Deductible Research Articles

Has the R&D Extra Deduction Policy Stimulated the R&D Efficiency of Enterprises? --An Empirical Study based on Listed Chinese Manufacturing Enterprises

Has the R&D Extra Deduction Policy Stimulated the R&D Efficiency of Enterprises? --An Empirical Study based on Listed Chinese Manufacturing Enterprises

Ambulatory Surgery Centers Reduce Patient Out-of-Pocket Expenditures for Isolated Arthroscopic Rotator Cuff Repair, but Patient Out-of-Pocket Expenditures Are Increasing at a Faster Rate Than Total Healthcare Utilization Reimbursement From Payers

To categorize and trend annual out-of-pocket expenditures for arthroscopic rotator cuff repair (RCR) patients relative to total healthcare utilization (THU) reimbursement and compare drivers of patient out-of-pocket expenditures (POPE) in a granular fashion via analyses by insurance type and surgical setting. Patients who underwent outpatient arthroscopic RCR in the United States from 2013 to 2018 were identified from the IBM MarketScan Database. Primary outcome variables were total POPE and THU reimbursement, which were calculated for all claims in the 9-month perioperative period. Trends in outcome variables over time and differences across insurance types were analyzed. Multivariable analysis was performed to investigate drivers of POPE. A total of 52,330 arthroscopic RCR patients were identified. Between 2013 and 2018, median POPE increased by 47.5% ($917 to $1,353), and median THU increased by 9.3% ($11,964 to $13,076). Patients with high deductible insurance plans paid $1,910 toward their THU, 52.5% more than patients with preferred provider plans ($1,253, P= .001) and 280.5% more than patients with managed care plans ($502, P= .001). All components of POPE increased over the study period, with the largest observed increase being POPE for the immediate procedure (P= .001). On multivariable analysis, out-of-network facility, out-of-network surgeon, and high-deductible insurance most significantly increased POPE. POPE for arthroscopic RCR increased at a higher rate than THU over the study period, demonstrating that patients are paying an increasing proportion of RCR costs. A large percentage of this increase comes from increasing POPE for the immediate procedure. Out-of-network facility status increased POPE 3 times more than out-of-network surgeon status, and future cost-optimization strategies should focus on facility-specific reimbursements in particular. Last, ambulatory surgery centers (ASCs) significantly reduced POPE, so performing arthroscopic RCRs at ASCs is beneficial to cost-minimization efforts. This study highlights that although payers have increased reimbursement for RCR, patient out-of-pocket expenditures have increased at a much higher rate. Furthermore, this study elucidates trends in and drivers of patient out-of-pocket payments for RCR, providing evidence for development of cost-optimization strategies and counseling of patients undergoing RCR.

Macro tax incentives and corporate sustainable innovation: Evidence from Chinese Enterprises.

Innovation has become the driving force behind China's economy's sustainable growth. Due to the efficient transmission of taxation leverage, preferential tax policies are frequently used to stimulate innovation. Therefore, the incentive effect of preferential tax policies on sustainable innovation has gradually become the focus of attention. This paper takes the 2016-2019 China A-share listed high-tech enterprises as a sample, calculates tax incentive intensity with the aid of B-index, and studies the incentive effect of preferential tax policies on the sustainability of corporate innovation. This study shows that: (1) Tax incentive intensity has a positive incentive effect on corporate sustainable innovation. (2) The R&D expenses plus deduction policy and the preferential tax rate policy can significantly enhance corporate sustainable innovation, but there is a substitution effect between them. (3) Based on the heterogeneity of institutional environment and enterprise characteristics, the incentive effect of tax preferential policies is more obvious in enterprises which are non-state-owned and in areas with low government intervention and sound legal system. However, the incentive effect of different types of preferential policies differs in the size of the enterprise. This study will provide reference for the improvement of preferential tax policy system and the optimization of innovation policy environment.

Tax incentives and upward R&D manipulation – evidence from the R&D tax deduction policy in China

PurposeThis paper investigates whether China's R&D tax deduction policy triggers firms to manipulate their R&D expenditures upward.Design/methodology/approachThis paper employs the ratio of actual tax savings as a proxy for the benefits of the R&D tax deduction policy based on manually collected and systematically cross-checked data. The relationship between tax benefits and abnormal R&D spending is estimated in a sample of Chinese A-share listed companies for the period 2007–2018.FindingsThe findings suggest that tax deductions lead to positive abnormal R&D spending and that this deviation in R&D spending may be attributed to firms' upward R&D manipulation for tax avoidance. The results also indicate that this behavior is more significant for the period after the policy revision, in non-HNTEs (high and new technology enterprises), and in firms with a high ratio of R&D expenses.Research limitations/implicationsIt is difficult to establish a sophisticated and unified model to identify the specific strategy of upward R&D manipulation that firms use to obtain tax benefits.Practical implicationsManagers should take into account upward R&D manipulation when designing governance mechanisms. Policymakers in developing countries may further pursue preferential tax policies that cover every stage of innovation activities gradually; the local provincial governments need to leverage their proximity and flexibility advantages to develop a tax collection and administration system.Originality/valueThis study contributes to the understanding of the complex effect of R&D tax incentives and helps more fully illuminate firms' upward R&D manipulation behavior from the perspective of tax planning strategies, which are underexplored in previous research.

R&D Deduction Intensity, Entrepreneurship and Total Factor Productivity of Firms

This paper selects A-share listed manufacturing companies from 2016 to 2022 for analysis, and uses the data to investigate the interrelationships among three dimensions: the strength of R&D add-on deduction, entrepreneurship, and total factor productivity of firms. The aim is to explain the policy implementation effects of China's R&D add-on deduction policy since the 1990s. This paper examines the significant effect of the strength of the add-on deduction policy on enhancing the total factor productivity of firms and the positive moderating role of entrepreneurship in the impact of the strength of R&D add-on deduction on the total factor productivity of firms. The purpose of this paper is to provide a realistic basis for the national policy of optimizing R&D cost-added deduction to promote high-quality development of China's listed manufacturing industry.

Are incentives excessive or insufficient? The impact of R&D fiscal policies on R&D inefficiency in China

The extant literature on evaluating the influence of R&D fiscal policies primarily focused on the advantages of the input or output additionality, neglecting that excessive incentives caused by R&D fiscal policies may lead to R&D inefficiency. From the perspective of resource misallocation, this paper divides R&D inefficiency into input redundancy and output insufficiency, then further measures the impact of three typical R&D fiscal policies on R&D inefficiency based on the firm-level sample of Zhongguancun Science Park in China. A two-step empirical analytical framework is constructed in this paper, namely, the inefficiency measurement step and the influence assessment step. The results prove that R&D fiscal policies may lead to resource misallocation and aggravate R&D inefficiency, and the heterogeneous conclusions cross three policies are found. Specifically, the subsidy policy significantly promotes the increase of R&D inefficiency, which primarily reflects in the rise of input redundancy. The pre-tax additional deduction policy does not show a significant impact on the R&D inefficiency but increases the input redundancy. On the contrary, the preferential tax rate for high-tech enterprises policy effectively inhibits the inefficiency. This paper not only attempts to reveal the formation of R&D inefficiency theoretically from the perspective of resource misallocation, but also takes China as an empirical sample to provide evidence for guiding the design of more effective R&D fiscal policies.

Cost-benefit analysis of Intensive Care Unit with Activity-Based Costing approach in the era COVID-19 pandemic: A case study from Iran.

Providing intensive care to acute patients is a vital part of health systems. However, the high cost of Intensive Care Units (ICU) has limited their development, especially in low-income countries. Due to the increasing need for intensive care and limited resources, ICU cost management is important. This study aimed to analyze the cost-benefit of ICU during COVID-19 in Tehran, Iran. This cross-sectional study is an economic evaluation of health interventions. The study was conducted in the COVID-19 dedicated ICU, from the provider's point of view and within one-year horizon. Costs were calculated using a top-down approach and the Activity-Based Costing technique. Benefits were extracted from the hospital's HIS system. Benefit Cost ratio (BCR) and Net Present Value (NPV) indexes were used for cost-benefit analysis (CBA). A sensitivity analysis was performed to evaluate the dependence of the CBA results on the uncertainties in the cost data. Analysis was performed with Excel and STATA software. The studied ICU had 43 personnel, 14 active beds, a 77% bed occupancy rate, and 3959 occupied bed days. The total costs were $2,372,125.46 USD, of which 70.3% were direct costs. The highest direct cost was related to human resources. The total net income was $1,213,314.13 USD. NPV and BCR were obtained as $-1,158,811.32 USD and 0.511 respectively. Despite operating with a relatively high capacity, ICU has had high losses during the COVID-19. Proper management and re-planning in the structure of human resources is recommended due to its importance in the hospital economy, provision of resources based on needs assessment, improvement of drugs management, reduction of insurance deductions in order to reduce costs and improve ICU productivity.

A Scoping Review of Health Insurance Deductions in Hospitals: Root Causes and Solutions

Context: The issue of insurance deductions is one of the major problems that lead to the shortage of financial resources in hospitals. The present study was conducted to review the root causes of insurance deductions and propose solutions to reduce them in Iranian hospitals. Methods: This was a scoping review of the literature on health insurance deductions in hospitals in Iran within 2000 - 2023 to synthesize the findings of original Persian and English studies that focused on the causes of deductions and propose strategies to reduce them in Iranian hospitals. The relevant concepts and terminology in health insurance deductions were found through medical subject headings (MeSH). The articles were screened based on the preferred reporting items for systematic reviews and meta-analysis (PRISMA) checklist. Analysis of research data (text of the articles) was carried out by the content analysis technique in MAXQDA software (version 10). Results: A total of 1121 publications were identified, of which 41 publications met the inclusion criteria and were reviewed. Based on the present analysis, most studies (61%) were published within 2016 - 2020, 12.2% of the included studies were qualitative, and 48.8% were performed in hospitals. Finally, 46 causes of deductions and 35 solutions to reduce insurance deductions were extracted. The leading causes of deductions were associated with service delivery, service registration, sending documents, and conversion of services into revenue. The most important causes of deductions in dimensions of providing and registering services were a lack of familiarity of service providers with insurance rules and regulations, coding and relative value book, extravagance and motivation of providers to earn more revenue, and lack of strong infrastructure to register services. Furthermore, strategies for reducing health insurance deductions were categorized into three groups, namely meta (ministries of health), macro (universities), and mezzo (hospitals). The top strategies to reduce health insurance deductibles were associated with several dimensions, such as providers, process modification, policy reform, and infrastructure modification. The most important strategies to reduce deductions in these four dimensions were teaching the documentation principles to all medical staff, familiarizing physicians with insurance laws and correct coding, continuous interaction between insurance companies and hospitals, and revisions in the repayment system. Conclusions: The causes of deductions could be determined through several dimensions. To manage and reduce the number of deductions, these causes should be carefully examined in the dimensions of service delivery, service registration, and document regulation and audit, and each hospital should use relevant strategies according to the weak points. However, solving the issue of deductions is not only related to hospitals; it is necessary for policymakers and health managers in the ministries of health, universities of medical sciences, and health insurance organizations to adopt necessary policies, especially in the field of hospital information management, to reduce deductions. According to the presented topics, the efficiency of hospitals and, ultimately, the quality of medical care can improve through a correct and more accurate understanding of the causes of deficits. It also prevents the waste of financial resources in hospitals, which is the main support in providing services and survival.

The Reduction of Realized Variance in Deductible Insurance

The Reduction of Realized Variance in Deductible Insurance

Analysis of length of stay for patients admitted to Korean hospitals based on the Korean National Health Insurance Service Database

The aim of this study is not only to predict length of stay (LOS) for all patients admitted to medical institutions in South Korea, but also to unveil features that would significantly influence LOS. As our dataset, we used the 2016–2019 health checkup cohort DB data stored in the virtual server of National Health Insurance Service (NHIS) of Korea. Since this study presents the pioneer work of predicting LOS for all inpatients in South Korea to our best knowledge, we referred to extant literature completed elsewhere for feature selection with regard to LOS analysis. In this paper, we compared the prediction performance of inpatients' LOS between four machine learning models including XGBoost, Decision Tree, Random Forest, and Support Vector Machine. The results indicate that the XGBoost model shows the best performance with accuracy of 0.7472 and AUC of 0.88. Furthermore, using the XGBoost model, we discovered features that had a significant influence in predicting LOS with the use of feature importance. We found that the critical features in determining LOS were examination records which are consisted of age, the deductible insurance ratio and information with regard to one's main diagnosis and the number of sub diagnosis, the number of doctors and beds available in hospitals, cholesterol level, body mass index (BMI), and the admission month. The significance in this study is that we found the important common features that affect LOS for inpatients across medical department and we could make a generalization of our research result.

Study on the Influence of Additional Deduction Policy Adjustment on High-Tech Enterprises-Taking Lepu Medical as an Example

Study on the Influence of Additional Deduction Policy Adjustment on High-Tech Enterprises-Taking Lepu Medical as an Example

Регулирование применения технологий искусственного интеллекта в организационных системах

Currently there is no special legislative regulation in the Russian Federation that takes into account the specifics of the use of artificial intelligence technologies. There are acute issues of working out the mechanisms of civil liability in the event of harm caused by artificial intelligence systems that have a high degree of autonomy in their decision-making, including in terms of ways to compensate for the harm caused by the actions of such systems. Based on the analysis of foreign experience in the legal regulation of civil liability for harm caused by the activities of artificial intelligence systems, and the experience of forming the legal framework in the field of artificial intelligence in Russia, it is proposed to apply tort liability to activities related to the use of artificial intelligence systems, and compensation for damage caused by such activities to be carried out from the funds of a specially created system of compulsory civil liability insurance for developers and owners of artificial intelligence systems, including a specially introduced entity – a specialized operator of artificial intelligence systems, and provide for an insurance deductible due to the autonomy (unpredictability) of the actions of artificial intelligence systems intellect.

Determinants to the adoption of energy-efficient retrofits and the role of policy measures

ABSTRACT Buildings are responsible for around 45% of total energy consumption and one-third of CO2 emissions annually in Switzerland. Policymakers have argued that an increased rate of energy-saving retrofits in existing buildings will play a critical role in meeting the energy and climate policy goals. This article examines the determinants for the households’ investment decisions to undertake energy-efficient retrofits and investigates the role of policy measures. We estimate random effects probit models using a rich data for 1663 owned single-family Swiss households for retrofits undertaken during 2010 to 2014. Results suggest that while the building vintage appears to be a relevant determinant; energy-related attitudes of decision makers and policy instruments are also likely to play an important role. In particular, we find a suggestive evidence of tax deduction policy in supporting households’ decisions to undertake energy-saving retrofits as well as the intensity of renovation. Direct monetary policies such as tax deductions should be focused particularly upon poorly insulated old buildings and those that rely on non-renewable energy sources for heating purposes.

Analysis of drug prescriptions and insurance deductions of the governmental pharmacy of Lorestan University of Medical Sciences

Background: Standards-based prescribing can increase the effectiveness of treatment and the optimal management of financial resources, including reducing the costs of insurance deductions. Therefore, reducing insurance deductions is necessary for pharmacy management. So, this study aimed to analysis the prescriptions and insurance deductions of the governmental pharmacy of Lorestan University of Medical Sciences. Materials and Methods: This study is a retrospective cross-sectional study that includes a review of all prescriptions of the Social Security and the Armed Forces insurances. The information was collected through the checklist. Then, they were statistically analyzed by SPSS22 and excel software’s. Results: The results showed that the highest number of prescriptions is related to general practitioners and the highest monetary amounts of the monthly deductions related to the Armed Forces Insurance is “price adjustment and low demand” (1700606 Rials) and the highest monetary amounts of the deductions in connection with the Social Security Insurance is “wrong code of the medical system (4617125 Rials). Conclusion: Based on the results, it can be concluded that the most important causes of the deductions are related to human errors. Hence to reduce the deductions, first be more coordination’s between the insurances and pharmacies for covered items and the regulations second monitoring and up-to-date training of individuals on the correct entry of information based on the standards and regulations

Assessing the demand for hydrological drought insurance in irrigated agriculture

Concerns about hydrological drought risk and irrigation water supply reliability have grown in recent years due to the increasing demand for water for irrigation and other uses, and the decline in water availability due to climate change. Hydrological drought insurance hedging against water supply gaps can be a key instrument for adapting irrigated agriculture to this new scenario, since it improves the resilience of the irrigation sector, which is having to cope with increasing uncertainty and vulnerability. The objective of this paper is to assess farmers’ willingness to pay (WTP) for index-based hydrological drought insurance under different policy designs, considering several different amounts of insured capital, insurance deductibles, and contract terms. To that end, it uses a discrete choice experiment as the valuation method and the Sector BXII irrigation district (southern Spain) as a case study. The results show that farmers would be willing to pay for the proposed hydrological drought insurance, stating a higher preference for policy designs with lower amounts of insured capital, lower deductibles, and shorter contract terms. Moreover, the results also show the existence of heterogeneity among farmers’ preferences, depending on their socio-economic characteristics. Finally, we compare the distribution of farmers’ WTP for different policy design options of the proposed insurance with the commercial premium estimated using actuarial analysis. The comparison confirms that only the options with lower levels of insured capital present a mean WTP below the commercial premium, while the rest of the policy design options would need to be subsidized like other agricultural insurance schemes to make them attractive to most farmers.

A deductible comparison of cost per-loss, cost per-payment event, loss elimination ratio under exponentially and lognormally distributed severities

The maximum amount of losses retained by the insured under deductible policy modifications is usually set as part of the terms of the policy conditions. The objective of this study are to (i) estimate mean losses of an insured risk by means of the operational behavior of density function with deductible modifications and (ii) compare the mean severities under exponentially and log-normally distributed arbitrary policy in a cost per loss and cost per payment contingencies. The results show that despite the established fact in literature that log-normal severity distribution has a thicker tail than the exponential distribution, its cost per loss payment is correspondingly lower than the corresponding values of the exponential mean loss. Computational evidence over the trend of the change in the loss eliminated in the domain for which deductible has been defined revealed that the cost per loss amount is less than the cost per payment amount in the two models. The method can be used to estimate aggregate claims as the deductible level increases for every scheme holder and such that the estimated claims could be compared with the hypothetical observed claims which can be arrived at by applying the hypothetical deductible value to the background losses.

Assessing the Insurance Deductible Effect on Outcomes After Elective Spinal Surgery

Private insurers use the calendar deductible system, placing pressure on patients and medical personnel to perform medical services before the end of the year to maximize patient savings. The impact of the deductible calendar on patient-reported outcomes (PROs) after spine surgery is poorly understood. The objective of our study was to investigate if patients undergoing surgery in December had different PROs and demographics compared with all other months. The Quality Outcome Database, a national spine registry, was queried for patients who underwent elective spine surgery between January 2012 and January 2021 for degenerative spine conditions. PROs and demographics were compared between the December and non-December groups using various statistical tests. A total of 978 patients (9.3%) underwent anterior cervical discectomy and fusion in December versus 9548 (90.7%) in other months. There was a significantly higher percentage of patients in December who had private insurance and were employed. A total of 1104 patients (8.5%) underwent lumbar fusion in December versus 11,826 (91.5%) in other months. There was a significantly greater chance of undergoing surgery in December if patients had private insurance and were employed. Although some PROs were statistically significant for the lumbar and cervical cohorts between December and non-December patients, none were clinically significant. Patients undergoing elective spine surgery in December were more likely to have private insurance and be employed. PROs for ACDF and lumbar fusions were not affected by surgical timing (December yes/no). Other spinal procedures directed at more chronic diseases might be more susceptible to external influence of insurance deductibles.

Problems and Improvement of the Special Additional Deduction System of Personal Income Tax

The new individual income tax law was officially implemented in 2019, and one of the highlights is the new six special additional deduction policies. The emergence of the special additional deduction policy aims to solve the problems of people's livelihood, reduce the tax burden of the people, and achieve social equity. At this stage, various special additional deduction policies have been implemented in various places. While achieving certain results, the disadvantages of the policy have become increasingly prominent. The policy still needs to keep pace with the times, spit out the old and accept the new. This paper will analyze the problems existing in the implementation of the special additional deduction system of personal income tax at this stage, draw lessons from foreign beneficial experience, and combine social reality to put forward scientific and feasible suggestions for improving the special additional deduction system.

Optimal insurance strategy in a risk process under a safety level imposed on the increments of the process

The problem of designing an optimal insurance strategy in a modification of the risk process with discrete time is investigated. This model introduces stage-by-stage probabilistic constraints (Value-at-Risk (VaR) constraints) on the insurer's capital increments during each stage. Also, the set of admissible insurances is determined by a safety level reflecting a ‘good’ or ‘bad’ capital increment at the previous stage. The mathematical expectation of the insurer's final capital is used as the objective functional. The total loss of the insurer at each stage is modeled by the Gaussian (normal) distribution with parameters depending on a seded loss function (or, in other words, an insurance policy) selected. In contrast to traditional dynamic optimization models for insurance strategies, the proposed approach allows to construct the value functions (and hence the optimal insurance policies) by simply solving a sequence of static insurance optimization problems. It is demonstrated that the optimal seded loss function at each stage depends on the prescribed value of the safety level: it is either a stop-loss insurance or conditional deductible insurance having a discontinuous point. In order to reduce ex post moral hazard, we also investigate the case, where both parties in an insurance contract are obligated to pay more for a larger realization of loss. This leads to that the optimal seeded loss functions are either stop-loss insurances or unconditional deductible insurances.

Impacts of the Weighted Deduction Policy for R&D Expenses on Innovation Additionality of Firms: Empirical Evidence from China

Based on the data of 3894 companies disclosed in the 2014–2017 Small and Medium Enterprises (SME) Board and Growth Enterprise Market (GEM) Annual Reports, our research evaluates the impacts of the weighted deduction policy for research and development (R&D) expenses on innovation additionality in the “Propensity Score Matching” (PSM) approach, from the moderation perspective of marketization, market competition, and political connections. The empirical findings are as follows: (1) The weighted deduction policy for R&D expenses has a positive effect on the additionality of input and output. The policy has an “additionality effect” on invention patents and utility patents, but it is not significant on appearance patents. (2) Low degree of marketization and high degree of market competition have positive moderating effects on the additionality of input and output. (3) Political connections strengthen the incentive effect of the weighted deduction policy for R&D expenses on the additionality of input and output. From the perspective of additionality, our research results enrich the literature on studies of incentive effects of policy innovation and also provide empirical support for the adjustment of the weighted deduction policy for R&D expenses.