Average Dollar Amount Research Articles

NIH Funding of Researchers in Surgery: Decreased Career Development Awards Over Time

Over time, NIH funding has become increasingly competitive. In addition, academic surgeons' research competes with time required for patient care, operating, and administrative work. Due to these competing interests for surgeons, we hypothesize that the percentage of NIH grants awarded to researchers from departments of surgery is decreasing. The NIH Research Portfolio Online Reporting Tool was queried for the number and value of new and renewal R01 grants, and career development awards noting which surgery departments received awards from 1998 to -2018. Statistical analysis was performed using univariate and multivariable logistic regression. The number of career development awards granted to researchers from departments of surgery decreased significantly over time (P=0.007) while new R01's and R01 renewal awards were stable. The number of grants awarded to researchers from all procedural departments were compared to non-procedural departments and again, career development awards decreased significantly (P=0.005) over time but new R01's and R01 renewals stayed stable. Looking at the difference in average dollar amount received for new R01, renewal R01, or career development awards between department of surgery awardees and non-surgery over time, there was no significant difference. NIH funding is becoming increasingly competitive and surgeons have many competing interests. Our study found that there has been a significant decrease in career development awards to department of surgery awardees and procedural specialists. The decrease in receipt of these awards is particularly concerning given that they are meant to provide protected time for developing researchers and thus have potential consequences for future research.

Bundling residential rooftop photovoltaics with energy efficiency upgrades: does it really pay off?

Using data from a survey of solar adopters in the USA, the present paper examines the effect of adding insulation on electricity bill savings. We identify whether solar adopters added insulation to their house close to the time of rooftop photovoltaics (PV) installation as a bundling strategy, and examine whether such decisions are correlated with higher electricity bill savings. We find that only 7% of solar adopters in the sample ended up bundling their PV installation with additional insulation. About 58% of solar adopters in the sample have not added insulation at all. The evidence in the present study suggests that solar adopters who choose the bundling strategy have larger, older houses, located in counties with higher electricity prices than those adopters who did not add insulation at all. Results show that while all solar adopters who choose the bundling strategy have a higher average dollar amount of savings, only those with high initial bills end up with a higher percentage of savings. The results of the present study provide some insights into the energy decision-making of households and provide some input for policies focused on combining renewable energy with efficiency standards.

Investing in Neighborhoods: The Mitigating Role of Home Mortgage Loans on Intimate Partner Violence.

Prior research examining how macro-level factors contribute to aggregate rates of intimate partner violence (IPV) across neighborhoods has focused almost exclusively on economic disadvantage or residential instability. Fewer studies have assessed what structural factors might ameliorate rates of domestic violence, such as economic investment. Housing investment improves communities by increasing the number of homeowners, who tend to be more committed to the neighborhood and more likely to develop strong social ties with other residents. The benefits of strong socially connected communities should extend to IPV victims, as studies have shown that female IPV victims tend to be less connected with their social environment and live in less supportive communities. This study examines the influence of external economic investment through home mortgage loans on the number of IPV incidents in a neighborhood and whether an influx of investment mitigates the negative effects of structural conditions on IPV. We examine these issues using panel data on home loan investment among neighborhoods in Cleveland, Ohio, between 1995 and 2010 to predict female and male domestic assault victimization rates. We find that the number of home purchase loans in a neighborhood has no appreciable impact on the level of IPV incidents, but as the average dollar amount of investment increases, the number of IPV incidents significantly decreases. This relationship is moderated by the neighborhood level of disadvantage: in highly disadvantaged neighborhoods, even low average dollar amounts contribute to a reduction in the number of female victims of domestic assault, but the same relationship is not apparent for male victims or in low disadvantaged neighborhoods. Our findings suggest that investment is important for disrupting the relationship between neighborhood structure and IPV, and implementing place-based strategies to encourage homeownership, particularly in disadvantaged neighborhoods, will be especially impactful.

A Novel Point-of-Care Solution to Streamline Local Wound Formulary Development and Promote Cost-effective Wound Care.

To develop and implement a point-of-care digital solution to streamline the creation and maintenance of wound care product formularies and promote cost-effective wound management. Researchers used Design Thinking methodology to develop the Formulary Module, a point-of-care digital solution within a clinical and reimbursement decision support web application for wound care and hyperbaric clinicians. The module was implemented in a US hospital-based outpatient wound clinic as follows: A baseline list of products was established, with brands automatically grouped by product category. Brands within each dressing category were compared, and redundancy eliminated. Study authors assessed the financial impact of formulary implementation in the wound clinic by comparing inventory expenditure before and after implementation. Implementation of the digital Formulary Module resulted in a 36% decrease in products (67 to 43 across 22 types), 38.73% decrease in the monthly average dollar spent on chargeable products, 29.56% decrease in the average dollar amount spent on chargeable products per patient visit, and increased staff efficiency. The Formulary Module has the potential to increase the adoption of cost-effective practices in wound care significantly.

The CMS Changes to a US ECMO Reimbursement: The Financial Impact upon ECMO Programs

Purpose Non-US (United States) countries differentiate reimbursement based on support type and indication. Historically, the US has reimbursed all ECMO cases at the same rate while most non-US countries use single payer systems. US reimbursement for ECMO has recently changed. Effective October 1st , 2018 The Center for Medicare Services (CMS) changed the ECMO associated Diagnostic Related Grouping (DRG) codes, varying reimbursement. Based almost exclusively on cannulation site, US reimbursement for ECMO cases may be lowered by 30%- 90%. The aim of this study was to investigate the financial impact from the DRG changes of US ECMO programs. Methods We reviewed adult cardiac ECMO cases performed during 2016 and 2017. Reimbursement was calculated applying the US national average dollar amount for ECMO support as done in the year 2017 (plan A). Subsequently, cases were categorized by cannulation site, and presence of Ventricular Assist Device (VAD). Reimbursement was calculated using the 2018 US CMS DRG and the associated national average dollar amount (plan B). Reimbursement amounts were compared. Results When comparing the difference in calculated reimbursement for 2016 and 2017 using plan A and B, estimated losses of 1.2 and 3.3 million dollars in reimbursement were identified respectively. Conclusion The US CMS changes to DRG codes and payment for ECMO support are largely driven by cannulation site and may result in a significant decrease in revenue for hospitals caring for these patients. Single payer systems across the globe reimburse ECMO support based on mode and indication for support, a more accurate way to determined resources spent. This impact could potentially affect ECMO programs through-out the US. Further research is needed to compare to non-US countries.

Tax Efficiency of Minority Investment Portfolios

In this study we use the 2010-2013 Survey of Consumer Finances to analyze the allocation and location of financial assets in categorizing the tax-efficiency of investment portfolios by race/ethnicity. We find that Blacks and Hispanics tend to be more tax-efficient since they invest largely through tax-deferred accounts. We also find that minority households that own taxable accounts have less than 10% the average dollar amount in those accounts than held by White households. This information is important for educators, counselors and planners since minority households may have less liquid and more conservative portfolios affecting their overall financial well-being.

An Analysis of Medicare Reimbursement to Ophthalmologists: Years 2012 to 2013

To analyze trends in utilization and payment of ophthalmic services in the Medicare population for years 2012 and 2013. Retrospective, cross-sectional study. A retrospective cross-sectional observational analysis was performed using publicly available Medicare Physician and Other Supplier aggregate file and the Physician and Other Supplier Public Use File. Variables analyzed included aggregate beneficiary demographics, Medicare payments to ophthalmologists, ophthalmic medical services provided, and the most common Medicare-reimbursed ophthalmic services. In 2013, total Medicare Part B reimbursement for ophthalmology was $5.8 billion, an increase of 3.6% from the previous year. From 2012 to 2013, the total number of ophthalmology services rendered increased by 2.2%, while average dollar amount reimbursed per ophthalmic service decreased by 5.4%. The top 5 highest reimbursed services accounted for 85% of total ophthalmic Medicare payments in 2013, an 11% increase from 2012. During 2013, drug reimbursement represented 32.8% of the total Medicare payments to ophthalmologists. Ranibizumab and aflibercept alone accounted for 95% of the entire $1.9 billion in drug reimbursements ophthalmologists in 2013. Medicare Part B reimbursement for ophthalmologists was primarily driven by use of anti-vascular endothelial growth factor (anti-VEGF) injections from 2012 to 2013. Of the total drug payments to ophthalmologists, biologic anti-VEGF agents ranibizumab and aflibercept accounted for 95% of all drug reimbursement. This is in contrast to other specialties, in which drug reimbursement represented only a small portion of Medicare reimbursement.

Remittances and immigration enforcement

Abstract Recent increases in U.S. immigration enforcement at the local and state level may be impacting remittance flows to developing countries by curtailing undocumented immigration, restricting the cyclicality of migration flows and limiting employment opportunities for the undocumented. We examine how the remitting patterns of Mexican migrants in the United States are being impacted by two types of immigration enforcement policies: police-based initiatives, such as 287(g) agreements and Secure Communities, and employment-based programs, as is the case with employment verification mandates. We find that increased enforcement reduces the share of migrants sending money home. However, legal migrants remitting money home increase their money outflows enough to offset any reductions in remittance payments from their undocumented counterparts. As a result, the average dollar amount remitted per Mexican migrant rises in the midst of increased uncertainty, safeguarding remittances as one of the least volatile sources of income in the developing world.

Wage Theft Among Latino Day Laborers in Post-Katrina New Orleans: Comparing Contractors with Other Employers

This study examines the nature of wage theft among Latino day laborers who participated in post-Katrina construction work. It addresses three important issues: (a) Is wage theft more prevalent in circumstances where there is very little enforcement of labor law? (b) Are professional contractors more likely to commit wage theft than other employers such as homeowners and small businesses? And (c) Do contractors and non-contractors who commit wage theft vary in the reasons given to justify their crime? Through survey interviews with 304 Latino day laborers conducted at four procurement sites across the city, respondents indicate that 78 % were victims of wage theft over the previous year (2008). Comparisons of wage theft across multiple studies expose the need for the development of a common conceptualization of a rate of wage theft and the benefit of using similar sampling frames to facilitate cross-comparison. Analysis reveals that there was no significant variation in the incidence of wage theft by employer type. Contractors and non-contractors did not differ significantly in the average dollar amount of wage theft, in the number of days worked before wage theft was committed, or in the hourly wage promised to employees. Contractors were, however, much more likely to justify wage theft by citing lack of funds than non-contractors.

Could the NIH Payline be too High?

BioTechniquesVol. 55, No. 1 From the EditorOpen AccessCould the NIH payline be too high?Nathan S. BlowNathan S. BlowBioTechniquesSearch for more papers by this authorPublished Online:3 Apr 2018https://doi.org/10.2144/000114045AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinkedInRedditEmail The paylines at the various institutes making up the NIH are near historical lows, making it increasingly competitive to obtain funding. This is partially due to the recent budget sequesteration, but is also a result of flat government funding levels coming on the heels of years of double digit growth, as well as an unexpected funding “bump” from the fiscal stimulus package.There have been many media reports, editorials, and even rallies bemoaning the 2013 cuts and the lack of funding increases in recent years. A major concern is the possible impact that the current constraints on grants will have on young scientists as they start their careers. Even with new investigator initiatives and suggested caps on the number of grants for established scientists, there is concern that important research efforts will go under-funded, or even unfunded, due to the current budget woes. So, the question of the day would seem to be whether or not the payline needs to be moved to improve the probability of grant success for all researchers and, even more critically, how this might be accomplished.Eight percent funding (ten for new investigators) at some institutes does seem very small indeed. But in the end, could we be thinking about this in the wrong way? Might that number in fact be too high, at least for established investigators? The payline, and subsequently the number of funded scientists, comes down to a question of resource allocation and, to an extent, a question of whether or not the NIH should be setting stricter rules on the number of grants or the amount of money any single investigator can receive. Here, I argue that it is important to more closely examine cost-benefit ratios for all awards.If we look at a small, random sampling of NIH grant awardees during 2013 (excluding program projects and small business grants) and compare these awards to production as measured by article output, an interesting trend can be observed. Averaging the awards and output for 3 randomly selected investigators whose 2013 grants total over $1 million dollars, we find an average dollar amount of $1.65 million and an average article production output of 30 for 2013 thus far. When looking at 3 random grantees awarded less than $1 million, we find an average funding amount of $573,000 and an average of 3 articles published in 2013, thus far. The numbers (although obviously my data set does not include the most robust sample size) would seem to indicate that more funding produces more articles.Now, before you say this is obvious, the more interesting point here is that more funding would in fact appear to produce disproportionately more articles, implying that labs with more funding are significantly more productive than their smaller counterparts. This could be attributed to sheer resources. On the other hand, maybe study sections are doing the right thing—identifying investigators with the ability to rapidly shape scientific progress and awarding them appropriately. While a larger sampling of grants and a more detailed analysis of productivity now or in the coming years could alter these conclusions, it is important to start thinking about grants in this fashion—especially if funding continues to lag behind the rate of inflation.So, is it fair to place restrictions on investigators making such significant contributions to science? Unfortunately, I think the answer is clear—restrictions could only serve to further reduce scientific output and therefore run against the needs and desire of the NIH. However, such a lack of restrictions on grant awards would also create more competitive conditions for all established investigators.Obviously, it is important to support young researchers as they start their careers, and this should be accomplished by raising paylines significantly when it comes to first time submissions and awards. But beyond that point, grants should be made on the basis of merit alone, without regard for the amount of money awarded to any one investigator. This will prove challenging to many, but could ultimately produce the necessary change and accountability needed to push life science research forward.Please share your thoughts and comments by posting at our Molecular Biology Forums under “To the Editor” (http://molecularbiology.forums.biotechniques.com) or sending an email directly to the editor (bioeditor@biotechniques.com).FiguresReferencesRelatedDetails Vol. 55, No. 1 Follow us on social media for the latest updates Metrics History Published online 3 April 2018 Published in print July 2013 Information© 2013 Author(s)PDF download

The Impact of FIN 48 and Economic Nexus on Multistate Tax Settlements

This study examines whether the adoption and enactment of Financial Interpretation No. 48 (hereafter “the FIN 48 period”) and the extension of nexus to include economic nexus rather than only physical presence impacts the number of settlements and the dollar amounts of settlements using data from the National Nexus Program (NNP) of the Multistate Tax Commission. The NNP provides a unique setting for public and private firms to voluntarily settle both income and sales and use tax liabilities. Using a panel from 1994 to 2008, I find that the FIN 48 period is associated with a 44 percent increase in the number of NNP settlements for the average stateyear when nexus is defined as physical presence. For the average state-year where nexus is defined as economic nexus, the FIN 48 period is associated with a 137 percent increase in the number of settlements. However, the FIN 48 period and economic nexus have no overall impact on the dollar amount of settlement in the NNP. Further analysis reveals that the combination of the FIN 48 period and economic nexus is associated with a larger number of settlements for private firms and a larger average dollar amount of settlement for public firms.

Competition and Adverse Selection in the Small-Dollar Loan Market: Overdraft versus Payday Credit

We find that competition from payday lenders leads depository institutions to raise overdraft fees and reduce the availability of “free” checking accounts. We attribute this rise in prices partly to adverse selection created by banks’ practice of charging a flat fee regardless of the overdraft amount―pricing that favors depositors prone to large overdrafts. Payday credit is priced per dollar borrowed, so when that option is available, depositors prone to small overdrafts switch. That selection works against banks; large overdrafts cost more to supply and, if depositors default, banks lose more, so prices rise. Consistent with this adverse selection hypothesis, we document that the average dollar amount per returned check at banks and other depository institutions increases when depositors have access to payday credit. Our findings illuminate competition and pricing frictions in the large, yet largely unstudied, small-dollar loan market.

Winning Does Matter: Patterns in Private Giving to Athletic and Academic Programs at NCAA Division I-AA and I-AAA Institutions

In a study of “big-time” athletic programs, Stinson and Howard (2004) documented a shift in donor giving patterns toward increased support of athletic programs at the apparent expense of giving to academic programs. The shift toward greater athletic giving was most evident at those schools with major football programs. This study's primary purpose is to determine whether the changes found at the Division I-A level are also evident at schools that compete at the Division I-AA or I-AAA level. Linear mixed models indicate that successful athletic programs influence both the number of donors making gifts to an institution and the average dollar amount of those gifts. However, unlike the giving patterns at I-A football schools, winning football and men's basketball teams have direct effects on both athletic and academic gifts. Rather than producing a crowding-out effect, athletic success appears to enhance support for both athletic and academic programs.

Beverage Alcohol Sales to Minors

The purpose of the study was to assess the risk environment for operators who sell beverage alcohol and the use of false identification by minors. A series of personal injury lawsuits filed between 1987 and 2002, and data from a four-semester survey of 379 students were analyzed to provide an investigative summary for a particular period of time. Descriptive statistics identified the most frequent causes of personal injury, the types of injuries sustained, the outcome and average dollar amount awarded, the gender of the injured parties, the states where lawsuits were filed, and the attempts by those who are underage to purchase beverage alcohol using false identification. Operational methods to reduce the risk environment are presented.

Index futures arbitrage before and after the introduction of sixteenths on the NYSE

We find that market efficiency increased and the arbitrage link between index futures and the stock market strengthened after June 24, 1997, when the New York Stock Exchange reduced the minimum change for stock prices and quotes from an eighth to a sixteenth of a dollar. There has been a substantial increase in the number of arbitrage trades reported to the Securities and Exchange Commission (SEC) since the reduction in the minimum price increment. The average number of stocks traded and the average dollar amount underlying each arbitrage trade increases and decreases, respectively. The average index futures mispricing error (MPE) that triggers arbitrage is lower and reverts to zero more quickly.

Index-Futures Arbitrage Before and After the Introduction of Sixteenths on the NYSE

On June 24, 1997, the New York Stock Exchange reduced the minimum change for stock prices and quotes from an eighth to a sixteenth of a dollar. This study investigates the impact of the resulting decrease in spreads on S&P 500 index-futures arbitrage. For the period after June 24, 1997, we find that there is a substantial increase in the number of arbitrage trades reported to the Securities and Exchange Commission. The average number of stocks and the average dollar amount underlying each arbitrage trade increase and decrease respectively. The average index-futures mispricing error that triggers arbitrage is lower after sixteenths.

REFORMING TITLE I — A STUDY IN GRANT DESIGN

Title I of ESE A is aimed at tip grading the educationally disadvantaged. The payment formula has been severely criticized and it is our purpose to derive improved measures of the target population and the target payment rate, while examining the merits of a matching program. The principal conclusions are: (1) from families below the S5/4 povertyline should be counted instead of those below the subpoverty $2000 level or those over the arbitrary criteria of at least $2000 in welfare ; (2) payment rates should reflect the average dollar amount required to raise achievement and local cost variations; and (3) a variable matching program , with matching ratios reflecting the probability that funds will be matched and differences in local fiscal capacities, should be introduced. 'THE PURPOSE of the Title I program of the Elementary and Secondary Education Act, the largest Federal education program, is to provide for the special educational needs of educationally children. While few deny the need for Title I, several provisions of the program have come under increasing Congressional criticism. The subject of this paper is one of the key fiscal issues in the reform of Title I the design of the distribution formula. We will focus on the following areas: the target population; the target level of expenditures; and the specification of the grant. In so doing, an interesting applied analysis in the design of a grant formula is provided. *The authors are Brookings Economic Policy Fellow and Executive Director, Maryland Council of Economic Advisers. This study was financed by the Office of Education, Department of Health, Education and Welfare. The opinions expressed in the paper are only those of the authors. Present Program There are three parts to the present program: a basic grant, a special incentives grant, and a special grant for areas with high concentrations of low income children. Payments for the basic grant depend on the number of disadvantaged children and on the State's per pupil expenditure on education. For purposes of the grant, are defined as from families with an annual income of less than $2,000 or from families receiving more than $2,000 of AFDC payments.1 Neglected and institutionalized are also considered disadvantaged. The amount of money which each county receives is equal to the number of times one-half of the State's per pupil expenditure or the national average of per pupil expenditures, whichever is higher. Whenever the funds appropriated are insufficient to cover all eligible children, each county's payments are reduced proportionally. Thus far, Title I payments have always been reduced in this manner. Payments for the special incentives grant depend on each state's effort index relative to the national index. Effort here is defined as the ratio of state and local (that is, non-federal) educational expenditures in each state relative to the state's income. A special high concentration grant is also available to districts where the represent at least 20% of the school age population and to districts having at least 5,000 children, provided that the 5,000 represents at least 5% of the school age in the district. xThe income level actually was $2,000 for fiscal years 1966 and 1967. It was $3,000 for fiscal years 1968, 1969 and 1970. As of fiscal 1973 it will be $4,000. However, the limit effectively remains at $2,000 since appropriations are insufficient to cover a higher level.