Distribution Of Payments Research Articles

Private Insurers’ Payments For Routine Physician Office Visits Vary Substantially Across The United States

Anecdotal reports suggest that substantial variation exists in private insurers' payments for physician services, but systematic evidence is lacking. Using a retrospective analysis of insurance claims for routine office visits, consultations, and preventive visits from more than forty million physician claims in 2007, we examined variations in private payments to physicians and the extent to which variation is explained by patients' and physicians' characteristics and by geographic region. We found much variation in payments for these routine evaluation and management services. Physicians at the high end of the payment distribution were generally paid more than twice what physicians at the low end were paid for the same service. Little variation was explained by patients' age or sex, physicians' specialty, place of service, whether the physician was a "network provider," or type of plan, although about one-third of the variation was associated with the geographic area of the practice. Interventions that promote more price-consciousness on the part of patients could help reduce health care spending, but more data on the specific causes of price variation are needed to determine appropriate policy responses.

Modelling “shallow loss” crop revenue programs

PurposeThe purpose of this paper is to investigate changes proposed in 2012 to commodity programs for the new Farm Bill. Both the Senate and House Agriculture Committee versions of the new Farm Bill eliminate current commodity programs including direct payments, create new revenue‐based commodity program options designed to cover “shallow” revenue losses, and also introduce supplemental crop insurance coverage for shallow revenue losses.Design/methodology/approachThis paper documents the payment functions for the new revenue programs proposed in both the Senate and House Ag Committee Farm Bills, and also estimates expected payments for each using a model based on historical county yield data, farmer‐level risk rates from RMA, and commodity price levels from the March 2012 CBO baseline projections.FindingsThe authors find significant variation in expected per acre payment across programs, crops, and regions. In general, the Senate's bill would be expected to be preferred over the House's bill for corn and soybean producers, particularly those in the Midwest. Also, the RLC program in the House's Bill typically would be projected to pay much less than the Senate's SCO or ARC programs for most producers in the Midwest.Originality/valueThis study develops an extensive nationwide model of county and farm yield and price risks for the five major US crops and employs the model to evaluate expected payment rates and the distribution of payments under the House and Senate Farm Bill proposals. These analyses are important for program evaluation and should be of great interest to producers and policymakers.

A time-consistent model for cooperation in international pollution control

In this paper, transnational pollution is formulated as a differential game between sovereign governments. We consider the case when the countries want to cooperate and agree to act so that an international optimum can be achieved. For the cooperative scheme to be upheld throughout the game horizon, both group rationality and individual rationality are required to be satisfied at any point in time along the optimal trajectory. A payment distribution scheme is formulated to guarantee time consistency. We conclude that a payoff transfer is not necessary to ensure cooperation given that the countries are different only in environmental efficiency. However, if the countries differ in terms of damage parameters, a payoff transfer from the country with higher damage parameters to the country with lower damage parameters is required for the time-consistent cooperative solution.

The Viability of the $30 (or Less) Casebook

It is not uncommon for a new hardbound copy of today’s law school casebooks to exceed $200. And, each year, the prices inch ever higher. After exploring the various dynamics in the traditional publishing market that have led to the current prices for casebooks, this article describes the experiences of Semaphore Press, a publisher of law school casebooks that offers a very different approach to providing law school casebooks. Semaphore Press offers digital copies of required textbooks for law school classes, (in pdf format with no digit rights management (DRM) restrictions), at a suggested price of $30. In addition, students can alter the price they pay, paying less or more than the suggested price, or they even download a copy of a required casebook for free. Semaphore Press’s commitment, embodied in this design, is that - whatever else happens - the student obtains access to the course materials. This article explores the viability of this model, sharing data gathered over past semesters. Approximately 83% of students enrolled in courses in which a Semaphore Press book was assigned paid for the book. The article details the amounts of student payments, and explores why students may be paying for digital books that they know they can obtain for free. The Semaphore Press experience with digital casebooks containing no DRM suggests that under current market conditions, a voluntary payment distribution model with a suggested $30 price is not only a model welcomed by law students, but it is a viable option both for authors and adopting professors.

The making and unmaking of community-based water supplies in Manila

This article tracks the rise and fall of a community-based water supply programme in Manila, providing important insights into the issues of community participatory approaches to service provision, as well as the privatisation of basic services and public goods. The Manila Water Corporation, a private, for-profit company, developed an innovative programme to provide water to informal settlements through bulk connections, deploying the discourse of public participation to effectively transfer responsibility for distribution and collection of payments to local water users' organisations. The programme achieved considerable success, and also empowered local organisations or (more often) individuals, who used some of their increased legitimacy, influence, and income to mobilise for squatters' rights, challenging landlords and local governments. After an initial period, the company changed its policy and shifted instead to a programme that provides individual connections to informal settlements' households, su...

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One critical element for the success of REDD+implementation is its governance. The study aims to identify and analyze the existing REDD+ institutions from good governance point of view. The study are located in Central Lombok and Berau Districts, where REDD+ Demontration Activities already existed. In general, the study used qualitative methods, supported with scoring methode. The results show that REDD+ institutions have not fully reflected the three pillars of good governance, that there are still lack of community representation. Indicator of professionalism is at the highest score, while the indicator of participation is at the lowestscore. The institutions also have notapplied the principles of good governance yet. Allexisting REDD+ institutions are still temporary, that didn't represent a learning organization and tends overlapping functions. The research suggests several things: (i) Strengthening forest governance on the existing REDD+ institution carried out through strengthening the pillars of society and strengthening the principles of participation, (ii) Involvement of the communities should be enhanced in the institutional structure of REDD, (iii) Comprehensive assessment of the principles of good governance in the REDD+ institution at implementation stage that include payment distribution mechanism for emission reduction activities already undertaken, (iv) The function of the facilitate needs to be strengthened and (v) The structure institutions follow a REDD + strategies.

A Cooperative Differential Game Model for Multiuser Rate-Based Flow Control

Flow control is one typical resource management tool. Its objectives are to adjust the traffic in the network, and resolve data traffic congestion, maximize the utilization of available bandwidth resource and realize fairness among different sources. Taking more consideration on the interaction and the dynamic characteristics of the flow, in this paper, we propose a cooperative differential game of flow control. Our goal is to assign sources with appropriate transmission rate levels so as to the queue length in the bottleneck link is optimal for the network performance and their benefits are maximal. We derive a payment distribution mechanism that would constitute a time-consistent solution and guarantee individual rationality.

The Costs of Organisational Injustice in the Hungarian Health Care System

The new Hungarian Labour Code allows informal payments to be accepted, subject only to the prior permission of the employer. In Hungary, the area most affected is Health Care, where informal payments to medical staff are common. The article assesses the practice on ethical terms, focusing on organisational justice. It includes an analysis of distributional injustice, that is, of non-equitable payments to professionals, on the distribution of payments depending on the specialisation and status of the doctor, on his or her rights to allocate Health Care resources and/or on how assertive he or she is. We show, by means of a content analysis of internet postings and of interviews with physicians, the feelings and attitudes of both patients and doctors—thus enabling us to trace interactional and procedural injustice and portray the main driving forces of informal payment with causal loops. We use a new approach (a system dynamics computer simulation) to demonstrate how informal payments influence therapy procedures. The example of treating the common skin disease of psoriasis examines the specific behaviour of doctors in their everyday practice and estimates the extent to which the prescription of unnecessary or more expensive therapy increases the costs. With this multi-method approach, we demonstrate that the legislation allowing informal payment represents bad ethics, since it enforces organisational injustice, creates mistrust between physicians and patients, decreases performance and increases the total costs paid both by society and the Health Insurance Fund. Informal payments distort the allocation of resources, enforce discrimination based solely on money, violate the concept of solidarity and limit Human Rights in terms of health.

The farm size in the less-favoured areas and the economy of support spending on public goods production in the case of the Czech Republic

Opportunities for savings in both human labour and technical equipment were tested on the case of large farms situated in the less-favoured areas (LFA). Large LFA farms were found to be undoubtedly more efficient than the small ones, as well as the diversification of activities (to non-agricultural) was much wider at the large farms in the Czech Republic (CR). The targeting of the objectives of the LFA measure was analysed on the cases of the selected types of the small and large farms and also the amounts of support, devoted to reach these objectives. The paper further analyses economic results of the small and large farms in the LFA within the CR, and evaluates the impacts of the current LFA measures, where the payment distribution is based only on the grassland area, regardless of the farm size in the CR. Based on these analyses, it was suggested to distribute the LFA payments in the CR per 1ha of utilised agricultural area of farm. Also, it was showed that it would be suitable to introduce a graded decrease of the LFA payments rates according to the farm size. The analysis proves that the economic survival of the large farms, measured as the farm net value added per one annual work unit, will not be endangered.    

Exploring the distribution of direct payments of the Common Agricultural Policy

Direct payments are the most important expenditure of the Common Agricultural Policy (CAP). They are mostly spent on decoupled direct payments which are intended to be allocatively neutral. Increasing volumes of such transfers imply that distributive aspects of CAP expenditures become more important. This article looks at this issue by calculating various measures of concentration based on statistics on recipients of direct payments in EU27 in the period from 2000 to 2010. The findings are evaluated in the context of the objectives of the CAP and the reform proposals of the EU Commission from October 2011. It seems that country specific factors determine the concentration of direct payments and its change over time.

Who pays and who benefits from health care? An assessment of equity in health care financing and benefit distribution in Tanzania

Little is known about health system equity in Tanzania, whether in terms of distribution of the health care financing burden or distribution of health care benefits. This study undertook a combined analysis of both financing and benefit incidence to explore the distribution of health care benefits and financing burden across socio-economic groups. A system-wide analysis of benefits was undertaken, including benefits from all providers irrespective of ownership. The analysis used the household budget survey (HBS) from 2001, the most recent nationally representative survey data publicly available at the time, to analyse the distribution of health care payments through user fees, health insurance contributions [from the National Health Insurance Fund (NHIF) for the formal sector and the Community Health Fund (CHF), for the rural informal sector] and taxation. Due to lack of information on NHIF and CHF contributions in the HBS, a primary survey was administered to estimate CHF enrollment and contributions; assumptions were used to estimate NHIF contributions within the HBS. Data from the same household survey, administered to 2224 households in seven districts/councils, was used to analyse the distribution of health care benefits across socio-economic groups. The health financing system was mildly progressive overall, with income taxes and NHIF contributions being the most progressive financing sources. Out-of-pocket payments and contributions to the CHF were regressive. The health benefit distribution was fairly even but the poorest received a lower share of benefits relative to their share of need for health care. Public primary care facility use was pro-poor, whereas higher level and higher cost facility use was generally pro-rich. We conclude that health financing reforms can improve equity, so long as integration of health insurance schemes is promoted along with cross-subsidization and greater reliance on general taxation to finance health care for the poorest.

Stete od divljači na poljoprivrednim kulturama u Hrvatskoj

Conflicts between wildlife and humans have been reported from all over the world, but in Croatia the extent and intensity of the conflict is increasing. Agricultural damage by game is a major concern for both agricultural and wildlife agencies at the national level. In this study 4,695 cases of game damage over a 4-year period were analysed. Results indicated that the total amount of economic impact on agriculture from game damage was significant. The distribution of payments shows that a majority of payments have lower economic value with an average amount of single payment being 477.08 €. The annual number of payments was found to have a negative correlation coefficient (-0.469) to the total payment amount for damages. According to the number of payments (68% of the number of payments) and the payment amount (60% of total payment amount), the crop most often damaged was maize. Analysis of the data found that there was a negative growth trend of payment frequency and total payment amount for grape vineyards. The correlation between yearly number of payments and yearly production was not calculated for any crop. The high seasonal nature of payments was a determent of seasonal regression using a dummy variable regression (r2=0.93). A comparison of the monthly number of payments and monthly amounts is depicted by a time series using a seasonal line. The impact of wild boar damage on agriculture crops, in total, leads to the conclusion that this game species is a major problem. The results showed a specific subset of game damage in Croatia and, as such, it can be extrapolated to provide insight into the damage caused by wild boar in other countries.

Simulation analysis of medical insurance cost for urban residents in Kunming, China

Objective To predict the medical expenses and distribution of different medical payments of urban residents in Kunming,who are covered by the medical insurance scheme.Methods We created a static micro-simulation model for predicting and evaluating the 2008-2010 medical insurance scheme for urban residents of Kunming.The main datasets used for constructing the model included: a 0.1% population sample dataset from the national census of 2000 and a dataset of urban employees and retirees under the social medical insurance scheme.Other data used in the model involved the aggregated results of 1% population survey of Kunming conducted in 2005.Results Based on the population model of 2005,the population information and the data of employees and retirees covered by the social medical insurance scheme were integrated.The model provided information on resident incomes,medical expenses,medical expenses of outpatient services and severe illness;and the different kinds of payments could be forecasted by the model.Conclusion Results of the present research can help the government in making relevant heath policies while ensuring the sustainable development of medical insurance scheme.

Numbers and spatial distribution of payments granting decisions within the Common Agricultural Policy measures implemented in Poland over years 2002-2010

The article offers an assessment of spatial differences in the structure of payment granting decisions under the EU Common Agricultural Policy. The analysis was conducted for individual EU assistance measures divided into two groups: 1) intensifying measures, intended to step up production and improve the competitiveness of agriculture and 2) extensifying measures, intended to improve the environment and to help rural areas to diversify into non-agricultural activities. It was demonstrated that payments of group 2 prevailed in numerical terms, which was largely a result of the high participation of agricultural holdings in the agri-environmental programm

The Effects Of The Distribution Of Agricultural Direct Payments

The Common Agricultural Policy (the CAP) is the most important common policy of the European Union, for which reason it traditionally monopolizes a large part of the European Union budget. Without doubt, the aids that farms receive from this policy are the pillar on which it sustains the battered agricultural sectors. Among CAP aid, direct payments are particularly important, in 2008 accounting for about 37% of the total EU budget. The main objective of this paper is to analyse the effects that the distribution of the CAP direct payments have on the agrarian economy. Specifically, we have analysed the equality level in distribution of CAP direct aid in the countries of the European Union using a concentration index. In this way, we have examined the fairness of distribution of CAP direct aid in the agricultural sector.

Norms, moods, and free lunch: Longitudinal evidence on payments from a Pay-What-You-Want restaurant

We study the distribution and evolution of payments in a Pay-What-You-Want restaurant. Despite missing price tags and despite the option to pay nothing at all, we observe that the vast majority of guests makes strictly positive payments. Over the two years covered by our data, average payments decline slightly, converging at a positive level. At the same time, the number of daily guests increases steadily, resulting in a considerable increase in total revenues. We discuss one possible interpretation of the long-term trend in payments in terms of social norms. We further show that short-term fluctuations in average payments are partly explained by exogenous weather changes. We provide evidence that – in line with work in psychology – weather-induced changes in mood affect payments.

Cost-effectiveness targeting under multiple conservation goals and equity considerations in the Andes

SUMMARYInternationally, there is political impetus towards providing incentive mechanisms, such as payments for ecosystem services (PES), that motivate land users to conserve that which benefits wider society by creating an exchange value for conservation services. PES may incorporate a number of conservation goals other than just maximizing the area under a certain land use, so as to optimize multiple benefits from environmental conservation. Environmental additionality (conservation services generated relative to no intervention) and social equity aspects (here an equitable distribution of conservation funds) of PES depend on the conservation goals underlying the cost-effective targeting of conservation payments, which remains to be adequately explored in the PES literature. This paper attempts to evaluate whether multiple conservation goals can be optimized, in addition to social equity, when paying for the on-farm conservation of neglected crop varieties (landraces), so as to generate agrobiodiversity conservation services. Case studies based on a conservation auction in the Bolivian and Peruvian Andes (through which community-based groups identified the conservation area and the number of farmers taking part in conservation, as well as the payment required), identified significant cost-effectiveness tradeoffs between alternative agrobiodiversity conservation goals. There appears to be a non-complementary relationship between maximizing conservation area under specific landraces (a proxy for genetic diversity maintenance) and the number of farmers conserving such landraces (a proxy for agricultural knowledge and cultural traditions maintenance). Neither of the two are closely connected with maximizing the number of targeted farming communities (a proxy for informal seed exchange networks and hence geneflow maintenance). Optimizing cost-effectiveness with regard to conservation area or number of farmers would also be associated with a highly unequal distribution of payments. Multi-criteria targeting approaches can reach compromise solutions, but frameworks for these are still to be established and scientifically informed about the underlying link between alternative conservation goals and conservation service provision.

Appropriate Methods for Evaluating the Agricultural Policies Consequences at the Farm Level

TheCommon Agricultural Policyis foreseen to suffer important reforms after 2013, which will greatly affect the farms production environment. For thea priorianalysis of such policy measures, there was built a recursive single period model adapted to the Romanian farming system. The positive mathematical programming method in use, proved to be in the last period highly applied inagricultural policiesimpact studies at the European level. Furthermore, the model was employed in order to test three different agricultural scenarios that were proposed by the European Commission as reform alternatives. The first policy option presumes to leave unchanged the current direct payment system while slightly changing the payment distribution pattern among Member States. The second policy option envisages substantial changes of the direct payment system that would be allocated only if farmers bring societal benefits. The last option consists in phasing outdirect paymentsand provides limited financial support to farmers through the second Common Agricultural Policy pillar (rural development). All these options were investigated on the economical and financial data of 21 Romanian farms categorized according to the European classification system as mixed crops livestock farms. Results show that all these policy options have important effects on the farm revenue, in the sense that a decrease in the subsidy level produces important average gross margin falls. Soft landing approach in the first CAP pillars reform is desirable especially for the Romanian agriculture that still presents important farm structural shortcomings.

Impact of the Transition to ICD-10 on Medicare Inpatient Hospital Payments

On October 1, 2013, the reporting of diagnoses and procedures in the U.S. will transition from the clinical modification of the ninth revision of the International Classification of Diseases (ICD-9-CM) to the tenth revision (ICD-10). We estimate the impact of conversion to ICD-10 on Medicare MS-DRG payments to hospitals using 2009 Medicare data. Using the ICD-9-CM MS-DRG v27 (FY 2010), the converted ICD-10 MS-DRG v27, and the ICD-10 to ICD-9-CM Reimbursement Map for fiscal year 2010, we estimate the impact on aggregate payments to hospitals and the distribution of payments across hospitals. Although the transition from the ICD-9-CM to the ICD-10 version of MS-DRGs resulted in 1.68 percent of the patients being assigned to a different MS-DRG, payment increases and decreases due to the changes in MS-DRG assignment essentially netted out, resulting in a minimal impact on aggregate payments to hospitals (+0.05 percent) and on the distribution of payments across hospital types (-0.01 to +0.18 percent). Mapping ICD-10 data back to ICD-9-CM, and using the ICD-9-CM MS-DRGs, resulted in 3.66 percent of patients being assigned to a different MS-DRG, a modest decrease in aggregate payments to hospitals (-0.34 percent), and modest changes in the distribution of payments across hospital types (-0.14 to -0.46 percent). As demonstrated by MS-DRGs, a direct conversion of an application to ICD-10 can produce consistent results with the ICD-9-CM version of the application. However, the use of mappings between ICD-10 and ICD-9-CM will produce less consistent results, especially if the mapping is not tailored to the specific application.

The Welfare Effects of Health-Based Food Tax Policy

This paper examines the effects of health-oriented food tax reforms on the distribution of tax payments, food demand and health outcomes. Unlike earlier work, we also take into account the uncertainty related to both demand estimation and health estimates and report the confidence intervals for the overall health effects instead of only point estimates. A sugar tax of 1 € / kg reduces the incidence of type 2 diabetes on average by 13% and it also leads to a reduction in coronary heart disease. The health effects appear to be most pronounced for low-income individuals, and the reforms may therefore reduce health inequality. This effect undermines the traditional regressivity argument against the heavy taxation of unhealthy food.