...-XA17 User Fee Schedule for Trade Promotion Services AGENCY: U.S. & Foreign Commercial Service... promotion services under the current fee structure. ITA provides a wide range of trade promotion information... these more intensive trade promotion services. The fee revenue is expected to continue to contribute to...
U.S. Department of Health & Human Services — A fee schedule is a complete listing of fees used by Medicare to pay doctors or other providers-suppliers. This comprehensive listing of fee maximums is used to...
U.S. Department of Health & Human Services — Outpatient clinical laboratory services are paid based on a fee schedule in accordance with Section 1833(h) of the Social Security Act. The clinical laboratory fee...
U.S. Department of Health & Human Services — This website is designed to provide information on services covered by the Medicare Physician Fee Schedule (MPFS). It provides more than 10,000 physician services,...
U.S. Department of Health & Human Services — The list contains the fee schedule amounts, floors, and ceilings for all procedure codes and payment category, jurisdication, and short description assigned to each...
... locations for cable television services. 1.1155 Section 1.1155 Telecommunication FEDERAL COMMUNICATIONS... Schedule of regulatory fees and filing locations for cable television services. Fee amount Address 1. Cable Television Relay Service $315 FCC, Cable, P.O. Box 979084, St. Louis, MO 63197-9000 2. Cable TV System (per...
... teaching physicians. 415.172 Section 415.172 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.172 Physician fee schedule payment for services of teaching physicians. (a...
... amounts for volunteers, as explained at 75 FR 18752, and Centralized Billing Service Providers (CBSPs), as... Information Services Division; Revised User Fee Schedule AGENCY: Federal Bureau of Investigation (FBI.... Enourato, Section Chief, Resources Management Section, Criminal Justice Information Services Division, FBI...
...] RIN 1615-AB80 U.S. Citizenship and Immigration Services Fee Schedule; Correction AGENCY: U.S. Citizenship and Immigration Services, DHS. ACTION: Final rule; correction. SUMMARY: The Department of Homeland Security corrects an inadvertent error in the amendatory language of the final rule U.S. Citizenship and...
U.S. Department of Health & Human Services — Durable Medical Equipment, Prosthetics-Orthotics, and Supplies Fee Schedule. The list contains the fee schedule amounts, floors, and ceilings for all procedure codes...
... 47 Telecommunication 1 2010-10-01 2010-10-01 false Schedule of annual regulatory fees and filing locations for mass media services. 1.1153 Section 1.1153 Telecommunication FEDERAL COMMUNICATIONS COMMISSION... of annual regulatory fees and filing locations for mass media services. Radio [AM and FM] (47 CFR...
... proposed changes to the Schedule of Fees for Consular Services (Schedule) for nonimmigrant visa and border... (Machine-Readable Visas or MRVs) and adult Border Crossing Cards (BCCs). The rule also provides new tiers... these visas under the current cost structure. The Department endeavors to recover the cost of providing...
Latimer, E A; Kane, N M
The practice expense component of the Medicare fee schedule (MFS), which is currently based on historical charges and rewards physician procedures at the expense of cognitive services, is due to be changed by January 1, 1998. The Physician Payment Review Commission (PPRC) and others have proposed microcosting direct costs and allocating all indirect costs on a common basis, such as physician time or work plus direct costs. Without altering the treatment of direct costs, the service-class approach disaggregates indirect costs into six practice function costs. The practice function costs are then allocated to classes of services using cost-accounting and statistical methods. This approach would make the practice expense component more resource-based than other proposed alternatives.
.... Service Improvement and Fees. 2. Multiple Biometric Data Requests. 3. Transformation. 4. Increases... Reform Act. C. Small Business Regulatory Enforcement Fairness Act. D. Executive Order 12866. E. Executive...
... physician services in a teaching setting. 415.170 Section 415.170 Public Health CENTERS FOR MEDICARE... BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.170 Conditions for payment on a fee schedule basis...
... micrographic record or publication or computer report, the fee is $.15 per page, except that the first 100... 39 Postal Service 1 2010-07-01 2010-07-01 false Schedule of fees. 266.8 Section 266.8 Postal... Schedule of fees. (a) Policy. The purpose of this section is to establish fair and equitable fees to permit...
... requester for the services rendered. (i) Fee for copies of printed materials. When extra copies of printed... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Fee schedule. 402.165 Section 402.165 Employees' Benefits SOCIAL SECURITY ADMINISTRATION AVAILABILITY OF INFORMATION AND RECORDS TO THE PUBLIC...
... METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 915.404-4-71-5 Fee schedules. (a... subcontracting, normal contractor services performed by the government or another contractor: (1) The target fee...) The target fee schedule provides for 45 percent of the contract work to be subcontracted for such...
Gong, Dan; Jun, Lin; Tsai, James C
To calculate the associations between Medicare payment and service volume for complex and noncomplex cataract surgeries. The 2005-2009 CMS Part B National Summary Data Files, CMS Part B Carrier Summary Data Files, and the Medicare Physician Fee Schedule. Conducting a retrospective, longitudinal analysis using a fixed-effects model of Medicare Part B carriers representing all 50 states and the District of Columbia from 2005 to 2009, we calculated the Medicare payment-service volume elasticities for noncomplex (CPT 66984) and complex (CPT 66982) cataract surgeries. Service volume data were extracted from the CMS Part B National Summary and Carrier Summary Data Files. Payment data were extracted from the Medicare Physician Fee Schedule. From 2005 to 2009, the proportion of total cataract services billed as complex increased from 3.2 to 6.7 percent. Every 1 percent decrease in Medicare payment was associated with a nonsignificant change in noncomplex cataract service volume (elasticity = 0.15, 95 percent CI [-0.09, 0.38]) but a statistically significant increase in complex cataract service volume (elasticity = -1.12, 95 percent CI [-1.60, -0.63]). Reduced Medicare payment was associated with a significant increase in complex cataract service volume but not in noncomplex cataract service volume, resulting in a shift toward performing a greater proportion of complex cataract surgeries from 2005 to 2009. © Health Research and Educational Trust.
U.S. Department of Health & Human Services — The significant size of the Physician Fee Schedule Payment Amount File-National requires that database programs (e.g., Access, dBase, FoxPro, etc.) be used to read...
... DEFENSE NUCLEAR FACILITIES SAFETY BOARD 10 CFR Part 1703 FOIA Fee Schedule Update AGENCY: Defense Nuclear Facilities Safety Board. ACTION: Establishment of FOIA Fee Schedule. SUMMARY: The Defense Nuclear Facilities Safety Board is publishing its Freedom of Information Act (FOIA) Fee Schedule Update pursuant to...
... DEFENSE NUCLEAR FACILITIES SAFETY BOARD 10 CFR Part 1703 FOIA Fee Schedule Update AGENCY: Defense Nuclear Facilities Safety Board. ACTION: Establishment of FOIA Fee Schedule. SUMMARY: The Defense Nuclear Facilities Safety Board is publishing its Freedom of Information Act (FOIA) Fee Schedule Update pursuant to...
... comprehensive fee study and refined its cost accounting process, and determined that current fees do not recover... State. DNB--Dun and Bradstreet. EAD--Employment Authorization Document. FASAB--Federal Accounting... naturalization benefits and ensures the collection, safeguarding, and accounting of fees by USCIS. INA section...
Physician spending has substantially increased over the last few years in Canada to reach $27.4 billion in 2010. Total clinical payment to physicians has grown at an average annual rate of 7.6% from 2004 to 2010. The key policy question is whether or not this additional money has bought more physician services. So, the purpose of this study is to understand if we are paying more for the same amount of medical services in Canada or we are getting more bangs for our buck. At the same time, the paper attempts to find out whether or not there is a productivity difference between family physician services and surgical procedures. Using the Baumol theory and data from the National Physician Database for the period 2004-2010, the paper breaks down growth in physician remuneration into growth in unit cost and number of services, both from the physician and the payer perspectives. After removing general inflation and population growth from the 7.6% growth in total clinical payment, we found that real payment per service and volume of services per capita grew at an average annual rate of 3.2% and 1.4% respectively, suggesting that payment per service was the main cost driver of physician remuneration at the national level. Taking the payer perspective, it was found that, for the fee-for-service (FFS) scheme, volume of services per physician decreased at an average annual rate of -0.6%, which is a crude indicator that labour productivity of physicians on FFS has fallen during the period. However, the situation differs for the surgical procedures. Results also vary by province. Overall, our finding is consistent with the Baumol theory, which hypothesizes higher productivity growth in technology-driven sectors.
... 42 Public Health 3 2010-10-01 2010-10-01 false Publication of the ambulance fee schedule. 414.620... SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Fee Schedule for Ambulance Services § 414.620 Publication of the ambulance fee schedule. Changes in payment rates resulting...
... EXCHANGE COMMISSION ORGANIZATION; CONDUCT AND ETHICS; AND INFORMATION AND REQUESTS Information and Requests.... Regular service. Paper copies of original paper copies, or from microfiche accessible to the contractor...
... through the National Technical Information Service (NTIS) or payment through the Online Computer Library... in order to support the current cost of providing the service and will enable customers to estimate... Service 7 CFR Part 505 RIN 0518-8AA04 Modification of Interlibrary Loan Fee Schedule AGENCY: Agricultural...
... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false NARA reproduction fee... ADMINISTRATION PUBLIC AVAILABILITY AND USE FEES § 1258.12 NARA reproduction fee schedule. (a) Certification: $15...) Unlisted processes: For reproductions not covered by this fee schedule, see also § 1258.4. Fees for other...
Wynn, Barbara O; Boustead, Anne
The California Department of Industrial Relations/Division of Worker's Compensation asked RAND to provide technical assistance in developing a fee schedule for home health services provided to injured workers. The fee schedule needs to address the full spectrum of home health services ranging from skilled nursing and therapy services to unskilled personal care or chore services that may be provided by family members. RAND researchers consulted with stakeholders in the California workers' compensation system to outline issues the fee schedule should address, reviewed home health fee schedules used by other payers, and conducted interviews with WC administrators from other jurisdictions to elicit their experiences. California stakeholders identified unskilled attendant services as most problematic in determining need and payment rates, particularly services furnished by family members. RAND researchers concentrated on fee schedule options that would result in a single fee schedule covering the full range of home health care services furnished to injured workers and made three sets of recommendations. The first set pertains to obtaining additional information that would highlight the policy issues likely to occur with the implementation of the fee schedule and alternatives for assessing an injured worker's home health care needs. Another approach conforms most closely with the Labor Code requirements. It would integrate the fee schedules used by Medicare, In-Home Health Supportive Services, and the federal Office of Workers' Compensation. The third approach would base the home health fee schedule on rules used by the federal Office of Workers' Compensation.
The move to a value-based payment system was supposed to end perverse incentives that pay doctors more for delivering often unnecessary services. But things are changing slowly and the market is still 95% fee for service. There's talk of reworking the Medicare fee schedule so docs are paid more for the things that work, and less for those that don't.
... and 171 Revision of Fee Schedules; Fee Recovery for Fiscal Year 2012; Proposed Rule #0;#0;Federal... REGULATORY COMMISSION 10 CFR Parts 170 and 171 [NRC-2011-0207] RIN 3150-AJ03 Revision of Fee Schedules; Fee..., inspection, and annual fees charged to its applicants and licensees. The proposed amendments are necessary to...
... Part IV Nuclear Regulatory Commission 10 CFR Parts 170 and 171 Revision of Fee Schedules; Fee...] RIN 3150-AI70 Revision of Fee Schedules; Fee Recovery for FY 2010 AGENCY: Nuclear Regulatory... licensing, inspection, and annual fees charged to its applicants and licensees. The proposed amendments are...
... Part II Nuclear Regulatory Commission 10 CFR Parts 170 and 171 Revision of Fee Schedules; Fee...-2009-0333 RIN 3150-AI70 Revision of Fee Schedules; Fee Recovery for FY 2010 AGENCY: Nuclear Regulatory..., inspection, and annual fees charged to its applicants and licensees. The amendments are necessary to...
... 171 Revision of Fee Schedules; Fee Recovery for Fiscal Year 2011; Proposed Rule #0;#0;Federal Register... COMMISSION 10 CFR Parts 170 and 171 RIN 3150-AI93 [NRC-2011-0016] Revision of Fee Schedules; Fee Recovery for... fees charged to its applicants and licensees. The proposed amendments are necessary to implement the...
... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Schedule of fees. 260.70 Section 260.70... Products for Human Consumption Fees and Charges § 260.70 Schedule of fees. (a) Unless otherwise provided in a written agreement between the applicant and the Secretary, the fees to be charged and collected...
... 1703 Proposed FOIA Fee Schedule Update AGENCY: Defense Nuclear Facilities Safety Board. ACTION: Notice... the Board's proposed FOIA Fee Schedule Update published in the Federal Register of June 1, 2012. The...: The FOIA requires each Federal agency covered by the Act to specify a schedule of fees applicable to...
... DEFENSE NUCLEAR FACILITIES SAFETY BOARD 10 CFR Part 1703 Proposed FOIA Fee Schedule Update AGENCY... publishing its proposed Freedom of Information Act (FOIA) Fee Schedule Update and solicits comments from... on the proposed fee schedule should be mailed or delivered to the Office of the General Counsel...
... DEFENSE NUCLEAR FACILITIES SAFETY BOARD 10 CFR Part 1703 Proposed FOIA Fee Schedule Update AGENCY... publishing its proposed Freedom of Information Act (FOIA) Fee Schedule Update and solicits comments from... on the proposed fee schedule should be mailed or delivered to the Office of the General Counsel...
... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Reproduction fee schedule... RULES 9.3-Individual Access to Records § 51-9.304-5 Reproduction fee schedule. (a) The fee for... physical characteristics do not permit reproduction by routine electrostatic copying shall be the direct...
... 45 Public Welfare 4 2010-10-01 2010-10-01 false Schedule of fees. 2106.7 Section 2106.7 Public Welfare Regulations Relating to Public Welfare (Continued) COMMISSION OF FINE ARTS RULES FOR COMPLIANCE WITH 5 U.S.C. 552a, THE PRIVACY ACT OF 1974 § 2106.7 Schedule of fees. No fees will be charged for...
... 1703 Proposed FOIA Fee Schedule Update AGENCY: Defense Nuclear Facilities Safety Board. ACTION: Notice... Defense Nuclear Facilities Safety Board is publishing its proposed Freedom of Information Act (FOIA) Fee.... on or before July 2, 2012. ADDRESSES: Comments on the proposed fee schedule should be mailed or...
... Judicial Administration COURT SERVICES AND OFFENDER SUPERVISION AGENCY FOR THE DISTRICT OF COLUMBIA... Guidelines. They reflect direct costs for search, review (in the case of commercial requesters), and... case of commercial requesters), and duplicating documents to respond to a FOIA request. (c) Fees shall...
This major final rule with comment period addresses changes to the physician fee schedule, clinical laboratory fee schedule, and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. This final rule with comment period also includes a discussion in the Supplementary Information regarding various programs. (See the Table of Contents for a listing of the specific issues addressed in the final rule with comment period.)
..., sex printed erroneously) if submitted within one year of passport issuance. (g) Passport Book Security...) Passport card replacement NO FEE. for data correction (name, date of birth, place of birth, sex printed... depositions, including depositions by video teleconference (per daily appointment). (b) Attending or taking...
... purchasing a passport book with the intention of using it to cross the Canadian or Mexican borders for travel...) the Western Hemisphere Travel Initiative (WHTI) surcharge, which is embedded in the passport book and... cost recovery, there are limited circumstances, such as the passport book and card application fees for...
... using business rules that allowed the model to project unit costs for future years. The calculation of...SS), the activity-based costing model that the Department used to determine the fees for consular... , the Department chose to develop and use an activity-based costing (ABC) model to determine the true...
... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Schedule of fees. 404.9 Section 404.9 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES INFORMATION DISCLOSURE Procedures for Disclosure of Records Under the Freedom of Information Act. § 404.9 Schedule of fees. (a) General. Ex-Im Bank shall...
Hornbeck, Julia W.
Profile of fee-based information services offered by the Information Exchange Center of Georgia Institute of Technology notes history and background, document delivery to commercial clients and on-campus faculty, online and manual literature searching, staff, cost analysis, fee schedule, operating methods, client relations, marketing, and current…
... NOAA Environmental Data A Appendix A to Part 950 Commerce and Foreign Trade Regulations Relating to..., App. A Appendix A to Part 950—Schedule of User Fees for Access to NOAA Environmental Data Name of product/data/publication/information/service Current fee New fee NOAA National Data Centers Standard User...
This final rule implements fee schedules for payment of parenteral and enteral nutrition (PEN) items and services furnished under the prosthetic device benefit, defined in section 1861(s)(8) of the Social Security Act. The authority for establishing these fee schedules is provided by the Balanced Budget Act of 1997, which amended the Social Security Act at section 1842(s). Section 1842(s) of the Social Security Act specifies that statewide or other area wide fee schedules may be implemented for the following items and services still subject to the reasonable charge payment methodology: medical supplies; home dialysis supplies and equipment; therapeutic shoes; parenteral and enteral nutrients, equipment, and supplies; electromyogram devices; salivation devices; blood products; and transfusion medicine. This final rule describes changes made to the proposed fee schedule payment methodology for these items and services and provides that the fee schedules for PEN items and services are effective for all covered items and services furnished on or after January 1, 2002. Fee schedules will not be implemented for electromyogram devices and salivation devices at this time since these items are not covered by Medicare. In addition, fee schedules will not be implemented for medical supplies, home dialysis supplies and equipment, therapeutic shoes, blood products, and transfusion medicine at this time since the data required to establish these fee schedules are inadequate.
... and operated to publish or broadcast news to the public. For “freelance” journalists to be regarded as... requester agrees in writing to pay the anticipated total fee. In circumstances involving a total fee that...
... by the Public Information Officer on the basis of the balance between the benefit to the general public and the cost to the Water Resources Council. (d) Fees shall be limited to recovery of only direct... ORGANIZATION Availability of Information § 701.203 Schedule of fees. (a) The Public Information Officer will to...
... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Schedule of fees. 404.16 Section 404.16 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES INFORMATION DISCLOSURE Access to Records Under the Privacy Act of 1974 § 404.16 Schedule of fees. (a) Search and review. Ex-Im Bank shall not charge for...
... Debt Collection Act (Pub. L. 97-365), including disclosure to consumer reporting agencies and use of... full payment in advance where a requester has previously failed to pay fees in a timely fashion. (B) If...
... schedule; 5) The NRC could assess a fee for renewing a license to operate a low-level radioactive waste... upon small licensees and performed a trend analysis to calculate the appropriate fee tier levels. From... appropriate, except for topical reports whose costs exceed $50,000. Costs which exceed $50,000 for any topical...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Fee Schedule for Reference Biological Standards and Biological Preparations AGENCY: Centers for Disease Control and... for Disease Control and Prevention (CDC), located within the Department of Health and Human Services...
... Costs and Costs for Processing Offers of Cash Deposits or Obligations of the United States in Lieu of... processing costs and costs for processing offers of cash deposits or obligations of the United States in lieu... processing costs will decrease from $9.93 to $9.09 per bond. The fee for the review, processing, handling...
... Costs for Processing Offers of Cash Deposits or Obligations of the United States in Lieu of Sureties on... costs and costs for processing offers of cash deposits or obligations of the United States in lieu of... beginning of fiscal year (FY) 2013. The statute authorizes fees to cover the costs of the importer...
... MFP Multi-Factor Productivity MGMA Medical Group Management Association MIEA-TRHCA The Medicare... 69624), we revised the methodology for calculating direct PE RVUs from the top- down to the bottom-up... Based on RVUs To calculate the payment for each physicians' service, the components of the fee schedule...
... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Schedule of fees. 1302.6 Section 1302.6 Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET ADMINISTRATIVE PROCEDURES PRIVACY ACT PROCEDURES § 1302... and mailed or delivered to the Assistant to the Director for Administration, Office of Management and...
... DEPARTMENT OF THE TREASURY Fiscal Service Fee Schedule for the Transfer of U.S. Treasury Book-Entry Securities Held on the National Book-Entry System AGENCY: Bureau of the Public Debt, Fiscal... fee schedule applicable to transfers of U.S. Treasury book-entry securities maintained on the National...
... DEPARTMENT OF THE TREASURY Fiscal Service Fee Schedule for the Transfer of U.S. Treasury Book-Entry Securities Held on the National Book-Entry System AGENCY: Bureau of the Public Debt, Fiscal... fee schedule applicable to transfers of U.S. Treasury book-entry securities maintained on the National...
... DEPARTMENT OF THE TREASURY Fiscal Service Fee Schedule for the Transfer of U.S. Treasury Book-Entry Securities Held on the National Book-Entry System Authority: 31 CFR 357.45. AGENCY: Bureau of the...) is announcing a new fee schedule applicable to transfers of U.S. Treasury book-entry securities...
Shila Waritu, A; Bulzacchelli, Maria T; Begay, Michael E
Recent budget cuts have forced many local health departments (LHDs) to cut staff and services. Setting fees that cover the cost of service provision is one option for continuing to fund certain activities. To describe the use of fees by LHDs in Western Massachusetts and determine whether fees charged cover the cost of providing selected services. A cross-sectional descriptive analysis was used to identify the types of services for which fees are charged and the fee amounts charged. A comparative cost analysis was conducted to compare fees charged with estimated costs of service provision. Fifty-nine LHDs in Western Massachusetts. Number of towns charging fees for selected types of services; minimum, maximum, and mean fee amounts; estimated cost of service provision; number of towns experiencing a surplus or deficit for each service; and average size of deficits experienced. Enormous variation exists both in the types of services for which fees are charged and fee amounts charged. Fees set by most health departments did not cover the cost of service provision. Some fees were set as much as $600 below estimated costs. These results suggest that considerations other than costs of service provision factor into the setting of fees by LHDs in Western Massachusetts. Given their limited and often uncertain funding, LHDs could benefit from examining their fee schedules to ensure that the fee amounts charged cover the costs of providing the services. Cost estimates should include at least the health agent's wage and time spent performing inspections and completing paperwork, travel expenses, and cost of necessary materials.
... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Where can I find OTS's fee schedule? 502.55 Section 502.55 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY ASSESSMENTS AND... fees in a Thrift Bulletin. OTS will publish these fees at least 30 days before they are effective. ...
... patent fees. The publication of that Notice will open a comment window through which the public may...-P-2012-0002] Patent Public Advisory Committee Public Hearings on the Proposed Patent Fee Schedule... Trademark Office (USPTO) may set or adjust by rule any patent or trademark fee established, authorized, or...
Co-opting physicians to regulate Fee-for-Service (FFS) payment is more feasible and simpler to administer than capitation, Diagnosis-Related Groups (DRGs) and pay-for-performance. The key lies in designing and revising the fee schedule, which not only defines and sets the fee for each item, but also the conditions of billing. Adherence to these regulations must be strictly audited in order to control volume and costs, and to assure quality. The fee schedule requires periodic revisions on an item-by-item basis in order to maintain balance among the providers, to list new drugs, devices and equipment, and to reflect the lower market prices of existing ones. Implementing the fee schedule will facilitate the control of balance billing and extra billing, and the introduction of more sophisticated methods of payment in the future.
Full Text Available Co-opting physicians to regulate Fee-for-Service (FFS payment is more feasible and simpler to administer than capitation, Diagnosis-Related Groups (DRGs and pay-for-performance. The key lies in designing and revising the fee schedule, which not only defines and sets the fee for each item, but also the conditions of billing. Adherence to these regulations must be strictly audited in order to control volume and costs, and to assure quality. The fee schedule requires periodic revisions on an item-by-item basis in order to maintain balance among the providers, to list new drugs, devices and equipment, and to reflect the lower market prices of existing ones. Implementing the fee schedule will facilitate the control of balance billing and extra billing, and the introduction of more sophisticated methods of payment in the future.
Pearson, Luwei; Gandhi, Meena; Admasu, Keseteberhan; Keyes, Emily B
To examine user fees for maternity services and how they relate to provision, quality, and use of maternity services in Ethiopia. The national assessment of emergency obstetric and newborn care (EmONC) examined user fees for maternity services in 751 health facilities that provided childbirth services in 2008. Overall, only about 6.6% of women gave birth in health facilities. Among facilities that provided delivery care, 68% charged a fee in cash or kind for normal delivery. Health centers should be providing maternity services free of charge (the healthcare financing proclamation), yet 65% still charge for some aspect of care, including drugs and supplies. The average cost for normal and cesarean delivery was US $7.70 and US $51.80, respectively. Nineteen percent of these facilities required payment in advance for treatment of an obstetric emergency. The health facilities that charged user fees had, on average, more delivery beds, deliveries (normal and cesarean), direct obstetric complications treated, and a higher ratio of skilled birth attendants per 1000 deliveries than those that did not charge. The case fatality rate was 3.8% and 7.1% in hospitals that did and did not charge user fees, respectively. Utilization of maternal health services is extremely low in Ethiopia and, although there is a government decree against charging for maternity service, 65% of health centers do charge for some aspects of maternal care. As health facilities are not reimbursed by the government for the costs of maternity services, this loss of revenue may account for the more and better services offered in facilities that continue to charge user fees. User fees are not the only factor that determines utilization in settings where the coverage of maternity services is extremely low. Additional factors include other out-of-pocket payments such as cost of transport and food and lodging for accompanying relatives. It is important to keep quality of care in mind when user fees are under
... 10 Energy 2 2010-01-01 2010-01-01 false Schedule of fees for production and utilization facilities, review of standard referenced design approvals, special projects, inspections and import and export... AMENDED Schedule of Fees § 170.21 Schedule of fees for production and utilization facilities, review of...
... 7 Agriculture 7 2010-01-01 2010-01-01 false Fees for mediation services. 785.5 Section 785.5... AGRICULTURE SPECIAL PROGRAMS CERTIFIED STATE MEDIATION PROGRAM § 785.5 Fees for mediation services. A requirement that non-USDA parties who elect to participate in mediation pay a fee for mediation services will...
... LIBRARY OF CONGRESS Copyright Office 37 CFR Part 201 [Docket No. RM 2011-9] Fees AGENCY: Copyright... is publishing a final rule establishing an additional fee for a particular service: Travel expenses... Copyright Office's schedule of fees by adding a fee for travel expenses in connection with participation by...
... for Commercial Filming and Still Photography Permits AGENCY: Office of the Secretary, Bureau of Land... still photography conducted on public lands under their jurisdiction. The additional comment period is... proposed location fee schedule to establish land-use fees for commercial filming and still photography that...
... for Commercial Filming and Still Photography Permits AGENCY: Office of the Secretary, Bureau of Land... photography conducted on public lands under their jurisdiction. The proposed fee schedule would establish land-use fees for commercial filming and still photography that are consistent for the National Park...
... fees chargeable under this section are likely to exceed $250. If the requester has a history of prompt... assurance of full payment before commencing work on the request. If the requester has no history of payment... commencing work on the request. (ii) When a requester has previously failed to pay a fee in a timely fashion...
... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Fees for services. 270.4 Section 270.4 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE AVAILABILITY OF RECORDS § 270.4 Fees for services...
... to requests made under the Privacy Act. Fees will not be charged under either the FOIA or the Privacy... are posted on DOI's FOIA home page (see Appendix B). If you do not have access to the Internet, please...
...: (a) Taking possession of personal effects; making an inventory under an official seal (unless... Waiver] 250. (e) Refugee or significant public benefit parole case processing [35-Refugee/Parole] No fee...
... care; (f) Diagnosis or treatment of chronic infectious diseases; (g) Mental health care; or (h... Section 549.72 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT MEDICAL SERVICES Fees for Health Care Services § 549.72 Services provided without fees. We will not charge...
... [Docket No. NHTSA 2010-0035; Notice 1] RIN 2127-AK70 Schedule of Fees Authorized by 49 U.S.C. 30141 AGENCY...: This document proposes fees for Fiscal Year 2011 and until further notice, as authorized by 49 U.S.C...-562, since recodified at 49 U.S.C. 30141-47. The reader is referred to that notice for background...
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.
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.
... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Fees for certification services. 80.10 Section 80.10 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL COLOR...) Method of payment. All deposits and fees required by this section shall be paid by money order, bank...
... air carrier holds neither legal nor equitable interest in the security service fees except for the... 49 Transportation 9 2010-10-01 2010-10-01 false Handling of security service fees. 1510.11 Section 1510.11 Transportation Other Regulations Relating to Transportation (Continued) TRANSPORTATION SECURITY...
... and double frame slide film negatives and positive prints to agencies of the Department, County... review fees may still be assessed); or (3) When any notices, decisions, orders, or other materials are.... Aerial photographic film negatives or reproductions may not be loaned outside the Federal Government...
... photographs, blueprints, videotapes, engineering drawings, hard copies of aperture cards, etc., the fee...) Records will be provided in a form or format specified by the requester if they are readily reproducible in such format with reasonable efforts. If the records are not readily reproducible in the requested...
... manufacturers (32551). Wood preservative manufacturers (32519). This listing is not intended to be exhaustive... the Federal Food, Drug, and Cosmetic Act (FFDCA). Section 33 also created a schedule of decision.... For example, instead of the term ``fast-track,'' the schedule in the Congressional Record uses the...
Nakata, Yoshinori; Yoshimura, Tatsuya; Watanabe, Yuichi; Otake, Hiroshi; Oiso, Giichiro; Sawa, Tomohiro
The purpose of this paper is to examine whether the current surgical reimbursement system in Japan reflects resource utilization after the revision of fee schedule in 2014. The authors collected data from all the surgical procedures performed at Teikyo University Hospital from April 1 through September 30, 2014. The authors defined the decision-making unit as a surgeon with the highest academic rank in the surgery. Inputs were defined as the number of medical doctors who assisted surgery, and the time of operation from skin incision to closure. An output was defined as the surgical fee. The authors calculated surgeons' efficiency scores using data envelopment analysis. The efficiency scores of each surgical specialty were significantly different (p=0.000). This result demonstrates that the Japanese surgical reimbursement scales still fail to reflect resource utilization despite the revision of surgical fee schedule.
... applications for Federal tax incentives contained in Section 47 of the Internal Revenue Code (referred to... through the NPS's Web site at http://www.nps.gov/tps/tax-incentives.htm . The new fee schedule applies... preservation tax certification, and such funds shall be available until expended without further appropriation...
Liu, Yunchang; Li, Chunlin; Luo, Youlong; Shao, Yanling; Zhang, Jing
Currently, security is a critical factor for multimedia services running in the cloud computing environment. As an effective mechanism, trust can improve security level and mitigate attacks within cloud computing environments. Unfortunately, existing scheduling strategy for multimedia service in the cloud computing environment do not integrate trust mechanism when making scheduling decisions. In this paper, we propose a scheduling scheme for multimedia services in multi clouds. At first, a novel scheduling architecture is presented. Then, We build a trust model including both subjective trust and objective trust to evaluate the trust degree of multimedia service providers. By employing Bayesian theory, the subjective trust degree between multimedia service providers and users is obtained. According to the attributes of QoS, the objective trust degree of multimedia service providers is calculated. Finally, a scheduling algorithm integrating trust of entities is proposed by considering the deadline, cost and trust requirements of multimedia services. The scheduling algorithm heuristically hunts for reasonable resource allocations and satisfies the requirement of trust and meets deadlines for the multimedia services. Detailed simulated experiments demonstrate the effectiveness and feasibility of the proposed trust scheduling scheme.
Alrifai, Mohammad; Balke, Wolf-Tilo; Dolog, Peter
. In this paper, we propose a novel nonblocking scheduling mechanism that is used prior to the actual service invocations. Its aim is to reach an agreement between the client and all participating providers on what transaction processing times have to be expected, accepted, and guaranteed. This enables service......For improved flexibility and concurrent usage existing transaction management models for Web services relax the isolation property of Web service-based transactions. Correctness of the concurrent execution then has to be ensured by commit order-preserving transaction schedulers. However, local...... schedulers of service providers typically do take into account neither time constraints for committing the whole transaction, nor the individual services' constraints when scheduling decisions are made. This often leads to an unnecessary blocking of transactions by (possibly long-running) others...
....'' NRC's PDR: You may examine and purchase copies of public documents at the NRC's PDR, Room O1-F21, One... the NRC more bribe money to overlook incidents at nuclear power plants. Response. The NRC agrees with... stating that licensee fees are bribes to the NRC to overlook incidents at facilities. OBRA-90 and...
... factor for a hot cell facility licensed under fee category 1A(2)(c) be corrected from a moderate to a low... inspections, applications for new licenses and license renewals, and requests for license amendments. Second... (DOE) uranium recovery and transportation activities have increased. Another factor affecting [[Page...
... 7 Agriculture 3 2010-01-01 2010-01-01 false Fees and other costs for service. 62.300 Section 62...) Quality Systems Verification Programs Definitions Charges for Service § 62.300 Fees and other costs for service. Fees and other charges will be levied based on the following provisions: (a) Fees for service...
Full Text Available We propose a cloud service scheduling model that is referred to as the Task Scheduling System (TSS. In the user module, the process time of each task is in accordance with a general distribution. In the task scheduling module, we take a weighted sum of makespan and flowtime as the objective function and use an Ant Colony Optimization (ACO and a Genetic Algorithm (GA to solve the problem of cloud task scheduling. Simulation results show that the convergence speed and output performance of our Genetic Algorithm-Chaos Ant Colony Optimization (GA-CACO are optimal.
... AGED, BLIND, AND DISABLED Representation of Parties § 416.1520 Fee for a representative's services. (a... you or your representative from contacting us in person or in writing. (B) There was a death or...
... DISABILITY INSURANCE (1950- ) Representation of Parties § 404.1720 Fee for a representative's services. (a... you or your representative from contacting us in person or in writing. (B) There was a death or...
Medicare program; revisions to payment policies under the Physician Fee Schedule, Clinical Laboratory Fee Schedule, access to identifiable data for the Center for Medicare and Medicaid Innovation Models & other revisions to Part B for CY 2015. Final rule with comment period.
This major final rule with comment period addresses changes to the physician fee schedule, and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services, as well as changes in the statute. See the Table of Contents for a listing of the specific issues addressed in this rule.
... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Fees for FAA Services for Certain Flights B... (CONTINUED) ADMINISTRATIVE REGULATIONS FEES Pt. 187, App. B Appendix B to Part 187—Fees for FAA Services for... pay a fee for the FAA's rendering or providing certain services, including but not limited to the...
... have an impact of $100 million or more on the U.S. economy and thus is not a ``significant regulatory... electronic debit/credit payment program for libraries using OCLC's resource sharing service) or by invoice...
... personal estates of all officers and employees of the United States who die abroad while on official duty... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Fees for consular death and estates services... PROPERTY AND ESTATES DEATHS AND ESTATES Fees § 72.31 Fees for consular death and estates services. (a) Fees...
... representative plus an administrative fee per hundredweight) (CWT) 0.04 (iii) Lots sampled online during loading... service representative) 510.00 (5) Online customized data EGIS service: (i) One data file per week for 1...), 79a(1)), as amended by Pub. L. 97-35, 95 Stat. 371, 372) [45 FR 15810, Mar. 11, 1980; 45 FR 55119, Aug...
... Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) NAVAL STORES REGULATIONS AND... with the cost of the service rendered. Such fees and charges may be announced to the trade in such...
... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Foreign Service fees and incidental costs in... SERVICES NOTARIAL AND RELATED SERVICES Depositions and Letters Rogatory § 92.68 Foreign Service fees and incidental costs in the taking of evidence. The fees for the taking of evidence by officers of the Foreign...
... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Fees for services. 1.7 Section 1.7 Money and Finance: Treasury Office of the Secretary of the Treasury DISCLOSURE OF RECORDS Freedom of... Department shall charge for search time at the salary rate(s) (basic pay plus 16 percent) of the employee(s...
... 32 National Defense 6 2010-07-01 2010-07-01 false Fees for record services. 1900.13 Section 1900.13 National Defense Other Regulations Relating to National Defense CENTRAL INTELLIGENCE AGENCY PUBLIC...-printed (if available) Per 100 pages 5.00 Published (if available) Per item NTIS (2) Application of...
... Inspection Service (FGIS) with the authority to charge and collect reasonable fees to cover the cost of performing official services. The fees also cover the costs associated with managing the program. After a... associated administrative and supervisory costs. The fees for official inspection and weighing services were...
This timely and important book explores how fee-based services have developed in various types of sci-tech libraries. The authoritative contributors focus on the current changing financial aspects of the sci-tech library operation and clarify for the reader how these changes have brought about conditions in which traditional methods of funding are no longer adequate. What new options are open and how they are best being applied in today's sci-tech libraries is fully and clearly explained and illustrated. Topics explored include cost allocation and cost recovery, fees for computer searching, an
Full Text Available Compared with the traditional slow charging loads, random integration of large scale fast charging loads will exert more serious impacts on the security of power network operation. Besides, to maximize social benefits, effective scheduling strategies guiding fast charging behaviors should be formulated rather than simply increasing infrastructure construction investments on the power grid. This paper first analyzes the charging users’ various responses to an elastic charging service fee, and introduces the index of charging balance degree to a target region by considering the influence of fast charging loads on the power grid. Then, a multi-objective optimization model of the fast charging service fee is constructed, whose service fee can be further optimized by employing a fuzzy programming method. Therefore, both users’ satisfaction degree and the equilibrium of charging loads can be maintained simultaneously by reasonably guiding electric vehicles (EVs to different fast charging stations. The simulation results demonstrate the effectiveness of the proposed dynamic charging service pricing and the corresponding fast charging load guidance strategy.
Ginsburg, Paul B
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.
... 7 Agriculture 3 2010-01-01 2010-01-01 false Fees for extra cost and hourly rate service. 160.204... STORES REGULATIONS AND STANDARDS FOR NAVAL STORES Specific Fees Payable for Services Rendered § 160.204 Fees for extra cost and hourly rate service. The fees specified in §§ 160.201 and 160.202 apply to the...
Full Text Available More and more Web services raise the demands of personalized service recommendation; there exist some recommendation technologies, which improve the qualities of service recommendation by using service ranking and collaborative filtering. However, privacy and security are also important issues in service scheduling process; social relationships have been the key factors of interpersonal communication; service selection based on user preferences has become an inevitable trend. Starting from user demand preferences, this paper analyzes social topology and service demand information and obtains trusted social relationships; then we construct the fusion model of service historical preferences and potential ones; according to social service recommendation demands, TSRSR algorithm has completed designing. Through experiments, TSRSR algorithm is much better than the others, which can effectively improve potential preferences’ learning. Furthermore, the research results of this paper have more significance to study the security and privacy of service recommendation.
... authority to charge and collect reasonable fees to cover the cost of performing official services. These fees also cover the costs associated with managing the program. After a financial review of GIPSA's Fees for Official Inspection and Weighing Services, including a comparison of the costs and revenues...
... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Fees for services of the Treasury Department. 223.22 Section 223.22 Money and Finance: Treasury Regulations Relating to Money and Finance... BUSINESS WITH THE UNITED STATES § 223.22 Fees for services of the Treasury Department. (a) Fees shall be...
.... The Board will charge the requester fees for services provided in processing requests for information... limits for making a decision on the new or pending request. (e) Fee schedule. (1) Fees for document... of the information is not primarily in the commercial interest of the requester. This decision will...
Nigro, Peter D.
Discusses how banks brave enough to go against conventional wisdom, which says that customers should pay for everything, could end up with greater profits and more customer satisfaction by exchanging free minimum services for minimum reasonable balances. (RM)
... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Fees for service of legal process. 92.89 Section 92.89 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED SERVICES NOTARIAL AND RELATED SERVICES Quasi-Legal Services § 92.89 Fees for service of legal process. No charge should be made for...
Hirose, Masahiro; Kawamura, Toshihiko; Igawa, Mikio; Imanaka, Yuichi
Little is known about patient safety performance under the social insurance medical fee schedule in Japan. The Health Ministry in Japan introduced the preferential patient safety countermeasure fee (PPSCF) to promote patient safety in 2006 and revised the PPSCF system in 2010. This study aims to address the patient safety performance status at hospitals implementing the PPSCF. A nationwide questionnaire survey targeting 2674 hospitals with the PPSCF was performed in 2010 to 2011. The 627 participant hospitals were divided into the following three groups: 178 hospitals implementing PPSCF 1 with 400 beds or more (group A), 286 hospitals implementing PPSCF 1 with 399 beds or fewer (group B), and 163 hospitals implementing PPSCF 2 (group C). The mean numbers (standard errors) of patient safety managers were 1.45 (0.07) in group A, 1.12 (0.04) in group B, and 0.37 (0.12) in group C (P fee schedule in Japan.
...-27043; Amdt. No. 61-132] RIN 2120-AI77 Fees for Certification Services and Approvals Performed Outside..., 2007 (72 FR 18556). In that rule, the FAA amended its regulations to revise the fee requirement for... direct final rule revising the fee requirement of 14 CFR 61.13 for the issuance of an airman certificate...
... fraction thereof)......... 0.80 Duplicate copy of PS Form 3606 1.15 * * * * * International Business Reply Service (382) [For each country that offers International Business Reply Service, revise the fees to read... POSTAL SERVICE 39 CFR Part 20 International Mail: New Prices and Fee Changes--Mailing Services...
... COMMERCE MEASUREMENT SERVICES POLICIES, SERVICES, PROCEDURES, AND FEES § 200.115 Description of services.... Department of Commerce. (4) Federal Depository Libraries. (c) Revisions of SP 250 will be issued from time to... concerning policies, procedures, services, and fees may be obtained by writing the Office of Measurement...
Wilson, Leslie; Turkistani, Fatema A.; Huang, Wei; Tran, Dang M.; Lin, Tracy Kuo
Introduction California’s Workers’ Compensation System (CAWCS) Department of Industrial Relations questioned the adequacy of the current Medi-Cal fee-schedule pricing and requested analysis of alternatives that maximize price availability and maintain budget neutrality. Objectives To compare CAWCS pharmacy-dispensed (PD) drug prices under alternative fee schedules, and identify combinations of alternative benchmarks that have prices available for the largest percentage of PD drugs and that best reach budget neutrality. Methods Claims transaction-level data (2011–2013) from CAWCS were used to estimate total annual PD pharmaceutical payments. Medi-Cal pricing data was from the Workman’s Compensation Insurance System (WCIS). Average Wholesale Prices (AWP), Wholesale Acquisition Costs (WAC), Direct Prices (DP), Federal Upper Limit (FUL) prices, and National Average Drug Acquisition Costs (NADAC) were from Medi-Span. We matched National Drug Codes (NDCs), pricing dates, and drug quantity for comparisons. We report pharmacy-dispensed (PD) claims frequency, reimbursement matching rate, and paid costs by CAWCS as the reference price against all alternative price benchmarks. Results Of 12,529,977 CAWCS claims for pharmaceutical products 11.6% (1,462,814) were for PD drugs. Prescription drug cost for CAWCS was over $152M; $63.9M, $47.9M, and $40.6M in 2011–2013. Ninety seven percent of these CAWCS PD claims had a Medi-Cal price. Alternative mechanisms provided a price for fewer claims; NADAC 94.23%, AWP 90.94%, FUL 73.11%, WAC 66.98%, and DP 14.33%. Among CAWCS drugs with no Medi-Cal price in PD claims, AWP, WAC, NADAC, DP, and FUL provided prices for 96.7%, 63.14%, 24.82%, 20.83%, and 15.08% of claims. Overall CAWCS paid 100.52% of Medi-Cal, 60% of AWP, 97% of WAC, 309.53% of FUL, 103.83% of DP, and 136.27% of NADAC. Conclusions CAWCS current Medi-Cal fee-schedule price list for PD drugs is more complete than all alternative fee-schedules. However, all
Wilson, Leslie; Turkistani, Fatema A; Huang, Wei; Tran, Dang M; Lin, Tracy Kuo
California's Workers' Compensation System (CAWCS) Department of Industrial Relations questioned the adequacy of the current Medi-Cal fee-schedule pricing and requested analysis of alternatives that maximize price availability and maintain budget neutrality. To compare CAWCS pharmacy-dispensed (PD) drug prices under alternative fee schedules, and identify combinations of alternative benchmarks that have prices available for the largest percentage of PD drugs and that best reach budget neutrality. Claims transaction-level data (2011-2013) from CAWCS were used to estimate total annual PD pharmaceutical payments. Medi-Cal pricing data was from the Workman's Compensation Insurance System (WCIS). Average Wholesale Prices (AWP), Wholesale Acquisition Costs (WAC), Direct Prices (DP), Federal Upper Limit (FUL) prices, and National Average Drug Acquisition Costs (NADAC) were from Medi-Span. We matched National Drug Codes (NDCs), pricing dates, and drug quantity for comparisons. We report pharmacy-dispensed (PD) claims frequency, reimbursement matching rate, and paid costs by CAWCS as the reference price against all alternative price benchmarks. Of 12,529,977 CAWCS claims for pharmaceutical products 11.6% (1,462,814) were for PD drugs. Prescription drug cost for CAWCS was over $152M; $63.9M, $47.9M, and $40.6M in 2011-2013. Ninety seven percent of these CAWCS PD claims had a Medi-Cal price. Alternative mechanisms provided a price for fewer claims; NADAC 94.23%, AWP 90.94%, FUL 73.11%, WAC 66.98%, and DP 14.33%. Among CAWCS drugs with no Medi-Cal price in PD claims, AWP, WAC, NADAC, DP, and FUL provided prices for 96.7%, 63.14%, 24.82%, 20.83%, and 15.08% of claims. Overall CAWCS paid 100.52% of Medi-Cal, 60% of AWP, 97% of WAC, 309.53% of FUL, 103.83% of DP, and 136.27% of NADAC. CAWCS current Medi-Cal fee-schedule price list for PD drugs is more complete than all alternative fee-schedules. However, all reimbursement approaches would require combinations of pricing benchmarks
... STANDARD REFERENCE MATERIALS STANDARD REFERENCE MATERIALS Description of Services and List of Fees § 230.7 Description of services and list of fees, incorporation by reference. (a) The text of NIST Special Publication... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Description of services and list of...
....). List of Subjects in 28 CFR Part 0 Authority delegations (Government agencies), Government employees... Marshals Service employee, agent, or contractor. This proposed fee increase reflects the current costs to.... Marshals Service employee, agent, or contractor, plus travel costs and any other out-of- pocket expenses...
... charges fees for reviewing certification applications for Federal tax incentives contained in Section 47... administering the Historic Preservation Tax Incentives Program. Current fees do not cover the full costs of... application fees charged by State governments under similar State historic preservation tax credit programs...
... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Management fees for services... Licensees Management Services and Fees § 107.900 Management fees for services provided to a Small Business... apply to management services that you or your Associate provide to a Small Business that you do not...
... AMENDED Information for Medical Providers Medical Fee Schedule § 10.806 How are the maximum fees defined? For professional medical services, the Director shall maintain a schedule of maximum allowable fees.../Current Procedural Terminology (HCPCS/CPT) code which represents the relative skill, effort, risk and time...
... the Federal Register a schedule of standardized administrative fees we charge to recover the full cost... fee schedule is outdated and incongruent with the agency's current costs for this service. New... new standard fee on our most recent cost calculations for supplying this information and the standard...
... Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946... Schedule of Fees and Charges at Destination Markets § 51.44 Disposition of fees. (a) The fees collected for...
The impact of the fee-for-service reimbursement system on the utilisation of health services: Part III. A comparison of caesarean section rates in white nulliparous women in the private and public sectors.
Zhibin Jiang; Yuyan Tan; Özgür Yalçınkaya
This paper deals with the problem of scheduling additional train unit (TU) services in a double parallel rail transit line, and a mixed integer programming (MIP) model is formulated for integration strategies of new trains connected by TUs with the objective of obtaining higher frequencies in some special sections and special time periods due to mass passenger volumes. We took timetable scheduling and TUs scheduling as an integrated optimization model with two objectives: minimizing travel ti...
Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2018; Medicare Shared Savings Program Requirements; and Medicare Diabetes Prevention Program. Final rule.
This major final rule addresses changes to the Medicare physician fee schedule (PFS) and other Medicare Part B payment policies such as changes to the Medicare Shared Savings Program, to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services, as well as changes in the statute. In addition, this final rule includes policies necessary to begin offering the expanded Medicare Diabetes Prevention Program model.
Petersen, Hanne Løhmann; Larsen, Allan; Madsen, Oli B.G.
modifications of the timetable during the vehicle scheduling phase. This planning approach is referred to as the Simultaneous Vehicle Scheduling and Passenger Service Problem (SVSPSP). The SVSPSP is solved using a large neighbourhood search metaheuristic. The proposed framework is tested on data inspired......Passengers using public transport systems often experience waiting times when transferring between two scheduled services. We propose a planning approach which seeks to obtain a favorable trade-off between the conflicting objectives passenger service and operating cost, by allowing some moderate...
els Bank Teller scheduling system for optimizing a Banks customer service. The model takes into account real time .... tinuous observation by management personnel and thus results in .... relationships in a mathematical model. A mathematical ...
... next payment voucher for the amount of such overpayment or refund the difference to the Government, as... evaluation score, the Contractor will either credit the next payment voucher for the amount of such... the Award Fee for Service Contracts clause to allow the contracting officer to withhold fee payments...
... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false User fees for other veterinary... User fees for other veterinary diagnostic services or materials provided at NVSL (excluding FADDL). (a) User fees for other veterinary diagnostic services or materials available from NVSL (excluding FADDL...
To examine the association between state Medicaid vaccine administration fees and children's receipt of immunization services. The study used the 2008-2012 Medicaid Analytic eXtract data and included children aged 0-17 years and continuously enrolled in a Medicaid fee-for-service plan in each study year. Analyses were restricted to 8 states with a Medicaid managed-care penetration rate Medicaid vaccine administration fees, age group, sex, race/ethnicity, state unemployment rate, state managed-care penetration rate, and state and year-fixed effects. A total of 1,678,288 children were included. In 2008-2012, the average proportion of children making ≥1 vaccination visit per year was 31% and the mean number of vaccination visits was 0.9. State Medicaid reimbursements for vaccine administration was positively associated with immunization service utilization; for every $1 increase in the payment amount, the probability of children making ≥1 vaccination visit increased by 0.72 percentage point (95% confidence interval, 0.23-1.21; P=0.01), representing a 2% increase from the mean and the number of vaccination visits increased by 0.03 (95% confidence interval, -0.00 to 0.06; PMedicaid reimbursements for vaccine administration were associated with increased proportion of children receiving immunization services.
... arriving as passengers on board a commercial vessel traveling only between ports that are within the... passenger space and issue non-carrier tickets or travel documents must collect the fee in the same manner as... commercial vessels—(1) Vessels of 100 net tons or more—(i) Fee. Except as provided in paragraphs (b)(2) and...
... INTELLIGENCE PROCEDURES FOR DISCLOSURE OF RECORDS PURSUANT TO THE FREEDOM OF INFORMATION ACT § 1700.6 Fees for... for fee waivers or reductions may be appealed to the Director of the Intelligence Staff, or his... Photocopy (standard or legal) Per page .10 Microfiche Per frame .20 Pre-printed (if available) Per 100 pages...
Mahmood Daneshvar Farzanegan
Full Text Available Quality of Service (QoS provisioning is very important in next computer/communication networks because of increasing multimedia services. Hence, very investigations are performed in this area. Scheduling algorithms effect QoS provisioning. Lately, a scheduling algorithm called Regulated Burst Service Scheduling (RBSS suggested by author in  to provide a better service to bursty and delay sensitive services such as video. One of the most significant feature in RBSS is considering burstiness of arrival traffic in scheduling algorithm. In this paper, an upper bound of queue length or buffer size and service curve are calculated by Network Calculus analysis for RBSS. Because in RBSS queue length is a parameter that is considered in scheduling arbitrator, analysis results a differential inequality to obtain service curve. To simplify, arrival traffic is assumed to be linear that is defined in the paper clearly. This paper help to analysis delay in RBSS for different traffic with different specifications. Therefore, QoS provisioning will be evaluated.
... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PRIVACY ACT REGULATIONS § 5b.13 Fees. (a) Policy. Where applicable, fees for copying records will be charged in accordance with the schedule set... whether the search is manual, mechanical, or electronic. Where a copy of the record must be made in order...
Petersen, Hanne Løhmann; Larsen, Allan; Madsen, Oli B.G.
, by modifying the timetable. The planning approach is referred to as the simultaneous vehicle scheduling and passenger service problem (SVSPSP). The SVSPSP is modelled as an integer programming problem and solved using a large neighborhood search metaheuristic. The proposed framework is tested on data inspired......Passengers using public transport systems often experience waiting times when transferring between two scheduled services. In this paper we propose a planning approach that seeks to obtain a favourable trade-off between the two contrasting objectives, passenger service and operating cost...
Garcia, Hong-Mei C.; Yun, David Y.; Ge, Yiqun; Khan, Javed I.
There exists tremendous opportunity in hospital-wide resource optimization based on system integration. This paper defines the resource planning and scheduling requirements integral to PACS, RIS and HIS integration. An multi-site case study is conducted to define the requirements. A well-tested planning and scheduling methodology, called Constrained Resource Planning model, has been applied to the chosen problem of radiological service optimization. This investigation focuses on resource optimization issues for minimizing the turnaround time to increase clinical efficiency and customer satisfaction, particularly in cases where the scheduling of multiple exams are required for a patient. How best to combine the information system efficiency and human intelligence in improving radiological services is described. Finally, an architecture for interfacing a computer-aided resource planning and scheduling tool with the existing PACS, HIS and RIS implementation is presented.
Reinhardt, Line Blander
while ensuring that given transit time limits for the carried cargo is satisfied, and considering the layover time for containers transshipping between services. Workshift times and cost are included ensuring that changing the port visit time will not introduce an addition cost for the port operations...
... legal holidays or what constitutes overtime service at a particular Science and Technology laboratory is... Premium hourly fee rates for overtime and legal holiday service. (a) When analytical testing in a Science... overtime work. When analytical testing in a Science and Technology facility requires the services of...
Kristensen, Troels; Olsen, Kim Rose; Schroll, Henrik
BACKGROUND: In primary care, fee-for-services (FFS) tariffs are often based on political negotiation rather than costing systems. The potential for comprehensive measures of patient morbidity to explain variation in negotiated FFS expenditures has not previously been examined. OBJECTIVES...... fees are based on average costing. However, our results indicate that there may be room for improvement of the association between politically negotiated FFS expenditures and morbidity in primary care....
... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Schedule of services. 353.6 Section 353.6 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF... limited to the following: (1) Development of exercise objectives and scenarios, preexercise logistics...
... Transfer of U.S. Treasury Book-Entry Securities Held on the National Book-Entry System AGENCY: Bureau of... (Treasury) is announcing a new fee schedule applicable to transfers of U.S. Treasury book-entry securities maintained on the National Book-Entry System (NBES) that occur on or after January 2, 2014. DATES: Effective...
... regulatory fees are mandated by Congress and are collected to recover the regulatory costs associated with... base our fee schedule on the available cost data first used in 1997.\\74\\ Since the inception of that... service categories (some of which are not able to pass the cost of the fee to the end user), and this...
... 7 Agriculture 2 2010-01-01 2010-01-01 false Fees and charges at shipping point areas. 51.45 Section 51.45 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE..., AND STANDARDS) Regulations 1 Schedule of Fees and Charges at Shipping Point Areas § 51.45 Fees and...
Criner, D.E.; Schenk, J.L.
The relationship between an engineering firm and a client can be favorably influenced by a clearly defined incentive plan. This paper addresses several approaches and the advantages and disadvantages of each. It also summarizes the lessons learned to date in using incentive fee arrangements
Dvořák, P.; Hanousek, Jan
-, č. 388 (2009), s. 1-25 ISSN 1211-3298 R&D Projects: GA MŠk LC542; GA ČR GA402/09/1595 Institutional research plan: CEZ:MSM0021620846 Keywords : bank fee s * Central and Eastern Europe * international comparison Subject RIV: AH - Economics http://www.cerge-ei.cz/pdf/wp/Wp388.pdf
... behalf of, or a free-lance journalist who reasonably expects to have his or her work product published or... search, review, and duplication. A requester in this category does not receive any free search, review... free pages. (iii) All other requesters. The OCC assesses a fee for a requester who does not fit into...
Sysіuk Svitlana V.
Full Text Available The article is aimed at highlighting features of the provision of the fee-based services by library institutions, identifying problems related to the legal and regulatory framework for their calculation, and the methods to implement this. The objective of the study is to develop recommendations to improve the calculation of the fee-based library services. The theoretical foundations have been systematized, the need to develop a Provision for the procedure of the fee-based services by library institutions has been substantiated. Such a Provision would protect library institution from errors in fixing the fee for a paid service and would be an informational source of its explicability. The appropriateness of applying the market pricing law based on demand and supply has been substantiated. The development and improvement of accounting and calculation, taking into consideration both industry-specific and market-based conditions, would optimize the costs and revenues generated by the provision of the fee-based services. In addition, the complex combination of calculation leverages with development of the system of internal accounting together with use of its methodology – provides another equally efficient way of improving the efficiency of library institutions’ activity.
... DIRECT SINGLE FAMILY HOUSING LOANS AND GRANTS Regular Servicing § 3550.153 Fees. RHS may assess reasonable fees including a tax service fee, fees for late payments, and fees for checks returned for...
In the local fee-for-service sector, 'third-party payment' means that both doctors and patients have little awareness of the direct costs of services. In other systems, such as HMOs, there is a strong cost consciousness on the part of practitioners. These differences in practice setting account in part for the different patterns of ...
three medical aid schemes in which providers are paid on a fee-far-service basis. ... The majority of health care providers in the private sector in. South Mrica are ... hospital, which bills the HMO for all services and accommo- dation expenses.
DeMuth, Nancy Marwick; Kamis, Edna
Fee, sociodemographic, and provider characteristics contributed little unique variance to explaining the volume of services used. Clinical considerations were, as predicted, most important in explaining service utilization. Implications for national health insurance are also discussed, since public third-party reimbursement did not lead to…
Zhang, Yin-hua; He, Guo-ping; Liu, Jing-wei
The objective of this study was to compare the fee-for-service and set fee for diagnosis-related group systems with regard to quality of medical care and cost to appendectomy patients. We conducted a retrospective study of 208 inpatients (from 20 hospitals) who undergone appendectomy in Changsha, China during 2013. Data were obtained from databases of medical insurance information systems directly connected to the hospital information systems. We collected and compared patient ages, length of study, and total medical costs for impatient appendectomies between patients using fee-for-service and set fee for diagnosisrelated group systems. One hundred thirty-three patients used the fee for service system and 75 used the set fee diagnosis related group system. For those using the diagnosis-related group system, the mean length of hospitalization (6.2 days) and mean number of prescribed antimicrobials (2.4) per patient were significantly lower than those of the patients who used the fee-for-service system (7.3 days and 3.0, respectively; p = 0.018; p < 0.05) and were accompanied by lower medical costs and cost of antimicrobials (RMB 2,518 versus RMB 4,484 and RMB476 versus RMB1,108, respectively; p = 0.000, p = 0.000). There were no significant differences in post-surgical complications between the two systems. The diagnosis-related group system had significantly medical costs for appendectomy compared to the fee-for-service system, without sacrificing quality of medical care.
... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Fees for management services... Small Businesses by NMVC Companies Management Services and Fees § 108.900 Fees for management services... management services that you or your Associate provide to a Small Business during the term of a Financing or...
Kirkham, A A; Neil-Sztramko, S E; Morgan, J; Hodson, S; Weller, S; McRae, T; Campbell, K L
Rigorously applied exercise interventions undertaken in a research setting result in improved health-related quality of life (hrqol) in cancer survivors, but research to demonstrate effective translation of that research to practice is needed. The objective of the present study was to determine the effect of fee-for-service cancer rehabilitation programs in the community on hrqol and on self-reported physical activity and its correlates. After enrolment and 17 ± 4 weeks later, new clients (n = 48) to two fee-for-service cancer rehabilitation programs completed the 36-Item Short Form Health Survey (rand-36: rand Corporation, Santa Monica, CA, U.S.A.), the Godin Leisure-Time Exercise Questionnaire, and questions about physical activity correlates. Normal fee-for-service operations were maintained, including a fitness assessment and individualized exercise programs supervised in a group or one-on-one setting, with no minimum attendance required. Fees were associated with the assessment and with each exercise session. Of the 48 participants, 36 (75%) completed both questionnaires. Improvements in the physical functioning, role physical, pain, and energy/fatigue scales on the rand-36 exceeded minimally important differences and were of a magnitude similar to improvements reported in structured, rigorously applied, and free research interventions. Self-reported levels of vigorous-intensity (p = 0.021), but not moderate-intensity (p = 0.831) physical activity increased. The number of perceived barriers to exercise (p = 0.035) and the prevalence of fatigue as a barrier (p = 0.003) decreased. Exercise self-efficacy improved only in participants who attended 11 or more sessions (p = 0.002). Exercise enjoyment did not change (p = 0.629). Enrolment in fee-for-service cancer rehabilitation programs results in meaningful improvements in hrqol comparable to those reported by research interventions, among other benefits. The fee-for-service model could be an effective model for
... Indian Preference § 170.916 May tribes impose taxes or fees on those performing IRR Program services? Yes... 25 Indians 1 2010-04-01 2010-04-01 false May tribes impose taxes or fees on those performing IRR Program services? 170.916 Section 170.916 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR...
Loring, Carol; Neil, R Brock; Gillim-Ross, Laura; Bashore, Matthew; Shah, Sandip
The decrease in appropriations for state public health laboratories (SPHLs) has become a major concern as tax revenues and, subsequently, state and federal funding, have decreased. These reductions have forced SPHLs to pursue revenue-generating opportunities to support their work. We describe the current state of funding in a sampling of SPHLs and the challenges these laboratories face as they implement or expand fee-for-service testing. We conducted surveys of SPHLs to collect data concerning laboratory funding sources, test menus, fee-for-service testing, and challenges to implementing fee-for-service testing. Most SPHLS receive funding through three revenue sources: state appropriation, federal funding, and fee-for-service testing (cash funds). Among SPHLs, state appropriations ranged from $0 to more than $6 per capita, federal funding ranged from $0.10 to $5 per capita, and revenue from fee-for-service testing ranged from $0 to $4 per capita. The tests commonly performed on a fee-for-service basis included assays for sexually transmitted diseases, mycobacterial cultures, newborn screening, and water testing. We found that restrictive legislation, staffing shortages, inadequate software for billing fee-for-service testing, and regulations on how SPHLs use their generated revenue are impediments to implementing fee-for-service testing. Some SPHLs are considering implementing or expanding fee-for-service testing as a way to recapture funds lost as a result of state and federal budget cuts. This analysis revealed many of the obstacles to implementing fee-for-service testing in SPHLs and the potential impact on SPHLs of continued decreases in funding.
... DEPARTMENT OF THE TREASURY Fiscal Service Financial Management Service Proposed Collection of Information: Schedule of Excess Risks AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice and request for comments. SUMMARY: The Financial Management Service, as part of its continuing...
Contracts between health insurers and providers are private; i.e. not public. By modelling this explicitly, we find the following. Insurers with bigger provider networks,pay higher fee-for-service rates to providers. This makes it more likely that a patient is treated and hence health care costs
Aug 4, 1990 ... The fee-for-service system, as it is structured in South. Africa, thus leads to ..... Conclusion. The design of an appropriate method of paying providers is ... Physician induced demand; an empirical analysis of the consumer ...
... while meeting minimum reserve requirements set by the Agricultural Marketing Service, which require... proposed fee and the existing reserve are sufficient to cover the costs of providing classification... requirements set forth in the Regulatory Flexibility Act (RFA) (5 U.S.C. 601-612), AMS has considered the...
... expected to meet minimum reserve requirements set by the Agricultural Marketing Service, which require... proposed fee and the existing reserve are sufficient to cover the costs of providing classification... requirements set forth in the Regulatory Flexibility Act (RFA) (5 U.S.C. 601-612), AMS has considered the...
waiting time costs as well as schedule delay costs measured relative to their desired time of arrival at the destination. They may either arrive at the station to choose just the next departure or they may plan for a specific departure in which case they incur also a planning cost. Then planning......This brief paper derives the marginal social cost of headway for a scheduled service, i.e. the cost for users of marginal increases to the time interval between departures. In brief we may call it the value of headway in analogy with the value of travel time and the value of reliability. Users have...... for a specific departure is costly but becomes more attractive at longer headways. Simple expressions for the user cost result. In particular, the marginal cost of headway is large at short headways and smaller at long headways. The difference in marginal costs is the value of time multiplied by half the headway....
Since the July 1978 publication of an estimated fee for storage and disposal, several changes have occurred in the parameters which impact the spent fuel fee. DOE has mounted a diversified program of geologic investigations that will include locating and characterizing a number of potential repository sites in a variety of different geologic environments with diverse rock types. As a result, the earliest operation date of a geologic repository is now forecast for 1997. Finally, expanded spent fuel storage capabilities at reactors have reduced the projected quantities of fuel to be stored and disposed of. The current estimates for storage and disposal are presented. This fee has been developed from DOE program information on spent fuel storage requirements, facility availability, facility cost estimates, and research and development programs. The discounted cash flow technique has used the most recent estimates of cost of borrowing by the Federal Government. This estimate has also been used in calculating the Federal charge for uranium enrichment services. A prepayment of a percentage of the storage portion of the fee is assumed to be required 5 years before spent fuel delivery. These funds and the anticipated $300 million in US Treasury borrowing authority should be sufficient to finance the acquisition of storage facilities. Similarly, a prepayment of a percentage of the disposal portion would be collected at the same time and would be used to offset disposal research and development expenditures. The balance of the storage and disposal fees will be collected upon spent fuel delivery. If disposal costs are different from what was estimated, there will be a final adjustment of the disposal portion of the fee when the spent fuel is shipped from the AFR for permanent disposal. Based on current spent fuel storage requirements, at least a 30 percent prepayment of the fee will be required
... rendered. (d) Fee for copies of printed materials. When extra copies of printed material are available, the... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Fees for providing information and related services for non-program purposes. 402.175 Section 402.175 Employees' Benefits SOCIAL SECURITY...
... the IPD-GDP from 2007 through 2012, thus reflecting the rate of inflation over 5 years. The inflation... establish the 2013 cost recovery service fee. While BEA may revise the inflation rate in the future, BSEE... will periodically adjust fees for inflation according to changes in the Implicit Price Deflator for...
... study employed the same Activity Based Cost (ABC) accounting method detailed in the Final Rule... widely accepted accounting principles and complies with the provisions of 31 U.S.C. 9701 and other... purposes. The total resource costs associated with providing these name check services have been calculated...
Motalleb, Mahdi; Thornton, Matsu; Reihani, Ehsan; Ghorbani, Reza
Highlights: • Proposing a market model for contingency reserve services using demand response. • Considering transient limitations of grid frequency for inverter-based generations. • Price-sensitive scheduling of residential batteries and water heaters using dynamic programming. • Calculating the profits of both generation companies and demand response aggregators. - Abstract: During power grid contingencies, frequency regulation is a primary concern. Historically, frequency regulation during contingency events has been the sole responsibility of the power utility. We present a practical method of using distributed demand response scheduling to provide frequency regulation during contingency events. This paper discusses the implementation of a control system model for the use of distributed energy storage systems such as battery banks and electric water heaters as a source of ancillary services. We present an algorithm which handles the optimization of demand response scheduling for normal operation and during contingency events. We use dynamic programming as an optimization tool. A price signal is developed using optimal power flow calculations to determine the locational marginal price of electricity, while sensor data for water usage is also collected. Using these inputs to dynamic programming, the optimal control signals are given as output. We assume a market model in which distributed demand response resources are sold as a commodity on the open market and profits from demand response aggregators as brokers of distributed demand response resources can be calculated. In considering control decisions for regulation of transient changes in frequency, we focus on IEEE standard 1547 in order to prevent the safety shut-off of inverter-based generation and further exacerbation of frequency droop. This method is applied to IEEE case 118 as a demonstration of the method in practice.
Laugesen, Miriam J; Glied, Sherry A
Higher health care prices in the United States are a key reason that the nation's health spending is so much higher than that of other countries. Our study compared physicians' fees paid by public and private payers for primary care office visits and hip replacements in Australia, Canada, France, Germany, the United Kingdom, and the United States. We also compared physicians' incomes net of practice expenses, differences in financing the cost of medical education, and the relative contribution of payments per physician and of physician supply in the countries' national spending on physician services. Public and private payers paid somewhat higher fees to US primary care physicians for office visits (27 percent more for public, 70 percent more for private) and much higher fees to orthopedic physicians for hip replacements (70 percent more for public, 120 percent more for private) than public and private payers paid these physicians' counterparts in other countries. US primary care and orthopedic physicians also earned higher incomes ($186,582 and $442,450, respectively) than their foreign counterparts. We conclude that the higher fees, rather than factors such as higher practice costs, volume of services, or tuition expenses, were the main drivers of higher US spending, particularly in orthopedics.
Full Text Available Travel agencies normally receive commission from airlines, tour operators, accommodation establishments and car hire companies in exchange for bookings. Global trends in this commission structure indicate dramatic changes, especially regarding airlines. The majority of them have introduced a system of commission capping, whereby commission paid to travel agencies has been reduced and expectations are that it might even become zero in future. Against this background, travel agencies are considering introducing a system of service fees. It implies that clients will have to pay for services such as the preparation of quotations for national and/or international holidays or business trips. This paper discusses the results of research that was undertaken amongst the middle to higher income classes of the residents of Bloemfontein regarding the introduction of service fees by travel agencies.
Full Text Available This study aims to develop some models to aid in making decisions on the combined fleet size and vehicle assignment in working service network where the demands include two types (minimum demands and maximum demands, and vehicles themselves can act like a facility to provide services when they are stationary at one location. This type of problem is named as the dynamic working vehicle scheduling with dual demands (DWVS-DD and formulated as a mixed integer programming (MIP. Instead of a large integer program, the problem is decomposed into small local problems that are guided by preset control parameters. The approach for preset control parameters is given. By introducing them into the MIP formulation, the model is reformulated as a piecewise form. Further, a piecewise method by updating preset control parameters is proposed for solving the reformulated model. Numerical experiments show that the proposed method produces better solution within reasonable computing time.
Hatt, Laurel E; Makinen, Marty; Madhavan, Supriya; Conlon, Claudia M
User fee removal has been put forward as an approach to increasing priority health service utilization, reducing impoverishment, and ultimately reducing maternal and neonatal mortality. However, user fees are a source of facility revenue in many low-income countries, often used for purchasing drugs and supplies and paying incentives to health workers. This paper reviews evidence on the effects of user fee exemptions on maternal health service utilization, service provision, and outcomes, including both supply-side and demand-side effects. We reviewed 19 peer-reviewed research articles addressing user fee exemptions and maternal health services or outcomes published since 1990. Studies were identified through a USAID-commissioned call for evidence, key word search, and screening process. Teams of reviewers assigned criteria-based quality scores to each paper and prepared structured narrative reviews. The grade of the evidence was found to be relatively weak, mainly from short-term, non-controlled studies. The introduction of user fee exemptions appears to have resulted in increased rates of facility-based deliveries and caesarean sections in some contexts. Impacts on maternal and neonatal mortality have not been conclusively demonstrated; exemptions for delivery care may contribute to modest reductions in institutional maternal mortality but the evidence is very weak. User fee exemptions were found to have negative, neutral, or inconclusive effects on availability of inputs, provider motivation, and quality of services. The extent to which user fee revenue lost by facilities is replaced can directly affect service provision and may have unintended consequences for provider motivation. Few studies have looked at the equity effects of fee removal, despite clear evidence that fees disproportionately burden the poor. This review highlights potential and documented benefits (increased use of maternity services) as well as risks (decreased provider motivation and quality
Schoenfeld, Andrew J; Makanji, Heeren; Jiang, Wei; Koehlmoos, Tracey; Bono, Christopher M; Haider, Adil H
Whether compensation for professional services drives the use of those services is an important question that has not been answered in a robust manner. Specifically, there is a growing concern that spine care practitioners may preferentially choose more costly or invasive procedures in a fee-for-service system, irrespective of the underlying lumbar disorder being treated. (1) Were proportions of interbody fusions higher in the fee-for-service setting as opposed to the salaried Department of Defense setting? (2) Were the odds of interbody fusion increased in a fee-for-service setting after controlling for indications for surgery? Patients surgically treated for lumbar disc herniation, spinal stenosis, and spondylolisthesis (2006-2014) were identified. Patients were divided into two groups based on whether the surgery was performed in the fee-for-service setting (beneficiaries receive care at a civilian facility with expenses covered by TRICARE insurance) or at a Department of Defense facility (direct care). There were 28,344 patients in the entire study, 21,290 treated in fee-for-service and 7054 treated in Department of Defense facilities. Differences in the rates of fusion-based procedures, discectomy, and decompression between both healthcare settings were assessed using multinomial logistic regression to adjust for differences in case-mix and surgical indication. TRICARE beneficiaries treated for lumbar spinal disorders in the fee-for-service setting had higher odds of receiving interbody fusions (fee-for-service: 7267 of 21,290 [34%], direct care: 1539 of 7054 [22%], odds ratio [OR]: 1.25 [95% confidence interval 1.20-1.30], p fee-for-service setting irrespective of the underlying diagnosis. These results speak to the existence of provider inducement within the field of spine surgery. This reality portends poor performance for surgical practices and hospitals in Accountable Care Organizations and bundled payment programs in which provider inducement is allowed
Allard, Marie; Jelovac, Izabela; Léger, Pierre-Thomas
This paper analyzes the consequences of allowing gatekeeping general practitioners (GPs) to select their payment mechanism. We model GPs' behavior under the most common payment schemes (capitation and fee for service) and when GPs can select one among them. Our analysis considers GP heterogeneity in terms of both ability and concern for their patients' health. We show that when the costs of wasteful referrals to costly specialized care are relatively high, fee for service payments are optimal to maximize the expected patients' health net of treatment costs. Conversely, when the losses associated with failed referrals of severely ill patients are relatively high, we show that either GPs' self-selection of a payment form or capitation is optimal. Last, we extend our analysis to endogenous effort and to competition among GPs. In both cases, we show that self-selection is never optimal.
... Representation of Parties § 410.686b Fee for services performed for an individual before the Social Security... person or in writing; (ii) There was a death or serious illness in the individual's family; (iii...
.... 4(b). When a statute does not address issues of how to calculate fees or what costs to include in..., investment, productivity, innovation, or on the ability of United States-based enterprises to compete with...
... REGULATION Fee Schedule § 286.30 Collection of fees and fee rates for technical data. (a) Fees for technical data. Technical data, other than technical data that discloses critical technology with military or... 32 National Defense 2 2010-07-01 2010-07-01 false Collection of fees and fee rates for technical...
Chung, Sukyung; Lesser, Lenard I; Lauderdale, Diane S; Johns, Nicole E; Palaniappan, Latha P; Luft, Harold S
Under the Affordable Care Act (ACA), Medicare coverage expanded in 2011 to fully cover annual preventive care visits. We assessed the impact of coverage expansion, using 2007-13 data from primary care patients of Medicare-eligible age at the Palo Alto Medical Foundation (204,388 patient-years), which serves people in four counties near San Francisco, California. We compared trends in preventive visits and recommended preventive services among Medicare fee-for-service and Medicare health maintenance organization (HMO) patients as well as non-Medicare patients ages 65-75 who were covered by private fee-for-service and private HMO plans. Among Medicare fee-for-service patients, the annual use of preventive visits rose from 1.4 percent before the implementation of the ACA to 27.5 percent afterward. This increase was significantly larger than was seen for patients in the other insurance groups. Nevertheless, rates of annual preventive care visit use among Medicare fee-for-service patients remained 10-20 percentage points lower than was the case for people with private coverage (43-44 percent) or those in a Medicare HMO (53 percent). ACA policy changes led to increased preventive service use by Medicare fee-for-service beneficiaries, which suggests that Medicare coverage expansion is an effective way to increase seniors' use of preventive services. Project HOPE—The People-to-People Health Foundation, Inc.
Wood, M Sandra
This outstanding volume won the 1986 Ida and George Eliot Prize--awarded by the Medical Library Association for the work judged most effective in furthering medical librarianship. Library professionals review the controversy behind fee-for-service programs and provide a rationale for incorporating them into contemporary library philosophies of service. Some fee-based services are necessary for survival in a society that treats information as a marketable commodity; this comprehensive book gives practical advice on cost analysis, cost recovery and marketing of reference services, and presents i
Eckhardt, D. E., Jr.
Although real-time operating systems provide many of the task control services necessary to process time-critical applications (i.e., applications with fixed, invariant deadlines), it may still be necessary to provide a scheduling algorithm at a level above the operating system in order to coordinate a set of synchronized, time-critical tasks executing at different cyclic rates. The scheduling requirements for such applications and develops scheduling algorithms using services provided by contemporary real-time operating systems.
... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Transit flights; scheduled international... WITHIN THE UNITED STATES Transit Flights § 375.50 Transit flights; scheduled international air service... to the International Air Services Transit Agreement in transit across the United States may not be...
... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false What is the Service schedule to adopt the National Framework? 86.101 Section 86.101 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE... schedule to adopt the National Framework? The Secretary of the Interior adopted the National Framework on...
Full Text Available Reliability and safety in flight is extremely necessary and that depend on the adoption of proper maintenance system. Therefore, it is essential for aircraft maintenance companies to perform the manpower scheduling efficiently. One of the objectives of this paper is to provide an Integer Programming approach to determine the optimal solutions to aircraft maintenance planning and scheduling and hence the planning and scheduling processes can become more efficient and effective. Another objective is to develop a set of computational schedules for maintenance manpower to cover all scheduled flights. In this paper, a sequential methodology consisting of 3 stages is proposed. They are initial maintenance demand schedule, the maintenance pairing and the maintenance group(s assignment. Since scheduling would split up into different stages, different mathematical techniques have been adopted to cater for their own problem characteristics. Microsoft Excel would be used. Results from the first stage and second stage would be inputted into integer programming model using Microsoft Excel Solver to find the optimal solution. Also, Microsoft Excel VBA is used for devising a scheduling system in order to reduce the manual process and provide a user friendly interface. For the results, all can be obtained optimal solution and the computation time is reasonable and acceptable. Besides, the comparison of the peak time and non-peak time is discussed.
Yunjie Song PhD
Full Text Available This article examines the differences in mortality measured health status between the Medicare Advantage (MA program and Fee-for-Service (FFS program from 1999 to 2007. At the national level, differences in mortality rates were associated with MA market share. In some counties, enrollees in the MA program were 40% less likely to die than their peers in the FFS program, but in other counties, they were 20% more likely to die. Cost shifting between the two programs could bias county classifications of average FFS spending, and enlarged disparities in health status could make it difficult to evaluate risk adjusters.
Full Text Available To assess state coverage and utilization of Medicaid smoking cessation medication benefits among fee-for-service enrollees who smoked cigarettes.We used the linked National Health Interview Survey (survey years 1995, 1997-2005 and the Medicaid Analytic eXtract files (1999-2008 to assess utilization of smoking cessation medication benefits among 5,982 cigarette smokers aged 18-64 years enrolled in Medicaid fee-for-service whose state Medicaid insurance covered at least one cessation medication. We excluded visits during pregnancy, and those covered by managed care or under dual enrollment (Medicaid and Medicare. Multivariate logistic regression was used to determine correlates of cessation medication benefit utilization among Medicaid fee-for-service enrollees, including measures of drug coverage (comprehensive cessation medication coverage, number of medications in state benefit, varenicline coverage, individual-level demographics at NHIS interview, age at Medicaid enrollment, and state-level cigarette excise taxes, statewide smoke-free laws, and per-capita tobacco control funding.In 1999, the percent of smokers with ≥1 medication claims was 5.7% in the 30 states that covered at least one Food and Drug Administration (FDA-approved cessation medication; this increased to 9.9% in 2008 in the 44 states that covered at least one FDA-approved medication (p<0.01. Cessation medication utilization was greater among older individuals (≥ 25 years, females, non-Hispanic whites, and those with higher educational attainment. Comprehensive coverage, the number of smoking cessation medications covered and varenicline coverage were all positively associated with utilization; cigarette excise tax and per-capita tobacco control funding were also positively associated with utilization.Utilization of medication benefits among fee-for-service Medicaid enrollees increased from 1999-2008 and varied by individual and state-level characteristics. Given that the
... AGRICULTURE RURAL BUSINESS INVESTMENT COMPANY (âRBICâ) PROGRAM Financing of Enterprises by RBICs Limitations on Disposition of Assets § 4290.900 Management fees for services provided to an Enterprise by RBIC or... management services that you or your Associate provide to an Enterprise that you do not finance. (b) The...
Atherly, Adam; Mortensen, Karoline
Objective The Patient Protection and Affordable Care Act (ACA) increases Medicaid physician fees for preventive care up to Medicare rates for 2013 and 2014. The purpose of this paper was to model the relationship between Medicaid preventive care payment rates and the use of U.S. Preventive Services Task Force (USPSTF)–recommended preventive care use among Medicaid enrollees. Data Sources/Study Session We used data from the 2003 and 2008 Medical Expenditure Panel Survey (MEPS), a national probability sample of the U.S. civilian, noninstitutionalized population, linked to Kaiser state Medicaid benefits data, including the state Medicaid-to-Medicare physician fee ratio in 2003 and 2008. Study Design Probit models were used to estimate the probability that eligible individuals received one of five USPSF-recommended preventive services. A difference-in-difference model was used to separate out the effect of changes in the Medicaid payment rate and other factors. Data Collection/Extraction Methods Data were linked using state identifiers. Principal Findings Although Medicaid enrollees had a lower rate of use of the five preventive services in univariate analysis, neither Medicaid enrollment nor changes in Medicaid payment rates had statistically significant effects on meeting screening recommendations for the five screenings. The results were robust to a number of different sensitivity tests. Individual and state characteristics were significant. Conclusions Our results suggest that although temporary changes in primary care provider payments for preventive services for Medicaid enrollees may have other desirable effects, they are unlikely to substantially increase the use of these selected USPSTF-recommended preventive care services among Medicaid enrollees. PMID:24628495
Kuo-Feng Huang; Shih-Jung Wu
Supporting Quality of Service (QoS) guarantees for diverse multimedia services is the primary concern for IEEE802.16j networks. A scheduling scheme that satisfies the QoS requirements has become more important for wireless communications. We proposed an adaptive nontransparent-based distributed scheduling scheme (ANDS) for IEEE 802.16j networks. ANDS comprises three major components: Priority Assignment, Resource Allocation, Preserved Bandwidth Adjustment. Different service-type connections p...
... diem costs associated with inspection of the shipment. These fees are in place of, not in addition to... Federal holiday. (h) Fee schedule. Inspection fee schedule Fee cost per shipment per year 2008 2009 2010... 50 Wildlife and Fisheries 1 2010-10-01 2010-10-01 false What fees apply to me? 14.94 Section 14.94...
Skyrocketing health care costs are forcing payers to demand delivery efficiencies that preserve and promote quality care while reducing costs. Hospitals are challenged to meet the pressure from payers to deliver value and outcome-based health care while preserving sufficient financial margins. The fee-for-service (FFS) model with its perverse incentives to incur high-volume services is no longer, if ever, sufficient to ensure quality, cost-efficient health care. In response, payers have sought to force the issue through accelerated efforts to bundle payments to providers. It is theorized that by tying together providers throughout the continuum or episode of care for a patient, efficiencies in delivery inclusive of cost reductions will be obtained. This article examines the bundled payment models and the financial considerations for hospital facility providers.
... (including Christmas bonuses), termination or severance pay, rewards, jury fees, marriage fees and other...). For the special rules relating to the includibility in an employee's gross income of an amount equal...
Medicare Program; End-Stage Renal Disease Prospective Payment System, Coverage and Payment for Renal Dialysis Services Furnished to Individuals With Acute Kidney Injury, End-Stage Renal Disease Quality Incentive Program, Durable Medical Equipment, Prosthetics, Orthotics and Supplies Competitive Bidding Program Bid Surety Bonds, State Licensure and Appeals Process for Breach of Contract Actions, Durable Medical Equipment, Prosthetics, Orthotics and Supplies Competitive Bidding Program and Fee Schedule Adjustments, Access to Care Issues for Durable Medical Equipment; and the Comprehensive End-Stage Renal Disease Care Model. Final rule.
This rule updates and makes revisions to the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for calendar year 2017. It also finalizes policies for coverage and payment for renal dialysis services furnished by an ESRD facility to individuals with acute kidney injury. This rule also sets forth requirements for the ESRD Quality Incentive Program, including the inclusion of new quality measures beginning with payment year (PY) 2020 and provides updates to programmatic policies for the PY 2018 and PY 2019 ESRD QIP. This rule also implements statutory requirements for bid surety bonds and state licensure for the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP). This rule also expands suppliers' appeal rights in the event of a breach of contract action taken by CMS, by revising the appeals regulation to extend the appeals process to all types of actions taken by CMS for a supplier's breach of contract, rather than limit an appeal for the termination of a competitive bidding contract. The rule also finalizes changes to the methodologies for adjusting fee schedule amounts for DMEPOS using information from CBPs and for submitting bids and establishing single payment amounts under the CBPs for certain groupings of similar items with different features to address price inversions. Final changes also are made to the method for establishing bid limits for items under the DMEPOS CBPs. In addition, this rule summarizes comments on the impacts of coordinating Medicare and Medicaid Durable Medical Equipment for dually eligible beneficiaries. Finally, this rule also summarizes comments received in response to a request for information related to the Comprehensive ESRD Care Model and future payment models affecting renal care.
Medicare program; revisions to payment policies under the Physician Fee Schedule, and other part B payment policies for CY 2008; delay of the date of applicability of the revised anti-markup provisions for certain services furnished in certain locations (Sec. 414.50). Final rule.
This final rule delays until January 1, 2009 the applicability of the anti-markup provisions in Sec. 414.50, as revised at 72 FR 66222, except with respect to the technical component of a purchased diagnostic test and with respect to any anatomic pathology diagnostic testing services furnished in space that: Is utilized by a physician group practice as a "centralized building" (as defined at Sec. 411.351 of this chapter) for purposes of complying with the physician self-referral rules; and does not qualify as a "same building" under Sec. 411.355(b)(2)(i) of this chapter.
Two Wrongs Do Not Make a Right: Flaws in Alternatives to Fee-for-Service Payment Plans Do Not Mean Fee-for-Service Is a Good Solution to Rising Prices Comment on "Fee-for-Service Payment - An Evil Practice That Must Be Stamped Out?".
Professor Naoki Ikegami's "Fee-for-service payment - an evil practice that must be stamped out" summarizes many of the failings of alternatives to fee-for-service (FFS) payment systems. His article also offers several suggestions for improving FFS systems. However, even powerful arguments against many of the alternatives to FFS, does not make a convincing argument for FFS systems. In addition, there are significant misunderstandings in Professor Ikegami's presentation of and use of United States payment methods, the role of private vs. public insurance systems, and the increasing role of "accountable care organizations. © 2015 by Kerman University of Medical Sciences.
Nakata, Yoshinori; Watanabe, Yuichi; Narimatsu, Hiroto; Yoshimura, Tatsuya; Otake, Hiroshi; Sawa, Tomohiro
The goal of this study is to evaluate the pure impact of the revision of surgical fee schedule on surgeons' productivity. We collected data from the surgical procedures performed by the surgeons working in Teikyo University Hospital from 1 April through 30 September in 2013-2016. We employed non-radial and non-oriented Malmquist model. We defined the decision-making unit as a surgeon with the highest academic rank in surgery. Inputs were defined as (1) the number of doctors who assisted surgery and (2) the time of surgical operation. The output was defined as the surgical fee for each surgery. We focused on the revisions in 2014 and 2016. We first calculated each surgeon's natural logarithms of the changes in productivity, technique and efficiency in 2013-2014, in 2014-2015 and in 2015-2016. Then, we subtracted the changes in 2014-2015 from the changes in 2013-2014 and in 2015-2016. We analyzed 62 surgeons who performed 7602 surgical procedures. The productivity changes were not significantly different from 0. Their efficiency change was significantly greater than 0, while their technical change was smaller than 0 in revision 2014. Their efficiency change was significantly smaller than 0, while their technical change was greater than 0 in revision 2016 (p increase overall productivity through revision if we could increase both efficiency and technique.
... payments exceed the final evaluation score, the Contractor will either credit the next payment voucher for... [insert payment office] will make payment based on [Insert method of authorizing award fee payment, e.g... fee has been paid, the Contracting Officer may direct the withholding of further payment of award fee...
Mladovsky, Philipa; Ba, Maymouna
Plan Sésame (PS) is a user fee exemption policy launched in 2006 to provide free access to health services to Senegalese citizens aged 60 and over. Analysis of a large household survey evaluating PS echoes findings of other studies showing that user fee removal can be highly inequitable. 34 semi-structured interviews and 19 focus group discussions with people aged 60 and over were conducted in four regions in Senegal (Dakar, Diourbel, Matam and Tambacounda) over a period of six months during 2012. They were analysed to identify underlying causes of exclusion from/inclusion in PS and triangulated with the household survey. The results point to three steps at which exclusion occurs: (i) not being informed about PS; (ii) not perceiving a need to use health services under PS; and (iii) inability to access health services under PS, despite having the information and perceived need. We identify lay explanations for exclusion at these different steps. Some lay explanations point to social exclusion, defined as unequal power relations. For example, poor access to PS was seen to be caused by corruption, patronage, poverty, lack of social support, internalised discrimination and adverse incorporation. Other lay explanations do not point to social exclusion, for example: poor implementation; inadequate funding; high population demand; incompetent bureaucracy; and PS as a favour or moral obligation to friends or family. Within a critical realist paradigm, we interpret these lay explanations as empirical evidence for the presence of the following hidden underlying causal mechanisms: lacking capabilities; mobilisation of institutional bias; and social closure. However, social constructionist perspectives lead us to critique this paradigm by drawing attention to contested health, wellbeing and corruption discourses. These differences in interpretation lead to subsequent differential policy recommendations. This demonstrates the need for the adoption of a "multi
McDonald, Sandra A; Sommerkamp, Kara; Egan-Palmer, Maureen; Kharasch, Karen; Holtschlag, Victoria
Biorepositories offer tremendous scientific value to a wide variety of customer groups (academic, commercial, industrial) in their ability to deliver a centralized, standardized service model, encompassing both biospecimen storage and related laboratory services. Generally, the scientific expertise and economies of scale that are offered in centralized, properly resourced research biobanks has yielded value that has been well-recognized by universities, pharmaceutical companies, and other sponsoring institutions. However, like many facets of the economy, biobanks have been under increasing cost pressure in recent years. This has been a particular problem in the academic arena, where direct support from grant sources (both governmental and philanthropic) typically now is more difficult to secure, or provides reduced financial support, relative to previous years. One way to address this challenge is to establish or enhance a well-defined fee-for-service model which is properly calibrated to cover operational costs while still offering competitive value to users. In this model, customers are never charged for the biospecimens themselves, but rather for the laboratory services associated with them. Good communication practices, proper assessment of value, implementation of best practices, and a sound business plan are all needed for this initiative to succeed. Here we summarize our experiences at Washington University School of Medicine in the expectation they will be useful to others.
Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2017; Medicare Advantage Bid Pricing Data Release; Medicare Advantage and Part D Medical Loss Ratio Data Release; Medicare Advantage Provider Network Requirements; Expansion of Medicare Diabetes Prevention Program Model; Medicare Shared Savings Program Requirements. Final rule.
This major final rule addresses changes to the physician fee schedule and other Medicare Part B payment policies, such as changes to the Value Modifier, to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services, as well as changes in the statute. This final rule also includes changes related to the Medicare Shared Savings Program, requirements for Medicare Advantage Provider Networks, and provides for the release of certain pricing data from Medicare Advantage bids and of data from medical loss ratio reports submitted by Medicare health and drug plans. In addition, this final rule expands the Medicare Diabetes Prevention Program model.
DeGregorio, Geneva; Manga, Simon; Kiyang, Edith; Manjuh, Florence; Bradford, Leslie; Cholli, Preetam; Wamai, Richard; Ogembo, Rebecca; Sando, Zacharie; Liu, Yuxin; Sheldon, Lisa Kennedy; Nulah, Kathleen; Welty, Thomas; Welty, Edith; Ogembo, Javier Gordon
Cervical cancer screening is one of the most effective cancer prevention strategies, but most women in Africa have never been screened. In 2007, the Cameroon Baptist Convention Health Services, a large faith-based health care system in Cameroon, initiated the Women's Health Program (WHP) to address this disparity. The WHP provides fee-for-service cervical cancer screening using visual inspection with acetic acid enhanced by digital cervicography (VIA-DC), prioritizing care for women living with HIV/AIDS. They also provide clinical breast examination, family planning (FP) services, and treatment for reproductive tract infection (RTI). Here, we document the strengths and challenges of the WHP screening program and the unique aspects of the WHP model, including a fee-for-service payment system and the provision of other women's health services. We retrospectively reviewed WHP medical records from women who presented for cervical cancer screening from 2007-2014. In 8 years, WHP nurses screened 44,979 women for cervical cancer. The number of women screened increased nearly every year. The WHP is sustained primarily on fees-for-service, with external funding totaling about $20,000 annually. In 2014, of 12,191 women screened for cervical cancer, 99% received clinical breast exams, 19% received FP services, and 4.7% received treatment for RTIs. We document successes, challenges, solutions implemented, and recommendations for optimizing this screening model. The WHP's experience using a fee-for-service model for cervical cancer screening demonstrates that in Cameroon VIA-DC is acceptable, feasible, and scalable and can be nearly self-sustaining. Integrating other women's health services enabled women to address additional health care needs. The Cameroon Baptist Convention Health Services Women's Health Program successfully implemented a nurse-led, fee-for-service cervical cancer screening program using visual inspection with acetic acid-enhanced by digital cervicography in
Hakeberg, M; Wide Boman, U
To analyse patient profiles in two payment models, the capitation (DCH) and the fee-for-service (FFS) systems, in relation to socioeconomic status, self-reported health and health behavior, as well as patient attitudes to and satisfaction with the DCH model in the Public Dental Service (PDS) in Sweden. The present survey included a random national sample of the adult population in Sweden. A telemarketing company, TNS SIFO, was responsible for the sample selection and telephone interviews conducted in May 2013. The 3,500 adults (aged =19 years) included in the sample gave a participation rate of 49.7%. Individuals choosing DCH were younger. FFS patients rated their health as less good, were less physically active, were more often smokers and had a lower household income. The DCH patients were more satisfied with their payment model than the FFS patients (98% vs 85%). A multivariate analysis showed that three of the variables significantly contributed to the model predicting DCH patients: age, with an odds ratio of 0.95, household income (OR=1.85) and importance of oral health for well-being (OR=2.05). There was a pattern of dimensions indicating the choice of payment model among adult patients in the Swedish Public Dental Service. The patients in DCH had higher socioeconomic position, were younger, rated their oral health as better and were more satisfied with the payment model (DCH) than the patients in the FFS system. Copyright© 2016 Dennis Barber Ltd
... institution of graduate higher education, an institution of undergraduate higher education, an institution of professional education and an institution of vocational education, which operates a program or programs of... interest to the public. These examples are not intended to be all inclusive. In the case of “freelance...
... secondary school, an institution of graduate higher education, an institution of undergraduate higher education, an institution of professional education, or an institution of vocational education which... purchase or subscription by the general public). These examples are not intended to be all-inclusive...
... OFFICE, LIBRARY OF CONGRESS COPYRIGHT OFFICE AND PROCEDURES FREEDOM OF INFORMATION ACT: POLICIES AND... chapter, or have been established by the Register of Copyrights or Library of Congress pursuant to the... for time spent in resolving legal or policy issues affecting access to Office records. No charge will...
Conquest, Jennifer H; Skinner, John; Kruger, Estie; Tennant, Marc
The objectives of this study were to (i) compare a Capped Payment formula for adults, to the fee-for-service model and the New South Wales Government services payment model; (ii) identify the presenting oral health needs of a 65+ years of age cohort during the period January 2011 to March 2015. Australia faces an ageing population with the vast majority accessing free market dental care, whilst the poor access Government services. This cohort retains most of their dentition increasing demand on Government services. The analysis of New South Wales Government adult de-identified patients' record unit data was from 2011 to 2015, for the three payment models and undertaken in three stages; (i) development of the Capped Payment Model; (ii) evaluation of twenty (20) case studies of adults 65+ years of age; (iii) analyse the cost efficiency of the three payment models. This study found that the Government model was the most cost effective. The Capped-fee model performed less efficiently, particularly in the 75+ age group, with the fee-for-service model generally more costly. It was $2580 (85%) more costly for the 65-74 age cohort, and $4619 (66%) for the 75+ age cohort. Policy makers in partnership with Government and private service providers should seek to develop partnerships with Government, private services and universities, scope opportunities in applying a Capped-fee funding model, and one that helps address the oral needs of the elderly. © 2017 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.
... 45 Public Welfare 4 2010-10-01 2010-10-01 false Fees. 2105.5 Section 2105.5 Public Welfare.... 552, THE FREEDOM OF INFORMATION ACT § 2105.5 Fees. (a) Fees shall be charged according to the schedule... been notified that it cannot be determined in advance whether any records will be made available, fees...
White, M.K.; Lewallen, M.A.; Merrill, E.T.; Fleischman, R.M.
Three types of fees for federal spent fuel management service were calculated for a reference case and a number of variations. These fee types are a uniform fee applicable to all customers, a fee for disposal of spent fuel, and a fee for interim storage plus disposal of spent fuel. Results ranged from $124/kg to $256/kg for the uniform fee, $112/kg to $213/kg for the disposal fee, and $144/kg to $319/kg for the storage plus disposal fee. The reference case assumed that spent fuel would first be received by the government in 1983 at a 5,000 MT away-from-reactor (AFR) basin. The first repository (45,000 MT) was assumed ready for fuel in 1988, and the second (100,000 MT) in 1997. The reference case results in fees of $129/kg for the uniform fee, $117/kg for disposal, and $232/kg for storage plus disposal. The sensitivity cases were grouped in five general categories of variations from the reference case assumptions: demand for storage/disposal services, facility schedules and characteristics, methodology for calculating the fee, discount rate and AFR financing, and delays or failure of the first repository
Patel, Kavita; Presser, Elise; George, Meaghan; McClellan, Mark
Fee-for-service payments encourage high-volume services rather than high-quality care. Alternative payment models (APMs) aim to realign financing to support high-value services. The 2 main components of gastroenterologic care, procedures and chronic care management, call for a range of APMs. The first step for gastroenterologists is to identify the most important conditions and opportunities to improve care and reduce waste that do not require financial support. We describe examples of delivery reforms and emerging APMs to accomplish these care improvements. A bundled payment for an episode of care, in which a provider is given a lump sum payment to cover the cost of services provided during the defined episode, can support better care for a discrete procedure such as a colonoscopy. Improved management of chronic conditions can be supported through a per-member, per-month (PMPM) payment to offer extended services and care coordination. For complex chronic conditions such as inflammatory bowel disease, in which the gastroenterologist is the principal care coordinator, the PMPM payment could be given to a gastroenterology medical home. For conditions in which the gastroenterologist acts primarily as a consultant for primary care, such as noncomplex gastroesophageal reflux or hepatitis C, a PMPM payment can support effective care coordination in a medical neighborhood delivery model. Each APM can be supplemented with a shared savings component. Gastroenterologists must engage with and be early leaders of these redesign discussions to be prepared for a time when APMs may be more prevalent and no longer voluntary. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.
... Physical Therapy; Hospice and Palliative Care from All Physicians; Geriatric Psychiatry from Psychiatry... related to therapy services. Chava Sheffield, (410) 786-2298, for issues related to certified registered... of Certain Physician Pathology Services G. Therapy Services H. Primary Care and Care Coordination I...
Mobley, Lee Rivers; Subramanian, Sujha; Koschinsky, Julia; Frech, H E; Trantham, Laurel Clayton; Anselin, Luc
To determine whether Medicare managed care penetration impacted the diffusion of endoscopy services (sigmoidoscopy, colonoscopy) among the fee-for-service (FFS) Medicare population during 2001-2006. We model utilization rates for colonoscopy or sigmoidoscopy as impacted by both market supply and demand factors. We use spatial regression to perform ecological analysis of county-area utilization rates over two time intervals (2001-2003, 2004-2006) following Medicare benefits expansion in 2001 to cover colonoscopy for persons of average risk. We examine each technology in separate cross-sectional regressions estimated over early and later periods to assess differential effects on diffusion over time. We discuss selection factors in managed care markets and how failure to control perfectly for market selection might impact our managed care spillover estimates. Areas with worse socioeconomic conditions have lower utilization rates, especially for colonoscopy. Holding constant statistically the socioeconomic factors, we find that managed care spillover effects onto FFS Medicare utilization rates are negative for colonoscopy and positive for sigmoidoscopy. The spatial lag estimates are conservative and interpreted as a lower bound on true effects. Our findings suggest that managed care presence fostered persistence of the older technology during a time when it was rapidly being replaced by the newer technology. © Health Research and Educational Trust.
... Commission authorization in any other mass media radio service (except the international broadcast (HF... 47 Telecommunication 1 2010-10-01 2010-10-01 false General exemptions from regulatory fees. 1.1162 Section 1.1162 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Schedule...
Sanders, Jim; Guse, Clare E
There is a significant disparity in hypertensive treatment rates between those with and without health insurance. If left untreated, hypertension leads to significant morbidity and mortality. The uninsured face numerous barriers to access chronic disease care. We developed the Community-based Chronic Disease Management (CCDM) clinics specifically for the uninsured with hypertension utilizing nurse-led teams, community-based locations, and evidence-based clinical protocols. All services, including laboratory and medications, are provided on-site and free of charge. In order to ascertain if the CCDM model of care was as effective as traditional models of care in achieving blood pressure goals, we compared CCDM clinics' hypertensive care outcomes with 2 traditional fee-for-service physician-led clinics. All the clinics are located near one another in poor urban neighborhoods of Milwaukee, Wisconsin. Patients seen at the CCDM clinics and at 1 of the 2 traditional clinics showed a statistically significant improvement in reaching blood pressure goal at 6 months (P fee-for-service clinics when compared with the CCDM clinics. The CCDM model of care is at least as effective in controlling hypertension as more traditional fee-for-service models caring for the same population. The CCDM model of care to treat hypertension may offer another approach for engaging the urban poor in chronic disease care. © The Author(s) 2016.
Full Text Available An efficient scheduling scheme is proposed to increase the available capacity of VoIP services over evolved UTRA uplink. On top of the advantages of persistent scheduling, the proposed scheme adaptively share the resources of two VoIP users to get early-termination gain of dynamic scheduler. Through system-level simulations, the performance of the proposed algorithm is evaluated in terms of the capacity enhancement of VoIP services. Comparisons with the original persistent scheduling and the HSUPA scheduler reveal that the proposed scheme increases the capacity of VoIP services up to 20%.
Mitchell, Jean M; Hadley, Jack; Gaskin, Darrell J
Relatively little research has examined physicians' supply responses to Medicare fee cuts especially whether fee reductions for specific procedures have "spillover" effects that cause physicians to increase the supply of other services they provide. In this study we investigate whether ophthalmologist changed their provision of non-cataract services to Medicare patients over the time period 1992-1994, when the Medicare Fee Schedule (MFS) resulted in a 17.4% reduction in the average fee paid for a cataract extraction. Following the McGuire-Pauly model of physician behavior (McGuire and Pauly, 1991), we estimated a supply function for non-cataract procedures that included three price variables (own-price, a Medicare cross-price and a private cross-price) and an income effect. The Medicare cross-price and income variables capture spillover effects. Consistent with the model's predictions, we found that the Medicare cross-price is significant and negative, implying that a 10% reduction in the fee for a cataract extraction will cause ophthalmologists to supply about 5% more non-cataract services. Second, the income variable is highly significant, but its impact on the supply of non-cataract services is trivial. The suggests that physicians behave more like profit maximizing firms than target income seekers. We also found that the own-price and the private cross-price variables are highly significant and have the expected positive and negative effects on the volume of non-cataract services respectively. Our results demonstrate the importance of evaluating volume responses to fee changes for the array of services the physician performs, not just the procedure whose fee has been reduced. Focusing only on the procedure whose fee has been cut will yield an incomplete picture of how fee reductions for specific procedures affect physician supply decisions.
Kingsbury, J.D.; Moller, I.
The Joint Industry Gas Processing Fee Task Force Report, JP-90, was designed to promote negotiation of gas processing fees that are based on principles of equity and fairness for both natural gas producers and processors. Another purpose of the JP-90 was to develop an effective dispute resolution process for use in those cases where negotiations have failed. At its inception, JP-90 was the only guideline for unregulated fee practices in the oil and gas sector in North America. Today PJVA-95, the revised version of JP-90, is in its final draft. It addresses the changing focus of the gas processing business, and changing regulatory roles in Alberta and British Columbia. A number of other fee mechanisms also have been described, such as the jumping pound formula, fixed fees, fees based on price, wellhead purchases, and others. These mechanisms developed over time to allow the processor and the producer to share the price risk. The changing role of regulatory agencies in fee dispute resolution was also discussed briefly
Muhlestein, David B; Croshaw, Andrew A; Merrill, Thomas P
To determine the willingness of accountable care organizations (ACOs) to bear financial risk for the healthcare they provide. Structured interviews conducted between January and June 2012 with 57 ACOs led by hospitals and physician groups located throughout the United States. Findings are based on the 38 ACOs that were actively providing care under an ACO payment arrangement at the time of the interview. Among these ACOs, 71% cover a portion of their ACO population with contracts that put the ACOs at some financial risk, while 45% have risk-based contracts for their entire ACO population. Payments based on fee-for-service (FFS) billing still dominate, as 92% of ACOs use FFS-based billing for at least a portion of their ACO population and 71% are fully reimbursed using FFS-based billing. Under the auspices of an ACO, providers are accepting some financial risk for their accountable care patient population. There is still strong reliance on FFS-based billing methods as providers experiment with different payment models.
Liu, Weihua; Yang, Yi; Wang, Shuqing; Liu, Yang
Order insertion often occurs in the scheduling process of logistics service supply chain (LSSC), which disturbs normal time scheduling especially in the environment of mass customization logistics service. This study analyses order similarity coefficient and order insertion operation process and then establishes an order insertion scheduling model of LSSC with service capacity and time factors considered. This model aims to minimize the average unit volume operation cost of logistics service integrator and maximize the average satisfaction degree of functional logistics service providers. In order to verify the viability and effectiveness of our model, a specific example is numerically analyzed. Some interesting conclusions are obtained. First, along with the increase of completion time delay coefficient permitted by customers, the possible inserting order volume first increases and then trends to be stable. Second, supply chain performance reaches the best when the volume of inserting order is equal to the surplus volume of the normal operation capacity in mass service process. Third, the larger the normal operation capacity in mass service process is, the bigger the possible inserting order's volume will be. Moreover, compared to increasing the completion time delay coefficient, improving the normal operation capacity of mass service process is more useful.
Full Text Available Servicing is applied periodically in practice with the aim of restoring the system state and prolonging the lifetime. It is generally seen as an imperfect maintenance action which has a chief influence on the maintenance strategy. In order to model the maintenance effect of servicing, this study analyzes the deterioration characteristics of system under scheduled servicing. And then the deterioration model is established from the failure mechanism by compound Poisson process. On the basis of the system damage value and failure mechanism, the failure rate refresh factor is proposed to describe the maintenance effect of servicing. A maintenance strategy is developed which combines the benefits of scheduled servicing and preventive maintenance. Then the optimization model is given to determine the optimal servicing period and preventive maintenance time, with an objective to minimize the system expected life-cycle cost per unit time and a constraint on system survival probability for the duration of mission time. Subject to mission time, it can control the ability of accomplishing the mission at any time so as to ensure the high dependability. An example of water pump rotor relating to scheduled servicing is introduced to illustrate the failure rate refresh factor and the proposed maintenance strategy. Compared with traditional methods, the numerical results show that the failure rate refresh factor can describe the maintenance effect of servicing more intuitively and objectively. It also demonstrates that this maintenance strategy can prolong the lifetime, reduce the total lifetime maintenance cost and guarantee the dependability of system.
Ganle, John K; Parker, Michael; Fitzpatrick, Raymond; Otupiri, Easmon
Inequities in accessibility to, and utilisation of maternal healthcare services impede progress towards attainment of the maternal health-related Millennium Development Goals. The objective of this study is to examine the extent to which maternal health services are utilised in Ghana, and whether inequities in accessibility to and utilization of services have been eliminated following the implementation of a user-fee exemption policy, that aims to reduce financial barriers to access, reduce inequities in access, and improve access to and use of birthing services. We analyzed data from the 2007 Ghana Maternal Health Survey for inequities in access to and utilization of maternal health services. In measuring the inequities, frequency tables and cross-tabulations were used to compare rates of service utilization by region, residence and selected socio-demographic variables. Findings show marginal increases in accessibility to and utilisation of skilled antenatal, delivery and postnatal care services following the policy implementation (2003-2007). However, large gradients of inequities exist between geographic regions, urban and rural areas, and different socio-demographic, religious and ethnic groupings. More urban women (40%) than rural, 53% more women in the highest wealth quintile than women in the lowest, 38% more women in the best performing region (Central Region) than the worst (Upper East Region), and 48% more women with at least secondary education than those with no formal education, accessed and used all components of skilled maternal health services in the five years preceding the survey. Our findings raise questions about the potential equity and distributional benefits of Ghana's user-fee exemption policy, and the role of non-financial barriers or considerations. Exempting user-fees for maternal health services is a promising policy option for improving access to maternal health care, but might be insufficient on its own to secure equitable access to
Fields, Dail; Pruett, Jana; Roman, Paul M
The Affordable Care Act (ACA) is forecast to increase the demand for and utilization of substance use disorder (SUD) treatment. Massachusetts implemented health reforms similar to the ACA in 2006-2007 that included expanding coverage for SUD treatment. This study explored the impact of Massachusetts health reforms from 2007 to 2010 on SUD treatment providers in Massachusetts, who relied on fee-for-service billings for more than 50% of their revenue. The changes across treatment facilities located in Massachusetts were compared to changes in other similar fee-for-service-funded SUD treatment providers in Northeast states bordering Massachusetts and in all other states across the US. From 2007-2010, the percentage changes for Massachusetts based providers were significantly different from the changes among providers located in the rest of the US for admissions, outpatient census, average weeks of outpatient treatment, residential/in-patient census, detoxification census, length of average inpatient and outpatient stays, and provision of medication-assisted treatment. Contrary to previous studies of publicly funded treatment providers, the results of this exploratory study of providers dependent on fee-for-service revenues were consistent with some predictions for the overall effects of the ACA.
Teno, Joan M; Christian, Thomas J; Gozalo, Pedro; Plotzke, Michael
When Medicare Advantage (MA) patients elect hospice, all covered services are reimbursed under the Medicare fee-for-service (FFS) program. This financial arrangement may incentivize MA plans to refer persons to hospice near end of life when costs of care typically rise. To characterize hospice discharge patterns for MA versus FFS patients and examine whether patterns differ by MA concentration across hospital referral regions (HRRs). The rate and pattern of live discharges and length of stay (LOS) between FFS and MA patients were examined. A multivariate mixed-effects model examined whether hospice patients in MA versus FFS had differential patterns of discharges. In addition, we tested whether concentrations of MA hospice patients in a patient's HRR were associated with different patterns of discharges. In fiscal year 2014, there were 1,199,533 hospice discharges with 331,142 MA patients having a slightly higher live discharge rate (15.8%) compared to 868,391 FFS hospice discharges (15.4%). After controlling for patient characteristics, the adjusted odds ratio (AOR) was 1.01 (95% CI 0.99-1.02). MA patients were less likely to have early live discharges (AOR 0.87 95% CI 0.84-0.91) and burdensome transitions (AOR 0.61 95% CI 0.58-0.64) but did not differ in live discharges post 210 days. Among hospice deaths, MA hospice patients were less likely to have a three-day or less LOS (AOR 0.95 95% 0.94-0.96) and a LOS exceeding 180 days (AOR 0.97 95% 0.96-0.99). The concentration of MA patients in a HRR had minimal impact. MA hospice patients' discharge patterns raised less concerns than FFS.
Li, Yixuan; Li, Hui; Liu, Yuze; Ji, Yuefeng
Software Defined Optical Network (SDON) can be considered as extension of Software Defined Network (SDN) in optical networks. SDON offers a unified control plane and makes optical network an intelligent transport network with dynamic flexibility and service adaptability. For this reason, a comprehensive optical transmission service, able to achieve service differentiation all the way down to the optical transport layer, can be provided to service function chaining (SFC). IP over optical network, as a promising networking architecture to interconnect data centers, is the most widely used scenarios of SFC. In this paper, we offer a flexible and dynamic resource allocation method for diverse SFC service requests in the IP over optical network. To do so, we firstly propose the concept of optical service function (OSF) and a multi-layer SFC model. OSF represents the comprehensive optical transmission service (e.g., multicast, low latency, quality of service, etc.), which can be achieved in multi-layer SFC model. OSF can also be considered as a special SF. Secondly, we design a resource allocation algorithm, which we call OSF-oriented optical service scheduling algorithm. It is able to address multi-layer SFC optical service scheduling and provide comprehensive optical transmission service, while meeting multiple optical transmission requirements (e.g., bandwidth, latency, availability). Moreover, the algorithm exploits the concept of Auxiliary Graph. Finally, we compare our algorithm with the Baseline algorithm in simulation. And simulation results show that our algorithm achieves superior performance than Baseline algorithm in low traffic load condition.
... (1993). The Board concludes that the fee changes adopted here will not have a significant economic... merge their properties or franchises (or a part thereof) into one corporation for ownership, management...
... INFORMATION CONTACT: Rebecca Cole, (410) 786-4497, for issues related to physician payment and for all other... issues related to renal dialysis provisions and payments for end-stage renal disease facilities. Diane...-State Renal Disease Related Services for Home Dialysis (CPT Codes 90963, 90964, 90965, and 90966) 1. End...
... of services. FOR FURTHER INFORMATION CONTACT: Rebecca Cole, (410) 786-4497. SUPPLEMENTARY INFORMATION...). On page 40180, in our discussion of the four disease modules covered by the proposed PQRI group... disease modules. On page 40186, in our discussion of the proposed Physician Quality Reporting Initiative...
... Multispecialty Points of Comparison List b. Codes with Low Work RVUs Commonly Billed in Multiple Units Per Single Encounter c. Codes with High Volume and Low Work RVUs d. Codes with Site-of-Service-Anomalies e. Codes with... Wage Index Values (7) Wage index Values for Areas With No Hospital Data (8) Reduction to the ESRD Wage...
Abrishami, S.; Naghibzadeh, M.; Epema, D.H.J.
The advent of Cloud computing as a new model of service provisioning in distributed systems encourages researchers to investigate its benefits and drawbacks on executing scientific applications such as workflows. One of the most challenging problems in Clouds is workflow scheduling, i.e., the
Based on the practice and experiences of pre-service and in-service inspections for Daya Bay Nuclear Power Plant (NPP) by Research Institute of Nuclear Power Operation (RINPO) following RSEM code, requirements of utility and actual situation in China, the in-service inspection preparation for organization, techniques and equipment/tooling, materials, personnel and documentation is briefly described. And the scheduling and coordinating consideration for planed in-service inspection activities during NPP outage is emphatically introduced. (2 refs., 4 figs.)
Garchitorena, Andres; Miller, Ann C; Cordier, Laura F; Ramananjato, Ranto; Rabeza, Victor R; Murray, Megan; Cripps, Amber; Hall, Laura; Farmer, Paul; Rich, Michael; Orlan, Arthur Velo; Rabemampionona, Alexandre; Rakotozafy, Germain; Randriantsimaniry, Damoela; Gikic, Djordje; Bonds, Matthew H
Despite overwhelming burdens of disease, health care access in most developing countries is extremely low. As governments work toward achieving universal health coverage, evidence on appropriate interventions to expand access in rural populations is critical for informing policies. Using a combination of population and health system data, we evaluated the impact of two pilot fee exemption interventions in a rural area of Madagascar. We found that fewer than one-third of people in need of health care accessed treatment when point-of-service fees were in place. However, when fee exemptions were introduced for targeted medicines and services, the use of health care increased by 65 percent for all patients, 52 percent for children under age five, and over 25 percent for maternity consultations. These effects were sustained at an average direct cost of US$0.60 per patient. The pilot interventions can become a key element of universal health care in Madagascar with the support of external donors. Project HOPE—The People-to-People Health Foundation, Inc.
Guerino, Paul; Ewald, Erin; Laffan, Alison M.
Abstract Purpose: Data on the health and well-being of the transgender population are limited. However, using claims data we can identify transgender Medicare beneficiaries (TMBs) with high confidence. We seek to describe the TMB population and provide comparisons of chronic disease burden between TMBs and cisgender Medicare beneficiaries (CMBs), thus laying a foundation for national level TMB health disparity research. Methods: Using a previously validated claims algorithm based on ICD-9-CM codes relating to transsexualism and gender identity disorder, we identified a cohort of TMBs using Medicare Fee-for-Service (FFS) claims data. We then describe the demographic characteristics and chronic disease burden of TMBs (N = 7454) and CMBs (N = 39,136,229). Results: Compared to CMBs, a greater observed proportion of TMBs are young (under age 65) and Black, although these differences vary by entitlement. Regardless of entitlement, TMBs have more chronic conditions than CMBs, and more TMBs have been diagnosed with asthma, autism spectrum disorder, chronic obstructive pulmonary disease, depression, hepatitis, HIV, schizophrenia, and substance use disorders. TMBs also have higher observed rates of potentially disabling mental health and neurological/chronic pain conditions, as well as obesity and other liver conditions (nonhepatitis), compared to CMBs. Conclusion: This is the first systematic look at chronic disease burden in the transgender population using Medicare FFS claims data. We found that TMBs experience multiple chronic conditions at higher rates than CMBs, regardless of Medicare entitlement. TMBs under age 65 show an already heavy chronic disease burden which will only be exacerbated with age. PMID:29125908
Full Text Available The spectrum fees called as “Biaya Hak Pengguna Frekuensi” (BHP-F for cellular services in Indonesia are currently calculated based on apparatus, proportionally to the number of transceiver stations and radio channels. Unfortunately, the formula cannot promote the efficiency of frequency spectrum efficiency. ITU-R SM 2012-2 recommended the spectrum fee formula that can promote the efficiency; Administrative Incentives Price (AIP also claims to promote the effectiveness of the radio spectrum utilization. By combining ITU-R SM 2012-2 with AIP, the frequency fee formula can promote not only the efficiency but also the effectiveness of spectrum utilization. This paper will explain and discus the modification of ITU-R SM 2012-2 with AIP in designing the spectrum fees for cellular services in Indonesia.
... 42 Public Health 3 2010-10-01 2010-10-01 false Psychiatric services. 415.184 Section 415.184 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Psychiatric services. To qualify for physician fee schedule payment for psychiatric services furnished under...
Rodríguez-Vigil, Efraín; Kianes-Pérez, Zaira
To evaluate and compare the quality of diabetes care in a large managed care system and fee-for-service payment system in Puerto Rico. This retrospective cross-sectional study assessed the adherence to standards of diabetes care in 1,687,202 subjects--226,210 from a fee-for-service population and 1,460,992 from a managed care group. Patients with diabetes mellitus were identified from insurance claims reports. Type of health-care provider, service location, number of visits, and laboratory utilization were also assessed. From the analysis, we identified 90,616 patients with diabetes (5.4% of the overall study group). Of these, 66,587 (73.5%) were found to have at least one encounter with a physician in a medical visit. Of the 66,586 patients with diabetes who visited a physician, only 4% were treated by an endocrinologist. General laboratory utilization was 34% for the entire population of patients with diabetes studied. In the group of patients with documented laboratory tests, 93% had a documented fasting blood glucose test; in contrast, hemoglobin A lc testing was performed in only 9% of the patients. The fee-for-service group had a higher rate of visits to medical specialists and general laboratory utilization, whereas the managed care group had a higher rate of hospital admissions and emergency department visits. The quality of diabetes management and the subsequent outcomes are related to patient and health-care provider adherence to standards of care. In this analysis, we found that patients and physicians are responsible for low compliance with recognized standards of diabetes care in Puerto Rico. The lack of adequate management will lead to increased mortality, development and severity of chronic complications, and increased emergency department utilization. Therefore, health-care providers and payers should find ways to achieve more effective promotion of adherence to accepted standards of care for patients with diabetes.
To explore whether a common industry measure of overall patient illness burden, used to assess the total costs of members in a health plan, would be suitable to describe variation in a summary metric of utilization that assesses specialist physician direct patient care services not grouped into clinical episodes, but with exclusion criteria applied to reduce any bias in the data. Data sources/study setting Calendar year 2006 administrative data on 153,557 commercial members enrolled in a non-profit single-state statewide Health Maintenance Organization (HMO) and treated by 4356 specialists in 11 specialties. The health plan's global referral process and specialist fee-for-service reimbursement likely makes these results applicable to the non-managed care setting, as once a global referral was authorized there was no required intervention by the HMO or referring primary care provider for the majority of any subsequent specialist direct clinical care. Study design Specialty-specific correlations and ordinary least-squares regression models to assess variations in specialist direct patient care work effort with patient overall illness burden, after the application of exclusion criteria to reduce potential bias in the data. Principle findings Statistically significant positive correlations exist between specialist direct patient care work effort and patient overall illness burden for all studied specialties. Regression models revealed a generally monotonic increasing relationship between illness burden categories and aggregate specialist direct patient care work effort. Almost all regression model differences from the reference category across specialties are statistically significant (P ≤ 0.012). Assessment of additional results demonstrates the relationship has more substantive significance in some specialties and less in others. The most substantive relationships in this study were found in the specialties of orthopaedic surgery, general surgery and interventional
Ward, Martha C; Lally, Cathy; Druss, Benjamin G
Medicaid is an important funder of care for individuals with behavioral (psychiatric and/or substance use) diagnoses, and expenditures will likely increase with expansion of services under the Affordable Care Act. This study provides national estimates of Medicaid expenditures using a comprehensive sample of fee-for-service Medicaid enrollees with behavioral diagnoses. Data for analysis came from 2003 to 2004 Medicaid Analytic eXtract (MAX) files for 50 states and the District of Columbia. Individuals with behavioral diagnoses had high rates of chronic medical comorbidities, and expenditures for medical (non-behavioral) diagnoses accounted for 74 % of their health care expenditures. Total Medicaid expenditure was approximately 15 billion dollars (equivalent to 18.91 billion in 2016 dollars) for individuals with any behavioral diagnosis. Medicaid fee-for-service beneficiaries with behavioral diagnoses have a high treated prevalence of individual medical comorbid conditions, and the majority of health care expenditures in these individuals are for medical, rather than behavioral health, services.
Wang, Jianwu; Korambath, Prakashan; Altintas, Ilkay; Davis, Jim; Crawl, Daniel
With more and more workflow systems adopting cloud as their execution environment, it becomes increasingly challenging on how to efficiently manage various workflows, virtual machines (VMs) and workflow execution on VM instances. To make the system scalable and easy-to-extend, we design a Workflow as a Service (WFaaS) architecture with independent services. A core part of the architecture is how to efficiently respond continuous workflow requests from users and schedule their executions in the cloud. Based on different targets, we propose four heuristic workflow scheduling algorithms for the WFaaS architecture, and analyze the differences and best usages of the algorithms in terms of performance, cost and the price/performance ratio via experimental studies.
Wang, Jianwu; Korambath, Prakashan; Altintas, Ilkay; Davis, Jim; Crawl, Daniel
With more and more workflow systems adopting cloud as their execution environment, it becomes increasingly challenging on how to efficiently manage various workflows, virtual machines (VMs) and workflow execution on VM instances. To make the system scalable and easy-to-extend, we design a Workflow as a Service (WFaaS) architecture with independent services. A core part of the architecture is how to efficiently respond continuous workflow requests from users and schedule their executions in the cloud. Based on different targets, we propose four heuristic workflow scheduling algorithms for the WFaaS architecture, and analyze the differences and best usages of the algorithms in terms of performance, cost and the price/performance ratio via experimental studies. PMID:29399237
... payments exceed the final evaluation score, the Contractor will either credit the next payment voucher for... either credit the next payment voucher for the amount of such overpayment or refund the difference to the... fee payments, at a not-to-exceed amount of $100,000 for the contract, in reserve to protect the...
...;Prices of new books are listed in the first FEDERAL REGISTER issue of each #0;week. #0; #0; #0; #0;#0..., Testing, and Standards. Fees for Classification Under the Cotton Statistics and Estimates Act of 1927 This... www.regulations.gov . List of Subjects in 7 CFR Part 28 Administrative practice and procedure, Cotton...
... uncertainties related to crop size and cash-flow timing while meeting minimum reserve requirements set by the... cotton crop at that same level. This fee and the existing reserve are sufficient to cover the costs of... Pursuant to requirements set forth in the Regulatory Flexibility Act (RFA) (5 U.S.C. 601-612), AMS has...
... uncertainties related to crop size and cash-flow timing while meeting minimum reserve requirements set by the... cotton crop at that same level. This fee and the existing reserve are sufficient to cover the costs of... Flexibility Act Pursuant to requirements set forth in the Regulatory Flexibility Act (RFA) (5 U.S.C. 601-612...
... manage uncertainties related to crop size and cash-flow timing while meeting minimum reserve requirements... level. This proposed fee and the existing reserve are sufficient to cover the costs of providing.... Regulatory Flexibility Act Pursuant to requirements set forth in the Regulatory Flexibility Act (RFA) (5 U.S...
... size and cash-flow timing while meeting minimum reserve requirements set by the Agricultural Marketing... level. This proposed fee and the existing reserve are sufficient to cover the costs of providing... challenge to the provisions of this rule. Regulatory Flexibility Act Pursuant to requirements set forth in...
... Secretary shall make fair market value appraisals of areas administered by the Service within five years... reappraised on a schedule of at least once every five years. Until areas are appraised, the fair market value... fee lands added to such areas after that date shall be on the basis of fair market value. ...
Timbie, Justin W; Bogart, Andy; Damberg, Cheryl L; Elliott, Marc N; Haas, Ann; Gaillot, Sarah J; Goldstein, Elizabeth H; Paddock, Susan M
To compare performance between Medicare Advantage (MA) and Fee-for-Service (FFS) Medicare during a time of policy changes affecting both programs. Performance data for 16 clinical quality measures and 6 patient experience measures for 9.9 million beneficiaries living in California, New York, and Florida. We compared MA and FFS performance overall, by plan type, and within service areas associated with contracts between CMS and MA organizations. Case mix-adjusted analyses (for measures not typically adjusted) were used to explore the effect of case mix on MA/FFS differences. Performance measures were submitted by MA organizations, obtained from the nationwide fielding of the Medicare Consumer Assessment of Healthcare Providers and Systems (MCAHPS) Survey, or derived from claims. Overall, MA outperformed FFS on all 16 clinical quality measures. Differences were large for HEDIS measures and small for Part D measures and remained after case mix adjustment. MA enrollees reported better experiences overall, but FFS beneficiaries reported better access to care. Relative to FFS, performance gaps were much wider for HMOs than PPOs. Excluding HEDIS measures, MA/FFS differences were much smaller in contract-level comparisons. Medicare Advantage/Fee-for-Service differences are often large but vary in important ways across types of measures and contracts. © Health Research and Educational Trust.
Jan A. Van Mieghem
This article studies the optimal prices and service quality grades that a queuing system---the "firm"---provides to heterogeneous, utility-maximizing customers who measure quality by their experienced delay distributions. Results are threefold: First, delay cost curves are introduced that allow for a flexible description of a customer's quality sensitivity. Second, a comprehensive executable approach is proposed that analytically specifies scheduling, delay distributions and prices for arbitr...
... 32 National Defense 5 2010-07-01 2010-07-01 false PA fees. 701.123 Section 701.123 National... OFFICIAL RECORDS AVAILABILITY OF DEPARTMENT OF THE NAVY RECORDS AND PUBLICATION OF DEPARTMENT OF THE NAVY DOCUMENTS AFFECTING THE PUBLIC DON Privacy Program § 701.123 PA fees. The PA fee schedule is only applicable...
Short Anthony J
Full Text Available Abstract The introduction of Medicare Benefits Schedule items for allied health professionals in 2004 was a pivotal event in the public funding of non-medical primary care services. This commentary seeks to provide supplementary discussion of the article by Menz (Utilisation of podiatry services in Australia under the Medicare Enhanced Primary Care program, 2004-2008 Journal of Foot and Ankle Research 2009, 2:30, by placing these findings within the context of the podiatry profession, clinical decision making and the broader health workforce and government policy.
The Nuclear Regulatory Commission has issued its final rule on fee collections for fiscal year 1993, partly in response to a court decision that challenged the agency's FY 1991 fee schedule. Because the NRC must recover all of its annual budget - in excess of $500 million - through fees on licensees and users of agency services, those licensees and users are very sensitive about who shoulders how much of the burden. The new rule voids the previous NRC policy of exempting nonprofit educational institutions from the fee schedule, and the allocation of generic costs for low-level waste management to groups of licensees, rather than to individual licensees. The new rule went into effect on August 19
Robert, Emilie; Ridde, Valéry; Marchal, Bruno; Fournier, Pierre
Background Four years prior to the Millenium Development Goals (MDGs) deadline, low- and middle-income countries and international stakeholders are looking for evidence-based policies to improve access to healthcare for the most vulnerable populations. User fee exemption policies are one of the potential solutions. However, the evidence is disparate, and systematic reviews have failed to provide valuable lessons. The authors propose to produce an innovative synthesis of the available evidence on user fee exemption policies in Africa to feed the policy-making process. Methods The authors will carry out a realist review to answer the following research question: what are the outcomes of user fee exemption policies implemented in Africa? why do they produce such outcomes? and what contextual elements come into play? This type of review aims to understand how contextual elements influence the production of outcomes through the activation of specific mechanisms, in the form of context-mechanism-outcome configurations. The review will be conducted in five steps: (1) identifying with key stakeholders the mechanisms underlying user fee exemption policies to develop the analytical framework, (2) searching for and selecting primary data, (3) assessing the quality of evidence using the Mixed-Method Appraisal Tool, (4) extracting the data using the analytical framework and (5) synthesising the data in the form of context-mechanism-outcomes configurations. The output will be a middle-range theory specifying how user fee exemption policies work, for what populations and under what circumstances. Ethics and dissemination The two main target audiences are researchers who are looking for examples to implement a realist review, and policy-makers and international stakeholders looking for lessons learnt on user fee exemption. For the latter, a knowledge-sharing strategy involving local scientific and policy networks will be implemented. The study has been approved by the ethics
Chen, Chen-Peng; Hwang, Ruey-Lung; Shih, Wen-Mei
Balancing thermal comfort with the requirement of energy conservation presents a challenge in hot and humid areas where air-conditioning (AC) is frequently used in cooling indoor air. A field survey was conducted in Taiwan to demonstrate the adaptive behaviors of occupants in relation to the use of fans and AC in a school building employing mixed-mode ventilation where AC use was managed under a fee-for-service mechanism. The patterns of using windows, fans, and AC as well as the perceptions of students toward the thermal environment were examined. The results of thermal perception evaluation in relation to the indoor thermal conditions were compared to the levels of thermal comfort predicted by the adaptive models described in the American Society of Heating, Refrigerating, and Air-Conditioning Engineers Standard 55 and EN 15251 and to that of a local model for evaluating thermal adaption in naturally ventilated buildings. A thermal comfort-driven adaptive behavior model was established to illustrate the probability of fans/AC use at specific temperature and compared to the temperature threshold approach to illustrate the potential energy saving the fee-for-service mechanism provided. The findings of this study may be applied as a reference for regulating the operation of AC in school buildings of subtropical regions.
... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false BTS Schedule P-12(a), Fuel Consumption by... TRANSPORTATION Reporting Rules § 291.44 BTS Schedule P-12(a), Fuel Consumption by Type of Service and Entity. (a.... (e)(1) The cost of fuel shall include shrinkage, but excludes: (i) “Throughput” and “in to plane...
... 47 Telecommunication 1 2010-10-01 2010-10-01 false Witness fees. 1.339 Section 1.339....339 Witness fees. Witnesses who are subpenaed and respond thereto are entitled to the same fees, including mileage, as are paid for like service in the courts of the United States. Fees shall be paid by...
Fonseca, Joao Filipe Paiva; Larsen, Allan; van der Hurk, Evelien
In this talk, we deal with a generalization of the well-known Vehicle Scheduling Problem(VSP) that we call Simultaneous Vehicle Scheduling and Passenger Service Problem with Flexible Dwell Times (SVSPSP-FDT). The SVSPSP-FDT generalizes the VSP because the original timetables of the trips can...... be changed (i.e., shifted and stretched) in order to minimize a new objective function that aims at minimizing the operational costs plus the waiting times of the passengers at transfer points. Contrary to most generalizations of the VSP, the SVSPSP-FDT establishes the possibility of changing trips' dwell...... times at important transfer points based on expected passenger ows. We introduce a compact mixed integer linear formulation of the SVSPSP-FDT able to address small instances. We also present a meta-heuristic approach to solve medium/large instances of the problem. The e ectiveness of the proposed...
Ludwick, D. A.; Doucette, John
Our aging population has exacerbated strong and divergent trends between health human resource supply and demand. One way to mitigate future inequities is through the adoption of health information technology (HIT). Our previous research showed a number of risks and mitigating factors which affected HIT implementation success. We confirmed these findings through semistructured interviews with nine Alberta clinics. Sociotechnical factors significantly affected physicians' implementation success. Physicians reported that the time constraints limited their willingness to investigate, procure, and implement an EMR. The combination of antiquated exam room design, complex HIT user interfaces, insufficient physician computer skills, and the urgency in patient encounters precipitated by a fee-for-service remuneration model and long waitlists compromised the quantity, if not the quality, of the information exchange. Alternative remuneration and access to services plans might be considered to drive prudent behavior during physician office system implementation. PMID:19081787
D. A. Ludwick
Full Text Available Our aging population has exacerbated strong and divergent trends between health human resource supply and demand. One way to mitigate future inequities is through the adoption of health information technology (HIT. Our previous research showed a number of risks and mitigating factors which affected HIT implementation success. We confirmed these findings through semistructured interviews with nine Alberta clinics. Sociotechnical factors significantly affected physicians' implementation success. Physicians reported that the time constraints limited their willingness to investigate, procure, and implement an EMR. The combination of antiquated exam room design, complex HIT user interfaces, insufficient physician computer skills, and the urgency in patient encounters precipitated by a fee-for-service remuneration model and long waitlists compromised the quantity, if not the quality, of the information exchange. Alternative remuneration and access to services plans might be considered to drive prudent behavior during physician office system implementation.
... 42 Public Health 1 2010-10-01 2010-10-01 false Fees. 4.7 Section 4.7 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS NATIONAL LIBRARY OF MEDICINE § 4.7 Fees. The Director may charge reasonable fees for any service provided by the Library under this part...
... LEGAL SERVICES CORPORATION 45 CFR Part 1609 Fee-Generating Cases AGENCY: Legal Services...) proposes to amend the Legal Services Corporation's regulation on fee-generating cases to clarify that it... intended. LSC's regulation at 45 CFR part 1609, Fee- Generating Cases, is based on Sec. 1007(b)(1) of the...
Eduyn Ramiro Lopez-Santana
Full Text Available This paper presents an approach of software engineering to a research proposal to make an Expert System to scheduling on service systems using methodologies and processes of software development. We use the adaptive software development as methodology for the software architecture based on the description as a software metaprocess that characterizes the research process. We make UML’s diagrams (Unified Modeling Language to provide a visual modeling that describes the research methodology in order to identify the actors, elements and interactions in the research process.
... wireless radio, mass media, common carrier, cable and international services shall be filed in full on an... 47 Telecommunication 1 2010-10-01 2010-10-01 false Payment of charges for regulatory fees. 1.1157 Section 1.1157 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Schedule...
... instrument and cover mass media, common carrier, international, and cable service fee payments. Each... Section 1.1158 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Schedule.... dollars and drawn on a United States financial institution and made payable to the Federal Communications...
McCauley, Claire-Odile; McKenna, Hugh; Keeney, Sinead; McLaughlin, Derek
The aim of this study was to co-create of an interview schedule exploring mental health recovery in collaboration with young adult service users. Service user involvement in research has been increasingly recognized as providing a vital authentic insight into mental health recovery. Engagement and collaboration with service users have facilitated the exploration of inaccessible or under-investigated aspects of the lived experience of mental health recovery, not only directing the trajectory of research, but making it relevant to their own contextual experience. A qualitative content analysis framework was employed in the co-creation of a semi-structured interview schedule through an engagement process with service users. Two separate engagement groups took place at the premises of the service user organizations, between January - February 2014. Miles and Huberman's analysis framework was chosen for this phase as it enabled the visual presentation of factors, concepts or variables and the established relationship between them. The lived experience of mental ill health in young adulthood and how this was understood by others was a particularly relevant theme for participants. Further themes were identified between the impact of painful experiences at this developmental life stage leading to a deeper understanding of others through finding meaning in their own mental health recovery journey. Our findings identified that suffering painful experiences is an integral aspect in the process of mental health recovery. This understanding has particular relevance to mental health nursing practice, ensuring the care delivered is cognizant of the suffering or painful experiences that young adults are encountering. © 2017 John Wiley & Sons Ltd.
.... The Department's fee schedule is reviewed and implemented on a two-year cycle. Delaying the fee... staff to manage the administrative workload in a timely fashion, increase the Office of Designation's...
Mirchandani, Pitu; Madsen, Oli B.G.; Adler, Jonathan
There is much reason to believe that fleets of service vehicles of many organizations will transform their vehicles that utilize alternative fuels which are more sustainable. The electric vehicle is a good candidate for this transformation, especially which “refuels” by exchanging its spent...... batteries with charged ones. This paper discusses the issues that must be addressed if a transit service were to use electric vehicles, principally the issues related to the limited driving range of each electric vehicle’s set of charged batteries and the possible detouring for battery exchanges....... In particular, the paper addresses the optimization and analysis of infrastructure design alternatives dealing with (1) the number of battery-exchange stations, (2) their locations, (3) the recharging capacity and inventory management of batteries at each facility, and (4) routing and scheduling of the fleet...
Taiwan's global budgeting for hospital health care, in comparison to other countries, assigns a regional budget cap for hospitals' medical benefits claimed on the basis of fee-for-service (FFS) payments. This study uses a stays-hospitals-years database comprising acute myocardial infarction inpatients to examine whether the reimbursement policy mitigates the medical benefits claimed to a third-payer party during 2000-2008. The estimated results of a nested random-effects model showed that hospitals attempted to increase their medical benefit claims under the influence of initial implementation of global budgeting. The magnitudes of hospitals' responses to global budgeting were significantly attributed to hospital ownership, accreditation status, and market competitiveness of a region. The results imply that the regional budget cap superimposed on FFS payments provides only blunt incentive to the hospitals to cooperate to contain medical resource utilization, unless a monitoring mechanism attached with the payment system.
This report describes the study conducted by the Department of Energy (the Department) regarding payment charges for the federal interim storage (FIS) of spent fuel and presents the details of the study results. It describes the selection of a methodology for calculating a FIS fee schedule, sets forth the estimates of cost for construction and operation of FIS facilities, provides a range of estimates for the fee for FIS services, and identifies special contractual considerations associated with providing FIS services to authorized users. The fee is structured for a range of spent fuel capacities because of uncertainties regarding the schedule of availability and amount of spent fuel that may require and qualify for FIS. The results set forth in the report were used as a basis for development of the report entitled Payment Charges for Federal Interim Storage of Spent Nuclear Fuel from Civilian Nuclear Power Plants in the United States, dated July 1983
Yang, Yi; Xu, Haitao; Liu, Xiaoyan; Wang, Yijia; Liang, Zhicheng
In mass customization logistics service, reasonable scheduling of the logistics service supply chain (LSSC), especially time scheduling, is benefit to increase its competitiveness. Therefore, the effect of a customer order decoupling point (CODP) on the time scheduling performance should be considered. To minimize the total order operation cost of the LSSC, minimize the difference between the expected and actual time of completing the service orders, and maximize the satisfaction of functional logistics service providers, this study establishes an LSSC time scheduling model based on the CODP. Matlab 7.8 software is used in the numerical analysis for a specific example. Results show that the order completion time of the LSSC can be delayed or be ahead of schedule but cannot be infinitely advanced or infinitely delayed. Obtaining the optimal comprehensive performance can be effective if the expected order completion time is appropriately delayed. The increase in supply chain comprehensive performance caused by the increase in the relationship coefficient of logistics service integrator (LSI) is limited. The relative concern degree of LSI on cost and service delivery punctuality leads to not only changes in CODP but also to those in the scheduling performance of the LSSC. PMID:24715818
Liu, Weihua; Yang, Yi; Xu, Haitao; Liu, Xiaoyan; Wang, Yijia; Liang, Zhicheng
In mass customization logistics service, reasonable scheduling of the logistics service supply chain (LSSC), especially time scheduling, is benefit to increase its competitiveness. Therefore, the effect of a customer order decoupling point (CODP) on the time scheduling performance should be considered. To minimize the total order operation cost of the LSSC, minimize the difference between the expected and actual time of completing the service orders, and maximize the satisfaction of functional logistics service providers, this study establishes an LSSC time scheduling model based on the CODP. Matlab 7.8 software is used in the numerical analysis for a specific example. Results show that the order completion time of the LSSC can be delayed or be ahead of schedule but cannot be infinitely advanced or infinitely delayed. Obtaining the optimal comprehensive performance can be effective if the expected order completion time is appropriately delayed. The increase in supply chain comprehensive performance caused by the increase in the relationship coefficient of logistics service integrator (LSI) is limited. The relative concern degree of LSI on cost and service delivery punctuality leads to not only changes in CODP but also to those in the scheduling performance of the LSSC.
Baji, Petra; Pavlova, Milena; Gulácsi, László; Zsófia, Homolyáné Csete; Groot, Wim
The objective of this paper is to study the short-term effects of the introduction of the visit fee in Hungary in 2007 on informal patient payments. We present the pattern of informal payments in primary, out-patient specialist and in in-patient care in the period before and shortly after the visit fee was introduced. We also analyse whether in the short run, the introduction of visit fee decreased the probability of paying informally. For the analysis, we use a dataset for a representative sample of 2500 respondents collected in 2007 shortly after the introduction of the visit fee, which contains data on informal payments for healthcare services. According to our results, 9% of the patients paid informally during their last visit to GP (2 Euros on average), 14% paid informally for specialist care (35 Euros on average) and 50% paid informally for hospitalisation (58 Euros on average). We find a significant reduction in the probability of paying informally only for elderly patients in case of in-patient care. Our results suggest that informal payments are widely spread in Hungary, especially in in-patient care. The short run potential of the introduction of the visit fee to reduce informal payments seems to be minor. Copyright © 2011 John Wiley & Sons, Ltd.
... LEGAL SERVICES CORPORATION 45 CFR Part 1609 Fee-Generating Cases AGENCY: Legal Services... on fee-generating cases to clarify that it applies only to LSC and private non-LSC funds. DATES: This... fee-generating cases to clarify that it applies only to LSC and private non-LSC funds. 76 FR 6381. On...
van Hasselt, Martijn; McCall, Nancy; Keyes, Vince; Wensky, Suzanne G; Smith, Kevin W
To compare health care utilization and payments between NCQA-recognized patient-centered medical home (PCMH) practices and practices without such recognition. Medicare Part A and B claims files from July 1, 2007 to June 30, 2010, 2009 Census, 2007 Health Resources and Services Administration and CMS Utilization file, Medicare's Enrollment Data Base, and the 2005 American Medical Association Physician Workforce file. This study used a longitudinal, nonexperimental design. Three annual observations (July 1, 2008-June 30, 2010) were available for each practice. We compared selected outcomes between practices with and those without NCQA PCMH recognition. Individual Medicare fee-for-service (FFS) beneficiaries and their claims and utilization data were assigned to PCMH or comparison practices based on where they received the plurality of evaluation and management services between July 1, 2007 and June 30, 2008. Relative to the comparison group, total Medicare payments, acute care payments, and the number of emergency room visits declined after practices received NCQA PCMH recognition. The decline was larger for practices with sicker than average patients, primary care practices, and solo practices. This study provides additional evidence about the potential of the PCMH model for reducing health care utilization and the cost of care. © Health Research and Educational Trust.
Thinggaard, Frank; Kiertzner, Lars
of both audit fees and other fees paid to the auditor on a consolidated group level. Until 1.1. 2005 special Danish legal provisions require listed companies to be audited by two independent auditors. We have especially focused on the influence of this joint auditor effect on the pricing of audit fees....... Our results indicate that the requirement to have two independent auditors reduces total audit fees, most likely because of competitive pressure, but only in the segment of larger companies. We have applied the core audit fee determinants model which has evolved in international research with generic...... proxy variables for client size, complexity, risk profile and auditor size contributing to the level of audit fees. Our findings indicate similarities with respect to the determining factors, but again a distinction has to be made between segments of large and small companies. In the small Danish...
Ayoib Che Ahmad; Nava Subramaniam
Although internal auditing (IA) services have been traditionally performed in-house, organizations are increasingly outsourcing such services. Using a Transaction Cost Economics (TCE) perspective, this study examined the influence of several organizational-level variables on the decision to outsource or in-house their internal audit function. The study also identified the type of IA services that were likely to be out-sourced rather than in-housed, the extent to which incumbent external finan...
Warren, David; Childress, David; Salvatierra, George; Thompson, Chuck; Williams, Roger M
...), a field operating agency of the Air Force Civil Engineer, are two primary organizations providing project management and contract administration services for major Iraq reconstruction projects...
McKinnon, Britt; Harper, Sam; Kaufman, Jay S
Coverage of skilled delivery care has been increasing across most low-income countries; however, it remains far from universal and is very unequally distributed according to socioeconomic position. In an effort to increase coverage of skilled delivery care and reduce socioeconomic inequalities, governments of several countries in sub-Saharan Africa have recently adopted policies that remove user fees for facility-based delivery services. There is little rigorous evidence of the impact of these policies and few studies have examined effects on socioeconomic inequalities. This study investigates the impact of recent delivery fee exemption policies in Ghana, Senegal, and Sierra Leone on socioeconomic differences in the use of facility-based delivery services. Using Demographic and Health Survey data from nine sub-Saharan African countries, we evaluated the user fee policy changes using a difference-in-differences approach that accounts for underlying common secular trends and time invariant differences among countries, and allows for differential effects of the policy by socioeconomic position. Removing user fees was consistent with meaningful increases in facility deliveries across all categories of household wealth and maternal education. We found little evidence of differential effects of removing user fees across quartiles of household wealth, with increases of 5.4 facility deliveries per hundred live births (95% CI: 2.1, 8.8) among women in the poorest quartile and 6.8 per hundred live births (95% CI: 4.0, 9.7) for women in the richest quartile. However, our results suggest that educated women benefited more from removing user fees compared to women with no education. For women with at least some secondary education, the estimated effect was 8.6 facility deliveries per hundred live births (95% CI: 5.4, 11.9), but only 4.6 per hundred live births (95% CI: 2.2, 7.0) for women with no education (heterogeneity p-value = 0.04). Thus, while removing fees at the point
...] APHIS User Fee Web Site AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION: Notice. SUMMARY: The Animal and Plant Health Inspection Service charges user fees, as authorized by law, to... contains information about the Agency's user fees. ADDRESSES: The Agency's user fee Web site is located at...
Azuara, J. A.
The article reviews the main modifications introduced by the Law on CSN Fees in the agency's financing system which is based on charging service rendering fees. The new regulations adjust the fees to the actual cost of services and lays down conditions for setting the fees in each case. (Author)
... requirements set by the Agricultural Marketing Service, which require maintenance of a reserve fund amount... and the existing reserve are sufficient to cover the costs of providing classification services for... requirements set forth in the Regulatory Flexibility Act (RFA) (5 U.S.C. 601-612), AMS has considered the...
Bian, Boyang; Kelton, Christina M L; Guo, Jeff J; Wigle, Patricia R
Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are widely prescribed for the treatment of hypertension and heart failure, as well as for kidney disease prevention in patients with diabetes mellitus and the management of patients after myocardial infarction. To (a) describe ACE inhibitor and ARB utilization and spending in the Medicaid fee-for-service program from 1991 through 2008, and (b) estimate the potential cost savings for the collective Medicaid programs from a higher ratio of generic ACE inhibitor utilization. A retrospective, descriptive analysis was performed using the National Summary Files from the Medicaid State Drug Utilization Data, which are composed of pharmacy claims that are subject to federally mandated rebates from pharmaceutical manufacturers. For the years 1991-2008, quarterly claim counts and expenditures were calculated by summing data for individual ACE inhibitors and ARBs. Quarterly per-claim expenditure as a proxy for drug price was computed for all brand and generic drugs. Market shares were calculated based on the number of pharmacy claims and Medicaid expenditures. In the Medicaid fee-for-service program, ACE inhibitors accounted for 100% of the claims in the combined market for ACE inhibitors and ARBs in 1991, 80.6% in 2000, and 64.7% in 2008. The Medicaid expenditure per ACE inhibitor claim dropped from $37.24 in 1991 to $24.03 in 2008 when generics accounted for 92.5% of ACE inhibitor claims; after adjusting for inflation for the period from 1991 to 2008, the real price drop was 59.2%. Brand ACE inhibitors accounted for only 7.5% of the claims in 2008 for all ACE inhibitors but 32.1% of spending; excluding the effects of manufacturer rebates, Medicaid spending would have been reduced by $28.7 million (9%) in 2008 if all ACE inhibitor claims were generic. The average price per ACE inhibitor claim in 2008 was $24.03 ($17.64 per generic claim vs. $103.45 per brand claim) versus $81.98 per ARB
....1028 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS INSPECTION ACT...
... MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS INSPECTION ACT... provided for by such agreement. Marking, Branding, and Identifying Product ...
... allow a consular officer to waive the physical appearance of an applicant in the J-1 visa class, but... Department of State visa adjudicator to both determine whether the employment falls under the E-3 program...'' increase for petition-based employment visas, and stated that adjudication of these petition-based visa...
... distribution or redistribution of radiopharmaceuticals, generators, reagent kits, and/or sources and devices... radiopharmaceuticals, generators, reagent kits, and/or sources or devices not involving processing of byproduct... for the export and import of radioactive waste and requires NRC to consult with domestic host state...
... to recover the costs of ``allocating visas'' described in section 203(c) of the Immigration and... Statement of Federal Accounting Standards (SFFAS), available at http://www.fasab.gov/pdffiles/sffas-4.pdf... advances in automation making it easier to verify U.S. immigration status. As such, the Department will...
Department of Homeland Security — TSA has implemented congressionally mandated security fees to help finance the increased cost of securing the nation's aviation transportation system. The revenue...
Nguyen, Louis L; Smith, Ann D; Scully, Rebecca E; Jiang, Wei; Learn, Peter A; Lipsitz, Stuart R; Weissman, Joel S; Helmchen, Lorens A; Koehlmoos, Tracey; Hoburg, Andrew; Kimsey, Linda G
Although many factors influence the management of carotid artery stenosis, it is not well understood whether a preference toward procedural management exists when procedural volume and physician compensation are linked in the fee-for-service environment. To explore evidence for provider-induced demand in the management of carotid artery stenosis. The Department of Defense Military Health System Data Repository was queried for individuals diagnosed with carotid artery stenosis between October 1, 2006, and September 30, 2010. A hierarchical multivariable model evaluated the association of the treatment system (fee-for-service physicians in the private sector vs salary-based military physicians) with the odds of procedural intervention (carotid endarterectomy or carotid artery stenting) compared with medical management. Subanalysis was performed by symptom status at the time of presentation. The association of treatment system and of management strategy with clinical outcomes, including stroke and death, was also evaluated. Data analysis was conducted from August 15, 2015, to August 2, 2016. The odds of procedural intervention based on treatment system was the primary outcome used to indicate the presence and effect of provider-induced demand. Of 10 579 individuals with a diagnosis of carotid artery stenosis (4615 women and 5964 men; mean [SD] age, 65.6 [11.4] years), 1307 (12.4%) underwent at least 1 procedure. After adjusting for demographic and clinical factors, the odds of undergoing procedural management were significantly higher for patients in the fee-for-service system compared with those in the salary-based setting (odds ratio, 1.629; 95% CI, 1.285-2.063; P fee-for-service system were significantly more likely to undergo procedural management for carotid stenosis compared with those in the salary-based setting. These findings remained consistent for individuals with and without symptomatic disease.
... representative to the service location (at other than a specified duty point) is more than 25 miles from an FGIS... representative will be assessed from the FGIS office to the service point and return. When commercial modes of transportation (e.g., airplanes) are required, the actual expense incurred for the round-trip travel will be...
Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE uniform health maintenance organization (HMO) benefit--Prime enrollment fee exemption for survivors of active duty deceased sponsors and medically retired uniformed services members and their dependents. Final rule.
This final rule creates an exception to the usual rule that TRICARE Prime enrollment fees are uniform for all retirees and their dependents and responds to public comments received to the proposed rule published in the Federal Register on June 7, 2013. Survivors of Active Duty Deceased Sponsors and Medically Retired Uniformed Services Members and their Dependents are part of the retiree group under TRICARE rules. In acknowledgment and appreciation of the sacrifices of these two beneficiary categories, the Secretary of Defense has elected to exercise his authority under the United States Code to exempt Active Duty Deceased Sponsors and Medically Retired Uniformed Services Members and their Dependents enrolled in TRICARE Prime from paying future increases to the TRICARE Prime annual enrollment fees. The Prime beneficiaries in these categories have made significant sacrifices for our country and are entitled to special recognition and benefits for their sacrifices. Therefore, the beneficiaries in these two TRICARE beneficiary categories who enrolled in TRICARE Prime prior to 10/1/2013, and those since that date, will have their annual enrollment fee frozen at the appropriate fiscal year rate: FY2011 rate $230 per single or $460 per family, FY2012 rate $260 or $520, FY2013 rate $269.38 or $538.56, or the FY2014 rate $273.84 or $547.68. The future beneficiaries added to these categories will have their fee frozen at the rate in effect at the time they are classified in either category and enroll in TRICARE Prime or, if not enrolling, at the rate in effect at the time of enrollment. The fee remains frozen as long as at least one family member remains enrolled in TRICARE Prime and there is not a break in enrollment. The fee charged for the dependent(s) of a Medically Retired Uniformed Services Member would not change if the dependent(s) was later re-classified a Survivor.
Huckfeldt, Peter J; Escarce, José J; Rabideau, Brendan; Karaca-Mandic, Pinar; Sood, Neeraj
Traditional fee-for-service (FFS) Medicare's prospective payment systems for postacute care provide little incentive to coordinate care or control costs. In contrast, Medicare Advantage plans pay for postacute care out of monthly capitated payments and thus have stronger incentives to use it efficiently. We compared the use of postacute care in skilled nursing and inpatient rehabilitation facilities by enrollees in Medicare Advantage and FFS Medicare after hospital discharge for three high-volume conditions: lower extremity joint replacement, stroke, and heart failure. After accounting for differences in patient characteristics at discharge, we found lower intensity of postacute care for Medicare Advantage patients compared to FFS Medicare patients discharged from the same hospital, across all three conditions. Medicare Advantage patients also exhibited better outcomes than their FFS Medicare counterparts, including lower rates of hospital readmission and higher rates of return to the community. These findings suggest that payment reforms such as bundling in FFS Medicare may reduce the intensity of postacute care without adversely affecting patient health. Project HOPE—The People-to-People Health Foundation, Inc.
Garrett, Amy B.
This study examines 104 articles on the fee versus free controversy in libraries, written primarily between the years of 1992 and 1997. The content analysis assesses the types of libraries that charges fees--academic, public, school, or special; who is charged--everyone, businesses and their personnel, law firms and lawyers; and what services the…
Bundorf, M Kate; Schulman, Kevin A; Stafford, Judith A; Gaskin, Darrell; Jollis, James G; Escarce, José J
To examine the effects of market-level managed care activity on the treatment, cost, and outcomes of care for Medicare fee-for-service acute myocardial infarction (AMI) patients. Patients from the Cooperative Cardiovascular Project (CCP), a sample of Medicare beneficiaries discharged from nonfederal acute-care hospitals with a primary discharge diagnosis of AMI from January 1994 to February 1996. We estimated models of patient treatment, costs, and outcomes using ordinary least squares and logistic regression. The independent variables of primary interest were market-area managed care penetration and competition. The models included controls for patient, hospital, and other market area characteristics. We merged the CCP data with Medicare claims and other data sources. The study sample included CCP patients aged 65 and older who were admitted during 1994 and 1995 with a confirmed AMI to a nonrural hospital. Rates of revascularization and cardiac catheterization for Medicare fee-for-service patients with AMI are lower in high-HMO penetration markets than in low-penetration ones. Patients admitted in high-HMO-competition markets, in contrast, are more likely to receive cardiac catheterization for treatment of their AMI and had higher treatment costs than those admitted in low-competition markets. The level of managed care activity in the health care market affects the process of care for Medicare fee-for-service AMI patients. Spillovers from managed care activity to patients with other types of insurance are more likely when managed care organizations have greater market power.
... Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY SECURITIES EXCHANGE ACT DISCLOSURE RULES... part before it will accept the filing. The OCC provides an applicable fee schedule for such filings in the “Notice of Comptroller of the Currency Fees” described in 12 CFR 8.8. (b) Fees must be paid by...
Murdock, John E; Phillips, Ceib; Beane, Richard; Quinonez, Rocio
Access to orthodontic services for children enrolled in Medicaid is limited nationwide. Orthodontists cite low fee reimbursement as a significant barrier to Medicaid participation. The purpose of this study was to examine, under a specific set of practice assumptions, the simulated effect on profitability of treating patients covered by Medicaid in orthodontic practices in North Carolina by using a break-even analysis for the 2005 fiscal year. Questionnaires were mailed to 154 orthodontists in active practice in North Carolina. The response rate was 58%. Seventy respondents met the eligibility criteria. Respondents were categorized into 4 groups based on the number of 2005 Medicaid case starts (I, 0; II, 1-5; III, 6-12; IV, 13 or more). By using the aggregated responses for treatment fees, treatment times, and overhead percentages for each group, average per-patient costs were calculated for each group and used in a break-even analysis. Group I accounted for 60% of respondents; group II, 20%; group III, 9%; and group IV, 11%. Assuming that the break-even point had not been reached, the group I practice would have an average estimated loss of $164 per patient whereas groups II, III, and IV would realize average profits from $98 to $256. The break-even point increased slightly in groups I, II, and III after the total number of patients in the patient pool was increased by 5%, assuming that additional patients were enrolled in Medicaid: group I, 203 to 210; group II, 220 to 226; group III, 158 to 160. The break-even point for group IV was 234 patients. Assuming that the break-even point had been reached, all groups were estimated to realize average per-patient profits of $1483 to $1897. Break-even analysis is a basic economic concept applicable to orthodontic practices. Under the specific conditions of this study, the inclusion of 5% of patients enrolled in Medicaid in the active patient pool had minimal effect on the financial break-even point and, assuming that the
.... The current fees are based on the usual costs, such as salaries, equipment, travels, and supplies... valid reproduction of a file; this service is available for an additional fee. Cost means the total... created and maintained them. Sec. 1258.4 What costs make up the NARA fees? (a) 44 U.S.C. 2116(c) allows...
... Directors, USDA, APHIS, Plant Protection and Quarantine and the States for which they are responsible, may be obtained from the Animal and Plant Health Inspection Service, Plant Protection and Quarantine... their agents, must contact the Regional Director, USDA, APHIS, Plant Protection and Quarantine, 5 for...
Agricultural extension services are crucial for the rapid spread of research results to farmers and for transmitting information about farmers' needs, circumstances, and problems to researchers. In developing countries, public extension organizations are dominant. These public extension systems are often inadequately ...
.... (b) Motions to quash. Any person to whom a subpoena is directed may, prior to the time specified... Board, determines in his, her, or its discretion, to be just, reasonable, and proper. ... PRACTICE AND PROCEDURE Rules and Procedures Applicable to Formal Investigations § 622.106 Service of...
Libraries have traditionally been custodians of information which are provided free of charge to users. Recent decline in funds to libraries and the change in the concept of information from a free resource to a marketable resource in the information age have necessitated the re-evaluation of free services in the libraries.
... or sample) 13.75 (iii) Factor analysis (per factor) 5.65 (2) Additional Tests—Unit Rates (Hops): (i... Commodities): (i) Factor analysis (per factor) 5.65 (4) Stowage Examination (service-on-request) 4 (i) Ship... (24) Protein 16.00 (25) Sanitation (light filth) 47.00 (26) Sieve test 11.00 (27) Smoke Point 43.00...
... public interest because it is likely to contribute significantly to public understanding of the... the rate of $41.00 per hour. (c) Service involved in checking records to be certified to determine authenticity, including clerical work, etc., identical thereto, at the rate of $28.00 per hour. (d) Photocopies...
Cancino, Ramon S; Jack, Brian W; Jarvis, John; Cummings, Alice Kate; Cooper, Ellie; Cremieux, Pierre-Yves; Burgess, James F
In 2011, fee-for-service patients with both Medicare and Medicaid (dual eligible) sustained $319.5 billion in health care costs. To describe the emergency department (ED) use and hospital admissions of adult dual eligible patients aged under 65 years who used an urban safety net hospital. This was a retrospective database analysis of patients aged between 18 and 65 years with Medicare and Medicaid, who used an urban safety net academic health center between January 1, 2011, and December 31, 2011. We compared patients with and without behavioral health illness. The main outcome measures were hospital admission and ED use. Chi-square and Wilcoxon rank-sum tests were used for descriptive statistics on categorical and continuous variables, respectively. Greedy propensity score matching was used to control for confounding factors. Rate ratios (RR) and 95% confidence intervals (CI) were determined after matching and after adjusting for those variables that remained significantly different after matching. In 2011, 10% of all fee-for-service dual eligible patients aged less than 65 years in Massachusetts were seen at Boston Medical Center. Data before propensity score matching showed significant differences in age, sex, race/ethnicity, marital status, education, employment, physical comorbidities, and Charlson Comorbidity Index score between patients with and without behavioral health illness. Analysis after propensity score matching found significant differences in sex, Hispanic race, and other education and employment status. Compared with patients without behavioral health illness, patients with behavioral health illness had a higher RR for hospital admissions (RR = 2.07; 95% CI = 1.81-2.38; P fee-for-service plan had significantly higher rates of hospital admission and ED use compared with dual eligible patients without behavioral health illness at the largest urban safety net medical center in New England. Safety net hospitals care for a large proportion of dual
Huang, Yu-Li; Bryce, Alan H; Culbertson, Tracy; Connor, Sarah L; Looker, Sherry A; Altman, Kristin M; Collins, James G; Stellner, Winston; McWilliams, Robert R; Moreno-Aspitia, Alvaro; Ailawadhi, Sikander; Mesa, Ruben A
Optimal scheduling and calendar management in an outpatient chemotherapy unit is a complex process that is driven by a need to focus on safety while accommodating a high degree of variability. Primary constraints are infusion times, staffing resources, chair availability, and unit hours. We undertook a process to analyze our existing management models across multiple practice settings in our health care system, then developed a model to optimize safety and efficiency. The model was tested in one of the community chemotherapy units. We assessed staffing violations as measured by nurse-to-patient ratios throughout the workday and at key points during treatment. Staffing violations were tracked before and after the implementation of the new model. The new model reduced staffing violations by nearly 50% and required fewer chairs to treat the same number of patients for the selected clinic day. Actual implementation results indicated that the new model leveled the distribution of patients across the workday with an 18% reduction in maximum chair utilization and a 27% reduction in staffing violations. Subsequently, a positive impact on peak pharmacy workload reduced delays by as much as 35 minutes. Nursing staff satisfaction with the new model was positive. We conclude that the proposed optimization approach with regard to nursing resource assignment and workload balance throughout a day effectively improves patient service quality and staff satisfaction.
O'Malley, Ann S; Sarwar, Rumin; Keith, Rosalind; Balke, Patrick; Ma, Sai; McCall, Nancy
Support for ongoing care management and coordination between office visits for patients with multiple chronic conditions has been inadequate. In January 2015, Medicare introduced the Chronic Care Management (CCM) payment policy, which reimburses providers for CCM activities for Medicare beneficiaries occurring outside of office visits. To explore the experiences, facilitators, and challenges of practices providing CCM services, and their implications going forward. Semi-structured telephone interviews from January to April 2016 with 71 respondents. Sixty billing and non-billing providers and practice staff knowledgeable about their practices' CCM services, and 11 professional society representatives. Practice respondents noted that most patients expressed positive views of CCM services. Practice respondents also perceived several patient benefits, including improved adherence to treatment, access to care team members, satisfaction, care continuity, and care coordination. Facilitators of CCM provision included having an in-practice care manager, patient-centered medical home recognition, experience developing care plans, patient trust in their provider, and supplemental insurance to cover CCM copayments. Most billing practices reported few problems obtaining patients' consent for CCM, though providers felt that CMS could better facilitate consent by marketing CCM's goals to beneficiaries. Barriers reported by professional society representatives and by billing and non-billing providers included inadequacy of CCM payments to cover upfront investments for staffing, workflow modification, and time needed to manage complex patients. Other barriers included inadequate infrastructure for health information exchange with other providers and limited electronic health record capabilities for documenting and updating care plans. Practices owned by hospital systems and large medical groups faced greater bureaucracy in implementing CCM than did smaller, independent practices
In fall of 2011 the University at Buffalo Libraries circulation department undertook Six Sigma training for the purpose of overhauling its student scheduling process. The department was able to mitigate significant staffing budgetary reductions and resource reallocations and to overcome the unique challenges of scheduling student labor for a…
Kazempour, S. Jalal; Moghaddam, M. Parsa; Haghifam, M.R.; Yousefi, G.R.
This work addresses a new framework for self-scheduling of an individual price-taker pumped-storage plant in a day-ahead (DA) market. The goal is achieving the best trade-off between the expected profit and the risks when the plant participates in DA energy, spinning reserve and regulation markets. In this paper, a set of uncertainties including price forecasting errors and also the uncertainty of power delivery requests in the ancillary service markets are contemplated. Considering these uncertainties, a new approach is proposed which is called dynamic self-scheduling (DSS). This risk-constrained dynamic self-scheduling problem is therefore formulated and solved as a mixed integer programming (MIP) problem. Numerical results for a case study are discussed. (author)
... 29 Labor 1 2010-07-01 2010-07-01 true Fees; cost; expenses; decisions. 25.7 Section 25.7 Labor... ORDER 10988 § 25.7 Fees; cost; expenses; decisions. (a) Arbitrator's fees, per diem and travel expenses... entirely by the agency. (b) The standard fee for the services of an arbitrator should be $100 per day...
... 7 Agriculture 2 2010-01-01 2010-01-01 false Fees and costs; payment. 28.115 Section 28.115... Fees and Costs § 28.115 Fees and costs; payment. All charges for practical forms of cotton standards and all fees and expenses for services of inspection of bales and supervision of sampling...
... New Fee Site AGENCY: Rio Grande National Forest, USDA Forest Service. ACTION: Notice of New Fee Site... Forest is proposing to add a cabin for rent to the public for a $50 fee for the overnight rental. It was.... People are invited to comment on this proposal. DATES: Send any comments about these fee proposals by...
... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Will I be charged fees? 2.15 Section 2.15... INFORMATION ACT Requests for Records under the FOIA § 2.15 Will I be charged fees? Bureaus will charge fees consistent with the provisions in §§ 2.16 and 2.17. The fee schedule in appendix C to this part applies to...
Rodin, Ervin Y
The purpose of this present research was to develop a generic model and methodology for analyzing and optimizing large-scale air transportation networks including both their routing and their scheduling...
Kiertzner, Lars; Thinggaard, Frank
to the auditor at the consolidated group level has been required by the Danish Financial Statements Act. Until 1/1-2005, listed companies are required to be audited by two independent auditors. Here, we have especially focused on the effect of this requirement on the pricing of audit fees. Our results indicate...... that having two independent auditors reduces total audit fees (most likely due to competitive pressure), but only for larger companies. We have used the core audit fee determinants model, which is a result of international research, with generic proxy variables for client size, complexity, risk profile...... and auditor size. Our findings indicate similarities with respect to the determining factors, but again a distinction has to be made between large and small companies. In small Danish companies, client size and complexity in a formal technical sense are decisive, which might indicate that audits...
Thinggaard, Frank; Kiertzner, Lars
to the auditor at the consolidated group level has been required by the Danish Financial Statements Act. Until 1/1-2005, listed companies are required to be audited by two independent auditors. Here, we have especially focused on the effect of this requirement on the pricing of audit fees. Our results indicate...... that having two independent auditors reduces total audit fees (most likely due to competitive pressure), but only for larger companies. We have used the core audit fee determinants model, which is a result of international research, with generic proxy variables for client size, complexity, risk profile...... and auditor size. Our findings indicate similarities with respect to the determining factors, but again a distinction has to be made between large and small companies. In small Danish companies, client size and complexity in a formal technical sense are decisive, which might indicate that audits...
Hanazaki, Kazuhiro; Tominaga, Ryuji; Nio, Masaki; Iwanaka, Tadashi; Okoshi, Kae; Kaneko, Koichi; Nagano, Hiroaki; Nishida, Takahiro; Nishida, Hiroshi; Hoshino, Ken; Maehara, Tadaaki; Masuda, Munetaka; Matsufuji, Hiroshi; Yanaga, Katsuhiko; Tabayashi, Koichi; Satomi, Susumu; Kokudo, Norihiro
The aim of this study was to achieve improvements in the work environment of Japanese surgeons and shortage of surgeons. Questionnaires were distributed to selected Japanese surgical Society (JSS) members. Retrospective analysis was conducted comparing the current 2011 survey with previous 2007 survey. To examine the influence of 2010 revision of the fee for medical services performed by surgeons, we distributed a second questionnaire to directors of hospitals and administrators of clerks belonging to official institutes in JSS. Collective data were analyzed retrospectively. The main potential causes for the shortage of surgeons in Japan were long hours (72.8 %), excessive emergency surgeries (69.4 %), and high risk of lawsuit (67.7 %). Mean weekly working hours of surgeons in national or public university hospitals and private university hospitals were 96.2 and 85.6, respectively. Approximately 70 % of surgeons were forced to do hardworking tasks, possibly leading to death from overwork. Of note, approximately 25 % of surgeons had over time of more than 100 h a week, coinciding to the number of hours that might lead to death from fatigue, described in the Japanese labor law. Although the total medical service fee in hospitals, especially in large-scale hospitals with more than 500 beds, increased markedly after 2010 revision of the fee for medical services performed by surgeons, few hospitals gave perquisites and/or incentives to surgeons. To prevent and avoid collapse of the surgical specialty in Japan, an improvement in the work environment of surgeons by initiation of the JSS would be required as soon as possible.
... mathematical formula used to calculate the apportioned rate for each fee charge category for fiscal year 2010... procedures which must be exhausted prior to any judicial challenge to this rule or the application of its... 20250-0270. (7) Statistics Branch Office. The Statistics Branch office of Science and Technology...
... 42 Public Health 5 2010-10-01 2010-10-01 false OIG fees for the cost of advisory opinions. 1008.31... SERVICES OIG AUTHORITIES ADVISORY OPINIONS BY THE OIG Advisory Opinion Fees § 1008.31 OIG fees for the cost of advisory opinions. (a) Responsibility for fees. The requestor is responsible for paying a fee...
Briffa, Thomas G; Hammett, Christopher J; Cross, David B; Macisaac, Andrew I; Rankin, James M; Board, Neville; Carr, Bridie; Hyun, Karice K; French, John; Brieger, David B; Chew, Derek P
The aim of the present study was to explore the association of health insurance status on the provision of guideline-advocated acute coronary syndrome (ACS) care in Australia. Consecutive hospitalisations of suspected ACS from 14 to 27 May 2012 enrolled in the Snapshot study of Australian and New Zealand patients were evaluated. Descriptive and logistic regression analysis was performed to evaluate the association of patient risk and insurance status with the receipt of care. In all, 3391 patients with suspected ACS from 247 hospitals (23 private) were enrolled in the present study. One-third of patients declared private insurance coverage; of these, 27.9% (304/1088) presented to private facilities. Compared with public patients, privately insured patients were more likely to undergo in-patient echocardiography and receive early angiography; furthermore, in those with a discharge diagnosis of ACS, there was a higher rate of revascularisation (P fee-for-service. In contrast, proportionately fewer privately insured ACS patients were discharged on selected guideline therapies and were referred to a secondary prevention program (P = 0.056), neither of which directly attracts a fee. Typically, as GRACE (the Global Registry of Acute Coronary Events) risk score rose, so did the level of ACS care; however, propensity-adjusted analyses showed lower in-hospital adverse events among the insured group (odds ratio 0.68; 95% confidence interval 0.52-0.88; P = 0.004). Fee-for-service reimbursement may explain differences in the provision of selected guideline-advocated components of ACS care between privately insured and public patients.
Bodnar, Peter; Azadeh, Kaveh; Koster, René de
The problem considered in this paper is how to schedule inbound and outbound trucks subject to time windows at a multidoor cross-dock. Dock doors can either be dedicated to inbound or outbound trucks or be capable of handling both truck types. In addition, loads are allowed to be temporarily...
... pricing design changes in First-Class Mail. One involves the introduction of two separate pricing... the value of the services the accounting fee supports and the goal of recovering institutional costs... INFORMATION: I. Introduction II. Class-Specific Summary III. Preferred Mail IV. Mail Classification Schedule...
...--Fees and Charges AGENCY: Department of State. ACTION: Final rule. SUMMARY: The Department of State is amending its regulations regarding fees and charges for Exchange Visitor Program services. The fees permit the Department to recoup the cost of providing such Exchange Visitor Program services. DATES...
... be recognized unless the Representative withdraws or abandons such capacity or the Appellant directs... stipulated fee or on a contingent fee basis will be approved by the Board. No fee for service will be...) Usefulness of the Representative's services; (2) The nature and complexity of the appeal; (3) The capacity in...
... DEPARTMENT OF AGRICULTURE Forest Service Notice of New Fee Site AGENCY: Monongahela National Forest, USDA Forest Service. ACTION: Notice of New Fee Site. SUMMARY: The Monongahela National Forest is... amenities. Fees for overnight use will be used for the continued operation and maintenance of Island...
... DEPARTMENT OF AGRICULTURE Forest Service Notice of New Fee Site AGENCY: Kaibab National Forest, USDA Forest Service, Arizona. ACTION: Notice of New Fee Sites. SUMMARY: The Kaibab National Forest is proposing to charge fees for the overnight rental of three historic facilities on the North Kaibab Ranger...
... DEPARTMENT OF AGRICULTURE Forest Service Notice of New Recreation Fee AGENCY: Prescott National Forest, Southwestern Region, USDA Forest Service. ACTION: Notice of New Recreation Fee. SUMMARY: The Prescott National Forest is proposing to charge a fee at the new Eagle Ridge Group Campground near Prescott...
... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Appealing the fee. 549.73 Section 549.73 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT MEDICAL SERVICES Fees for Health Care Services § 549.73 Appealing the fee. You may seek review of issues related to...
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.
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.
Full Text Available For a better service level of a train operating plan, we propose an integrated optimization method of train planning and train scheduling, which generally are optimized, respectively. Based on the cost analysis of both passengers travelling and enterprises operation, and the constraint analysis of trains operation, we construct a multiobjective function and build an integrated optimization model with the aim of reducing both passenger travel costs and enterprise operating costs. Then, a solving algorithm is established based on the simulated annealing algorithm. Finally, using as an example the Changzhutan intercity rail network, as an example we analyze the optimized results and the influence of the model parameters on the results.
Like the journals themselves, AGU publication fees have been restructured to accommodate the new online, publish-as-ready approach. The new fee structure is based on authors' providing electronic files of their text and art in acceptable formats (Word, WordPerfect, and LaTeX for text, and .eps or .tif for digital art). However, if you are unable to supply electronic files, you can opt for a higher-charge, full-service route in which AGU will create electronic files from hard copy. All authors for AGU journals are expected to support the journal archive through fees based on number as well as size of article files. The revenue from these fees is set aside for the "Perpetual Care Trust Fund," which will support the migration of the journal archive to new formats or media as technology changes. For several journals, excess length fees remain in place to encourage submission of concisely written articles. During this first transition year, most author fees are based on the number of print page equivalents (pdf) in an article; in the future, however, charges are expected to be associated with file size. The specific fees for each journal are posted on AGU's Web site under Publications-Tools for Authors.
... 271.9 Banks and Banking FEDERAL RESERVE SYSTEM (CONTINUED) FEDERAL OPEN MARKET COMMITTEE RULES... because it is likely to contribute significantly to public understanding of the operation or activities of... the subject of the records concerns the operations or activities of the government; (ii) Whether...
Vanderbeke Dave; Christiaens Johan; Verbruggen Sandra
Although the number of non-profit audit fee studies recently has risen, evidence in the hospital sector is rather scarce. Apart from NHS studies, hospitals are a fairly new topic and several specific fee determinants are yet to be tested. For instance, hospitals can have a private or a public status and they have a distinct number of clinical services. These and other dependent variables known from earlier research are added to a fee model and investigated. As hypothesized the hospital status...
The paper concerns a new research area that is Quality of Web Service (QoWS). The need for QoWS is motivated by a still growing number of Internet users, by a steady development and diversification of Web services, and especially by popularization of e-commerce applications. The goal of the paper is a critical analysis of the literature concerning scheduling algorithms for e-commerce Web servers. The paper characterizes factors affecting the load of the Web servers and discusses ways of improving their efficiency. Crucial QoWS requirements of the business Web server are identified: serving requests before their individual deadlines, supporting user session integrity, supporting different classes of users and minimizing a number of rejected requests. It is justified that meeting these requirements and implementing them in an admission control (AC) and scheduling algorithm for the business Web server is crucial to the functioning of e-commerce Web sites and revenue generated by them. The paper presents results of the literature analysis and discusses algorithms that implement these important QoWS requirements. The analysis showed that very few algorithms take into consideration the above mentioned factors and that there is a need for designing an algorithm implementing them.
Joselany Áfio Caetano
Full Text Available Objective: To analyze the vaccine schedule for preterm infants in a program of special immunobiologicals. Methods: A documental study conducted at a Reference Center of Special Immunobiologicals (CREATE situated in a general hospital of tertiary care in pediatrics. The sample consisted of 112 newborns with gestational age below 37 weeks and weighing less than 2500g, suitable for vaccination, assisted in 2006-2007. Data collection was done from registration forms, reference records and registers of control of special immunobiologicals’ administration, in year 2008. Results: The results showed that 22 (20% newborns were weighing between 1000 and 1499g. Regarding gestational age, 39 (35% were born between 30 and 34 weeks of pregnancy. Most proceeded from public institutions, 37 (69%. The vaccination schedule of most children, 68 (61%, was incomplete. The main clinical indications for special immunobiologicals were prematurity and bronchopulmonary dysplasia. It was observed that 89% (n = 100 of preterm infants received the pneumococcal vaccine (Prevenar. For preterm infants who were at risk of developing serious events related to the tetravalent vaccine, it was elected the scheme Prevenar + DTPa + Hib. Simultaneous administration of meningococcal conjugate vaccines - C (MncC with Prevenar was indicated for candidates for cochlear implants. Conclusion: The integral care to the preterm newborn involves early immunization, that is, the one that starts in the neonatal unit, and requires the inclusion of special immunobiologicals, which should be criteriously recommended.
Van Oort, N.; Boterman, J.W.; Van Nes, R.
This paper presents research on optimizing service reliability of longheadway services in urban public transport. Setting the driving time, and thus the departure time at stops, is an important decision when optimizing reliability in urban public transport. The choice of the percentile out of
Effect of Filmless Imaging on Utilization of Radiologic Services with a Two-stage, Hospital-Wide Implementation of a Picture Archiving and Communication System: Initial Experience of a Fee-for-Service Model
Full Text Available A medium-sized general hospital using a fee-for-service model implemented a hospital-wide picture archiving and communication system (PACS in two stages. This study evaluated the reporting time with filmless operation and the effect of filmless imaging on referring physicians' use of the radiologic service before and after completion of the second stage of PACS implementation. The relationship between the total number of hospital patients and the number of radiologic department patients was also evaluated. All sample images were retrieved from the PACS. All corresponding reports except for one for a computerized tomography study were available. The median reporting time for different studies performed during working hours was less than 2 hours. There was a significantly positive and linear relationship (p < 0.01 between the total number of hospital patients and the number of radiologic department patients after hospital-wide implementation of PACS. We conclude that the fee-for-service model had no negative impact on referring physicians' use of radiologic services in a filmless hospital.
... preparations; sanitary preparations for medical purposes; dietetic substances adapted for medical use, food for... and other preparations for making beverages. 33. Alcoholic beverages (except beers). 34. Tobacco; smokers' articles; matches. Services 35. Advertising; business management; business administration; office...
In-service inspection methods for low-power research reactors are described which have been developed during the past 37 years of the operation of the TRIGA reactor Vienna. Special tools have been developed during this period and their application for maintenance and in-serve inspection is discussed. Two practical in-service inspections at a TRIGA reactor and at a MTR reactor are presented. Further a typical maintenance plan for a TRIGA reactor is listed in the annex. (author)
Carolina Aguiar da Rosa
identify elements that characterize groups of firms with different SNA fees analysis of variance was used, evaluating variables from the total assets, equity, net income and external audit services – SAE fees. The results show that most SNAare used by companies to audit tax (31%. Moreover, the audit SOX holds a significant cost, representing 16% of total SNA, but there is a low incidence, which can be justified by a concern with recent corporate governance. One concern with the disclosure of SNA can arise because 50% of the costs evidenced by the companies comprising the group "other services" and the types of services that are part of this group are not explained. In addition, information inconsistencies were found between RF and RA in 35% of the companies. Concerning the cost variable of SNA, this study provides evidence that the highest SNA fees were evidenced by the sample companies which evidenced the highest SAE fees.
Sarah Rudd; Chris Stewart
The Reserve Bank has conducted a survey on bank fees each year since 1997. The results of the latest survey show that banks’ aggregate fee income rose slightly in the banks’ 2011 financial years, but that growth in fee income was less than that in banks’ total assets. Fee income from households declined while fee income from businesses grew, largely as a result of increases in fees on business loans and bank bills.
..., an institution of graduate higher education, an institution of undergraduate higher education, an institution of professional education, and an institution of vocational education, which operates a program or... examples are not intended to be all-inclusive. Moreover, as traditional methods of news delivery evolve (e...
Alipour, Manijeh; Mohammadi-Ivatloo, Behnam; Moradi-Dalvand, Mohammad; Zare, Kazem
Plug-in electric vehicles are expected to play a major role in the transportation system as the environmental problems and energy crisis are being more and more urgent recently. Implementing a large number of vehicles with proper control could bring an opportunity of large storage and flexibility for power systems. The plug-in electric vehicle aggregator is responsible for providing power and controlling the charging pattern of the plug-in electric vehicles under its contracted area. This paper deals with the problem of optimal scheduling problem of plug-in electric vehicle aggregators in electricity market considering the uncertainties of market prices, availability of vehicles and status of being called by the ISO in the reserve market. The impact of the market price and reserve market uncertainties on the electric vehicle scheduling problem is characterized through a stochastic programming framework. The objective of the aggregator is to maximize its profit by charging the plug-in electric vehicles on the low price time intervals as well as participating in ancillary service markets. The operational constraints of plug-in electric vehicles and constraints of vehicle to grid are modeled in the proposed framework. An illustrative example is provided to confirm the performance of the proposed model. - Highlights: • Optimal scheduling of vehicle aggregators in electricity market has been addressed. • The operational constraints of plug-in vehicle to grid are considered. • The uncertainties of calling status in reserve market and market prices are modeled. • Vehicles' driving patterns and availability uncertainty are modeled. • The effect of risk measure weight in the vehicle to grid model has been studied.
... demand exists for a good, resource, or service, its market price will be determined using commercial... substantial competitive demand, market price will be determined by taking into account the prevailing prices... advance, when feasible. The benefit of charging user fees must outweigh the cost of collecting the fees...
... 7 Agriculture 2 2010-01-01 2010-01-01 false Fees; certificates. 27.81 Section 27.81 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... CLASSIFICATION UNDER COTTON FUTURES LEGISLATION Regulations Costs of Classification and Micronaire § 27.81 Fees...
... INFORMATION Rules for Disclosure of Records § 3b.223 Fees. (a) Fees will be charged for the direct cost of... practicable, self-service duplication of requested documents may also be made on duplicating machines by the... to determine if they fall within the disclosure requirements of this part; and (3) When the system...
... TELEVISION SERVICE Open Video Systems § 76.1511 Fees. An open video system operator may be subject to the... local franchising authority or other governmental entity, in lieu of the franchise fees permitted under... open video system operator or its affiliates, including all revenues received from subscribers and all...
... Health Insurance Providers Fee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of... insurance for United States health risks. This fee is imposed by section 9010 of the Patient Protection and... insurance for United States health risks. DATES: Written or electronic comments must be received by June 3...
... SERVICE OF PROCESS; RELEASE OF OFFICIAL INFORMATION IN LITIGATION; AND TESTIMONY BY NSA PERSONNEL AS WITNESSES § 93.6 Fees. Consistent with the guidelines in § 93.1(e), NSA may charge reasonable fees to... providing such information, and may include: (a) The costs of time expended by NSA employees to process and...
The cloud is a fairly new concept in computer science, altough almost everyone has been or is in contact with it on a regular basis. As more and more systems and applications are migrating from the desktop and into the cloud, keeping a high availability in cloud services is becoming increasingly important. Seeing that the cloud users are dependant on the cloud services being online and accessable via the Internet, creating fault tolerant cloud systems is key to keeping the cloud stable and tr...
... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Housing counseling fees. 214.313... HOUSING COUNSELING PROGRAM Program Administration § 214.313 Housing counseling fees. (a) Participating agencies may charge reasonable and customary fees for housing education and counseling services, as long as...
... 28.122 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY STANDARDS AND STANDARD... Standards Act Fees and Costs § 28.122 Fee for practical classing examination. The fee for the practical...
... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Royalty fees for ephemeral... BUSINESS ESTABLISHMENT SERVICES § 384.3 Royalty fees for ephemeral recordings. (a) Basic royalty rate. For... minimum fees shall be nonrefundable, but shall be fully creditable to royalty payments due under paragraph...
... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Fees charged by the Office. 297.206 Section 297.206 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PRIVACY PROCEDURES FOR PERSONNEL RECORDS Request for Access § 297.206 Fees charged by the Office. (a) No fees will be charged for search and review time...
... REGULATIONS FEES § 187.15 Payment of fees. (a) The fees of this part are payable to the Federal Aviation Administration by check, money order, wire transfers, draft, payable in U.S. currency and drawn on a U.S. bank, or by credit card payable in U.S. currency, prior to the provision of any service under this part. (b...
... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Fees and closing costs. 4001.122... Requirements and Underwriting Procedures § 4001.122 Fees and closing costs. (a) The holder or servicer of the... delinquency and default fees. (b) Allowable closing costs incurred in connection with the refinancing and...
... updating the cost components comprising the fee. Cost components shall be updated as follows: (1) Direct... determined by the cost study in Regulations Governing Fees For Service, 1 I.C.C. 2d 60 (1984), or subsequent... by total office costs for the office directly associated with user fee activity. Actual updating of...
... 46 Shipping 1 2010-10-01 2010-10-01 false Assessment and collection of fees. 9.14 Section 9.14 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC EXTRA COMPENSATION FOR OVERTIME SERVICES § 9.14 Assessment and collection of fees. Assessment and collection of fees...
... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Mask work fees. 211.3 Section... PROCEDURES MASK WORK PROTECTION § 211.3 Mask work fees. (a) Section 201.3 of this chapter prescribes the fees or charges established by the Register of Copyrights for services relating to mask works. (b) Section...
Donoue, George; Hoffman, Karla; Sherry, Lance; Ferguson, John; Kara, Abdul Qadar
The air transportation system is a significant driver of the U.S. economy, providing safe, affordable, and rapid transportation. During the past three decades airspace and airport capacity has not grown in step with demand for air transportation; the failure to increase capacity at the same rate as the growth in demand results in unreliable service and systemic delay. This report describes the results of an analysis of airline strategic decision-making that affects geographic access, economic access, and airline finances, extending the analysis of these factors using historic data (from Part 1 of the report). The Airline Schedule Optimization Model (ASOM) was used to evaluate how exogenous factors (passenger demand, airline operating costs, and airport capacity limits) affect geographic access (markets-served, scheduled flights, aircraft size), economic access (airfares), airline finances (profit), and air transportation efficiency (aircraft size). This analysis captures the impact of the implementation of airport capacity limits, as well as the effect of increased hedged fuel prices, which serve as a proxy for increased costs per flight that might occur if auctions or congestion pricing are imposed; also incorporated are demand elasticity curves based on historical data that provide information about how passenger demand is affected by airfare changes.
... securities received by a Bank in mixed cash letters. (2) To comply with the provisions of the Balanced Budget... accordance with the schedule of fees as hereafter published, subject to the availability of funds therefor...
Tasca, F A; Assunção, L B; Finotti, A R
Stormwater management (SWM) includes a wide range of services aimed at environmental protection, enhancement of water resources and flood control. Local governments are responsible for managing all these aspects within their jurisdiction, but they often present limitations in generating revenues. Thus, many municipalities have been seeking a dedicated funding source for these programs and practices. This publication provides a brief overview of current legal issues associated with stormwater funding focusing on the most used method: fees. It is a successful mechanism to fund legal obligations of municipalities; however, it must have a significant value to motivate the reduction of runoff. Through literature, we found stormwater fees in Australia, Brazil, Canada, Ecuador, France, Germany, Poland, South Africa and the United States (USA). France had the highest average monthly fee, but this financing experience was suspended in 2014. Brazil has the lowest fee by m², comparable to the US fee. While in Brazil overall SWM represents low priority investments, the USA represents one of the most evolved countries in stormwater funding practices. It was noticed by reviewing the international experience that charging stormwater fees is a successful mechanism to fund the legal obligations and environmental protection.
Meuffels, W.J.M.; Fleuren, H.A.; Cruijssen, F.C.A.M.; Dam, E.R.
Express service carriers provide time-guaranteed deliveries of parcels via a network consisting of nodes and hubs. In this, nodes take care of the collection and delivery of parcels, and hubs have the function to consolidate parcels in between the nodes. The tactical network design problem assigns
... OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General... by a non-Service physician, clinic, or hospital, in which case the record will be forwarded only to the physician, clinic, or hospital concerned. (3) When the service or document is requested by an...
Full Text Available In this paper we discuss several consequences of the freight transnational rail liner service on the rail corridor capacity. The Northern part of the IVth TEN-T corridor on Romanian territory has specific feature related to the passenger flows connecting important Romanian demographic and economic clusters, on one side, and on the other side, to its diagonal crossing aspect, from the Western border to the Constanta port, connecting the Central Europe countries to the Black Sea regions, which means that there are a lot of expectation in terms of this corridor rail capacity: this corridor will, be for a long time further, the single and first completed continuous upgraded and modernised rail corridor. Its utilization will necessarily be heterogeneously planned (meaning for passengers rapid trains and freight rapid trains, from domestic/internal market, but especially for external market of Romania. In this paper, we consider a simple mathematical model for the calculus of capacity in two different cases: for a homogeneous utilization, meaning that all trains have the same running speeds and for heterogeneous utilization, when the passenger trains have the higher speed and hence, the higher priority over the freight trains, even if some of them are freight transnational liner service. Special feature of liner rail service has to be considered (fixed schedule, no stops for passenger train advance. We draw several useful possible solutions to be considered in order to preserve the active corridor capacity, and to assure a smooth flow for the transnational liner services, which ultimately will enhance the rail attractiveness.
... fees. 25.53 Section 25.53 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) THE NATIONAL WILDLIFE REFUGE SYSTEM ADMINISTRATIVE PROVISIONS Fees and Charges § 25.53 Establishment of single visit entrance fees. Entrance fees established for single visit...
... requester of the identity of the private contractor who will perform the duplication services. The fee for... Activity Financial Control and Compliance Manual MUR Index Guideline for Presentation in Good Order Office...
... PROGRAM NATIONAL SECURITY AGENCY/CENTRAL SECURITY SERVICE (NSA/CSS) FREEDOM OF INFORMATION ACT PROGRAM... requested. There are no fees associated with a Privacy Act request, except as stated in NSA/CSS Regulation...
Zhao, Cuirong; Wang, Chao; Shen, Chengwu; Wang, Qian
Fee for services (FFS) is the prevailing method of payment in most Chinese public hospitals. Under this retrospective payment system, medical care providers are paid based on medical services and tend to over-treat to maximize their income, thereby contributing to rising medical costs and uncontrollable health expenditures to a large extent. Payment reform needs to be promptly implemented to move to a prospective payment plan. The diagnosis-related group (DRG)-based case-mix payment system, with its superior efficiency and containment of costs, has garnered increased attention and it represents a promising alternative. This article briefly describes the DRG-based case-mix payment system, it comparatively analyzes differences between FFS and case-mix funding systems, and it describes the implementation of DRGs in China. China's social and economic conditions differ across regions, so establishment of a national payment standard will take time and involve difficulties. No single method of provider payment is perfect. Measures to monitor and minimize the negative ethical implications and unintended effects of a DRG-based case-mix payment system are essential to ensuring the lasting social benefits of payment reform in Chinese public hospitals.
Martino, Steven C; Elliott, Marc N; Haviland, Amelia M; Saliba, Debra; Burkhart, Q; Kanouse, David E
To compare patient experiences and disparities for older adults with depressive symptoms in managed care (Medicare Advantage [MA]) versus Medicare Fee-for-Service (FFS). Data came from the 2010 Medicare CAHPS survey, to which 220,040 MA and 135,874 FFS enrollees aged 65 and older responded. Multivariate linear regression was used to test whether case-mix-adjusted associations between depressive symptoms and patient experience differed for beneficiaries in MA versus FFS. Dependent measures included four measures of beneficiaries' experiences with doctors (e.g., reports of doctor communication) and seven measures of beneficiaries' experiences with plans (e.g., customer service). Beneficiaries with depressive symptoms reported worse experiences than those without depressive symptoms regardless of coverage type. For measures assessing interactions with the plan (but not for measures assessing interactions with doctors), the disadvantage for beneficiaries with versus without depressive symptoms was larger in MA than in FFS. Disparities in care experienced by older Medicare beneficiaries with depressive symptoms tend to be more negative in managed care than in FFS. Efforts are needed to identify and address the barriers these beneficiaries encounter to help them better traverse the managed care environment. © Health Research and Educational Trust.
Miljković Strahinja D.
Full Text Available By accessing a franchising network at the moment of contracting a franchising agreement, a franchisor concedes the franchise package of rights to a franchisee. Making use of the benefits provided by business operations in a developed and market-recognizable franchise network, the franchisee has certain contractual obligations which are embodied in financial compensation to the franchisor. The franchisee is obliged to pay the franchisor certain fees, such as: 1 the initial franchise fee; 2 the continuing franchise fee and 3 the advertising fee. The initial franchise fee may be regarded as 'an entry fee', i.e. a ticket to a franchising network. The continual fee is an active revenue which allows a franchisor to finance the activities of rendering a wide range of services to a franchisee and, concurrently, to make profit. The advertising fee is paid to a franchisor by a franchisee for services rendered in the field of advertising business. In the author's opinion, the professional public in the country should pay considerable attention to this topic, with specific reference to the experiences of countries with developed franchising business practices.
... members of the public under this subpart: (1) Fee schedule. (i) Searching for records, per hour or... administrative time limit prescribed in subsection (a)(6) of the FOIA (i.e., 10 working days from receipt of... Water Commission, and mailed to the Finance and Accounting Office, United States Section, International...
Full Text Available
ENGLISH ABSTRACT: Operations Research is perceived to be on the verge of demise as a decision support tool in industry. However, this is not true, since the relevancy and interdisciplinary nature of Operations Research makes it an indispensable part of operations management. What should rather be asked is how Operations Research is introduced to undergraduate industrial engineering students. This paper reports on one of the optimisation initiatives undertaken for a service contractor using integer programming as part of a semester project. Although the model addresses specific business issues related to the contractor, it can easily be generalised for other applications.
AFRIKAANSE OPSOMMING: Operasionele Navorsing word geag as ’n kwynende besluitnemingsinstrument in die nywerheid. Dit is egter onwaar, aangesien die toepaslikheid en interdissiplinêre karakter van Operasionele Navorsing dit ‘n onmisbare rol laat speel in operasionele bestuur. Die vraag wat eerder gevra moet word is hoe Operasionele Navorsing aan voorgraadse bedryfsingenieurswesestudente aangebied word. Hierdie artikel doen verslag oor een van die optimerings-inisiatiewe wat as deel van ‘n semesterprojek vir ‘n diensverskaffer uitgevoer is, en maak van heeltal-programmering gebruik. Alhoewel die model kontrakteur-spesifieke besigheidsreëls aanspreek, kan dit maklik veralgemeen word vir wyer toepassing.
Full Text Available Ancillary services are critical to maintaining the safe and stable operation of power systems that contain a high penetration level of renewable energy resources. As a high-quality regulation resource, the regional integrated energy system (RIES with energy storage system (ESS can effectively adjust the non-negligible frequency offset caused by the renewable energy integration into the power system, and help solve the problem of power system frequency stability. In this paper, the optimization model aiming at regional integrated energy system as a participant in the regulation market based on pay-for-performance is established. Meanwhile YALMIP + CPLEX is used to simulate and analyze the total operating cost under different dispatch modes. This paper uses the actual operation model of the PJM regulation market to guide the optimal allocation of regulation resource in the regional integrated energy system, and provides a balance between the power trading revenue and regulation market revenue in order to achieve the maximum profit.
The application forms for the payment of education fees have been updated and are now available in the Admin e-guide (under the “Useful Documents” heading): Payment of education fees (including language course fees) – AC12A (form to be used by staff members recruited before 1 January 2007, with the exception of former “local staff”). Payment of education fees – AC12B (form to be used by staff members recruited on or after 1 January 2007, by fellows, scientific associates and guest professors and by former “local staff” whose contracts started before 1 January 2007). The Education Fees service will continue to accept the old forms until the end of the current academic year, i.e. until 31 August 2015. Members of the personnel are reminded that any false declaration or failure to declare information with a view to deceiving others or achieving a gain that would result in a financial loss for CERN or...
Tung, Yu-Chi; Chang, Guann-Ming; Cheng, Shou-Hsia
As healthcare spending continues to increase, reimbursement cuts have become 1 type of healthcare reform to contain costs. Little is known about the long-term impact of cuts in reimbursement, especially under a global budget cap with fee-for-service (FFS) reimbursement, on processes and outcomes of care. The FFS-based reimbursement cuts have been implemented since July 2002 in Taiwan. We examined the long-term association of FFS-based reimbursement cuts with trends in processes and outcomes of care for stroke. We analyzed all 411,487 patients with stroke admitted to general acute care hospitals in Taiwan during the period 1997 to 2010 through Taiwan's National Health Insurance Research Database. We used a quasi-experimental design with quarterly measures of healthcare utilization and outcomes and used segmented autoregressive integrated moving average models for the analysis. After accounting for secular trends and other confounders, the implementation of the FFS-based reimbursement cuts was associated with trend changes in computed tomography/magnetic resonance imaging scanning (0.31% per quarter; P=0.013), antiplatelet/anticoagulant use (-0.20% per quarter; Pprocesses and outcomes of care over time. However, the reimbursement cuts from the FFS-based global budget cap are associated with trend changes in processes and outcomes of care for stroke. The FFS-based reimbursement cuts may have long-term positive and negative associations with stroke care. © 2014 American Heart Association, Inc.
Burdy, G; Dalban-Sillas, B; Leclerc, C; Bonnaventure, F; Roullet Audy, J-C; Frileux, P
The aim of this study was to perform a detailed analysis of income and expense in a department of general surgery in a French hospital under the new system of funding based on a "fee-for-service" principle. All hospital stays of year 2006 were analysed retrospectively. The conditions of admission (elective vs. emergency), the principal diagnosis, and surgical procedures were examined. We determined hospital costs and the reimbursement for every admission. One thousand nine hundred and eighty-five hospitalizations generated an income of 8Meuros with a deficit of 1.3Meuros. The 775 elective admissions generated 50% of the income and 13% of the deficit (178,562euros). Seven hundred and forty-nine emergency admissions generated 45% of the income and 82% of deficit (1.1Meuros). Four hundred and sixty-one admissions for endoscopy generated 5% of the income and 5% of the deficit (67,249euros). Hospital stays of less than two days (the minimum duration of stay for total reimbursement) caused a loss of 122,624euros. Length of hospital stay below the lower limit caused a loss of 42,850euros. Elective surgical activity in digestive surgery can generate a balanced budget provided the length of hospital stay is reduced to the minimum, sometimes to the detriment of patient comfort. Emergency admissions result in a large deficit between cost and reimbursement; this fact may lead hospitals to avoid emergency activity in the future unless appropriate remedial measures are taken.
Human Resources Division
The Human Resources Division wishes to remind members of the personnel that, according to Article R IV 1.13 of the Staff Regulations, the amount of any financial benefit linked to education fees received from a source outside the Organization is deducted from the benefits paid by the Organization. Similarly, housing benefit, allowances or any other contributions towards the cost of accommodation shall also be deducted from the amount paid by CERN. The Human Resources Division also wishes to draw the attention of members of the personnel to the provisions of Article R IV 1.24 (Journey expenses) which state: 'Three times per period of two years the Organization shall reimburse the journey expenses in respect of each child covered by the provisions of Article R A 8.01 a) for the return trip between the duty station of the member of the personnel and the educational establishment.' Members of the personnel are reminded that the ticket or proof of payment of th...
Wilk, Adam S; Evans, Leigh C; Jones, David K
Six states that have rejected the Patient Protection and Affordable Care Act's (ACA) Medicaid expansion nonetheless extended the primary care "fee bump," by which the federal government increased Medicaid fees for primary care services up to 100 percent of Medicare fees during 2013-14. We conducted semistructured interviews with leaders in five of these states, as well as in three comparison states, to examine why they would continue a provision of the ACA that moderately expands access at significant state expense while rejecting the expansion and its large federal match, focusing on relevant economic, political, and procedural factors. We found that fee bump extension proposals were more successful where they were dissociated from major national policy debates, actionable with the input of relatively few stakeholder entities, and well aligned with preexisting policy-making structures and decision trends. Republican proposals to cap or reduce federal funding for Medicaid, if enacted, would compel states to contain program costs. In this context, states' established decision-making processes for updating Medicaid fee schedules, which we elucidate in this study, may shape the future of the Medicaid program. Copyright © 2018 by Duke University Press 2018.
... following: (1) Personnel compensation and benefits, budget code series 1100 (excluding codes 1151 and 1152... 2200. (4) Rental, communications, utilities, budget code series 2300. (5) Printing and reproduction, budget code series 2400. (6) Contractual services, budget code series 2500. (7) Supplies and materials...
Rampa, Sankeerth; Wilson, Fernando A; Wang, Hongmei; Wehbi, Nizar K; Smith, Lynette; Allareddy, Veerasathpurush
Hospital-based emergency department (ED) visits for dental problems have been on the rise. The objectives of this study are to provide estimates of hospital-based ED visits with dental conditions in New York State and to examine the impact of Medicaid reimbursement fee for dental services on the utilization of EDs with dental conditions. New York State Emergency Department Database for the year 2009-2013 and Health Resources and Services Administration's Area Health Resource File were used. All ED visits with diagnosis for dental conditions were selected for analysis. The present study found a total of 325,354 ED visits with dental conditions. The mean age of patient was 32.4 years. A majority of ED visits were made by those aged 25-44 years (49%). Whites comprised 52.1% of ED visits. Proportion of Medicaid increased from 22% (in 2009) to 41.3% (in 2013). For Medicaid patients, the mean ED charges and aggregated ED charges were $811.4 and $88.1 million, respectively. Eleven counties had fewer than 4 dentists per 10,000 population in New York State. High-risk groups identified from the study are those aged 25-44 years, uninsured, covered by Medicaid and private insurance, and residing in low-income areas. The study highlights the need for increased Medicaid reimbursement for dentists and improves access to preventive dental care especially for the vulnerable groups. Copyright © 2017 Elsevier Inc. All rights reserved.
.... NARA-2013-045] RIN 3095-AB81 Fees AGENCY: National Archives and Records Administration (NARA). ACTION... records fees regulation to remove the payment policy section, which sets out methods of payment. This is... practical or helpful to keep a general statement of methods of payment in the regulation on fees. The...
... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 51 [REG-112805-10] RIN 1545-BJ39 Branded Prescription Drug Fee; Correction AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice..., August 6, 2012 (77 FR 46653) relating to the branded prescription drug fee imposed by the Affordable Care...
... POSTAL SERVICE 39 CFR Part 111 Clarification of the Post Office Box Lock Replacement Fee AGENCY... of the lock replacement fee for Post Office TM boxes to reflect current practice. DATES: January 2... Standards for Domestic Mailing Services (75 FR 39477-39492). The applicability of the lock replacement fee...
... fees and/or fair market value. The Forest Service waives the collection of fees otherwise required... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Waiver of fees and/or fair market value. 223.280 Section 223.280 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF...
U.S. Department of Health & Human Services — The CMS Records Schedule provides disposition authorizations approved by the National Archives and Records Administration (NARA) for CMS program-related records...
... MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY... United States Cotton Standards Act Fees and Costs § 28.118 When no fee collected for new certificate or...
Koroukian, Siran M; Basu, Jayasree; Schiltz, Nicholas K; Navale, Suparna; Bakaki, Paul M; Warner, David F; Dor, Avi; Given, Charles W; Stange, Kurt C
Recent studies suggest that managed care enrollees (MCEs) and fee-for-service beneficiaries (FFSBs) have become similar in case-mix over time; but comparisons of health outcomes have yielded mixed results. To examine changes in differentials between MCEs and FFSBs both in case-mix and health outcomes over time. Temporal study of the linked Health and Retirement Study (HRS) and Medicare data, comparing case-mix and health outcomes between MCEs and FFSBs across 3 time periods: 1992-1998, 1999-2004, and 2005-2011. We used multivariable analysis, stratified by, and pooled across the study periods. The unit of analysis was the person-wave (n=167,204). HRS participants who were also enrolled in Medicare. Outcome measures included self-reported fair/poor health, 2-year self-rated worse health, and 2-year mortality. Our main covariate was a composite measure of multimorbidity (MM), MM0-MM3, defined as the co-occurrence of chronic conditions, functional limitations, and/or geriatric syndromes. The case-mix differential between MCEs and FFSBs persisted over time. Results from multivariable models on the pooled data and incorporating interaction terms between managed care status and study period indicated that MCEs and FFSBs were as likely to die within 2 years from the HRS interview (P=0.073). This likelihood remained unchanged across the study periods. However, MCEs were more likely than FFSBs to report fair/poor health in the third study period (change in probability for the interaction term: 0.024, P=0.008), but less likely to rate their health worse in the last 2 years, albeit at borderline significance (change in probability: -0.021, P=0.059). Despite the persistence of selection bias, the differential in self-reported fair/poor status between MCEs and FFSBs seems to be closing over time.
Kim, Dong-Jin; Kim, Ho-Sook; Oh, Minkyung; Kim, Eun-Young; Shin, Jae-Gook
Although studies assessing the cost effectiveness of genotype-guided warfarin dosing for the management of atrial fibrillation, deep vein thrombosis, and pulmonary embolism have been reported, no publications have addressed genotype-guided warfarin therapy in mechanical heart valve replacement (MHVR) patients or genotype-guided warfarin therapy under the fee-for-service (FFS) insurance system. The aim of this study was to evaluate the cost effectiveness of genotype-guided warfarin dosing in patients with MHVR under the FFS system from the Korea healthcare sector perspective. A decision-analytic Markov model was developed to evaluate the cost effectiveness of genotype-guided warfarin dosing compared with standard dosing. Estimates of clinical adverse event rates and health state utilities were derived from the published literature. The outcome measure was the incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY). One-way and probabilistic sensitivity analyses were performed to explore the range of plausible results. In a base-case analysis, genotype-guided warfarin dosing was associated with marginally higher QALYs than standard warfarin dosing (6.088 vs. 6.083, respectively), at a slightly higher cost (US$6.8) (year 2016 values). The ICER was US$1356.2 per QALY gained. In probabilistic sensitivity analysis, there was an 82.7% probability that genotype-guided dosing was dominant compared with standard dosing, and a 99.8% probability that it was cost effective at a willingness-to-pay threshold of US$50,000 per QALY gained. Compared with only standard warfarin therapy, genotype-guided warfarin dosing was cost effective in MHVR patients under the FFS insurance system.
The methodology for establishing a fee for federal spent fuel storage and disposal services is explained along with a presentation of the cost centers and cost data used to calculate the fee. Results of the initial fee calculation and the attendant sensitivity studies are also reviewed. The current status of the fee update is presented. The content of the proposed contract for federal services is briefly reviewed
... holiday inspection service shall be paid by the interested party making the application for such service... inclusive. If so required by the Inspection program personnel, such fees and charges shall be paid in...
Keathley, William C.
A Cost Plus Award Fee contract is the best procurement vehicle for the high-tech, one-of-a-kind, development projects that constitute most of NASA'S projects. The use of this type of contract requires more government and contractor effort than any other forms of contracts. An award fee contract is described as an arrangement whereby the government periodically awards a fee consistent with the cost, schedule and technical performance that is achieved by a contractor during a preset period with preset award fee pools. It's the only contracting method where both the government and contractor goals are closely linked. It also has a built-in mechanism to conveniently alter and emphasize program events in order to current external and internal situations. The award fee process also demands good communication between government and contractor participants.
Economides, George; Philippopoulos, Apostolis; Sakkas, Stelios
This paper studies the aggregate and distributional implications of introducing tuition fees for public education services into a tax system with income and consumption taxes. The setup is a neoclassical growth model where agents differ in capital holdings. We show that the introduction of tuition fees (a) improves individual incentives to work and/or save and (b) can be both efficient and equitable. The focus is on the role of tuition fees as an extra price and how this affects private incen...
One of the objectives of managed care organizations (MCOs) has been to reduce the rate of growth of health care expenditures, including that of physician fees. Yet, due to a lack of data, no one has been able to determine whether MCOs have been successful in encouraging the growth of price competition in the market for physician services in order to slow the growth in physician fees. This study uses a unique, national-level data set to determine what factors influenced the physician fees that MCOs negotiated during the 1990-92 period. The most influential characteristics were physician supply and managed care penetration, which suggest that the introduction of competition into the health care market was an effective force in reducing physician fees.
Monte Carlo simulation to analyze the cost-benefit of radioactive seed localization versus wire localization for breast-conserving surgery in fee-for-service health care systems compared with accountable care organizations.
Loving, Vilert A; Edwards, David B; Roche, Kevin T; Steele, Joseph R; Sapareto, Stephen A; Byrum, Stephanie C; Schomer, Donald F
In breast-conserving surgery for nonpalpable breast cancers, surgical reexcision rates are lower with radioactive seed localization (RSL) than wire localization. We evaluated the cost-benefit of switching from wire localization to RSL in two competing payment systems: a fee-for-service (FFS) system and a bundled payment system, which is typical for accountable care organizations. A Monte Carlo simulation was developed to compare the cost-benefit of RSL and wire localization. Equipment utilization, procedural workflows, and regulatory overhead differentiate the cost between RSL and wire localization. To define a distribution of possible cost scenarios, the simulation randomly varied cost drivers within fixed ranges determined by hospital data, published literature, and expert input. Each scenario was replicated 1000 times using the pseudorandom number generator within Microsoft Excel, and results were analyzed for convergence. In a bundled payment system, RSL reduced total health care cost per patient relative to wire localization by an average of $115, translating into increased facility margin. In an FFS system, RSL reduced total health care cost per patient relative to wire localization by an average of $595 but resulted in decreased facility margin because of fewer surgeries. In a bundled payment system, RSL results in a modest reduction of cost per patient over wire localization and slightly increased margin. A fee-for-service system suffers moderate loss of revenue per patient with RSL, largely due to lower reexcision rates. The fee-for-service system creates a significant financial disincentive for providers to use RSL, although it improves clinical outcomes and reduces total health care costs.
Castro, Eleni de Araújo Sales; de Almondes, Katie Moraes
Shift work schedules are biological standpoint worse because compel the body to anticipate periods of wakefulness and sleep and thus eventually cause a disruption of biological rhythms. The objective of this study is to evaluate the sleep pattern and decision-making in physicians working in mobile units of emergency attention undergoing day shift and rotating shift. The study included 26 physicians. The instruments utilized were a sociodemographic questionnaire, the Pittsburgh Sleep Quality Index, the Sleep Habits Questionnaire, the Epworth Sleepiness Scale and Chronotype Identification Questionnaire of Horne-Ostberg, the Iowa Gambling Task (IGT) and hypothetical scenarios of decision-making created according to the Policy-Capturing Technique. For inclusion and exclusion criteria, the participants answered the Chalder Fatigue Scale, the Beck Anxiety Inventory, the Beck Depression Inventory and the Inventory of Stress Symptoms for adults of Lipp. It was found good sleep quality for physicians on day shift schedule and bad sleep quality for physicians on rotating shift schedule. The IGT measure showed no impairment in decision-making, but the hypothetical scenarios revealed impairment decision-making during the shift for both schedules. Good sleep quality was related to a better performance in decision-making. Good sleep quality seems to influence a better performance in decision-making.
Magalhaes, Marcus V.; Fraga, Eder T. [PETROBRAS, Rio de Janeiro, RJ (Brazil); Shah, Nilay [Imperial College, London (United Kingdom)
This work addresses the refinery scheduling problem using mathematical programming techniques. The solution adopted was to decompose the entire refinery model into a crude oil scheduling and a product scheduling problem. The envelope for the crude oil scheduling problem is composed of a terminal, a pipeline and the crude area of a refinery, including the crude distillation units. The solution method adopted includes a decomposition technique based on the topology of the system. The envelope for the product scheduling comprises all tanks, process units and products found in a refinery. Once crude scheduling decisions are Also available the product scheduling is solved using a rolling horizon algorithm. All models were tested with real data from PETROBRAS' REFAP refinery, located in Canoas, Southern Brazil. (author)
Anafi, Patricia; Mprah, Wisdom K; Jackson, Allen M; Jacobson, Janelle J; Torres, Christopher M; Crow, Brent M; O'Rourke, Kathleen M
In 2008, the government of Ghana implemented a national user fee maternal care exemption policy through the National Health Insurance Scheme to improve financial access to maternal health services and reduce maternal as well as perinatal deaths. Although evidence shows that there has been some success with this initiative, there are still issues relating to cost of care to beneficiaries of the initiative. A qualitative study, comprising 12 focus group discussions and 6 interviews, was conducted with 90 women in six selected urban neighborhoods in Accra, Ghana, to examine users' perspectives regarding the implementation of this policy initiative. Findings showed that direct cost of delivery care services was entirely free, but costs related to antenatal care services and indirect costs related to delivery care still limit the use of hospital-based midwifery and obstetric care. There was also misunderstanding about the initiative due to misinformation created by the government through the media.We recommend that issues related to both direct and indirect costs of antenatal and delivery care provided in public health-care facilities must be addressed to eliminate some of the lingering barriers relating to cost hindering the smooth operation and sustainability of the maternal care fee exemption policy.
Murugiah, Karthik; Wang, Yun; Desai, Nihar R; Spatz, Erica S; Nuti, Sudhakar V; Dreyer, Rachel P; Krumholz, Harlan M
The aim of this study was to assess trends in hospitalizations and outcomes for Takotsubo cardiomyopathy (TTC). There is a paucity of nationally representative data on trends in short- and long-term outcomes for patients with TTC. The authors examined hospitalization rates; in-hospital, 30-day, and 1-year mortality; and all-cause 30-day readmission for Medicare fee-for-service beneficiaries with principal and secondary diagnoses of TTC from 2007 to 2012. Hospitalizations for principal or secondary diagnosis of TTC increased from 5.7 per 100,000 person-years in 2007 to 17.4 in 2012 (p for trend < 0.001). Patients were predominantly women and of white race. For principal TTC, in-hospital, 30-day, and 1-year mortality was 1.3% (95% confidence interval [CI]: 1.1% to 1.6%), 2.5% (95% CI: 2.2% to 2.8%), and 6.9% (95% CI: 6.4% to 7.5%), and the 30-day readmission rate was 11.6% (95% CI: 10.9% to 12.3%). For secondary TTC, in-hospital, 30-day, and 1-year mortality was 3% (95% CI: 2.7% to 3.3%), 4.7% (95% CI: 4.4% to 5.1%), and 11.4% (95% CI: 10.8% to 11.9%), and the 30-day readmission rate was 15.8% (95% CI: 15.1% to 16.4%). Over time, there was no change in mortality or readmission rate for both cohorts. Patients ≥85 years of age had higher in-hospital, 30-day, and 1-year mortality and 30-day readmission rates. Among patients with principal TTC, male and nonwhite patients had higher 1-year mortality than their counterparts, whereas in those with secondary TTC, mortality was worse at all 3 time points. Nonwhite patients had higher 30-day readmission rates for both cohorts. Hospitalization rates for TTC are increasing, but short- and long-term outcomes have not changed. At 1 year, 14 in 15 patients with principal TTC and 8 in 9 with secondary TTC are alive. Older, male, and nonwhite patients have worse outcomes. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Reserve Bank of Australia
The Reserve Bank has conducted a survey on bank fees each year since 1997. In 2009 growth in fee income increased slightly from recent years though it was again slower than growth in banksâ€™ balance sheets. Growth in fee income was higher for businesses than for households. Banks reacted to the financial crisis by competing more aggressively for deposit funding which resulted in total fee income from deposit accounts falling, and repricing loan products which contributed to an increase in fe...
... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 51 [TD 9544] RIN 1545-BK34 Branded... branded prescription drugs. This fee was enacted by section 9008 of the Patient Protection and Affordable...: This correction is effective on September 28, 2011 and applies to any fee on branded prescription drug...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0381] Generic Drug User Fee; Public Meeting; Correction AGENCY: Food and Drug Administration, HHS. ACTION... meeting entitled ``Generic Drug User Fee.'' The document published with an inadvertent error in the Dates...
... Health Insurance Providers Fee; Correction AGENCY: Internal Revenue Service (IRS), Treasury. ACTION... guidance on the annual fee imposed on covered entities engaged in the business of providing health insurance for United States health risks. FOR FURTHER INFORMATION CONTACT: Charles J. Langley, Jr. at (202...
..., and Approval of Mining Products AGENCY: Mine Safety and Health Administration (MSHA), Labor. ACTION..., evaluating, and approving mining products as provided by 30 CFR part 5. MSHA charges applicants a fee to... materials manufactured for use in the mining industry. The new fee schedule, effective January 1, 2011, is...
... Preference § 170.917 Can tribes receive direct payment of tribal employment taxes or fees? This section... payment schedule. Tribes may consider requesting direct payment of tribal employment taxes or fees from... 25 Indians 1 2010-04-01 2010-04-01 false Can tribes receive direct payment of tribal employment...
McClellan, Sean R; Panattoni, Laura; Chan, Albert S; Tai-Seale, Ming
Few studies have examined the association between patient-initiated electronic messaging (e-messaging) and clinical outcomes in fee-for-service settings. To estimate the association between patient-initiated e-messages and quality of care among patients with diabetes and hypertension. Longitudinal observational study from 2009 to 2013. In March 2011, the medical group eliminated a $60/year patient user fee for e-messaging and established a provider payment of $3-5 per patient-initiated e-message. Quality of care for patients initiating e-messages was compared before and after March 2011, relative to nonmessaging patients. Propensity score weighting accounted for differences between e-messaging and nonmessaging patients in generalized estimating equations. Large multispecialty practice in California compensating providers' fee-for-service. Patients with diabetes (N=4232) or hypertension (N=15,463) who had activated their online portal but not e-messaged before e-messaging became free. Quality of care included HEDIS-based process measures for hemoglobin (Hb) A1c, blood pressure, low-density lipoprotein (LDL), nephropathy, and retinopathy tests, and outcome measures for HbA1c, blood pressure, and LDL. E-messaging was measured as counts of patient-initiated e-message threads sent to providers. Patients were categorized into quartiles by e-messaging frequency. The probability of annually completing indicated tests increased by 1%-7% for e-messaging patients, depending on the outcome and e-messaging frequency. E-messaging was associated with small improvements in HbA1c and LDL for some patients with diabetes. Patient-initiated e-messaging may increase the likelihood of completing recommended tests, but may not be sufficient to improve clinical outcomes for most patients with diabetes or hypertension without additional interventions.
Barthe, B; Messing, K; Abbas, L
Workers' attempts to accommodate family needs may be considered illegitimate in the paid work sphere. Their attempts at work-family balancing (WFB) in that sphere can remain invisible, even when those attempts require considerable energy. Since identification of WFB strategies can potentially lead to suggestions to improve management practices, we report an attempt to find them in the work sphere. 14 care aides in a Québec residence for seniors and 2~schedule managers were recruited. Qualitative ergonomic analysis was employed. 24 hours observation; interviews of nursing and human resources staff; qualitative ergonomic analysis by two researchers; feedback collected from meetings with management and union. Strategies for schedule choice were compared between care aides with heavier vs. lighter family responsibilities. For workers with heavier family responsibilities, choice of work schedules was almost entirely conditioned by family considerations, leaving little leeway to manage workers' own health protection. Family constraints affected activity at work, and strategies for handling family constraints could potentially be affected by changes in work organization. Managers should encourage full discussion of work-family balancing strategies if they wish to adapt their working conditions to the workers, and ergonomists should include this balancing as a facet of work activity, despite possible negative consequences.
... royalties and direct use fees. 202.353 Section 202.353 Mineral Resources MINERALS MANAGEMENT SERVICE... standards for reporting and paying royalties and direct use fees. (a) For geothermal resources used to... a royalty or direct use fee is due on Form MMS-2014 in: (1) Millions of Btu to the nearest whole...
... MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) ORGANIC FOODS PRODUCTION ACT PROVISIONS NATIONAL ORGANIC PROGRAM Administrative Fees § 205.640 Fees and other charges for accreditation. Fees and other charges equal as nearly as may be to the cost of the...
... 7 Agriculture 3 2010-01-01 2010-01-01 false Fees for holiday or other nonworktime. 58.39 Section... Dairy Products Fees and Charges § 58.39 Fees for holiday or other nonworktime. If an applicant requests that inspection or grading service be performed on a holiday, Saturday, or Sunday or in excess of each...
... 42 Public Health 2 2010-10-01 2010-10-01 false Fees for the cost of advisory opinions. 411.375... Relationships Between Physicians and Entities Furnishing Designated Health Services § 411.375 Fees for the cost... revised the amount of the initial fee in a program issuance, in which case, the requestor must include the...
... generic drug user fees. New legislation would be required for FDA to establish and collect user fees for... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0381] Generic Drug User Fee; Public Meeting; Request for Comments AGENCY: Food and Drug Administration, HHS...
... THE CENSUS § 50.5 Fee structure for age search and citizenship information. Type of service Fee... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Fee structure for age search and citizenship information. 50.5 Section 50.5 Commerce and Foreign Trade Regulations Relating to Commerce and...
... and witness fees? 221.47 Section 221.47 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE... requirements for subpoenas and witness fees? (a) Request for subpoena. (1) Except as provided in paragraph (a... return it to the party on whose behalf the subpoena was served. (c) Witness fees. (1) A party who...
... of fees. 260.81 Section 260.81 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE, NATIONAL... Certification of Establishments and Fishery Products for Human Consumption Fees and Charges § 260.81 Readjustment and increase in hourly rates of fees. (a) When Federal Pay Act increases occur, the hourly rates...
... 7 Agriculture 14 2010-01-01 2009-01-01 true Payment of fees and insurance premiums. 1962.29... Security § 1962.29 Payment of fees and insurance premiums. (a) Fees. (1) Security instruments. Borrowers... the service cannot be obtained without cost. (b) Insurance premiums. County Supervisors are authorized...
... 30 Mineral Resources 2 2010-07-01 2010-07-01 false How do I calculate royalty or fees due on... Resources § 206.356 How do I calculate royalty or fees due on geothermal resources I use for direct use... revised fees schedules using the following formulas: ER02MY07.004 Where: RV = Royalty due as a function of...
... Customs Clearance and Delivery Fee International Reply Coupons International Business Reply Service The... * * * * * International Business Reply Service (382) [For each country that offers International Business Reply Service... POSTAL SERVICE 39 CFR Part 20 International Mail: Proposed Product Rate and Fee Changes AGENCY...
Prodinger, Birgit; Scheel-Sailer, Anke; Escorpizo, Reuben; Stucki, Gerold
Clinical assessment schedule (CLAS) is a core part of the ICF-based implementation of functioning reporting across health conditions and along the continuum of care. The Physical and Rehabilitation Medicine Section and Board of the European Union of Medical Specialists (UEMS PRM) workshop held in January 2016 aimed to develop and specify a CLAS within the context of rehabilitation services. UEMS PRM Workshop in Nottwil, Switzerland, January 2016. PRM physicians representatives from 12 European countries, as well as Israel and Japan, mostly delegates of UEMS PRM Section and Board, and experts with other rehabilitation professional backgrounds. Participants were divided into 6 working groups and asked to specify what functioning aspects would be essential to document using the available ICF sets for the identified rehabilitation services contained in the newly developed service classification (ICSO-R): acute, post-acute and long-term rehabilitation services. The 7 ICF Generic and 23 Rehabilitation Set categories were confirmed as well as specific health condition categories for acute rehabilitation services (mobile team), for postacute rehabilitation services (general outpatient rehabilitation, musculoskeletal and neurological rehabilitation, as well as specialized SCI rehabilitation), and for long-term rehabilitation services (day clinic and rehabilitation provided in the community). While general principles of the CLAS were defined, the need to align the CLAS for a specific service, as well as across services along the continuum of care was highlighted. All groups deliberated on this topic; however, no conclusive statement was presented yet. The groups recognized a need for a systematic effort to identify data collection tools currently used. CLASs will serve in the future to ensure that functioning information is systematically and consistently collected across services, and thus respond also to various global reports and initiatives which stress the need for
Kuiper, A.; Mandjes, M.
Appointment schedules aim at achieving a proper balance between the conflicting interests of the service provider and her clients: a primary objective of the service provider is to fully utilize her available time, whereas clients want to avoid excessive waiting times. Setting up schedules that
... tribes to utilize in calculating the amount of fees to pay, and to advise tribes of the potential...-annually; to provide for operations to calculate fees based on the gaming operation's fiscal year rather... competition, employment, investment, productivity, innovation, or the ability of the enterprises, to compete...
This article discusses the impact of client fees for family planning (FP) services on cost recovery and level of user services in developing countries. The UN Population Fund reports that developing country governments currently pay 75% of the costs of FP programs. Donors contribute 15%, and clients pay 10%. Current pressures are on FP services to broaden and improve their scope, while user demand is increasing. Program managers should consider the program's need for funds and the clients' willingness to pay. Clients are willing to pay about 1% of their income for contraception. A study of sterilization acceptance in Mexico finds that the average monthly case load declined by 10% after the 1st price increase from $43 to $55 and declined by 58% after the 2nd price increase to $60. Fewer low-income clients requested sterilization. A CEMOPLAF study in Ecuador finds that in three price increase situations the number of clients seeking services declined, but the economic mix of clients remained about the same. The decline was 20% in the group with a 20% price increase and 26% in the 40% increase group. In setting fees, the first need is to determine unit costs. The Futures Group International recommends considering political, regulatory, and institutional constraints for charging fees; priorities for revenue use; protection for poor clients; and monitoring of money collection and expenditure. Management Sciences for Health emphasizes consideration of the reasons for collection of fees, client affordability, and client perception of quality issues. Sliding scales can be used to protect poor clients. Charging fees for laboratory services can subsidize poor clients. A Bangladesh program operated a restaurant and catering service in order to subsidize FP services. Colombia's PROFAMILIA sells medical and surgical services and a social marketing program in order to expand clinics.
Warfare, Naval Sea Systems Command Acquisition Cycle Time : Defining the Problem David Tate, Institute for Defense Analyses Schedule Analytics Jennifer...research was comprised of the following high- level steps : Identify and review primary data sources 1...research. However, detailed reviews of the OMB IT Dashboard data revealed that schedule data is highly aggregated. Program start date and program end date
... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Royalty fees for the digital... SATELLITE DIGITAL AUDIO RADIO SERVICES Preexisting Subscription Services § 382.2 Royalty fees for the... monthly royalty fee for the public performance of sound recordings pursuant to 17 U.S.C. 114(d)(2) and the...
... deciding whether to use the fixed-fee or cost-reimbursable contracting method? 302-12.109 Section 302-12... Services Company § 302-12.109 What must we consider in deciding whether to use the fixed-fee or cost...-fee or cost-reimbursable contracting method: (a) Risk of alternative methods. Under a fixed fee...
... Branded Prescription Drug Fee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of proposed... issue of the Federal Register, the IRS is issuing temporary regulations relating to the branded... business of manufacturing or importing certain branded prescription drugs. The text of the temporary...
by clients have forced Quantity Surveying firms into competition with ... Furthermore, 43% of consulting engineering firms were discounting their fees at a rate of .... Quantity. Surveying services are also offered in the fields of dispute resolution,.
Full Text Available Minimum notary fees are the questionable regulatory feature of Romanian notary system. Classic latin notary system to which it belongs Romanian notary system is the most regulated and most restrictive of the four existing notary systems in the European Union. Notary fees are set by law. Notary is an unusual market activity when assessing service provision is not during but after the quality transpires. Minimum notary fees militate to ensure an adequate quality of notary services at an acceptable cost. In contrast, the liberalization of notary fees aims to increase competition among service providers to encourage professionals to act according to the principle of cost-effectiveness, increase quality or to offer innovative services practice the lowest prices. The purpose of writing is to assess the impact of price liberalization in Romania with reference to me deregulated Dutch notary system and similar systems similar to Romanian, the Belgian system and German system.
... the Commission may also be obtained by accessing its Internet server ( http://www.usitc.gov ). Persons... professional services. Written Submissions: Interested parties are invited to submit written statements and...
... Sanitation Inspections of Cruise Ships AGENCY: Centers for Disease Control and Prevention (CDC), Department... schedule for sanitation inspections of passenger cruise ships by VSP was first published in the Federal...), announces fees for vessel sanitation inspections for Fiscal Year (FY) 2013. These inspections are conducted...
... Sanitation Inspections of Cruise Ships AGENCY: Centers for Disease Control and Prevention (CDC), Department... diseases. The fee schedule for sanitation inspections of passenger cruise ships inspected under VSP was... sanitation inspections. These inspections are conducted by CDC's Vessel Sanitation Program (VSP). VSP assists...
... Law 112-29, 125 Stat. at 316-17. Section 10 also establishes certain procedural requirements for... optimal patent application inventory. Additionally, the fee schedule in this final rule will advance key... foundation of American economic growth and national competitiveness. Economic growth in advanced economies...
... Fee International Reply Coupons International Business Reply Service Registered Mail TM Return Receipt....3a to change the price to $2.20.] * * * * * 382 International Business Reply Service * * * * * 382.4... POSTAL SERVICE 39 CFR Part 20 International Mail: Proposed Changes in Prices and Fees AGENCY...
Fischer, Richard B.
Defines key terms and discusses things to consider when setting fees for a continuing education program. These include (1) the organization's philosophy and mission, (2) certain key variables, (3) pricing strategy options, and (4) the test of reasonableness. (CH)
Members of the personnel are reminded that only school fees from educational establishments recognized by local legislation are reimbursed by the Organization. Human Resources Division Tel. 72862/74474
General Services Administration — GSA eLibrary (formerly Schedules e-Library) is the online source for the latest contract award information for: GSA Schedules; Department of Veterans Affairs (VA)...
Manchikanti, Laxmaiah; Singh, Vijay; Caraway, David L; Benyamin, Ramsin M; Hirsch, Joshua A
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
Sciammarella, Susan; Fernandes, Maria Isabel; McKay, Devin
Reference desk scheduling is one of the most challenging tasks in the organizational structure of an academic library. The ability to turn this challenge into a workable and effective function lies with the scheduler and indirectly the cooperation of all librarians scheduled for reference desk service. It is the scheduler's sensitivity to such…
... 10 Energy 1 2010-01-01 2010-01-01 false Fees. 9.85 Section 9.85 Energy NUCLEAR REGULATORY COMMISSION PUBLIC RECORDS Privacy Act Regulations Fees § 9.85 Fees. Fees shall not be charged for search or... available for review, although fees may be charged for additional copies. Fees established under 31 U.S.C...
... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Royalty fees for public... SUBSCRIPTION SERVICES § 383.3 Royalty fees for public performances of sound recordings and the making of... regulations for all years 2007 and earlier. Such fee shall be recoupable and credited against royalties due in...
... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Royalty fees for the public... Preexisting Satellite Digital Audio Radio Services § 382.12 Royalty fees for the public performance of sound recordings and the making of ephemeral recordings. (a) In general. The monthly royalty fee to be paid by a...
... DEPARTMENT OF THE INTERIOR National Indian Gaming Commission 2013 Final Fee Rate and Fingerprint Fees AGENCY: National Indian Gaming Commission, Interior. ACTION: Notice. SUMMARY: Notice is hereby... annual fee rates of 0.00% for tier 1 and 0.072% (.00072) for tier 2. These rates shall apply to all...
The level of fee remissions offered by private schools bears upon the scope for relying on private schools to provide public benefit. Analyses of education voucher systems have generally ignored the possibility that they will partially crowd out school-financed fee remissions. Moreover, variation in fee remissions between private schools may be…
General Services Administration — Schedule Sales Query presents sales volume figures as reported to GSA by contractors. The reports are generated as quarterly reports for the current year and the...
Office of Personnel Management — Used to store information on Federal employees in the Senior Executive Service (SES) and appointed employees in the Schedule C System. Every four years, just after...
... NATIONAL INDIAN GAMING COMMISSION Fee Rate AGENCY: National Indian Gaming Commission. ACTION... Commission has adopted preliminary annual fee rates of 0.00% for tier 1 and 0.074% (.00074) for tier 2 for... part 518, the preliminary fee rate on class II revenues for calendar year 2011 shall be one-half of the...
... DEPARTMENT OF THE INTERIOR National Indian Gaming Commission Fee Rate AGENCY: National Indian..., that the National Indian Gaming Commission has adopted its 2013 preliminary annual fee rates of 0.00... self-regulation under 25 CFR part 518, the 2013 preliminary fee rate on Class II revenues shall be one...
... NATIONAL INDIAN GAMING COMMISSION Fee Rate AGENCY: National Indian Gaming Commission. ACTION... Commission has adopted preliminary annual fee rates of 0.00% for tier 1 and 0.060% (.00060) for tier 2 for... part 518, the preliminary fee rate on class II revenues for calendar year 2010 shall be one-half of the...
... NATIONAL INDIAN GAMING COMMISSION Fee Rate AGENCY: National Indian Gaming Commission. ACTION... Commission has adopted preliminary annual fee rates of 0.00% for tier 1 and 0.074% (.00074) for tier 2 for... part 518, the preliminary fee rate on class II revenues for calendar year 2012 shall be one-half of the...
... NATIONAL INDIAN GAMING COMMISSION Fee Rate AGENCY: National Indian Gaming Commission. ACTION... Commission has adopted final annual fee rates of 0.00% for tier 1 and 0.060% (.00060) for tier 2 for calendar... 518, the preliminary fee rate on class II revenues for calendar year 2010 shall be one-half of the...
... NATIONAL INDIAN GAMING COMMISSION Fee Rate AGENCY: National Indian Gaming Commission. ACTION... Commission has adopted final annual fee rates of 0.00% for tier 1 and 0.074% (.00074) for tier 2 for calendar... 518, the final fee rate on class II revenues for calendar year 2011 shall be one-half of the annual...
... NATIONAL INDIAN GAMING COMMISSION Fee Rate AGENCY: National Indian Gaming Commission. ACTION... Commission has adopted final annual fee rates of 0.00% for tier 1 and 0.074% (.00074) for tier 2 for calendar... 518, the final fee rate on class II revenues for calendar year 2012 shall be one-half of the annual...
J.M. Bowker; Gary Green; Dan MuCullom; Ken Cordell
Federal lands provide many recreation facilities and services. On some of these lands, fees have been and are currently being charged for certain recreational services. This study examined the attitudes of users, between 1995 and 2003, towards recreation user fees on public lands. Data from the National Survey on Recreation and the Environment on recreational...
... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false How are child development center... HOMELAND SECURITY PERSONNEL CHILD DEVELOPMENT SERVICES General § 55.11 How are child development center fees established? (a) Fees for the provision of services at child development centers shall be set by...
....00 processing fee. (d) All services in this section will incur a billing surcharge per invoice... RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE NATIONAL AGRICULTURAL LIBRARY FEES FOR LOANS AND COPYING § 505....00, is billed as a direct cost recovery based on charges to the library by the billing vendor...
Your attention is drawn to the 20 km distance limit set in Article R A 8.01 of the Staff Regulations, namely, that only accommodation fees of students attending an educational establishment which is more than 20 km from the place of residence and the duty station of the member of the personnel are reimbursed by the Organization, subject to the percentage rate and maximum amounts set out in this article and in Administrative Circular N° 12. Human Resources Division Tel : 72862 / 74474
Your attention is drawn to the 20 km distance limit set in Article R A 8.01 of the Staff Regulations, namely, that only accommodation fees of students attending an educational establishment which is more than 20 km from the place of residence and the duty station of the member of the personnel are reimbursed by the Organization, subject to the percentage rate and maximum amounts set out in this article and in Administrative Circular N° 12. Human Resources Division Tel: 72862 / 74474
Hermenier , Fabien; Henrio , Ludovic
International audience; In an Infrastructure As A Service (IaaS) cloud, the scheduler deploys VMs to servers according to service level objectives (SLOs). Clients and service providers must both trust the infrastructure. In particular they must be sure that the VM scheduler takes decisions that are consistent with its advertised behaviour. The difficulties to master every theoretical and practical aspects of a VM scheduler implementation leads however to faulty behaviours that break SLOs and ...
Full Text Available Objectives: Existing research has documented that shiftwork consequences may depend on the shift system parameters. Fast rotating systems (1–3 shifts of the same kind in a row and day work have been found to be less disruptive biologically and socially than slower rotating systems and afternoon and night work. The aim of this study was to compare day workers and shift workers of different systems in terms of rotation speed and shifts worked with regard to work–family and family–work positive and negative spillover, marital communication style, job satisfaction and health. Material and Methods: Employees (N = 168 of the maintenance workshops of transportation service working different shift systems (day shift, weekly rotating 2 and 3‑shift system, and fast rotating 3-shift system participated in the study. They completed the Work– Family Spillover Questionnaire, Marital Communication Questionnaire, Minnesota Job Satisfaction Questionnaire and the Physical Health Questionnaire (a part of the Standard Shiftwork Index. Results: The workers of quicker rotating 3-shift systems reported significantly higher scores of family-to-work facilitation (F(3, 165 = 4.175, p = 0.007 and a higher level of constructive style of marital communication (Engagement F(3, 165 = 2.761, p = 0.044 than the workers of slower rotating 2-shift systems. There were no differences between the groups of workers with regard to health and job satisfaction. Conclusions: A higher level of work–family facilitation and a more constructive style of marital communication were found among the workers of faster rotating 3-shift system when compared to the workers of a slower rotating 2-shift system (afternoon, night. This may indicate that the fast rotating shift system in contrary to the slower rotating one is more friendly for the work and family domains and for the relationship between them. Int J Occup Med Environ Health 2017;30(1:121–131
Iskra-Golec, Irena; Smith, Lawrence; Wilczek-Rużyczka, Ewa; Siemiginowska, Patrycja; Wątroba, Joanna
Existing research has documented that shiftwork consequences may depend on the shift system parameters. Fast rotating systems (1-3 shifts of the same kind in a row) and day work have been found to be less disruptive biologically and socially than slower rotating systems and afternoon and night work. The aim of this study was to compare day workers and shift workers of different systems in terms of rotation speed and shifts worked with regard to work-family and family-work positive and negative spillover, marital communication style, job satisfaction and health. Employees (N = 168) of the maintenance workshops of transportation service working different shift systems (day shift, weekly rotating 2 and 3‑shift system, and fast rotating 3-shift system) participated in the study. They completed the Work- Family Spillover Questionnaire, Marital Communication Questionnaire, Minnesota Job Satisfaction Questionnaire and the Physical Health Questionnaire (a part of the Standard Shiftwork Index). The workers of quicker rotating 3-shift systems reported significantly higher scores of family-to-work facilitation (F(3, 165) = 4.175, p = 0.007) and a higher level of constructive style of marital communication (Engagement F(3, 165) = 2.761, p = 0.044) than the workers of slower rotating 2-shift systems. There were no differences between the groups of workers with regard to health and job satisfaction. A higher level of work-family facilitation and a more constructive style of marital communication were found among the workers of faster rotating 3-shift system when compared to the workers of a slower rotating 2-shift system (afternoon, night). This may indicate that the fast rotating shift system in contrary to the slower rotating one is more friendly for the work and family domains and for the relationship between them. Int J Occup Med Environ Health 2017;30(1):121-131. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.
United States. Bonneville Power Administration.
This schedule is available for the contract purchase of Firm Power to be used within the Pacific Northwest (PNW). Priority Firm (PF) Power may be purchased by public bodies, cooperatives, and Federal agencies for resale to ultimate consumers, for direct consumption, and for Construction, Test and Start-Up, and Station Service. Rates in this schedule are in effect beginning October 1, 2006, and apply to purchases under requirements Firm Power sales contracts for a three-year period. The Slice Product is only available for public bodies and cooperatives who have signed Slice contracts for the FY 2002-2011 period. Utilities participating in the Residential Exchange Program (REP) under Section 5(c) of the Northwest Power Act may purchase Priority Firm Power pursuant to the Residential Exchange Program. Rates under contracts that contain charges that escalate based on BPA's Priority Firm Power rates shall be based on the three-year rates listed in this rate schedule in addition to applicable transmission charges. This rate schedule supersedes the PF-02 rate schedule, which went into effect October 1, 2001. Sales under the PF-07 rate schedule are subject to BPA's 2007 General Rate Schedule Provisions (2007 GRSPs). Products available under this rate schedule are defined in the 2007 GRSPs. For sales under this rate schedule, bills shall be rendered and payments due pursuant to BPA's 2007 GRSPs and billing process.
... used in the gaming industry and the Commission believes the clarification will eliminate concern that... DEPARTMENT OF THE INTERIOR National Indian Gaming Commission 25 CFR Part 514 Fees AGENCY: National Indian Gaming Commission, Interior. ACTION: Final rule. SUMMARY: The National Indian Gaming Commission...
... used in the gaming industry and the Commission believes the clarification will eliminate concern that... DEPARTMENT OF THE INTERIOR National Indian Gaming Commission 25 CFR Part 514 RIN 3141-AA40 Fees AGENCY: National Indian Gaming Commission, Interior. ACTION: Proposed rule. SUMMARY: The National Indian...
In order to answer regular enquiries on this subject, members of the personnel are reminded that only school fees from educational establishments recognized as such by the competent authorities of the Member State concerned are reimbursed by the Organization. Human Resources Division Tel. 72862/74474
Larco Martinelli, J.A.; Wiers, V.C.S.; Fransoo, J.C.
Time is the most critical resource at the disposal of schedulers. Hence, an adequate management of time from the schedulers may impact positively on the scheduler’s productivity and responsiveness to uncertain scheduling environments. This paper presents a field study of how schedulers make use of
Title 44 United States Code, ''Public Printing and Documents,'' regulations cited in the General Services Administration's (GSA) ''Federal Information Resources Management Regulations'' (FIRMR), Part 201-9, ''Creation, Maintenance, and Use of Records,'' and regulation issued by the National Archives and Records Administration (NARA) in 36 CFR Chapter XII, Subchapter B, ''Records Management,'' require each agency to prepare and issue a comprehensive records disposition schedule that contains the NARA approved records disposition schedules for records unique to the agency and contains the NARA's General Records Schedules for records common to several or all agencies. The approved records disposition schedules specify the appropriate duration of retention and the final disposition for records created or maintained by the NRC. NUREG-0910, Rev. 2, contains ''NRC's Comprehensive Records Disposition Schedule,'' and the original authorized approved citation numbers issued by NARA. Rev. 2 totally reorganizes the records schedules from a functional arrangement to an arrangement by the host office. A subject index and a conversion table have also been developed for the NRC schedules to allow staff to identify the new schedule numbers easily and to improve their ability to locate applicable schedules
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-6051-N] Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee Amount... period entitled ``Medicare, Medicaid, and Children's Health Insurance Programs; Additional Screening...
David N. Bengston; David P. Fan
The Recreation Fee Demonstration Program (RFDP) is a pilot program authorized by Congress in 1996. The RFDP allows the U.S. Department of Agriculture Forest Service, and the United States Department of the Interior Park Service, Bureau of Land Management, and Fish and Wildlife Service to experiment with new or increased fees at up to 100 recreation sites per agency....
... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Fees. 253.16 Section 253.16 Wildlife and... Fees. (a) Application fee. The Division will not accept an application without the application fee. Fifty percent of the application fee is fully earned at application acceptance, and is not refundable...
Nabyonga Orem, Juliet; Mugisha, Frederick; Kirunga, Christine; Macq, Jean; Criel, Bart
Inadequate health financing is one of the major challenges health systems in low-income countries currently face. Health financing reforms are being implemented with an increasing interest in policies that abolish user fees. Data from three nationally representative surveys conducted in Uganda in 1999/2000, 2002/03 and 2005/06 were used to investigate the impact of user fee abolition on the attainment of universal coverage objectives. An increase in illness reporting was noted over the three surveys, especially among the poorer quintiles. An increase in utilization was registered in the period immediately following the abolition of user fees and was most pronounced in the poorest quintile. Overall, there was an increase in utilization in both public and private health care delivery sectors, but only at clinic and health centre level, not at hospitals. Our study shows important changes in health-care-seeking behaviour. In 2002/03, the poorest population quintile started using government health centres more often than private clinics whereas in 1999/2000 private clinics were the main source of health care. The richest quintile has increasingly used private clinics. Overall, it appears that the private sector remains a significant source of health care. Following abolition of user fees, we note an increase in the use of lower levels of care with subsequent reductions in use of hospitals. Total annual average expenditures on health per household remained fairly stable between the 1999/2000 and 2002/03 surveys. There was, however, an increase of US$21 in expenditure between the 2002/03 and 2005/06 surveys. Abolition of user fees improved access to health services and efficiency in utilization. On the negative side is the fact that financial protection is yet to be achieved. Out-of-pocket expenditure remains high and mainly affects the poorer population quintiles. A dual system seems to have emerged where wealthier population groups are switching to the private sector.
... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Estimated cost, base fee... Provisions and Clauses 2452.216-70 Estimated cost, base fee and award fee. As prescribed in 2416.406(e)(1), insert the following clause in all cost-plus-award-fee contracts: Estimated Cost, Base Fee and Award Fee...
... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Base Fee and Award Fee... Base Fee and Award Fee Proposal. As prescribed in 416.470, insert the following provision: Base Fee and Award Proposal (FEB 1988) For the purpose of this solicitation, offerors shall propose a base fee of...
Gravelle, Hugh; Waterson, Michael
This paper analyzes the effects on the litigation process of alternative contracts between plaintiffs and their lawyers. Three contracts are compared: normal (hourly fee), contingent mark up fees, and contingent share contracts. The focus is on the first two, a recent change in English law governing legal fees providing the motivation. The influences of the contract type on the acceptance of settlement offers, the settlement probability, the accident probability, the demand for trials, and th...
... Section 600.518 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND... documentary proof to the Assistant Administrator that the foreign nation under which the vessel is registered... are agreed upon, NOAA will present a bill for collection as the documentary demand for payment to the...
.../category-table.html . 2. The following acronyms are used in some of the tables: DART-Dose Adequacy Response... 2,409 applicant-initiated; excludes DART, pre-registration conference, Rapid Response review, DNT... insufficient funds, the Agency may try to make the transfer up to two times. All paper-based payments should be...
.... technician, administrative support, operator, programmer, database administrator, or action officer). (2... devices, and memory capacity used in the actual computer configuration. Only this CPU rate shall be...
... understanding of the operations or activities of the government and is not primarily in the commercial interest... 31th day following the day on which the bill was sent. Interest will be at the rate prescribed in 31 U... the time of clerical personnel at a rate of $4.75 per quarter hour. (6) When a request has been made...
... Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... officers in charge of testing laboratories to all persons from whom payment of fees and costs under the... order of “Agricultural Marketing Service, USDA.” [35 FR 8532, June 3, 1970. Redesignated at 46 FR 30075...
... 103.7(b) which relate to applications to the district director or service center director for... expenditures, such as essential medical expenses, or expenses for clothing, laundry, and child care, to the... officer in support of a fee waiver request are subject to verification by the Service. (i) In requiring...
... DEVELOPMENT PROJECT-BASED VOUCHER (PBV) PROGRAM Payment to Owner § 983.354 Other fees and charges. (a) Meals... require the tenant or family members to pay charges for meals or supportive services. Non-payment of such... services be included in the calculation of reasonable rent. Non-payment of such charges is grounds for...
... DEVELOPMENT SECTION 8 TENANT BASED ASSISTANCE: HOUSING CHOICE VOUCHER PROGRAM Rent and Housing Assistance Payment § 982.510 Other fees and charges. (a) The cost of meals or supportive services may not be included... meals or supportive services. Non-payment of such charges is not grounds for termination of tenancy. (c...
... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 51 [REG-112805-10] RIN 1545-BJ39 Branded Prescription Drug Fee; Hearing AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of... document provides notice of public hearing on proposed regulations relating to the branded prescription...
Forster, J.D.; Cohen, S.
After introducing the financial analyses, discount rates, and interest rates involved, the study discusses existing government guidelines for establishing charges for any service provided by the government to be paid by users of those services. Three current government user charges are analyzed including specifically their interest rate policies and how these charges provide precedent for the spent fuel acceptance and disposal fee: uranium enrichment services, the sale of electric power, and the delivery of experiments to orbit by the NASA Space Shuttle. The current DOE policy regarding this storage and disposal fee is stated and discussed. Features of this policy include: the full government cost is borne by users of the services provided; the fee is established and due in full at the time of spent fuel delivery; and the fee is adjusted when spent fuel is transferred from the AFR to the repository. Four evaluation criteria for use in analyzing the applications of discount rates in the spent fuel acceptance fee calculation are discussed. Three outstanding issues are discussed
Dizon, Matthew P; Linos, Eleni; Arron, Sarah T; Hills, Nancy K; Chren, Mary-Margaret
The Institute of Medicine has identified serious deficiencies in the measurement of cancer care quality, including the effects on quality of life and patient experience. Moreover, comparisons of quality in Veterans Affairs Medical Centers (VA) and other sites are timely now that many Veterans can choose where to seek care. To compare quality of ambulatory surgical care for keratinocyte carcinoma (KC) between a VA and fee-for-service (FFS) practice, we used unique clinical and patient-reported data from a comparative effectiveness study. Patients were enrolled in 1999-2000 and followed for a median of 7.2 years. The practices differed in a few process measures (e.g., median time between biopsy and treatment was 7.5 days longer at VA) but there were no substantial or consistent differences in clinical outcomes or a broad range of patient-reported outcomes. For example, 5-year tumor recurrence rates were equally low (3.6% [2.3-5.5] at VA and 3.4% [2.3-5.1] at FFS), and similar proportions of patients reported overall satisfaction at one year (78% at VA and 80% at FFS, P = 0.69). These results suggest that the quality of care for KC can be compared comprehensively in different health care systems, and suggest that quality of care for KC was similar at a VA and FFS setting.
... 28.117 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY STANDARDS AND STANDARD... Standards Act Fees and Costs § 28.117 Fee for new memorandum or certificate. For each new memorandum or...
....119 Section 28.119 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY STANDARDS AND... Cotton Standards Act Fees and Costs § 28.119 Fee when request for classification is withdrawn. When the...
... Section 28.116 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY STANDARDS AND STANDARD... Standards Act Fees and Costs § 28.116 Amounts of fees for classification; exemption. (a) For the...
... royalty fees and statements of account. 382.13 Section 382.13 Patents, Trademarks, and Copyrights COPYRIGHT ROYALTY BOARD, LIBRARY OF CONGRESS RATES AND TERMS FOR STATUTORY LICENSES RATES AND TERMS FOR... Audio Radio Services § 382.13 Terms for making payment of royalty fees and statements of account. (a...
... § 105-50.303 Cost basis in lieu of fees. Where the cost of services is to be recovered on other than a... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Cost basis in lieu of fees. 105-50.303 Section 105-50.303 Public Contracts and Property Management Federal Property...
... architect-engineer fee limitation. 836.606-73 Section 836.606-73 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS SPECIAL CATEGORIES OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Architect-Engineer Services 836.606-73 Application of 6 percent architect-engineer fee limitation...
... legislation would be required for FDA to establish and collect user fees for generic drugs, and FDA is... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0381] Generic Drug User Fee; Public Meeting; Request for Comments AGENCY: Food and Drug Administration, HHS...
The aim of this research was to analyse the effect of user fee removal in rural ... Conclusion: Although user fees matter, to a degree, service quality is a relatively more important contributor to the promotion ... been required to purchase supplies – bleach, to sterilise ... decision-making at the individual and household level,.
... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Industrial Funding Fee and Sales Reporting. 552.238-74 Section 552.238-74 Federal Acquisition Regulations System GENERAL SERVICES... shall include the Industrial Funding Fee (IFF). The Contractor shall maintain a consistent accounting...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0656] Animal Drug User Fee Act; Reopening of the Comment Period AGENCY: Food and Drug Administration, HHS... notice, FDA requested comments on the Animal Drug User Fee Act (ADUFA) program to date and solicited...
..., 2011)), provide that only attorneys, certified public accountants, enrolled agents, and registered tax... Fee To Take the Registered Tax Return Preparer Competency Examination AGENCY: Internal Revenue Service... regulations. The final regulations redesignate rules pertaining to fees for obtaining a preparer tax...
Harper, Richard W; Nasis, Arthur; Sundararajan, Vijaya
Rising health care costs above inflation are placing serious strains on the sustainability of the Australian Medicare system in its current structure. The Medicare Benefits Schedule (MBS), which lists rebates payable to patients for private medical services provided on a fee-for-service basis, is the cornerstone of the Australian health care system. Introduced in the 1980s, the MBS has changed little despite major advances in the evidence base for the practice of cardiology. We outline how we believe sensible changes to the MBS listings for four cardiac services--invasive coronary angiography, computed tomography coronary angiography, stress testing and percutaneous coronary intervention--would improve the clinical practice of cardiology and save substantial amounts of taxpayer money.
Because of the importance of air transportation scheduling, the emergence of small aircraft and the vision of future fuel-efficient aircraft, this thesis has focused on the study of aircraft scheduling and network design involving multiple types of aircraft and flight services. It develops models and solution algorithms for the schedule design problem and analyzes the computational results. First, based on the current development of small aircraft and on-demand flight services, this thesis expands a business model for integrating on-demand flight services with the traditional scheduled flight services. This thesis proposes a three-step approach to the design of aircraft schedules and networks from scratch under the model. In the first step, both a frequency assignment model for scheduled flights that incorporates a passenger path choice model and a frequency assignment model for on-demand flights that incorporates a passenger mode choice model are created. In the second step, a rough fleet assignment model that determines a set of flight legs, each of which is assigned an aircraft type and a rough departure time is constructed. In the third step, a timetable model that determines an exact departure time for each flight leg is developed. Based on the models proposed in the three steps, this thesis creates schedule design instances that involve almost all the major airports and markets in the United States. The instances of the frequency assignment model created in this thesis are large-scale non-convex mixed-integer programming problems, and this dissertation develops an overall network structure and proposes iterative algorithms for solving these instances. The instances of both the rough fleet assignment model and the timetable model created in this thesis are large-scale mixed-integer programming problems, and this dissertation develops subproblem schemes for solving these instances. Based on these solution algorithms, this dissertation also presents
Kortbeek, Nikky; Zonderland, Maartje E.; Braaksma, Aleida; Vliegen, Ingrid M. H.; Boucherie, Richard J.; Litvak, Nelly; Hans, Erwin W.
We present a methodology to design appointment systems for outpatient clinics and diagnostic facilities that offer both walk-in and scheduled service. The developed blueprint for the appointment schedule prescribes the number of appointments to plan per day and the moment on the day to schedule the