This paper provides one explanation why cash is still used for transactions despite a broad diffusion of noncash payment instruments. In particular, we argue that a distinctive feature of cash—a ...glance into one's pocket gives a signal of the remaining budget and past expenses—provides utility to some consumers. Using payment survey data, we show that consumers who need to keep control over their remaining liquidity and who have elevated costs of information processing conduct a larger percentage of payments using cash, withdraw less often, and hold larger cash balances than other consumers.
Understanding how physicians respond to incentives from payment schemes is a central concern in health economics research. We introduce a controlled laboratory experiment to analyse the influence of ...incentives from fee-for-service and capitation payments on physicians’ supply of medical services. In our experiment, physicians choose quantities of medical services for patients with different states of health. We find that physicians provide significantly more services under fee-for-service than under capitation. Patients are overserved under fee-for-service and underserved under capitation. However, payment incentives are not the only motivation for physicians’ quantity choices, as patients’ health benefits are of considerable importance as well. We find that patients in need of a high (low) level of medical services receive larger health benefits under fee-for-service (capitation).
There is growing interest in our society in making payments using mobile phones as an alternative to using cash, checks or credit cards. The objective of this study is to analyze the status of Near ...Field Communication (NFC) mobile payment systems in public transportation, as well as the factors that affect users' intentions to continue using said systems. To meet this objective, a personal survey was conducted on a sample of 180 users with experience using this type of system. A comprehensive review of the scientific literature justifies the development of a behavioral model that explains the continuance intention of NFC mobile payments through a structural equation model. The results show that satisfaction, service quality, effort expectancy, and perceived risk are determining factors of the continuance intention to use this technology. Finally, the managerial conclusions and implications offer the companies that manage these public services new business opportunities based on user behaviors.
•An analysis of the factors involved in NFC m-payment in public transportation.•A theoretical model was empirically assessed using SEM analysis.•Satisfaction is the factor with the greatest influence on continuance intention.•Service quality, effort expectancy, and perceived risk also impact on intention.•Convenience, social value and perceived trust do not show significant impacts.
Although research on pricing and lot-sizing decisions concerning payment types has been extensive, almost all of it has been done from the buyer’s perspective. In this study, we incorporate the ...following relevant and essential facts. If a seller allows a buyer to pay on credit, it increases sales volume. But if a seller asks a buyer for an advance payment, it decreases sales volume. Sometimes, a seller offers a buyer a price discount for an advance payment to increase sales and profitability. Asking a buyer for an advance payment bears interest earned and has no default risk. If a seller offers a buyer the opportunity to pay on credit, then a longer credit period may mean a higher the sales volume, but the default risk is higher, too. The seller wants to set an optimal selling price, replenishment time, and payment method simultaneously so that the profit per unit time is maximized. To achieve this, we develop and compare the seller’s profit per unit time under each of three payment methods—advance, cash and credit. Through numerical analyses, the following managerial insights are highlighted: (1) Under certain conditions, a specific payment type obtains the seller’s highest profit among all three payment types. (2) If advance payment is required, then it is critically important for a seller to offer a price discount. (3) An advance payment generates more profit than a credit payment provided that sales volume from a credit payment to an advance payment declines insignificantly and vice versa.
The Physician Payment Sunshine Act created the Open Payments Program (OPP), which is used to disclose transactions between physicians and industry. The impact of the coronavirus disease (COVID-19) ...pandemic on this relationship is yet to be determined. Our aim was to compare payments before and after the onset of COVID-19 through the OPP.INTRODUCTIONThe Physician Payment Sunshine Act created the Open Payments Program (OPP), which is used to disclose transactions between physicians and industry. The impact of the coronavirus disease (COVID-19) pandemic on this relationship is yet to be determined. Our aim was to compare payments before and after the onset of COVID-19 through the OPP.The OPP database was queried between 2014 and 2021 for all general surgery specialties. Payments were classified as general payments and research payments. Payments during 2014-2019 were classified as pre-COVID and compared to payments from 2020 to 2021 which were classified as post-COVID-Outbreak.METHODSThe OPP database was queried between 2014 and 2021 for all general surgery specialties. Payments were classified as general payments and research payments. Payments during 2014-2019 were classified as pre-COVID and compared to payments from 2020 to 2021 which were classified as post-COVID-Outbreak.From 2014 to 2021, 60,245 surgeons received general payments totaling $1.16 billion dollars. Comparing 2019 to 2020, general payments declined from $204.6 million to $108.5 million (-47%) and research payments from $157.3 million to $115.7 million (-26.5%). When comparing trends from 2014-2019 to 2020-2021, the mean number of payments was significantly higher at 394,782 versus 240,778 (P = 0.03) for general payments and 13,671 versus 10,382 (P = 0.03) for research payments. When comparing general payments among various surgical subspecialties, all fields saw a notable decline in general payments. Travel/lodging was the category of payment that saw the most significant change.RESULTSFrom 2014 to 2021, 60,245 surgeons received general payments totaling $1.16 billion dollars. Comparing 2019 to 2020, general payments declined from $204.6 million to $108.5 million (-47%) and research payments from $157.3 million to $115.7 million (-26.5%). When comparing trends from 2014-2019 to 2020-2021, the mean number of payments was significantly higher at 394,782 versus 240,778 (P = 0.03) for general payments and 13,671 versus 10,382 (P = 0.03) for research payments. When comparing general payments among various surgical subspecialties, all fields saw a notable decline in general payments. Travel/lodging was the category of payment that saw the most significant change.Industry payments declined as we entered the COVID-19 pandemic for both general and research payments. This decrease was seen across all surgical subspecialties. These trends in payments seen during the COVID-19 pandemic and the long-term economic impact of COVID-19 on the physician-industry relationship are still developing. Ongoing changes in future years to industry payments are worthy of continued monitoring.CONCLUSIONSIndustry payments declined as we entered the COVID-19 pandemic for both general and research payments. This decrease was seen across all surgical subspecialties. These trends in payments seen during the COVID-19 pandemic and the long-term economic impact of COVID-19 on the physician-industry relationship are still developing. Ongoing changes in future years to industry payments are worthy of continued monitoring.
An insightful overview of health insurers and a guide to sustainability for provider organizations.Physicians experience ongoing frustrations in their relationships with health plans. Even as they ...struggle to keep up with accelerating clinical advances, they face daunting challenges from payers that are transitioning from traditional fee-for-service contracts to complex alternative payment models. In Health Plans Unmasked, Martin Lustick, MD, offers insights and guidance for those who face the herculean task of transforming their business practices to achieve financial stability while improving outcomes for their patients.By explaining both how and why insurance companies behave the way they do, Dr. Lustick helps providers avoid mistakes and take advantage of opportunities for success. He provides information on:• The evolution of health care financing in the United States• The nuts and bolts of health plan capabilities and the real motives of health plan administrators• Tips for successful contracting strategies • Alternative payment models and the promises of value-based careWith a career spanning five decades as a practicing pediatrician, chief operating officer of a medical group, chief medical officer of a hospital, and chief medical officer of a health plan, Dr. Lustick provides a straightforward guide to sustainability for provider organizations. Physicians, office managers, and anyone in a health-related field will benefit from his breaking down the role of health plans in our health care ecosystem.
Background
Medicare’s Merit-based Incentive Payment System (MIPS) is a major value-based purchasing program. Little is known about how physician practice leaders view the program and its benefits and ...challenges.
Objective
To understand practice leaders’ perceptions of MIPS.
Design and Participants
Interviews were conducted from December 12, 2019, to June 23, 2020, with leaders of 30 physician practices of various sizes and specialties across the USA. Practices were randomly selected using the Medical Group Management Association’s membership database. Practices included small primary care and general surgery practices (1–9 physicians); medium primary care and general surgery practices (10–25 physicians); and large multispecialty practices (50 or more physicians). Participants were asked about their perceptions of MIPS measures; the program’s effect on patient care; administrative burden; and rationale for participation.
Main Measures
Major themes related to practice participation in MIPS.
Key Results
Interviews were conducted with 30 practices representing all US census regions. Six major themes emerged: (1) MIPS is understood as a continuation of previous value-based payment programs and a precursor to future programs; (2) measures are more relevant to primary care practices than other specialties; (3) leaders are conflicted on whether the program improves patient care; (4) MIPS creates a substantial administrative burden, exacerbated by annual programmatic changes; (5) incentives are small relative to the effort needed to participate; and (6) external support for participation can be helpful. Many participants indicated that their practice only participated in MIPS to avoid financial penalties; some reported that physicians cared for fewer patients due to the program’s administrative burden.
Conclusions
Practice leaders reported several challenges related to MIPS, including irrelevant measures, administrative burden, frequent programmatic changes, and small incentives. They held mixed views on whether the program improves patient care. These findings may be useful to policymakers hoping to improve MIPS.
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.
PDF
