Objective
To examine whether hospitals' experience in a prior payment model incentivizing care coordination is associated with their decision to adopt a new payment program for a care delivery ...innovation.
Data Sources
Data were sourced from Medicare fee‐for‐service claims in 2017, the list of participants in Bundled Payment for Care Improvement initiatives (BPCI and BPCI‐Advanced), the list of hospitals approved for Acute Hospital Care at Home (AHCaH) between November 2020 and August 2022, and the American Hospital Association Survey.
Study Design
Retrospective cohort study. Hospitals' adoption of AHCaH was measured as a function of hospitals' BPCI experiences. Hospitals' BPCI experiences were categorized into five mutually exclusive groups: (1) direct BPCI participation, (2) indirect participation through physician group practices (PGPs) after dropout, (3) indirect participation through PGPs only, (4) dropout only, and (5) no BPCI exposure.
Data Collection/Extraction Methods
All data are derived from pre‐existing sources. General acute hospitals eligible for both BPCI initiatives and AHCaH are included.
Principal Findings
Of 3248 hospitals included in the sample, 7% adopted AHCaH as of August 2022. Hospitals with direct BPCI experience had the highest adoption rate (17.7%), followed by those with indirect participation through BPCI physicians after dropout (11.8%), while those with no exposure to BPCI were least likely to participate (3.2%). Hospitals that adopted AHCaH were more likely to be located in communities where more peer hospitals participated in the program (median 10.8% vs. 0%). After controlling for covariates, the association of the adoption of AHCaH with indirect participation through physicians after dropout was as strong as with early BPCI adopter hospitals (average marginal effect: 5.9 vs. 6.2 pp, p < 0.05), but the other categories were not.
Conclusions
Hospitals that participated in the bundled payment model either directly or indirectly PGPs were more likely to adopt a care delivery innovation requiring similar competence in the next period.
Prior research has shown that credit cards increase spending behavior as measured by the willingness to pay (WTP) or basket value. This research aims to replicate the credit card effect and to extend ...this effect to mobile payments. In four empirical studies, of which three online studies and one lab study (total n = 692), we manipulated payment methods (i.e., cash, credit cards, and mobile payments) and measured spending behavior (i.e., WTP and basket value). Across four studies, we did not replicate the credit card effect on either measure of spending behavior, suggesting the effect in the literature may be inflated or may have been fading away. A meta-analysis of the relevant literature revealed the expected credit card effect but also showed that the credit card effect has become weaker through the years and that this effect is contingent on the location of data collection. We also did not find evidence that the credit card effect extends to mobile payments on either measure of spending behavior in the three online studies. However, we found a significant difference between mobile payments and cash on the basket value measure (but not for the WTP measure) in the lab study. This paper also explored whether the pain of payment or payment convenience may be a mechanism underlying the relationship between payment methods and spending behavior. Although the pain of payment tended to be lower and the payment convenience tended to be higher for mobile payments, these effects did not translate into more spending behaviors.
•Prior research has shown that credit cards increase spending behavior as measured by the WTP or basket value.•We study how mobile payments (and credit cards) versus cash affect the WTP and basket value.•The credit card effect has become weaker over the years.•The credit card effect cannot be extended to mobile payments in most cases.
Este estudo exploratório visa entender quem se beneficia com programas de parcelamento e perdão de dívidas tributárias. Para tanto, tem-se como objetivo de pesquisa identificar diferenças ...econômico-financeiras entre empresas que aderiram e que não aderiram ao Programa Especial de Regularização Tributária (PERT). Os resultados demonstram que as firmas que aderiram ao PERT possuem maiores volumes de ativos e são mais endividadas. Com base na teoria moderna de estrutura de capital, firmas com estas características tendem a ser mais poderosas, uma vez que podem usar de sua condição a fim de obter mais fontes de financiamento e crescer mais. Estatísticas também indicaram que o PERT pode ter beneficiado setores específicos. Estes resultados chamam a atenção para uma potencial influência de grupos de interesse sobre a aprovação de programas que levam à renúncia fiscal pelo Estado, em detrimento do real motivo pelo qual eles deveriam existir: ajudar a economia e melhorar a arrecadação em curto prazo.
Health Centers and Value-Based Payment TOBEY, RACHEL; MAXWELL, JAMES; TURER, ERIC ...
The Milbank quarterly,
09/2022, Volume:
100, Issue:
3
Journal Article
Peer reviewed
Open access
Policy Points
As essential access points to primary care for almost 29 million US patients, of whom 47% are Medicaid enrollees, health centers are positioned to implement the population health ...management necessary in value‐based payment (VBP) contracts.
Primary care payment reform requires multiple payment methodologies used together to provide flexibility to care providers, encourage investments in infrastructure and new services, and offer incentives for achieving better health outcomes.
State policy and significant financial incentives from Medicaid agencies and Medicaid managed care plans will likely be required to increase health center participation in VBP, which is consistent with broader state efforts to expand investment in primary care.
Context
Efforts are ongoing to advance value‐based payment (VBP), and health centers serve as essential access points to comprehensive primary care services for almost 29 million people in the United States. Therefore, it is important to assess the levels of health center participation in VBP, types of VBP contracts, characteristics of health centers participating in VBP, and variations in state policy environments that influence VBP participation.
Methods
This mixed methods study combined qualitative research on state policy environments and health center participation in VBP with quantitative analysis of Uniform Data System and health center financial data in seven vanguard states: Oregon, Washington, California, Colorado, New York, Hawaii, and Kentucky. VBP contracts were classified into three layers: base payments being transformed from visit‐based to population‐based (Layer 1), infrastructure and care coordination payments (Layer 2), and performance incentive payments (Layer 3).
Findings
Health centers in all seven states participated in Layer 2 and Layer 3 VBP, with VBP participation growing from 35% to 58% of all health centers in these states from 2013 to 2017. Among participating health centers, the average percentage of Medicaid revenue received as Layer 2 and Layer 3 VBP rose from 6.4% in 2013 to 9.1% in 2017. Oregon and Washington health centers participating in Layer 1 payment reforms received most of their Medicaid revenue in VBP. In 2017, VBP participation was associated with larger health center size in four states (P <.05), and higher average number of days cash on hand (P <.05) in three states.
Conclusions
A multilayer payment model is useful for implementing and monitoring VBP adoption among health centers. State policy, financial incentives from Medicaid agencies and Medicaid managed plans, and health center–Medicaid collaboration under strong primary care association and health center leadership will likely be required to increase health center participation in VBP.
Payments for environmental services (PES) programs incentivize landowners to protect or improve natural resources. Many conservationists fear that introducing compensation for actions previously ...offered voluntarily will reduce social capital (the institutions, relationships, attitudes, and values that govern human interactions), yet little rigorous research has investigated this concern. We examined the land cover management and communal social capital impacts of Mexico’s federal conservation payments program, which is a key example for other countries committed to reducing deforestation, protecting watersheds, and conserving biodiversity. We used a regression discontinuity (RD) methodology to identify causal program effects, comparing outcomes for PES participants and similar rejected applicants close to scoring cutoffs. We found that payments increased land cover management activities, such as patrolling for illegal activity, building fire breaks, controlling pests, or promoting soil conservation, by ∼50%. Importantly, increases in paid activities as a result of PES did not crowd out unpaid contributions to land management or other prosocial work. Community social capital increased by ∼8–9%, and household-level measures of trust were not affected by the program. These findings demonstrate that major environmental conditional cash transfer programs can support both land management and the attitudes and institutions underpinning prosocial behavior. Rigorous empirical research on this question can proceed only country by country because of methodological limitations, but will be an important line of inquiry as PES continues to expand worldwide.
A. The distribution of different terms in PES literature; B. The tendency of using different terms in China and other countries (first-author country).
Display omitted
•PES studies started to grow ...from 2005 and kept an increasing trend since then.•The most influential journal, country and, institutions were Ecological Economics, USA, and CAS.•Ecological compensation and eco-compensation were primarily used by Chinese researches.•The most concerned region and types of PES were China and “forest and carbon” PES.•Most studies paid attentions to the social aspects of PES initiatives.
Payments for ecosystem services (PES) is an effective policy in conserving ecosystem services and is increasingly applied globally. The concept of PES was firstly defined in 2005, researches with various terminologies, concepts, and practices emerged since then. This paper analyzed the research patterns of PES studies through bibliometric methods, with a special focus on the trends of terminology, location (geographical research hotspot), types of PES, and PES effectiveness evaluation based on author keywords analysis. The results showed that PES started to receive considerable academic attentions from 2005, and the number of PES publications have relatively kept an increasing trend since then. The most influential journal, country, research organization, and author were Ecological Economics, USA, Chinese Academy of Sciences (CAS, China), and Dr. Wunder. Further analysis revealed that there were various terminologies in PES studies, notably “ecological compensation” and “eco-compensation” (EC) were primarily adapted by Chinese research community. China was the geographical research hotspot and developing countries (Vietnam, Mexico, and Brazil) have received growing academic interests in last decade. “Forest and Carbon” PES was the most concerned types of PES in last five years. There were 125 articles evaluated the effectiveness of empirical PES initiatives, and the majority focused on the social aspect. We proposed two suggestions for future research: (1) adapting EC as an alternative term for PES studies because of its inclusiveness and representation of empirical practices; (2) enhancing integrated evaluation of PES programs to achieve multiple benefits.
Despite the extensive interest in cryptocurrencies over the past years, their application as a means of payment in e‐commerce and retail purchases continues to be much slower than anticipated. This ...paper investigates the underlying mechanisms and elements that drive consumer resistance in this space. Drawing upon the stimulus‐organism‐response paradigm and the innovation resistance theory, the paper explores how the characteristics of the current cryptocurrency landscape contribute to different factors associated with crypto‐payment rejection. Our findings from empirical and experimental studies reveal how ecosystem volatility and the lack of structural assurances for cryptocurrencies foster negative consumer perceptions, leading to resistance against crypto‐payment use. The paper develops new insights into the main predictors of consumer resistance to crypto‐payment, which is a precursor to the mainstream use of cryptocurrencies. Moreover, it sheds light on the interactions among context‐specific, psychological, and functional determinants of behavioral consumer response.
To combat adverse selection, governments increasingly base payments to health plans and providers on enrollees' scores from risk-adjustment formulae. In 2004, Medicare began to risk-adjust capitation ...payments to private Medicare Advantage (MA) plans to reduce selection-driven overpayments. But because the variance of medical costs increases with the predicted mean, incentivizing enrollment of individuals with higher scores can increase the scope for enrolling "overpriced" individuals with costs significantly below the formula's prediction. Indeed, after risk adjustment, MA plans enrolled individuals with higher scores but lower costs conditional on their score. We find no evidence that overpayments were on net reduced.
As a modern alternative to cash, check or credit cards, the interest in mobile payments is growing in our society, from consumers to merchants. The present study develops a new research model used ...for the prediction of the most significant factors influencing the decision to use m-payment. To this end, the authors have carried out a study through an online survey of a national panel of Spanish users of smartphones. Two techniques were used: first, structural equation modeling (SEM) was used to determine which variables had significant influence on mobile payment adoption; in a second phase, the neural network model was used to rank the relative influence of significant predictors obtained by SEM. This research found that the most significant variables impacting the intention to use were perceived usefulness and perceived security variables. On the other side, the results of neural network analysis confirmed many SEM findings, but also gave slightly different order of influence of significant predictors. The conclusions and implications for management provide companies with alternatives to consolidate this new business opportunity under the new technological developments.
•The main goal is to analyze the individuals' intention to use NFC m-payment.•The objective is to determine which variables are the most relevant.•SEM was used to determine which variables had significant influence on m-payment.•Neural network models were used to rank the relative influence of predictors from SEM.•This study provides a set of recommendations for relevant stakeholders.
Payment for Ecosystem Services (PES) is becoming increasingly popular as a way to manage ecosystems using economic incentives. The environmental economics approach to PES tries to force ecosystem ...services into the market model, with an emphasis on efficiency. The ecological economics approach, in contrast, seeks to adapt economic institutions to the physical characteristics of ecosystem services prioritizing ecological sustainability and just distribution and requiring a transdisciplinary approach. This paper summarizes the results of a participatory “atelier” workshop held in Costa Rica. We developed a set of principles (the Heredia Declaration) for PES systems and report on evolving initiatives in several countries. We discuss how the distinction between ecosystem goods (which are stock-flow resources) and ecosystem services (which are fund-service resources) and the physical characteristics of the fund-services affect the appropriate institutional form for PES. We conclude that PES systems represent an important way to effectively manage fund-service resources as public goods, and that this represents a significant departure from conventional market institutions.
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