Benchmark Costs Research Articles

An analysis of the impact on total cost of care within a pharmacist‐led comprehensive medication management program

AbstractIntroductionThe rise in health care expenditures continues to pose a significant concern regarding the longevity of the current health care system design. The literature has demonstrated a positive return on investment (ROI) when pharmacists perform medication management services. Building upon positive ROI literature, a clinically integrated network (CIN) in Michigan developed an approach to patient targeting for comprehensive medication management (CMM) services in existing alternative payment model (APM) Medicare Advantage, Medicaid, and Commercial contracts.ObjectivesThe primary objective of this study was to examine the real‐world impact of an advanced ambulatory care pharmacy model, inclusive of embedded clinic‐based ambulatory pharmacists, centralized ambulatory pharmacists, centralized population health pharmacists, and specially trained pharmacy technicians, on the total cost of care (TCOC) within a large integrated health system.MethodsFor CMM dates of service occurring in calendar year 2022, pharmacy and medical claims were evaluated during the 6‐month period prior to and following the initial CMM patient encounter. Upon completion of the study period, data were evaluated to assess TCOC and utilization trends for the study population.ResultsStatistically significant differences in median TCOC ($1427.84, p < 0.001), prescription drug costs ($222.82, p < 0.001), and medical costs ($462.26, p < 0.001) were observed between the pre‐CMM and post‐CMM timeframes for the study population. A 16% reduction in hospital admissions was observed between the pre‐CMM and post‐CMM timeframes.DiscussionThis study further supports that pharmacist intervention as part of a CMM program can favorably affect health care costs. Criteria such as a population's benchmark costs and utilization, insurance product types, and core conditions present can help determine whether expanding or initiating CMM services could be beneficial in improving care and health care costs.

Implications of food and nutrition security on household food expenditure: the case of Malaysia

IntroductionFood security is attracting more attention in Malaysia not only at the national level that concern toward the enhancement of food self-sufficiency but also at the individual level which concerns more on nutrition and health. The economic recession triggered by the COVID-19 pandemic has brought the food and nutrition security challenge to the higher priority. In this study, we assessed the feasibility of encouraging a healthy eating plan by taking into account two important elements, food cost and nutrient intake, to help tackle the food and nutrition insecurity challenges at the individual level.Method and materialsThis study used a goal programming model with dietary intake data from Malaysian Adult Nutrition Survey reports to develop food plans that can improve nutrition quality without increasing food cost. Missing data, such as nutrient compositions and food prices, were collected separately from existing governmental and non-governmental sources. Benchmark nutrient intakes were derived from Malaysian Dietary Guidelines and Malaysian Recommended Nutrient Intakes reports, whereas benchmark costs were estimated by mapping food prices to dietary intake. The cost of healthier diets was also assessed to examine the acceptability of dietary changes for the low-income population.ResultsThe results showed that healthier diets following national dietary guidelines are achievable with reasonable food choices shift without changing the cost of meal plan. Greater intake of milk and vegetables (for more calcium) and smaller intake of seafood and egg products (for less protein) will contribute to raise diet quality and achieve more adequate nutrition. However, the cost attached to healthier food plan is still likely to be burdensome for the food-insecure and low-income population.ConclusionsOur results suggest that policymakers should implement income-relevant laws to cut poverty and improve the population’s dietary intake. Income growth as a result of better skills and education is needed to ensure that the real incomes of Malaysian are well sustained, and increased to help low-income population make better and healthier food choices.

Decarbonization of remote mine electricity supply and vehicle fleets

ABSTRACT The need to drastically reduce greenhouse gas emissions is becoming more and more apparent. To avoid a tipping point, scientists agree that emissions need to reach net zero by 2050, which will require unprecedented changes to the way electricity is generated, particularly for remote off-grid mines. In this paper, the potential to achieve 100% renewable penetration for a remote mine will be investigated, with an example case study for a mine in the Canadian Arctic. Five key pillars to achieve net zero operation will be discussed: energy efficiency, hybrid power, microgrid integration, alternative vehicles, and low carbon technologies. In addition, the state-of-the-art in renewable generation, energy storage, and hydrogen storage are presented. The key enablers for a mine to achieve 100% renewable penetration for electricity and vehicles are identified, along with benchmark costs and savings opportunities. Strategies and challenges for existing mines to achieve high renewable penetration are discussed. The remote mine of the future will be significantly different from today’s operations; changes to the operating strategy and process, energy generation, and vehicle fleet will be the key enablers.

To decarbonize industry, we must decarbonize heat

Summary Industry is often termed “hard to decarbonize” because a vast, inhomogeneous array of processes comprise the sector. But developing new, decarbonized process heating technologies represents a single, broadly applicable pathway to eliminating a large portion of sectoral emissions—and approximately one-fifth of global CO2 emissions, overall. We begin this perspective with a brief review of the demand for and cost of industrial heat. Then, we highlight key challenges and R&D needs in developing zero-carbon industrial heating technologies. Technologies in four pathways are discussed: (1) zero-carbon fuels, (2) zero-carbon heat sources, (3) electrification of heat, and (4) better heat management. Finally, we identify cross-cutting challenges to the development and adoption of zero-carbon industrial heat technologies, the solution to any of which would constitute a significant breakthrough on the path to industrial decarbonization.

Australia—Anti-Dumping Measures on A4 Copy Paper

The World Trade Organization (WTO) Panel Report inAustralia – Anti-Dumping Measures on A4 Copy Paper(Australia – A4 Copy Paper) marks a significant development of the multilateral rules on anti-dumping. Under certain circumstances, WTO agreements permit members to impose anti-dumping measures to counteract the injurious effect of dumping on domestic industries, typically through import duties. The Report is the first to examine in detail when an anti-dumping authority may determine that a “particular market situation” exists in the country of exportation under Article 2.2 of the WTO Anti-Dumping Agreement, potentially justifying the imposition of elevated remedial duties. The Report also develops the jurisprudence on how such remedies may be calculated, expounding the use of benchmark costs for the calculation of a constructed normal value (CNV) under Article 2.2.1.1. These doctrinal questions are central to the longstanding debate over how far the Anti-Dumping Agreement allows anti-dumping measures against state intervention and market distortions. On both fronts, theAustralia – A4 Copy Paperpanel created flexibilities for WTO members to respond to government-induced distortions. In doing so, the Report deviates considerably from the course set by the Appellate Body in the landmarkEU – Biodieseldecision, which seemed to confine anti-dumping measures to responding to private action. At the same time, the panel left open several important issues relating to the adoption of CNVs and the use of benchmarks for their calculation, leaving wide latitude for investigating authorities to inflate dumping margins in practice.

Australia – Anti-Dumping Measures on A4 Copy Paper, WT/DS529/R

The WTO Panel Report in Australia – Anti-Dumping Measures on A4 Copy Paper marks a significant development of the multilateral rules on anti-dumping. The Report is the first to examine in detail when an anti-dumping authority may determine that a “particular market situation” exists in the country of exportation under Article 2.2 of the WTO Anti-Dumping Agreement, potentially justifying the imposition of elevated remedial duties. The Report also develops the jurisprudence on how such remedies may be calculated, expounding the use of benchmark costs for the calculation of a constructed normal value (‘CNV’) under Article 2.2.1.1. These doctrinal questions are central to the longstanding debate over how far the Anti-Dumping Agreement allows anti-dumping measures against state intervention and market distortions. On both fronts, the Australia – A4 Copy Paper panel created flexibilities for WTO members to respond to government-induced distortions. In doing so, the Report deviates considerably from the course set by the Appellate Body in the landmark EU – Biodiesel decision – which seemed to confine anti-dumping measures to responding to private action. At the same time, the panel left open several important issues relating to the adoption of CNVs and the use of benchmarks for their calculation, leaving wide latitude for investigating authorities to inflate dumping margins in practice.

Concentrated Solar Power In India:Current Status, Challenges and Future Outlook

India is blessed with good solar resources and many regions of the country receive above-average sunshine compared to other regions of the world. The primary technology used for harnessing and converting solar energy into electrical energy in India is based on photovoltaic (PV) cells. Concentrated solar power (CSP) has hardly contributed to the overall installed solar power capacity in the country. In this article, some of the challenges that have inhibited the growth of CSP are identified and possible solutions suggested. The critical challenges for CSP are related to the lack of reliable direct normal irradiance database, indigenous manufacturing and competition from PV. The results of a case study carried out to assess the impact of indigenous manufacturing and economies of scale on capital costs and levelized cost of electricity are presented. This study shows that even with indigenous manufacturing and considering economies of scale, the capital cost per MW (Megawatt) of installed capacity is higher than the Central Electricity Regulatory Commission benchmark costs. To initiate larger adoption of CSP in India, we may have to consider alternative configurations, such as coupling desalination or thermal cooling systems to a CSP power plant. The merits of such configurations, called poly-generation plants, are presented for the Indian scenario.

Economics of carbon dioxide capture and utilization-a supply and demand perspective.

Lately, the technical research on carbon dioxide capture and utilization (CCU) has achieved important breakthroughs. While single CO2-based innovations are entering the markets, the possible economic effects of a large-scale CO2 utilization still remain unclear to policy makers and the public. Hence, this paper reviews the literature on CCU and provides insights on the motivations and potential of making use of recovered CO2 emissions as a commodity in the industrial production of materials and fuels. By analyzing data on current global CO2 supply from industrial sources, best practice benchmark capture costs and the demand potential of CO2 utilization and storage scenarios with comparative statics, conclusions can be drawn on the role of different CO2 sources. For near-term scenarios the demand for the commodity CO2 can be covered from industrial processes, that emit CO2 at a high purity and low benchmark capture cost of approximately 33 €/t. In the long-term, with synthetic fuel production and large-scale CO2 utilization, CO2 is likely to be available from a variety of processes at benchmark costs of approx. 65 €/t. Even if fossil-fired power generation is phased out, the CO2 emissions of current industrial processes would suffice for ambitious CCU demand scenarios. At current economic conditions, the business case for CO2 utilization is technology specific and depends on whether efficiency gains or substitution of volatile priced raw materials can be achieved. Overall, it is argued that CCU should be advanced complementary to mitigation technologies and can unfold its potential in creating local circular economy solutions.

Cost evaluation of desalination and sewage treatment based on plants operated in Oman and use of software models

The performance of desalination and sewage treatment plants operated by contractors at sites of a large company in Oman was evaluated in relation to benchmark costs. Such benchmark costs, which are dependent on plant size and process used, were established based on estimates provided in research literature and based on site-specific estimates made using software models. Desalination economic evaluation program software was used to estimate site-specific costs of desalination and financing for environmental, affordable, and strategic investments that bring on large scale expenditure software was used to estimate site-specific costs of sewage treatment. The estimated site-specific benchmark cost of desalination was 1.20 US$/m3. The desalination cost subject to many variables reported in the literature ranges between 0.52 and 1.30 US$/m3. The estimated site-specific benchmark operational cost of sewage treatment up to the BOD level of 10–15 mg/L of treated water was 0.29 US$/m3. The cost of sewage water treatment, up to the BOD level of 10–15 mg/L of treated water, averages to 0.41 US$/m3 based on studies conducted. The evaluation of costs reveals that the cost of desalination and sewage treatment at the company sites was close to benchmark costs provided in the research literature as well as site-specific estimates made using software models.

Regulatory Price Performance, Excess Cost Indexes and Profitability: How Effective is Price Cap Regulation in the Water Industry?

In this study we apply an index number approach to allow for cross sectional comparisons of relative profitability, productivity and price performance of the regulated Water and Sewerage companies (WaSCs) in England and Wales during the years 1991-2008. In order to better analyse the impact of regulation on WaSC performance, we decompose actual economic profits into spatial multilateral Fisher productivity (TFP) index, the inverse of which is demonstrated to be a regulatory excess cost index that measures the deviation of a firm’s actual costs from benchmark costs, and a newly developed regulatory total price performance (TPP) index, which measures the excess of regulated revenues relative to benchmark costs. Increases (decreases) in regulatory price performance are indicative of the loosening (tightening) of price cap regulation. Moreover, we also show that the relationship between actual economic profitability, regulatory excess costs and regulatory price performance indices can be used to categorize regulatory price caps as “weak”, “powerful” or “catch-up promoting”. The results indicated that throughout the entire 1991-2008 period, price caps were never “powerful”, in the sense that they required less productive firms to immediately and fully catch-up to the most productive firm to regain economic profitability. More specifically, during the years 1991-2000 price caps were “weak” as prices were high enough for the firms to achieve economic profits despite their low productivity levels. However, after 2001 prices became “catch up promoting” as they required less productive companies to eliminate at least some excess costs in order to eliminate economic losses. Finally, we emphasize that as our results also clearly demonstrated a much closer alignment between allowed revenues and benchmark costs after 2001, Ofwat’s approach during this period was not only appropriate, but should also be continued in the 2009 price review.

Resources and costs for microbial sequence analysis evaluated using virtual machines and cloud computing.

BackgroundThe widespread popularity of genomic applications is threatened by the “bioinformatics bottleneck” resulting from uncertainty about the cost and infrastructure needed to meet increasing demands for next-generation sequence analysis. Cloud computing services have been discussed as potential new bioinformatics support systems but have not been evaluated thoroughly.ResultsWe present benchmark costs and runtimes for common microbial genomics applications, including 16S rRNA analysis, microbial whole-genome shotgun (WGS) sequence assembly and annotation, WGS metagenomics and large-scale BLAST. Sequence dataset types and sizes were selected to correspond to outputs typically generated by small- to midsize facilities equipped with 454 and Illumina platforms, except for WGS metagenomics where sampling of Illumina data was used. Automated analysis pipelines, as implemented in the CloVR virtual machine, were used in order to guarantee transparency, reproducibility and portability across different operating systems, including the commercial Amazon Elastic Compute Cloud (EC2), which was used to attach real dollar costs to each analysis type. We found considerable differences in computational requirements, runtimes and costs associated with different microbial genomics applications. While all 16S analyses completed on a single-CPU desktop in under three hours, microbial genome and metagenome analyses utilized multi-CPU support of up to 120 CPUs on Amazon EC2, where each analysis completed in under 24 hours for less than $60. Representative datasets were used to estimate maximum data throughput on different cluster sizes and to compare costs between EC2 and comparable local grid servers.ConclusionsAlthough bioinformatics requirements for microbial genomics depend on dataset characteristics and the analysis protocols applied, our results suggests that smaller sequencing facilities (up to three Roche/454 or one Illumina GAIIx sequencer) invested in 16S rRNA amplicon sequencing, microbial single-genome and metagenomics WGS projects can achieve cost-efficient bioinformatics support using CloVR in combination with Amazon EC2 as an alternative to local computing centers.

Insider Ownership, Institutional Ownership, and the Timing of Open Market Stock Repurchases

Using a unique dataset of monthly repurchase data, we investigate the timing of US open market stock repurchases. We find strong evidence that repurchase transactions follow abnormal price declines and precede abnormal price increases. Moreover, average repurchase prices are lower than comparable average market prices, and the cost of a firm’s repurchases is below benchmark costs of the same repurchases. We show that a firm’s ownership structure is a crucial determinant of its tendency to repurchase stock at comparatively low prices (i.e. to time repurchases). As insider ownership increases, a firm’s ability to time repurchases decreases. Also, at low levels of institutional ownership, there is a positive relation between this variable and a firm’s tendency to time repurchases; this relation becomes negative when institutional ownership is high. JEL Classifications: G14, G35. * Corresponding author: Amedeo De Cesari, Assistant Professor in Finance, Finance, Accounting, and Law Group, Aston Business School, Aston University, Aston Triangle, Birmingham B4 7ET, the United Kingdom; Tel.: +44 (0) 121 2043028; email: a.decesari@aston.ac.uk.

Flexible Insurance for Separate Accounts

With the advances in technology and lower costs to trading, separate account platforms and online brokers should be able to offer customized portfolio protection to their clients with the click of a button. This paper uses basic concepts from the option literature to show how this insurance could be oflered in two convenient forms. In one form, it would represent a straight cash payment by customers, and in another form, investors would exchange a portion of the upside of their returns for the protection. The paper uses the Black -Scholes model to show the benchmark costs associated with this type of protection, as well as performs a sintulation with an actual portfolio over various sub-periods from 2000 to 2006.

SELECTED ALTERNATIVES TO METHYL BROMIDE IN THE POSTHARVEST AND QUARANTINE TREATMENT OF ALMONDS AND WALNUTS: AN ECONOMIC PERSPECTIVE

Methyl bromide is a highly effective fumigant used in the postharvest and quarantine treatment of tree nuts. There will be a complete phase out in the United States of America (U.S.) of methyl bromide by 2005 according to The Montreal Protocol of 1991 with the exception of preshipment and quarantine uses as stated in the 1998 Clean Air Act. This study analyzed alternative treatment scenarios. The alternatives considered were phosphine, irradiation, and controlled atmosphere storage. Costs for each scenario were developed. Cost increases with irradiation ranged from two to fourteen times the benchmark costs for methyl bromide. Controlled atmosphere storage for both commodities had cost increases ranging from 174% to 256% over methyl bromide costs. Phosphine was used only to treat almonds. Phosphine application costs were 108% and 117% above the benchmark costs for methyl bromide. Le bromomethane est un pesticide a large spectre utilise dans les traitements apres recolte des noix et amandes. Cette etude evalue 3 methodes alternatives de traitement qui sont la phosphine, une irradiation gamma et un entreposage sous atmosphere controlee. Le but de cette etude est d'etablir des comparaisons entre ces methodes et de determiner le traitement le plus economique pour chacun des produits.

Changing maintenance procurement requires benchmark costs

Changing maintenance procurement requires benchmark costs

Benchmark costs for buildings

Benchmark costs for buildings

Better Medicare Cost Report Data are Needed to Help Hospitals Benchmark Costs and Performance

To evaluate costs and achieve cost control in the face of new technology and demands for efficiency from both managed care and governmental payers, hospitals need to benchmark their costs against those of other comparable hospitals. Since they typically use Medicare Cost Report (MCR) data for this purpose, a variety of cost accounting problems with the MCR may hamper hospitals' understanding of their relative costs and performance. Managers and researchers alike need to investigate the validity, accuracy, and timeliness of the MCR's cost accounting data.

The next ten years of health spending: what does the future hold? The Health Expenditures Projection Team.

The next ten years of health spending: what does the future hold? The Health Expenditures Projection Team.