play” with an object in a sequence of graspand-drop actions: The robot uses visual cues to generate a set of grasp hypotheses; it then executes......We address the issue of learning and representing object grasp affordance models. We model grasp affordances with continuous probability density functions (grasp densities) which link object-relative grasp poses to their success probability. The underlying function representation is nonparametric...... these and records their outcomes. When a satisfactory number of grasp data is available, an importance-sampling algorithm turns these into a grasp density. We evaluate our method in a largely autonomous learning experiment run on three objects of distinct shapes. The experiment shows how learning increases success...

A Neo-Rawlsian Approach to Residential Integration

Directory of Open Access Journals (Sweden)

Kevin J. Brown

2013-08-01

Full Text Available Over the past 40 years, the United States has engaged in various policies to integrate otherwise segregated black and white households within a shared space. However, little work has been done to fully articulate a moral argument for residential integration among black and white households. This paper offers what I refer to as the normative argument, which possesses two morally-impelled arguments for residential integration. Since the ethical appeal to integrate is often couched in the language of justice, I begin with a framework—based upon the work of the late philosopher John Rawls—for considering the moral aspects of residential integration. However, I go on to point out intractable problems related to the Rawlsian framework that would fail to flesh out all ethical considerations of the normative argument. From here, I provide a revised, or neo-Rawlsian, framework for understanding residential integration which addresses the aforementioned problems. This exercise is both important and necessary for the future of residential mixing, as better understanding the moral and ethical attributes of this discussion is, perhaps, the best means to lubricate the fundamental shift from 'spatial' to 'social' integration.

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

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...

38 CFR 36.4357 - Combination residential and business property.

Science.gov (United States)

2010-07-01

... Reporting § 36.4357 Combination residential and business property. If otherwise eligible, a loan for the purchase or construction of a combination of residential property and business property which the veteran... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Combination residential...

Actualization the risks local payment systems on the present stage of the national payment system

Directory of Open Access Journals (Sweden)

Korobeinikova Olga Mikhailovna

2014-09-01

Full Text Available In the article presented and estimated systematically possibilities of minimization the general and specific risks local payment systems and their participants, which actualized due to the activation of formation of national payment system in Russia amid increasing global political and financial risks and the need for economic security.

Urging Affordable Access to High-Value Cancer Drugs

Science.gov (United States)

This infographic highlights some of the main messages from the President’s Cancer Panel report Promoting Value, Affordability, and Innovation in Cancer Drug Treatment. The graphic includes the panel’s recommendations to maximize the value and affordability of cancer drug treatment.

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...

24 CFR 1000.102 - What are eligible affordable housing activities?

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false What are eligible affordable housing activities? 1000.102 Section 1000.102 Housing and Urban Development Regulations Relating to... § 1000.102 What are eligible affordable housing activities? Eligible affordable housing activities are...

Affordances in Mobile Augmented Reality Applications

Directory of Open Access Journals (Sweden)

Tor Gjøsæter

2014-10-01

Full Text Available This paper explores the affordances of augmented reality content in a mobile augmented reality application. A user study was conducted by performing a multi-camera video recording of seven think aloud sessions. The think aloud sessions consisted of individual users performing tasks, exploring and experiencing a mobile augmented reality (MAR application we developed for the iOS platform named ARad. We discuss the instrumental affordances we observed when users interacted with augmented reality content, as well as more complex affordances rising from conventions from media content, AR and the traditional WIMP paradigm. We find that remediation of traditional newspaper content through the MAR medium can provide engaging, pleasing and exciting user experiences. However, the some of the content still suffers from being shoveled onto the MAR platform without adapting it properly. Finally, we discuss what content was most successfully mediated to the user and how the content impacts the user experience.

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...

Housing ownership and affordability among low-income society in the poorest sub-district of Semarang, Central Java, Indonesia

Science.gov (United States)

Indrianingrum, Lulut

2017-03-01

The Government has intervened to deal with various affordable public housing programs, as well as financing programs for Low Income society in Indonesia. The characteristics of this society in each region are so diverse, that made the housing programs for this social segment uneasy in reaching the right target. Regulation of Housing and Settlement No. 2/2001 has mandated that the State are obliged to implement a habitable public housing for people, especially for the low income society. The purpose of this study is exploring the low-income residents' preferences and affordability of home ownership for their families in the poorest sub-district of Semarang. Aspects of studies include family conditions, financing, location, housing type and price. The research used a descriptive method to analyze a set of questionnaire data, distributed to low income residents in Sub district Tanjungmas, which isthe poorest sub district in Semarang. The results showed that the respondents developed a vision of home ownership by saving their money for the allocated housing budget and taking a bank installment. They tended to plan to get a house in their current neighborhood or nearby or anywhere else with the same price range. They really understood that, in order to get a better home and neighborhood they have to pay for higher prices. Therefore, their housing criteria or standards were set based on the quality of life in their current residential area, and should be located in a township (kampung).

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...

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

Science.gov (United States)

2016-08-22

making technical corrections and changes to regulations relating to costs to related organizations and Medicare cost reports; we are providing notice of the closure of three teaching hospitals and the opportunity to apply for available GME resident slots under section 5506 of the Affordable Care Act. We are finalizing the provisions of interim final rules with comment period that relate to a temporary exception for certain wound care discharges from the application of the site neutral payment rate under the LTCH PPS for certain LTCHs; application of two judicial decisions relating to modifications of limitations on redesignation by the Medicare Geographic Classification Review Board; and legislative extensions of the Medicare-dependent, small rural hospital program and changes to the payment adjustment for low-volume hospitals.

Young children's tool innovation across culture: Affordance visibility matters.

Science.gov (United States)

Neldner, Karri; Mushin, Ilana; Nielsen, Mark

2017-11-01

Young children typically demonstrate low rates of tool innovation. However, previous studies have limited children's performance by presenting tools with opaque affordances. In an attempt to scaffold children's understanding of what constitutes an appropriate tool within an innovation task we compared tools in which the focal affordance was visible to those in which it was opaque. To evaluate possible cultural specificity, data collection was undertaken in a Western urban population and a remote Indigenous community. As expected affordance visibility altered innovation rates: young children were more likely to innovate on a tool that had visible affordances than one with concealed affordances. Furthermore, innovation rates were higher than those reported in previous innovation studies. Cultural background did not affect children's rates of tool innovation. It is suggested that new methods for testing tool innovation in children must be developed in order to broaden our knowledge of young children's tool innovation capabilities. Copyright © 2017 Elsevier B.V. All rights reserved.

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...

Residential normalcy and environmental experiences of very old people: changes in residential reasoning over time.

Science.gov (United States)

Granbom, Marianne; Himmelsbach, Ines; Haak, Maria; Löfqvist, Charlotte; Oswald, Frank; Iwarsson, Susanne

2014-04-01

The decision to relocate in old age is intricately linked to thoughts and desires to stay put. However, most research focuses either on strategies that allow people to age in place or on their reasons for relocation. There is a need for more knowledge on very old peoples' residential reasoning, including thoughts about aging in place and thoughts about relocation as one intertwined process evolving in everyday life. The aim of this study was to explore what we refer to as the process of residential reasoning and how it changes over time among very old people, and to contribute to the theoretical development regarding aging in place and relocation. Taking a longitudinal perspective, data stem from the ENABLE-AGE In-depth Study, with interviews conducted in 2003 followed up in interviews in 2011. The 16 participants of the present study were 80-89years at the time of the first interview. During analysis the Theoretical Model of Residential Normalcy by Golant and the Life Course Model of Environmental Experience by Rowles & Watkins were used as sensitizing concepts. The findings revealed changes in the process of residential reasoning that related to a wide variety of issues. Such issues included the way very old people use their environmental experience, their striving to build upon or dismiss attachment to place, and their attempts to maintain or regain residential normalcy during years of declining health and loss of independence. In addition, the changes in reasoning were related to end-of-life issues. The findings contribute to the theoretical discussion on aging in place, relocation as a coping strategy, and reattachment after moving in very old age. Copyright © 2014 Elsevier Inc. All rights reserved.

Modeling Residential Electricity Consumption Function in Malaysia: Time Series Approach

OpenAIRE

L. L. Ivy-Yap; H. A. Bekhet

2014-01-01

As the Malaysian residential electricity consumption continued to increase rapidly, effective energy policies, which address factors affecting residential electricity consumption, is urgently needed. This study attempts to investigate the relationship between residential electricity consumption (EC), real disposable income (Y), price of electricity (Pe) and population (Po) in Malaysia for 1978-2011 period. Unlike previous studies on Malaysia, the current study focuses on the residential secto...

Dynamic management of integrated residential energy systems

Science.gov (United States)

Muratori, Matteo

This study combines principles of energy systems engineering and statistics to develop integrated models of residential energy use in the United States, to include residential recharging of electric vehicles. These models can be used by government, policymakers, and the utility industry to provide answers and guidance regarding the future of the U.S. energy system. Currently, electric power generation must match the total demand at each instant, following seasonal patterns and instantaneous fluctuations. Thus, one of the biggest drivers of costs and capacity requirement is the electricity demand that occurs during peak periods. These peak periods require utility companies to maintain operational capacity that often is underutilized, outdated, expensive, and inefficient. In light of this, flattening the demand curve has long been recognized as an effective way of cutting the cost of producing electricity and increasing overall efficiency. The problem is exacerbated by expected widespread adoption of non-dispatchable renewable power generation. The intermittent nature of renewable resources and their non-dispatchability substantially limit the ability of electric power generation of adapting to the fluctuating demand. Smart grid technologies and demand response programs are proposed as a technical solution to make the electric power demand more flexible and able to adapt to power generation. Residential demand response programs offer different incentives and benefits to consumers in response to their flexibility in the timing of their electricity consumption. Understanding interactions between new and existing energy technologies, and policy impacts therein, is key to driving sustainable energy use and economic growth. Comprehensive and accurate models of the next-generation power system allow for understanding the effects of new energy technologies on the power system infrastructure, and can be used to guide policy, technology, and economic decisions. This

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...

Stable and variable affordances are both automatic and flexible

Directory of Open Access Journals (Sweden)

Anna M Borghi

2015-06-01

Full Text Available The mere observation of pictures or words referring to manipulable objects is sufficient to evoke their affordances since objects and their nouns elicit components of appropriate motor programs associated with object interaction. While nobody doubts that objects actually evoke motor information, the degree of automaticity of this activation has been recently disputed. Recent evidence has indeed revealed that affordances activation is flexibly modulated by the task and by the physical and social context. It is therefore crucial to understand whether these results challenge previous evidence showing that motor information is activated independently from the task. The context and the task can indeed act as an early or late filter. We will review recent data consistent with the notion that objects automatically elicit multiple affordances and that top-down processes select among them probably inhibiting motor information that is not consistent with behaviour goals. We will therefore argue that automaticity and flexibility of affordances are not in conflict. We will also discuss how language can incorporate affordances showing similarities, but also differences, between the motor information elicited by vision and language. Finally we will show how the distinction between stable and variable affordances can accommodate all these effects.

Financing Non-Residential Photovoltaic Projects: Options and Implications

Energy Technology Data Exchange (ETDEWEB)

Bolinger, Mark

2009-01-09

Installations of grid-connected photovoltaic (PV) systems in the United States have increased dramatically in recent years, growing from less than 20 MW in 2000 to nearly 500 MW at the end of 2007, a compound average annual growth rate of 59%. Of particular note is the increasing contribution of 'non-residential' grid-connected PV systems--defined here as those systems installed on the customer (rather than utility) side of the meter at commercial, institutional, non-profit, or governmental properties--to the overall growth trend. Although there is some uncertainty in the numbers, non-residential PV capacity grew from less than half of aggregate annual capacity installations in 2000-2002 to nearly two-thirds in 2007. This relative growth trend is expected to have continued through 2008. The non-residential sector's commanding lead in terms of installed capacity in recent years primarily reflects two important differences between the non-residential and residential markets: (1) the greater federal 'Tax Benefits'--including the 30% investment tax credit (ITC) and accelerated tax depreciation--provided to commercial (relative to residential) PV systems, at least historically (this relative tax advantage has largely disappeared starting in 2009) and (2) larger non-residential project size. These two attributes have attracted to the market a number of institutional investors (referred to in this report as 'Tax Investors') seeking to invest in PV projects primarily to capture their Tax Benefits. The presence of these Tax Investors, in turn, has fostered a variety of innovative approaches to financing non-residential PV systems. This financial innovation--which is the topic of this report--has helped to overcome some of the largest barriers to the adoption of non-residential PV, and is therefore partly responsible (along with the policy changes that have driven this innovation) for the rapid growth in the market seen in recent years

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.

Service Differentiation in Residential Broadband Networks

DEFF Research Database (Denmark)

Sigurdsson, Halldór Matthias

2004-01-01

As broadband gains widespread adoption with residential users, revenue generating voice- and video-services have not yet taken off. This slow uptake is often attributed to lack of Quality of Service management in residential broadband networks. To resolve this and induce service variety, network...... access providers are implementing service differentiation in their networks where voice and video gets prioritised before data. This paper discusses the role of network access providers in multipurpose packet based networks and the available migration strategies for supporting multimedia services...... in digital subscriber line (DSL) based residential broadband networks. Four possible implementation scenarios and their technical characteristics and effects are described. To conclude, the paper discusses how network access providers can be induced to open their networks for third party service 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...

Modelling and forecasting Turkish residential electricity demand

International Nuclear Information System (INIS)

Dilaver, Zafer; Hunt, Lester C

2011-01-01

This research investigates the relationship between Turkish residential electricity consumption, household total final consumption expenditure and residential electricity prices by applying the structural time series model to annual data over the period from 1960 to 2008. Household total final consumption expenditure, real energy prices and an underlying energy demand trend are found to be important drivers of Turkish residential electricity demand with the estimated short run and the long run total final consumption expenditure elasticities being 0.38 and 1.57, respectively, and the estimated short run and long run price elasticities being -0.09 and -0.38, respectively. Moreover, the estimated underlying energy demand trend, (which, as far as is known, has not been investigated before for the Turkish residential sector) should be of some benefit to Turkish decision makers in terms of energy planning. It provides information about the impact of past policies, the influence of technical progress, the impacts of changes in consumer behaviour and the effects of changes in economic structure. Furthermore, based on the estimated equation, and different forecast assumptions, it is predicted that Turkish residential electricity demand will be somewhere between 48 and 80 TWh by 2020 compared to 40 TWh in 2008. - Research highlights: → Estimated short run and long run expenditure elasticities of 0.38 and 1.57, respectively. → Estimated short run and long run price elasticities of -0.09 and -0.38, respectively. → Estimated UEDT has increasing (i.e. energy using) and decreasing (i.e. energy saving) periods. → Predicted Turkish residential electricity demand between 48 and 80 TWh in 2020.

Costs of day hospital and community residential chemical dependency treatment.

Science.gov (United States)

Kaskutas, Lee Ann; Zavala, Silvana K; Parthasarathy, Sujaya; Witbrodt, Jane

2008-03-01

Patient placement criteria developed by the American Society of Addiction Medicine (ASAM) have identified a need for low-intensity residential treatment as an alternative to day hospital for patients with higher levels of severity. A recent clinical trial found similar outcomes at social model residential treatment and clinically-oriented day hospital programs, but did not report on costs. This paper addresses whether the similar outcomes in the recent trial were delivered with comparable costs, overall and within gender and ethnicity stratum. This paper reports on clients not at environmental risk who participated in a randomized trial conducted in three metropolitan areas served by a large pre-paid health plan. Cost data were collected using the Drug Abuse Treatment Cost Analysis Program (DATCAP). Costs per episode were calculated by multiplying DATCAP-derived program-specific costs by each client's length of stay. Differences in length of stay, and in per-episode costs, were compared between residential and day hospital subjects. Lengths of stay at residential treatment were significantly longer than at day hospital, in the sample overall and in disaggregated analyses. This difference was especially marked among non-Whites. The average cost per week was USD 575 per week at day hospital, versus USD 370 per week at the residential programs. However, because of the longer stays in residential, per-episode costs were significantly higher in the sample overall and among non-Whites (and marginally higher for men). These cost results must be considered in light of the null findings comparing outcomes between subjects randomized to residential versus day hospital programs. The longer stays in the sample overall and for non-White clients at residential programs came at higher costs but did not lead to better rates of abstinence. The short stays in day hospital among non-Whites call into question the attractiveness of day hospital for minority clients. Outcomes and costs

75 FR 60749 - Policy on Payment System Risk

Science.gov (United States)

2010-10-01

... FEDERAL RESERVE SYSTEM [Docket No. OP-1345] Policy on Payment System Risk AGENCY: Board of... of its Policy on Payment System Risk (PSR). The revisions explicitly recognize the role of the... payment flows for the banking system, while also helping to mitigate credit exposures of the Federal...

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...

Family-centred residential care : the new reality?

NARCIS (Netherlands)

Geurts, Esther M. W.; Boddy, Janet; Noom, Marc J.; Knorth, Erik J.

This paper considers therapeutic approaches to residential care with specific attention to the question of family involvement. It builds on a body of literature indicating the potential of residential care as a positive intervention for young people, and examines the contention that even when family

Integration of fuel cells into residential buildings

International Nuclear Information System (INIS)

Bell, J.M.; Entchev, E.; Gusdorf, J.; Szadkowski, F.; Swinton, M.; Kalbfleisch, W.; Marchand, R.

2004-01-01

Integration of small combined heat and power systems (CHP) into residential buildings is challenging as the loads are small, the load diversity is limited and there are a number of unresolved issues concerning sizing, control, peak loads, emergency operation, grid connection and export, etc. Natural Resources Canada has undertaken an initiative to investigate and develop techniques for the integration of small CHP systems into residential buildings using a highly instrumented house modified to allow quick installation and thorough monitoring of CHP integration techniques as well determining the performance of the CHP systems themselves when operating in a house. The first CHP system installed was a Stirling engine residential CHP system. It was used to examine the completeness of the CHP modifications to the house, to evaluate various building integration techniques and to measure the performance of the CHP system itself. The testing demonstrated the modified house to be an excellent facility for the development of CHP building integration techniques and the testing of residential CHP systems. The Stirling engine CHP system was found to operate well and produce meaningful input to the house. A second system (residential fuel cell) is presently being installed and building integration techniques and the performance of the fuel cell will be tested over the coming year. (author)

The Price of (Perceived Affordance: Commentary for Huron and Berec

Directory of Open Access Journals (Sweden)

Robert Gjerdingen

2009-11-01

Full Text Available It is argued that the symbolic objects in music and musical scores can permit affordances much as physical objects can. This construction of "affordance" places greater emphasis on cultural forms and human memory than the original idea proposed by James J. Gibson, and it aligns itself more closely with the refinements to "affordance" suggested by Donald Norman. For symbolic objects to permit strongly perceived affordances, it may be necessary for perceivers to have developed schematized perception in the course of over-learning culturally significant forms.

Improving perceptions of healthy food affordability: results from a pilot intervention.

Science.gov (United States)

Williams, Lauren K; Abbott, Gavin; Thornton, Lukar E; Worsley, Anthony; Ball, Kylie; Crawford, David

2014-03-10

Despite strong empirical support for the association between perceived food affordability and dietary intake amongst families with a lower socioeconomic position (SEP), there is limited evidence of the most effective strategies for promoting more positive perceptions of healthy food affordability among this group. This paper reports findings from a pilot intervention that aimed to improve perceptions of healthy food affordability amongst mothers. Participants were 66 mothers who were the parents of children recruited from primary schools located in socioeconomically disadvantaged suburbs. Intervention group participants viewed a slideshow focussed on healthy snack food affordability that illustrated cheaper healthier alternatives to common snack foods as well as food budgeting tips and price comparison education. A mixed between-within ANCOVA was conducted to examine group differences in perceived affordability of healthy food across three time points. Results revealed no difference in perceived affordability of healthy food between the two groups at baseline whereas at post-intervention and follow-up, mothers in the intervention group perceived healthy food as more affordable than the control group. Focussing on education-based interventions to improve perceptions of healthy food affordability may be a promising approach that complements existing nutrition promotion strategies.

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...

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...

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)

Large-Scale Residential Demolition

Science.gov (United States)

The EPA provides resources for handling residential demolitions or renovations. This includes planning, handling harmful materials, recycling, funding, compliance assistance, good practices and regulations.

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...

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...

Residentialization of Public Spaces: Bratislava Example

Science.gov (United States)

Bacová, Andrea; Puškár, Branislav; Vráblová, Edita

2017-10-01

The housing estates in Bratislava saturated the housing needs of a large number of inhabitants who come after World War II to the city. Design of public spaces often did not have priority in the process of designing. The solutions for mentioned exterior spaces had been planned after blocks of flat realization, but many of them are not realized to this day. The article analyzes the example of the unrealized public spaces in existing housing estates Devinska Nova Ves and Petržalka (city districts of Bratislava) and offer practical solutions in relation to residencialization method. Residencialization of missing public places is an effective method of adding identities to settlements. It improves the quality of residential environment and public spaces. The main aim is to create better conditions for social activities in public areas, which are missing on the present. The research will be focused on the examination of the urban, cultural and construction potential of the existing residential enviroment in Bratislava. The main aim of residentialization is not only to enhance the quality of spatial and building structures in the selected residential area and maintain long-term sustainability in the pertinent programme area, but mainly to improve the quality of living for the residents. The outputs of the project are proposals and practical procedures developed with regard to planning documents for local municipal authorities and regional organizations. The solutions will have a positive impact on the enhancement of the quality of public spaces, attractive social activities and of a conceptual link - residentialization.

Forecasting residential electricity demand in provincial China.

Science.gov (United States)

Liao, Hua; Liu, Yanan; Gao, Yixuan; Hao, Yu; Ma, Xiao-Wei; Wang, Kan

2017-03-01

In China, more than 80% electricity comes from coal which dominates the CO2 emissions. Residential electricity demand forecasting plays a significant role in electricity infrastructure planning and energy policy designing, but it is challenging to make an accurate forecast for developing countries. This paper forecasts the provincial residential electricity consumption of China in the 13th Five-Year-Plan (2016-2020) period using panel data. To overcome the limitations of widely used predication models with unreliably prior knowledge on function forms, a robust piecewise linear model in reduced form is utilized to capture the non-deterministic relationship between income and residential electricity consumption. The forecast results suggest that the growth rates of developed provinces will slow down, while the less developed will be still in fast growing. The national residential electricity demand will increase at 6.6% annually during 2016-2020, and populous provinces such as Guangdong will be the main contributors to the increments.

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...

Affordability Engineering: Bridging the Gap Between Design and Cost

Science.gov (United States)

Reeves, J. D.; DePasquale, Dominic; Lim, Evan

2010-01-01

Affordability is a commonly used term that takes on numerous meanings depending on the context used. Within conceptual design of complex systems, the term generally implies comparisons between expected costs and expected resources. This characterization is largely correct, but does not convey the many nuances and considerations that are frequently misunderstood and underappreciated. In the most fundamental sense, affordability and cost directly relate to engineering and programmatic decisions made throughout development programs. Systems engineering texts point out that there is a temporal aspect to this relationship, for decisions made earlier in a program dictate design implications much more so than those made during latter phases. This paper explores affordability engineering and its many sub-disciplines by discussing how it can be considered an additional engineering discipline to be balanced throughout the systems engineering and systems analysis processes. Example methods of multidisciplinary design analysis with affordability as a key driver will be discussed, as will example methods of data visualization, probabilistic analysis, and other ways of relating design decisions to affordability results.

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

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.

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...

Planning and User Interface Affordances

National Research Council Canada - National Science Library

St. Amant, Robert

1999-01-01

.... We identify a number of similarities between executing plans and interacting with a graphical user interface, and argue that affordances for planning environments apply equally well to user interface environments...

Adjustment problems and residential care environment

Directory of Open Access Journals (Sweden)

Jan Sebastian Novotný

2015-01-01

Full Text Available Problem: Residential care environment represents a specific social space that is associated with a number of negative consequences, covering most aspects of children and youth functioning. The paper analyzes of the presence of adjustment problems among adolescents from institutional care environment and compares this results with a population of adolescents who grew up in a family. Methods: The sample consisted of two groups of adolescents. The first group included 285 adolescents currently growing up in an residential care environment, aged 13 to 21 (M = 16.23, SD = 1.643. The second group consisted of 214 adolescents growing up in a family, aged 15 to 20 (M = 17.07, SD = 1.070. We used a questionnaire Youth Self Report. Data were analyzed using descriptive statistics and MANOVA. Results: Results showed that adolescents in residential care exhibit higher average values in all adjustment problems. Also, in the context of diagnostic categories are the residential care adolescents more frequently in non-normal range (borderline and clinical, primarily in the border range. The greatest differences were reflected in the Thought problems and Rule-breaking behavior. MANOVA showed a significant multivariate effect between groups of adolescents, Hotelling's T = .803, F(8, 490 = 49.202, p <.001, d = .445 (large effect. Univariate analysis further showed a significant effect for Withdrawn/depressed (p = .044, d = .089, small effect, Somatic complaints (p = .002, d = .139, medium effect, Social problems (p = 004, d = .127, a small effect, Thought problems (p <.001, d = .633, strong effect, Attention problems (p <.001, d = .320,strong effect, Rule-breaking behavior (p <.001 , d = .383, strong effect, and Aggressive behavior (p = 015, d = .110, small effect. Results for the dimension of Anxious/depressed were not significant (p = .159. Discussion: The results didn’t confirmed the assumption that more than 30% of residential care adolescents have adjustment

Affordances in activity theory and cognitive systems engineering

DEFF Research Database (Denmark)

Albrechtsen, H.; Andersen, H.H.K.; Bødker, S.

2001-01-01

on design for low level interaction modalities. To incorporate the concept of affordances in the design of human computer interaction it is necessary to systematically unravel affordances that supporthuman action possibilities. Furthermore, it is a necessity that Gibson's theory of affordances...... is supplemented by careful analyses of other human modalities and activities than visual perception. Within HMI two well established perspectives on HMI,Activity Theory (AT) and Cognitive Systems Engineering (CSE), have discussed such analyses and design of action possibilities focusing on providing computer...... to cover deeper semantic and pragmatic aspects of the ecology of work, as compared with the previous applications of Gibson's theory in HMI....

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...

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

Full Text Available Background/Aim. 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. Methods. 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. Results. 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 < 0,001 respectively. The univariate analysis showed that the highest correlation with the current 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 < 0.001, and ρ = 0.637, p < 0.001, respectively. Multivariate regression models confirmed the influence of the number of hospitalization days to costs under the current payment system (β = 0.843, p < 0.001 as well as under the projected DRG payment system (β = 0.737, p < 0.001. The same predictor was crucial for the difference in the current payment method and the projected DRG payment methods (β = 0.501, p <0.001. Conclusion. 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

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...

Is there value in retrospective 90-day bundle payment models for shoulder arthroplasty procedures?

Science.gov (United States)

Odum, Susan M; Hamid, Nady; Van Doren, Bryce A; Spector, Leo R

2018-05-01

The Centers for Medicare & Medicaid Services Bundled Payments for Care Improvement (BPCI) initiative was implemented as part of the Affordable Care Act. We implemented a retrospective payment model 2 for a 90-day total shoulder arthroplasty (TSA) episode to assess the value of TSA BPCI at our private practice. Expenditures and postacute event rates of 132 fee-for-service (FFS) patients who underwent a TSA operation between 2009 and 2012 were compared with 333 BPCI patients who had a TSA operation in 2015. The 90-day postacute events included an inpatient rehabilitation facility (IRF), skilled nursing facility (SNF), and home health (HH) admissions and readmissions. Expenditures were converted to 2016 dollars using the Consumer Price Index. Wilcoxon tests and multivariate generalized estimating equation were used to assess independent cost-drivers. The median FFS expenditure was $21,157 (interquartile range, $16,894-$30,748) compared with $17,894 (interquartile range, $15,796-$20,894) for BPCI (P model, we found BPCI had a 4% decrease in expenditures (P = .08). All postacute events were independently associated with higher expenditures. Our private practice implemented cost-containment practices, including clinical guidelines, patient navigators, and a BPCI management team. IRF and SNF utilization and the 90-day readmission rate significantly decreased. As a result, we were able to control the postacute spending, which resulted in decreased costs of performing TSA surgery. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Defining and Measuring the Affordability of New Medicines: A Systematic Review.

Science.gov (United States)

Antoñanzas, Fernando; Terkola, Robert; Overton, Paul M; Shalet, Natalie; Postma, Maarten

2017-08-01

In many healthcare systems, affordability concerns can lead to restrictions on the use of expensive efficacious therapies. However, there does not appear to be any consensus as to the terminology used to describe affordability, or the thresholds used to determine whether new drugs are affordable. The aim of this systematic review was to investigate how affordability is defined and measured in healthcare. MEDLINE, EMBASE and EconLit databases (2005-July 2016) were searched using terms covering affordability and budget impact, combined with definitions, thresholds and restrictions, to identify articles describing a definition of affordability with respect to new medicines. Additional definitions were identified through citation searching, and through manual searches of European health technology assessment body websites. In total, 27 definitions were included in the review. Of these, five definitions described affordability in terms of the value of a product; seven considered affordability within the context of healthcare system budgets; and 15 addressed whether products are affordable in a given country based on economic factors. However, there was little in the literature to indicate that the price of medicines is considered alongside both their value to individual patients and their budget impact at a population level. Current methods of assessing affordability in healthcare may be limited by their focus on budget impact. A more effective approach may involve a broader perspective than is currently described in the literature, to consider the long-term benefits of a therapy and cost savings elsewhere in the healthcare system, as well as cooperation between healthcare payers and the pharmaceutical industry to develop financing models that support sustainability as well as innovation.

Risks from Radon: Reconciling Miner and Residential Epidemiology

International Nuclear Information System (INIS)

Chambers, Douglas B.; Harley, Naomi H.

2008-01-01

Everyone is exposed to radon, an inert radioactive gas that occurs naturally and is present everywhere in the atmosphere. The annual dose from radon and its (short-lived) decay products is typically about one-half of the dose received by members of the public from all natural sources of ionizing radiation. Data on exposures and consequent effects have recently been reviewed by the National Council on Radiation Protection and Measurements (NCRP) and the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). Studies of underground miners provides a well-established basis for estimating risks from occupational exposures to radon and for studying factors that may affect the dose response relationship such as the reduction of risk (coefficients) with increasing time since exposure. Miners' studies previously formed the basis for estimating risks to people exposed to radon at home, with downward extrapolation from exposures in mines to residential levels of radon. Presently, the risk estimates from residential studies are adequate to estimate radon risks in homes. Although there are major uncertainties in extrapolating the risks of exposure to radon from the miner studies to assessing risks in the home, there is remarkably good agreement between the average of risk factors derived from miner studies and those from pooled residential case-control studies. There are now over 20 analytical studies of residential radon and lung cancer. These studies typically assess the relative risk from exposure to radon based on estimates of residential exposure over a period of 25 to 30 years prior to diagnosis of lung cancer. Recent pooled analyses of residential case-control studies support a small but detectable lung cancer risk from residential exposure, and this risk increases with increasing concentrations. The excess relative risk of lung cancer from long-term residential exposure is about the same for both smokers and non-smokers; however, because the

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...

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...

Affordances are Signs

Directory of Open Access Journals (Sweden)

John Pickering

2008-07-01

Full Text Available Peirce and Whitehead share a common project: to restrict the over-extension of reductionism, to show how matter must be sensate and to create an ontology of process and subjectivity. This article claims that biosemiotics can assist this project. Moreover, it shows that the concept of affordance is a means to produce a theory of causation that embraces physical, natural and cultural levels of order.

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 ...

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...

28 CFR 550.52 - Non-residential drug abuse treatment services.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Non-residential drug abuse treatment... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.52 Non-residential drug abuse treatment services. All institutions must have non-residential drug abuse treatment services, provided...

Regionalised tertiary psychiatric residential facilities.

Science.gov (United States)

Lesage, Alain; Groden, David; Goldner, Elliot M; Gelinas, Daniel; Arnold, Leslie M

2008-01-01

Psychiatric hospitals remain the main venue for long-term mental health care and, despite widespread closures and downsizing, no country that built asylums in the last century has done away with them entirely--with the recent exception of Italy. Differentiated community-based residential alternatives have been developed over the past decades, with staffing levels that range from full-time professional, to daytime only, to part-time/on-call. This paper reviews the characteristics of community-based psychiatric residential care facilities as an alternative to long-term care in psychiatric hospitals. It describes five factors decision makers should consider: 1. number of residential places needed; 2. staffing levels; 3. physical setting; 4. programming; and 5. governance and financing. In Italy, facilities with full-time professional staff have been developed since the mid-1990s to accommodate the last cohorts of patients discharged from psychiatric hospitals. In the United Kingdom, experiments with hostel wards since the 1980s have shown that home-like, small-scale facilities with intensive treatment and rehabilitation programming can be effective for the most difficult-to-place patients. More recently in Australia, Community Care Units (CCUs) have been applying this concept. In the Canadian province of British Columbia (BC), Tertiary Psychiatric Residential Facilities (TPRFs) have been developed as part of an effort to regionalise health and social services and downsize and ultimately close its only psychiatric hospital. This type of service must be further developed in addition to the need for forensic, acute-care and intermediate-level beds, as well as for community-based care such as assertive community treatment and intensive case management. All these types of services, together with long-term community-based residential care, constitute the elements of a balanced mental health care system. As part of a region's balanced mental health care plan, these Tertiary

Bullying and social media affordances

OpenAIRE

Brailas, Alexios

2016-01-01

What constitutes a good and sustainabledigital living?Social media literacyCan we talk about social media intelligence?Can we talk about digital intelligence?How bullying is complicated by special social media affordances?

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.

Residential heat pumps in the future Danish energy system

DEFF Research Database (Denmark)

Petrovic, Stefan; Karlsson, Kenneth Bernard

2016-01-01

for politically agreed targets which include: at least 50% of electricity consumption from wind power starting from 2020, fossil fuel free heat and power sector from 2035 and 100% renewable energy system starting from 2050. Residential heat pumps supply around 25% of total residential heating demand after 2035......Denmark is striving towards 100% renewable energy system in 2050. Residential heat pumps are expected to be a part of that system.We propose two novel approaches to improve the representation of residential heat pumps: Coefficients of performance (COPs) are modelled as dependent on air and ground...... temperature while installation of ground-source heat pumps is constrained by available ground area. In this study, TIMES-DK model is utilised to test the effects of improved modelling of residential heat pumps on the Danish energy system until 2050.The analysis of the Danish energy system was done...

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...

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...

The drivers to adopt renewable energy among residential users.

Science.gov (United States)

Rahman, Zahari Abdul; Elinda, Esa

2016-03-01

This study aims to examine the drivers to adopt renewable energy (RE) among residential users in Malaysia. Based on the theoretical framework of a consumer’s decision making process, an empirical study of the adoption of RE was conducted. A total of 501 residential users were used in this study. This study proved that perceived utility of new technology, perceived utility of new service, and perceived benefit of new technology are the drivers to adopt RE among residential users. These factors are knowing crucial to RE suppliers and producers because it will generates more demand from the residential users and the percentage of energy mix from RE sources can be increase.

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

Integration of motor traffic in residential areas.

NARCIS (Netherlands)

Schreuder, D.A.

1977-01-01

In stead of banning the cars from residential areas, the plan is to integrate them in such a way that they can still be used, but that they will loose their predominant position. The areas where this integration is to take place are called residential yards. This paper concentrates on the lighting

41 CFR 105-71.121 - Payment.

Science.gov (United States)

2010-07-01

...) 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... disbursements. The working capital advance method of payment shall not be used by grantees or subgrantees if the...

Energy affordability and the benefits system in Italy

International Nuclear Information System (INIS)

Miniaci, Raffaele; Scarpa, Carlo; Valbonesi, Paola

2014-01-01

In this paper, we discuss a number of ways to define and measure the affordability of energy consumption, and we examine the emergence of energy poverty in Italy in the period from 1998 to 2011. The paper examines the eligibility criteria for claiming the benefits available to support energy consumption for vulnerable families and it identifies the potential beneficiaries. The study assesses the appropriateness of the eligibility criteria by comparing the population targeted by the policy with the population actually facing affordability problems. A simulation exercise, using the hypothetical scenario most likely to result in energy benefits being made available, shows that, regardless of the affordability index adopted, the provision of state energy benefits has little impact on fuel poverty. - Highlights: • The paper provides a discussion of alternative measure of energy affordability. • We examine the emergence of fuel poverty in Italy from 1998 to 2011. • We assess the appropriateness of the Italian energy benefits eligibility criteria. • A simulation shows that the energy benefits have little impact on fuel poverty

Encapsulating the delivery of affordable housing: An overview of Malaysian practice

Directory of Open Access Journals (Sweden)

Jamaluddin Nor Baizura

2016-01-01

Full Text Available Urban population increases much faster than other geographical areas and this brings huge challenges to Malaysian government especially those responsible for the provision of housing. Moreover, the rise of living cost and pressure towards the current economic situation had inevitably led to huge demands for affordable housing. Thus, affordability and inaccessibility of people in owning a house has become one of the major issues in Malaysia. These issues are not only faced by the low-income group but mostly experienced by urban dwellers including the middle-income group whom are not eligible to apply for low-cost housing delivered by the government, yet cannot afford to buy a house. Hence, the Malaysian government had therefore established the Perumahan Rakyat 1 Malaysia (PR1MA as the catalyst in providing adequate, quality and affordable houses. Furthermore, the Syarikat Perumahan Negara Berhad (SPNB and the state governments also play their big role in providing affordable house at the state level. In trying to ensure smooth delivery of affordable housing, a systematic approach is required. This paper intends to examine the delivery of affordable housing in Malaysia. The objective was to assess the parties involved, and the various stages of the process. The methodology adopted for this study includes in-depth interviews with affordable housing agencies. Investigation showed that the major problem relates to a mismatch in the delivery of affordable housing. Moreover, the political and economic aspects, as well as the organization situation had also influenced the inefficiency of affordable housing delivery system. Additionally, the significant of this paper is expected to formulate an improved strategy and guidance in delivery system, thus ensuring that the method of practice is applicable throughout the country.

The Affordance Template ROS Package for Robot Task Programming

Science.gov (United States)

Hart, Stephen; Dinh, Paul; Hambuchen, Kimberly

2015-01-01

This paper introduces the Affordance Template ROS package for quickly programming, adjusting, and executing robot applications in the ROS RViz environment. This package extends the capabilities of RViz interactive markers by allowing an operator to specify multiple end-effector waypoint locations and grasp poses in object-centric coordinate frames and to adjust these waypoints in order to meet the run-time demands of the task (specifically, object scale and location). The Affordance Template package stores task specifications in a robot-agnostic XML description format such that it is trivial to apply a template to a new robot. As such, the Affordance Template package provides a robot-generic ROS tool appropriate for building semi-autonomous, manipulation-based applications. Affordance Templates were developed by the NASA-JSC DARPA Robotics Challenge (DRC) team and have since successfully been deployed on multiple platforms including the NASA Valkyrie and Robonaut 2 humanoids, the University of Texas Dreamer robot and the Willow Garage PR2. In this paper, the specification and implementation of the affordance template package is introduced and demonstrated through examples for wheel (valve) turning, pick-and-place, and drill grasping, evincing its utility and flexibility for a wide variety of robot applications.

Payment changes require integrating records.

Science.gov (United States)

Palley, M A

1990-06-01

The greatest challenges for healthcare organizations facing radical changes in their payment and reporting structures lie in finding ways to integrate various forms of patient information. An analysis of how three New York City hospitals dealt with their state's switch to an all-payer diagnosis related group-based payment system reveals strengths and weaknesses in their existing information systems and in steps taken to adapt to the change.

Mobile Payments : Comparison of Mobile Wallet Concepts

OpenAIRE

Narayan, Srikant

2013-01-01

Mobile payments are an emerging trend and an alternative to traditional payment methods. Mobile payments involve the usage of the mobile phone to handle credit transfers during purchase of goods and peer to peer money transfers referred to as mobile wallet service, instead of depending on bank cards and cash. In this scenario, while the mobile wallet industry still being in its infancy there exist a few drivers of mobile wallet solutions aiming to create a de-facto standard in the mobile mark...

Developing an Assessment Framework for Affordable and Sustainable Housing

Directory of Open Access Journals (Sweden)

Stephen Pullen

2010-07-01

Full Text Available Sustainable housing has been subject to research, practice and policy making for some considerable time. More recently attention has been drawn to the separate problem of declining affordability in housing. This paper describes research aimed at developing an assessment framework for both affordability and sustainability as part of the effort to incorporate both of these features into new housing projects. The research has a particular focus on developments aimed at urban densification. Background literature on both affordability and sustainability is reviewed as well as emerging schemes aimed at dealing with both aspects of housing developments. Performance indicators are identified and these are incorporated in an interim assessment framework which is tested using a group of industry experts. The research has highlighted areas where further development is required to attain quantitative assessments of affordable and sustainable housing developments

20 CFR 617.28 - Transportation payments.

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Transportation payments. 617.28 Section 617... ASSISTANCE FOR WORKERS UNDER THE TRADE ACT OF 1974 Reemployment Services § 617.28 Transportation payments. (a... transportation expenses if the training is outside the commuting area, but may not receive such assistance if...

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.

Residential damage in an area of underground coal mining

International Nuclear Information System (INIS)

Padgett, M.F.

1988-01-01

In order to estimate the potential for future subsidence-related residential damage, a statistical analysis of past residential damage in the Boulder-Weld, Colorado, coal field was performed. The objectives of this study were to assess the difference in damage severity and frequency between undermined and non-undermined areas, and to determine, where applicable, which mining factors significantly influence the severity and frequency of residential damage. The results of this study suggest that undermined homes have almost three times the risk of having some type of structural damage than do non-undermined homes. The study also indicated that both geologic factors, such as the ratio of sandstone/claystone in the overburden, and mining factors, such as the mining feature (room, pillar, entry, etc.), can significantly affect the severity of overlying residential damage. However, the results of this study are dependent on local conditions and should not be applied elsewhere unless the geologic, mining, and residential conditions are similar

Analysis of a Residential Building Energy Consumption Demand Model

Directory of Open Access Journals (Sweden)

Meng Liu

2011-03-01

Full Text Available In order to estimate the energy consumption demand of residential buildings, this paper first discusses the status and shortcomings of current domestic energy consumption models. Then it proposes and develops a residential building energy consumption demand model based on a back propagation (BP neural network model. After that, taking residential buildings in Chongqing (P.R. China as an example, 16 energy consumption indicators are introduced as characteristics of the residential buildings in Chongqing. The index system of the BP neutral network prediction model is established and the multi-factorial BP neural network prediction model of Chongqing residential building energy consumption is developed using the Cshap language, based on the SQL server 2005 platform. The results obtained by applying the model in Chongqing are in good agreement with actual ones. In addition, the model provides corresponding approximate data by taking into account the potential energy structure adjustments and relevant energy policy regulations.

42 CFR 413.64 - Payments to providers: Specific rules.

Science.gov (United States)

2010-10-01

... SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Payments to... following period. However, since initially there is no previous history of cost under the program, the... cost reporting periods, see § 413.350 regarding periodic interim payments for skilled nursing...

Accounting for share based payments according to TFRS-2

OpenAIRE

Yilmaz, Erdal

2015-01-01

TFRS-2 Share-Based Payment in accounting for all sharebased payment transactions including equity-settled share-based payment transactions, cash-settled sharebased payment transactions, and transactions in which the entity receives or acquires goods or services and the terms of the arrangement provide either the entity or the supplier of those goods or services with a choice of whether the entity settles the transaction in cash or by issuing equity instruments. In this study, scope of standar...

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...

Housing Affordability Data System (HADS)

Data.gov (United States)

Department of Housing and Urban Development — The Housing Affordability Data System (HADS) is a set of files derived from the 1985 and later national American Housing Survey (AHS) and the 2002 and later Metro...

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.

Active Affordance Learning in Continuous State and Action Spaces

NARCIS (Netherlands)

Wang, C.; Hindriks, K.V.; Babuska, R.

2014-01-01

Learning object affordances and manipulation skills is essential for developing cognitive service robots. We propose an active affordance learning approach in continuous state and action spaces without manual discretization of states or exploratory motor primitives. During exploration in the action

Financial Ties Between Emergency Physicians and Industry: Insights From Open Payments Data.

Science.gov (United States)

Fleischman, William; Ross, Joseph S; Melnick, Edward R; Newman, David H; Venkatesh, Arjun K

2016-08-01

The Open Payments program requires reporting of payments by medical product companies to teaching hospitals and licensed physicians. We seek to describe nonresearch, nonroyalty payments made to emergency physicians in the United States. We performed a descriptive analysis of the most recent Open Payments data released to the public by the Centers for Medicare & Medicaid Services covering the 2014 calendar year. We calculated the median payment, the total pay per physician, the types of payments, and the drugs and devices associated with payments to emergency physicians. For context, we also calculated total pay per physician and the percentage of active physicians receiving payments for all specialties. There were 46,405 payments totaling $10,693,310 to 12,883 emergency physicians, representing 30% of active emergency physicians in 2013. The percentage of active physicians within a specialty who received a payment ranged from 14.6% in preventive medicine to 91% in orthopedic surgery. The median payment and median total pay to emergency physicians were $16 (interquartile range $12 to $68) and $44 (interquartile range $16 to $123), respectively. The majority of payments (83%) were less than $100. Food and beverage (86%) was the most frequent type of payment. The most common products associated with payments to emergency physicians were rivaroxaban, apixaban, ticagrelor, ceftaroline, canagliflozin, dabigatran, and alteplase. Nearly a third of emergency physicians received nonresearch, nonroyalty payments from industry in 2014. Most payments were of small monetary value and for activities related to the marketing of antithrombotic drugs. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Tracking the Sun VIII. The Installed Price of Residential and Non-Residential Photovoltaic Systems in the United States

Energy Technology Data Exchange (ETDEWEB)

Barbose, Galen L. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Darghouth, Naïm R. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Millstein, Dev [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Spears, Mike [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Wiser, Ryan H. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Buckley, Michael [Exeter Associates, Columbia, MD (United States); Widiss, Rebecca [Exeter Associates, Columbia, MD (United States); Grue, Nick [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2015-08-01

Now in its eighth edition, Lawrence Berkeley National Laboratory (LBNL)’s Tracking the Sun report series is dedicated to summarizing trends in the installed price of grid-connected solar photovoltaic (PV) systems in the United States. The present report focuses on residential and nonresidential systems installed through year-end 2014, with preliminary trends for the first half of 2015. As noted in the text box below, this year’s report incorporates a number of important changes and enhancements. Among those changes, this year's report focuses solely on residential and nonresidential PV systems; data on utility-scale PV are reported in LBNL’s companion Utility-Scale Solar report series. Installed pricing trends presented within this report derive primarily from project-level data reported to state agencies and utilities that administer PV incentive programs, solar renewable energy credit (SREC) registration systems, or interconnection processes. In total, data were collected for roughly 400,000 individual PV systems, representing 81% of all U.S. residential and non-residential PV capacity installed through 2014 and 62% of capacity installed in 2014, though a smaller subset of this data were used in analysis.

47 CFR 0.469 - Advance payments.

Science.gov (United States)

2010-10-01

... the requester has no history of payment. Where allowable charges are likely to exceed $250.00 and the requester has a history of prompt payment of FOIA fees the Commission may notify the requester of the... (k) (i.e., twenty business days from receipt of initial requests and twenty business days from...

7 CFR 1466.23 - Payment rates.

Science.gov (United States)

2010-01-01

... practices on some or all of the operations of a producer related to organic production and the transition to organic production. Payments may not be made to cover the costs associated with organic certification or for practices that are eligible for cost-share payments under the National Organic Program (7 U.S.C...

38 CFR 70.30 - Payment principles.

Science.gov (United States)