In developing public procurement policy, governments are often concerned not only with value for money but also with promoting their social and environmental objectives.
However, imposing social and ...environmental requirements makes it harder for some suppliers to participate in public procurement. EC law thus limits the ability of national governments to implement such policies. But how should the balance be struck between these trade concerns and the desire of national governments to use procurement as a policy tool? And should the EC even harness Member States' procurement power to EC-wide objectives, such as green energy policy? Despite the new provisions included in the EC's new (2004) procurement directives, important issues remain unresolved. This volume focusses on new issues in the field, notably the innovative provisions in the new directives, new academic thinking and areas neglected in the debate, such as the impact of EC law on the CSR policies of private utilities.
The US healthcare system is rapidly moving toward rewarding value. Recent legislation, such as the Affordable Care Act and the Medicare Access and CHIP Reauthorization Act, solidified the role of ...value-based payment in Medicare. Many private insurers are following Medicare's lead. Much of the policy attention has been on programs such as accountable care organizations and bundled payments; yet, value-based purchasing (VBP) or pay-for-performance, defined as providers being paid fee-for-service with payment adjustments up or down based on value metrics, remains a core element of value payment in Medicare Access and CHIP Reauthorization Act and will likely remain so for the foreseeable future. This review article summarizes the current state of VBP programs and provides analysis of the strengths, weaknesses, and opportunities for the future. Multiple inpatient and outpatient VBP programs have been implemented and evaluated; the impact of those programs has been marginal. Opportunities to enhance the performance of VBP programs include improving the quality measurement science, strengthening both the size and design of incentives, reducing health disparities, establishing broad outcome measurement, choosing appropriate comparison targets, and determining the optimal role of VBP relative to alternative payment models. VBP programs will play a significant role in healthcare delivery for years to come, and they serve as an opportunity for providers to build the infrastructure needed for value-oriented care.
This study analyzes the perceptions which induce customers to purchase over the Internet, testing the moderating effect of e-purchasing experience. We distinguish between two groups: (1) potential ...e-customers, who are considering making their first e-purchase, and (2) experienced e-customers, who have made at least one e-purchase and are thinking about continuing to do so. The perceptions that induce individuals to purchase online for the first time may not be the same as those that produce repurchasing behavior. Our findings demonstrate that customer behavior does not remain stable because the experience acquired from past e-purchases means that perceptions evolve. The relationships between perceptions of e-commerce change with purchasing experience, whilst the influence of Internet experience is stable for all users. The implications are especially interesting for e-commerce providers whose business models depend on e-customer behavior.
Background: Emergency changes to food assistance programs can prevent widening nutrition disparities during societal shocks such as pandemics. Understanding whether and how COVID altered the ...nutritional quality of food assistance program participant food purchases can inform future emergency food response policies. We described the relationship between the shock of COVID and Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC) participant food purchases. Methods: We used a longitudinal dataset from October 2019 to December 2020 of transaction data from a large grocery store chain with 496 stores in North Carolina. This dataset includes all items purchased and payment type(s) used in transactions. WIC participants were identified by using WIC as a payment type. Our sample includes >1.2 million shopper-month observations from 187,005 unique WIC shoppers. We grouped food items into nutritionally relevant food groups. We used fixed effects models adjusted for time-varying covariates with a variable for pre/post March 2020 interacted with a linear time trend. We used robust standard errors. Outcomes were calories/shopper/day and share (%) of total calories purchased from each food group. Results: Among WIC shoppers, mean calories per day from fruits, vegetables, nuts and legumes (FVNL) were higher after March 2020 (+7.2 kcal/day); however, the share of total calories purchased from FVNL decreased (-0.6%) (both p<0.01). Similar trends were observed for FVNL without added salt, sugar, or fat. Mean calories per day from sugar-sweetened beverages (SSB) were higher after March 2020 (+37.4 kcal/day), as was the share of total calories purchased from SSBs (+0.5%) (both p<0.01). The calories per day from junk foods increased after March 2020 (+60.1 kcal/day, p<0.01) and the share of total calories from junk foods remained stable at about 25% of total calories purchased. Conclusions: Understanding how purchasing patterns shift during societal shocks is important in designing emergency food policies that reduce existing diet-related disease disparities. Emergency food policies that support nutrient-dense food groups may be particularly needed under these conditions.
La investigación sobre el comportamiento del consumidor deportivo en Bogotá se basó en una metodología cualitativa-exploratoria, utilizando el Customer Journey Map (CJM) en sesiones grupales y ...observación en tiendas deportivas. El resultado fue el Modelo de Estaciones del Consumidor Deportivo (MODE), compuesto por tres estados. El primero destaca la avalancha de información del entorno, donde influencias como redes sociales y estilo de vida dominan la decisión final. En el segundo estado, se aborda la decisión de pre-compra, enfocándose en el reconocimiento de la necesidad y la evaluación de alternativas. Finalmente, el tercer estado refleja la respuesta del consumidor, que puede ser positiva o negativa. El MODE destaca la complejidad del proceso de decisión de compra del consumidor deportivo, donde factores emocionales juegan un papel crucial. Este enfoque cualitativo permitió una profunda comprensión de las experiencias y conceptos clave que influyen en las decisiones de compra, proporcionando una perspectiva valiosa para estrategias de marketing y ventas en el sector deportivo en Bogotá. La investigación revela la importancia de abordar no solo los aspectos racionales, sino también las emociones en la estrategia de comercialización de productos deportivos.
Since the 2010s, all levels of governments in Canada have gradually initiated social procurement as a policy tool to further their social values and political agendas. Social enterprises of various ...shapes and sizes across the country have served as partners in the execution of those agendas. Selling Social examines the experiences of these enterprises in social procurement and social purchasing. Selling Social presents the findings of a three-year Canadian research project detailing experiences of work integration social enterprises (WISEs) selling their goods and services to organizational purchasers, including governments, businesses, and non-profit organizations. Drawing on survey findings and interviews, the book explores a diverse group of social enterprises from across Canada, showcasing their successes and their challenges based on real-life examples to aid social enterprises that are considering this path. The book emphasizes the importance of including social and environmental considerations in procurement and purchasing decisions, particularly at larger scales and through public policy. In doing so, Selling Social extends the understanding of social enterprises beyond their social and economic outcomes and into the broader movement towards responsible procurement and purchasing.
BACKGROUND/OBJECTIVES
Launched in October 2018, Medicareʼs Skilled Nursing Facility Value‐Based Purchasing (SNF VBP) program mandates financial penalties for SNFs with high 30‐day readmission rates. ...Our objective was to identify characteristics of SNFs associated with provider performance under the program.
DESIGN
Retrospective cross‐sectional analysis using Nursing Home Compare data for the 2019 SNF VBP. Facility‐level regressions examined the relationship between structural characteristics (nursing home size, rurality, profit status, hospital affiliation, region, and Star Ratings) and patient characteristics (neighborhood income, race/ethnicity, dual eligibility, disability, and frailty) and facility performance.
SETTING
US Medicare.
PARTICIPANTS
A total of 14 558 SNFs.
MEASUREMENTS
The 2019 SNF VBP performance scores and penalties.
RESULTS
Nationally, 72% (10 436) of SNFs were penalized; 21% (2996) received the maximum penalty of 1.98%. In multivariate analyses, rural SNFs were less likely to be penalized (odds ratio OR = 0.85; 95% confidence interval CI = 0.78‐0.92; P < .001; vs urban), while small SNFs were more likely to be penalized (≤70 beds: OR = 1.28; 95% CI = 1.15‐1.42; P < .001; 71‐120 beds: OR = 1.15; 95% CI = 1.05‐1.26; P = .003; vs >120 beds). SNFs with lower nurse staffing had higher odds of penalties (low: OR = 1.15; 95% CI = 1.03‐1.27; P = .010; vs high); nonprofit and government‐owned SNFs had lower odds of penalties (OR = 0.79; 95% CI = 0.72‐0.87; P < .001; government: OR = 0.72; 95% CI = 0.61‐0.84; P < .001; vs for profit); and SNFs with higher Star Ratings had lower odds of penalties (5 stars: OR = 0.47; 95% CI = 0.40‐0.54; P < .001; vs 1 star). In terms of patient population, SNFs located in low‐income ZIP codes (OR = 1.17; 95% CI = 1.03‐1.34; P = .019) or serving a high proportion of frail patients (OR = 1.39; 95% CI = 1.21‐1.60; P < .001) were more likely to be penalized than other SNFs. SNFs with high proportions of dual, black, Hispanic, or disabled patients did not have higher odds of penalization.
CONCLUSION
Structural and patient characteristics of SNFs may significantly impact provider performance under the SNF VBP. These findings have implications for policy makers and clinical leaders seeking to improve quality and avoid unintended consequences with VBP in SNFs. J Am Geriatr Soc 68:826–834, 2020
In this article, we examine how purchasing's strategic participation influences supply management activities via the choice of appropriate operational and strategic criteria. Specifically, the study ...focuses on supplier selection and monitoring ongoing supplier performance evaluation based on operational and strategic criteria. A combination of choosing appropriate supplier selection criteria and monitoring supplier performance ensures that the benefits of purchasing's participation in strategic planning translate into better purchasing performance of cost, quality, delivery, flexibility and innovation. We test the hypotheses using survey data collected from manufacturing companies in the US by means of a path model. Our results provide support for the tenet that purchasing's participation in strategic planning influences purchasing performance directly as well as through the mediating effects of supplier selection criteria and supplier performance evaluation. We discuss the theoretical and managerial implications of the findings and propose directions for further research.
The increasing interest in sustainable consumption has lead several scholars to investigate the determinants that drive the consumption of organic food. Most of this research is based on consumers' ...self‐reports of their purchasing behavior by exploring declared behavioral intentions. There is a lack of understanding concerning the determinants of organic food consumption based on actual purchasing behavior. To fill this gap, this study is based on a combination of actual purchasing data and self‐reported data from a sample of 79 Italian consumers. The determinants of organic food consumption are explored by analyzing the effects of subjective norms, attitude, perceived behavioral control, intention to buy, organic knowledge, and health consciousness on actual purchasing behavior. Our results suggest that actual purchasing behavior is positively influenced by intention to buy and negatively by subjective norms. Although attitude towards buying organics is positively affected by health consciousness and perceived behavioral control, consumer knowledge about organics is found to influence purchase intentions. Theoretical and managerial implications, along with avenues for future research, are discussed.
PDF
