Abstract
Payment mechanisms have attracted substantial research interest because of their consequent effect on care outcomes, including treatment costs, admission and readmission rates and patient ...satisfaction. Those mechanisms create the incentive environment within which health workers operate and can influence provider behaviour in ways that can facilitate achievement of national health policy goals. This systematic review aims to understand the effects of changes in hospital payment mechanisms introduced in low- and middle-income countries (LMICs) on hospital- and patient-level outcomes. A standardised search of seven databases and a manual search of the grey literature and reference lists of existing reviews were performed to identify relevant articles published between January 2000 and July 2019. We included original studies focused on hospital payment reforms and their effect on hospital and patient outcomes in LMICs. Narrative descriptions or studies focusing only on provider payments or primary care settings were excluded. The authors used the Risk of Bias in Non-Randomized Studies of Interventions tool to assess the risk of bias and quality. Results were synthesized in a narrative description due to methodological heterogeneity. A total of 24 articles from seven middle-income countries were included, the majority of which are from Asia. In most cases, hospital payment reforms included shifts from passive (fee-for-service) to active payment models—the most common being diagnosis-related group payments, capitation and global budget. In general, hospital payment reforms were associated with decreases in hospital expenditures, out-of-pocket payments, length of hospital stay and readmission rates. The majority of the articles scored low on quality due to weak study design. A shift from passive to active hospital payment methods in LMICs has been associated with lower hospital and patient costs as well as increased efficiency without any apparent compromise on quality. However, there is an important need for high-quality studies in this area.
A. The distribution of different terms in PES literature; B. The tendency of using different terms in China and other countries (first-author country).
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•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.
In 1998, Medicare adopted a per diem Prospective Payment System (PPS) for skilled nursing facility care, which was intended to deter the use of high-cost rehabilitative services. The average per diem ...decreased under the PPS, but because per diems increased for greater therapy minutes, the ability of the PPS to deter the use of high-intensity services was questionable. In this study, we assess how the PPS affected the volume and intensity of Medicare services. By volume we mean the product of the number of Medicare residents in a facility and the average length-of-stay, by intensity we mean the time per week devoted to rehabilitation therapy. Our results indicate that the number of Medicare residents decreased under PPS, but rehabilitative services and therapy minutes increased while length-of-stay remained relatively constant. Not surprisingly, when subsequent Medicare policy changes increased payment rates, Medicare volume far surpassed the levels seen in the pre-PPS period.
Debit or credit? Zinman, Jonathan
Journal of banking & finance,
02/2009, Letnik:
33, Številka:
2
Journal Article
Recenzirano
Empirical consumer payment price sensitivity has implications for theory, optimal regulation of payment card networks, and business strategy. A critical margin is the price of a credit card charge. A ...revolver who did not pay her most recent balance in full pays interest; other credit card users do not. I find that revolvers are substantially less likely to incur credit card charges and substantially more likely to use a debit card, conditional on several proxies for transaction demand and tastes. Debit use also increases with credit limit constraints and decreases with credit card possession. Additional results suggest that debit is becoming a stronger substitute for credit over time.
In late 2021 and early 2022, CEMLA conducted a thorough survey involving 12 central banks to analyze key aspects related to the potential implementation of a Central Bank Digital Currency (CBDC). The ...findings revealed prevalent issues and objectives regarding digital payments in the region, as well as promising avenues for central bank involvement. However, it highlighted the challenges of creating a universal CBDC framework due to significant disparities among neighboring countries. Nonetheless, the collaborative research approach promises valuable insights for future efforts. To protect participant anonymity, each country’s responses were anonymized with randomly assigned letters.
The survey extensively examined awareness and understanding of CBDCs across diverse stakeholders in Latin American nations, including the general public, corporations, and financial institutions. These insights could shape educational campaigns and communication strategies, enabling policymakers and central banks to effectively share information about CBDCs.
Moreover, this research effort sheds light on public perceptions, expectations, and concerns about CBDCs in Latin America. By exploring various dimensions such as awareness, interest, adoption potential, concerns, preferences, and regulatory considerations, the survey offers a comprehensive understanding of the CBDC landscape in the region. This holistic approach provides valuable insights for policymakers, central banks, and stakeholders to navigate the complexities of CBDC implementation effectively and responsibly.
Background
The Physician Payments Sunshine Act, part of the Affordable Care Act, requires pharmaceutical and medical device firms to report payments they make to physicians and, through its Open ...Payments program, makes this information publicly available.
Objective
To establish estimates of the exposure of the American patient population to physicians who accept industry payments, to compare these population-based estimates to physician-based estimates of industry contact, and to investigate Americans’ awareness of industry payments.
Design
Cross-sectional survey conducted in late September and early October 2014, with data linkage of respondents’ physicians to Open Payments data.
Participants
A total of 3542 adults drawn from a large, nationally representative household panel.
Main Measures
Respondents’ contact with physicians reported in Open Payments to have received industry payments; respondents’ awareness that physicians receive payments from industry and that payment information is publicly available; respondents’ knowledge of whether their own physician received industry payments.
Key Results
Among the 1987 respondents who could be matched to a specific physician, 65% saw a physician who had received an industry payment during the previous 12 months. This population-based estimate of exposure to industry contact is much higher than physician-based estimates from the same period, which indicate that 41% of physicians received an industry payment. Across the six most frequently visited specialties, patient contact with physicians who had received an industry payment ranged from 60 to 85%; the percentage of physicians with industry contact in these specialties was much lower (35–56%). Only 12% of survey respondents knew that payment information was publicly available, and only 5% knew whether their own doctor had received payments.
Conclusions
Patients’ contact with physicians who receive industry payments is more prevalent than physician-based measures of industry contact would suggest. Very few Americans know whether their own doctor has received industry payments or are aware that payment information is publicly available.
Policy Points
Six states received $250 million under the federal State Innovation Models (SIM) Initiative Round 1 to increase the proportion of care delivered under value‐based payment (VBP) models ...aligned across multiple payers.
Multipayer alignment around a common VBP model occurred within the context of state regulatory and purchasing policies and in states with few commercial payers, not through engaging many stakeholders to act voluntarily.
States that made targeted infrastructure investments in performance data and electronic hospital event notifications, and offered grants and technical assistance to providers, produced delivery system changes to enhance care coordination even where VBP models were not multipayer.
Context
In 2013, six states (Arkansas, Massachusetts, Maine, Minnesota, Oregon, and Vermont) received $250 million in Round 1 State Innovation Models (SIM) awards to test how regulatory, policy, purchasing, and other levers available to state governments could transform their health care system by implementing value‐based payment (VBP) models that shift away from fee‐for‐service toward payment based on quality and cost.
Methods
We gathered and analyzed qualitative data on states’ implementation of their SIM Initiatives between 2014 and 2018, including interviews with state officials and other stakeholders; consumer and provider focus groups; and review of relevant state‐produced documents.
Findings
State policymakers leveraged existing state law, new policy development, and federal SIM Initiative funds to implement new VBP models in Medicaid. States’ investments promoted electronic health information going from hospitals to primary care providers and collaboration across care team members within practices to enhance care coordination. Multipayer alignment occurred where there were few commercial insurers in a state, or where a state law or state contracting compelled commercial insurer participation. Challenges to health system change included commercial payer reluctance to coordinate on VBP models, cost and policy barriers to establishing bidirectional data exchange among all providers, preexisting quality measurement requirements across payers that impede total alignment of measures, providers’ perception of their limited ability to influence patients’ behavior that puts them at financial risk, and consumer concerns with changes in care delivery.
Conclusions
The SIM Initiative's test of the power of state governments to shape health care policy demonstrated that strong state regulatory and purchasing policy levers make a difference in multipayer alignment around VBP models. In contrast, targeted financial investments in health information technology, data analytics, technical assistance, and workforce development are more effective than policy alone in encouraging care delivery change beyond that which VBP model participation might manifest.
Abstract
This paper documents inconsistent terminologies and misleading analogies in current discussions of digital money and payments. It offers a more consistent framework for understanding the ...potential of technological innovation in providing the functions of money and payments: as media of exchange, stores of value, and units of account and the implications of cryptographic technologies underpinning cryptocurrencies for the future of money and payments. These could support efficiency gains in money and payments, but decentralization is not inherent to their application. Radical reform leading to improved economic outcomes is conceivable, but not through disruptive displacement of existing institutional arrangements.
In developing countries, ecological transfer payments (ETPs) are a preferred method of solving the dilemma of environmental governance. However, the associated policy effects have not yet been ...effectively evaluated. We use unique ETPs' data provided by the Ministry of Finance of China in a dynamic spatial panel data model. Our study finds that ETPs stimulate the efforts of local governments to improve environmental quality, and play a coordinated role in mitigating the race-to-the-bottom competition among regions. However, these transfer payments (TPs) do not promote ecological improvement. Although the design of non-ecological transfer payments (non-ETPs) considers ecological and environmental factors, they do not effectively play an incentive and coordinated role. The ETPs' behavior that encourages local governments to invest in environmental improvements exhibits more of a compensation rather than a leverage effect. This conclusion suggests that policymakers should pay attention to the coordinated role, and increase the weight of ecological factors, in the design of TPs.
•The incentive and coordination effects of ETP are carried out.•The unique datas of ETP provided by the Ministry of Finance of China are used.•The coordination effect is mainly discussed through the spatial interaction term.•The incentive and coordination effects of different transfer payment were compared.•The mechanism analysis was focused upon government expenditure on environment.
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