Financing Of Programs Research Articles

The ACA’s Medicaid Expansion: A Review of Ineligible Enrollees and Improper Payments

Enrollment in state-optional Medicaid expansions has significantly exceeded even the most optimistic forecasts. The open-ended federal financing of new adult Medicaid enrollees at elevated match rates — in excess of 90 percent — creates incentives for states and healthcare providers to improperly enroll new beneficiaries and inadequately monitor costs and eligibility. Several sources find that many states have done a poor job ensuring Medicaid enrollment only of those who meet eligibility requirements. First, several federal audits find massive problems with both incomplete and incompetent reviews and large-scale improper eligibility determinations. We summarize recent work that estimates causal effects of Medicaid expansions on enrollment. Using the publicly available American Community Survey, we demonstrate large increases in potentially improper enrollment from 2012 to 2017 in many expansion states across the United States. The evidence points to egregious eligibility errors in many states, including Arkansas, California, Colorado, Kentucky, Louisiana, Montana, New Mexico, New York, Oregon, Rhode Island, Washington, and West Virginia. Other expansion states have had much lower rates of improper enrollment. We offer recommendations to Congress, the Centers for Medicare and Medicaid Services, and the Congressional Budget Office on ways to confront improper enrollment in Medicaid, including both fundamental reform of program financing and meaningful federal oversight.

The History of ERAS (Enhanced Recovery After Surgery) Society and its development in Latin America.

The shortage of hospital beds and changes in the payment model have promoted an increased attention and financing of programs that focus on perioperative care efficiency in. Latin America. In this paper, Enhanced Recovery After Surgery (ERAS) programs developed by the ERAS® Society will be discussed. The implementation and use of ERAS®Society Guidelines consistently demonstrated a reduction in postoperative complications, hospital stay and costs. In the current paper, the definition of ERAS programs, their core elements, and the results of their implementation and regional developments are presented with special focus on Latin America.

Training upcoming academicians through interviews of pharmacy resident teaching certificate leaders.

Background:Discovering methods of Residency Teaching Certificate Programs (RTCPs) will allow for collaboration in developing best practices to ensure both high quality of programming and outcomes for participants.Objective:The primary objective of this project is to describe and compare how RTCPs are conducted in the state of Ohio. Secondarily, to identify current practices in assessing RTCPs in both programmatic effectiveness and individual resident teaching outcomes.Methods:The seven coordinators of the seven Ohio RTCPs (n=7) were contacted via email and asked to participate in an IRB-approved interview, either in-person or telephonically. Standardized questions were developed to inquire about six categories of interest: demographics/background, administration/logistics, content, assessment of the resident, program financing, and program continuous quality improvement (CQI). All seven programs participated in interviews. Data was coded by multiple members of the research team for presentation in aggregate form.Results:RTCPs include seminar days at the respective pharmacy colleges; however, the number, length, and content of seminars vary. The majority of programs (n=5) stated using inherited curriculum and materials passed down from previous coordinators. While each RTCP requires participants to submit a teaching portfolio, only three of seven programs assess the summative portfolios. All programs (n=7) award participants a certificate based on completion of requirements without a defined minimum performance standard. Two programs are collecting participant feedback after every session for CQI however no programs are completing an annual programmatic assessment of resident outcomes. The majority of coordinators (n=7) are interested in collaborating and sharing “best practices” between RTCPs in the state.Conclusions:Although published and available resources exist surrounding the development and delivery of RTCPs, in Ohio, their use varies greatly. The most striking outcomes highlighted the lack of resident and program assessment of outcomes in RTCPs. The research has brought forth ideas of ways to improve these programs through resident assessment, program assessment and also leads to reflection and innovation around the best way to deliver these programs.

ФІНАНСУВАННЯ ДЕРЖАВНИХ СОЦІАЛЬНИХ ПРОГРАМ: НОВІТНІ ПІДХОДИ ТА ІНСТРУМЕНТИ

A characteristic feature of the current stage of development of society is the socialization of economic systems and the subordination of the economic function of the state to social goals. State social programs play an important role in achieving them. The current state of their implementation in Ukraine significantly raises issues related to the formation of an effective system of financial support for state targeted social programs. The limited traditional sources of funding for state targeted programs actualizes the search for alternative forms and ways of their financial support. Attention to this issue was paid in the works of such researchers: L. Alekseenko, L. Barannyk, A. Barrientos, A. Boyko, V. Danylyshyn, O. Danyliuk, I. Yevdokimova, V. Zayats, V. Zyuzina, L. Lysyak, E. Libanova, O. Luta, O. Malinowska, N. Morel, J. Palme, N. Pigul, O. Ponomarenko, I. Prikhno, O. Staff, O. Tulai, B. Shulyuk and others. Today's realities require new approaches to solving the problems of financial support of state targeted social programs. The task of this study is to develop theoretical and methodological foundations for the formation and use of state social programs, to identify problematic issues in the financing of social programs in Ukraine and to develop recommendations for their solution. The article proposes directions for modernization of the financial system of implementation of these programs using the latest approaches and tools. Among the wide range of new forms and methods of financing state social programs, it is recommended to focus on public-private partnerships, public social procurement; financial investment in social projects; financial instruments of social orientation, fiscal incentives.

БЮДЖЕТНОЕ ФИНАНСИРОВАНИЕ ГОСУДАРСТВЕННЫХ ПРОГРАММ СОЦИАЛЬНО-ЭКОНОМИЧЕСКОГО РАЗВИТИЯ

The article is devoted to the study of the problem of budget support for the implementation of state eco-nomic and social programs. The relevance of the development of budget financing is determined. The analysis of the volume, dynamics and structure of financial resources of the state in recent years is carried out. The course and results of implementation of the program method of public administration, budget planning and execution are considered. The process of financing state programs with Federal budget funds is studied. Based on the analysis carried out in the article, the problems of applying the program principle and method in the domestic practice of budget financing of state programs are determined.

Employment and migration problems of rural youth in the Republic of Kalmykia

Migration of rural youth is a topical problem in Kalmykia. The purpose of the article is to analyze the reasons for the migration of rural youth, to identify the factors influencing the return of young people to the countryside, their desire to stay and work there. The main research methods are quantitative survey and in-depth interview. The analysis of the study results showed that more than half of the respondents want to leave their village or settlement. The main push factors for migration from rural areas are low wages, lack of jobs, underdeveloped infrastructure, lack of good quality medical care, etc. In most cases, educational migration is irrevocable. For some of the respondents, ‘educational migration’ begins earlier, because there are no senior grades at schools in their settlement or village, or they want to get a high-quality secondary education and to have the possibility to prepare for entering a university or specialized secondary school. The main factor influencing the return of young people to the countryside is the availability of jobs with decent wages, the possibility to have their own housing, as well as the developed of social sphere and sphere of leisure. The obtained results can be used in regional programs for the development of rural areas. Analysis of measures aimed at attracting youth to rural areas in other regions showed it is necessaryly to develop programs aimed at establishing interaction with school graduates and elaborating financial mechanisms to support students. It is also critical to resolve the issue of guaranteed financing of sectoral programs to attract young people to rural areas.

The features of the ensure the security of people involved in criminal proceedings in Ukraine

The article analyzes institute of the security assurance for people involved in criminal proceedings. It is established that despite the significant contribution made to solve important issues of this institute, the legal regulation of the process of security assurance for participants in criminal proceedings, as well as the mechanism of such assurance practically need immediate improvement, modernization, and further comprehensive research. Based on the analysis of the current state of security of participants in criminal proceedings, the reasons that affect the efficiency of such activities and measures to eliminate them, namely: financing of programs to ensure the security for people involved in criminal proceedings (creating a separate state fund through financial penalties for damages caused by crimes and funds that criminals make on bail); organizational support (establishment of appropriate terms of security measures, professional training of law enforcement officers who carry out security measures); establishing proper interaction between entities that protect such persons, etc. By analyzing these problems, we can conclude that they mainly lie in three major areas: legal, economic and organizational. The drawbacks in the legal mechanism for security ensuring for people involved in criminal proceedings in Ukraine are highlighted; the necessity and ways of improvement of the legislation in this area taking into account the world standards are substantiated. In this regard, we propose to at least supplement the CPC of Ukraine with a separate Chapter 10-1, setting it out as follows: “Application of procedural and special measures for the security of people involved in criminal proceedings”. It is also proposed that to ensure the security of people involved in criminal proceedings, it is necessary to create a special structural unit in the law enforcement system of Ukraine.

The Peculiarities of the Budgetary Policy of Georgia and the Directions of Improvement in Association with EU

The work deals with the role of budgetary policy on socio-economic development of the country, the practical significance of budgetary policy improvement, the peculiarities of program financing, the problems of rationalization of budget resources, the existing reality and the main directions of improvement the effectiveness. The aspects of research are compared to the advanced international practice. The research is focused on the problems and the anti-rational usage of budget funds in the budgetary process, the peculiarities and efficiency of forming the program budget, the problems in the formation of expected results and budget performance indicators of the programs/sub-programs.

Итоги научной деятельности Научно-исследовательского института травматологии и ортопедии за 2019 год

The article presents the main results of scientific activity in the framework of special-purpose programme financing, within the framework of which innovative. Methods of diagnostics and diseases treatment, limbs and spine injuries have been developed. They have been introduced into clinical practice of institute’s departments and into republic regions. Conferences, workshops, scientific products, the implementation of scientific and practical developments, training of personnel are presented in this article.

Evaluation of the implementation of Batik-skills training program

The purpose of this study is to evaluate the implementation of batik skills training program as a recommendation for program improvement. The method used in this research is a qualitative approach using Context, Input, Process, and Product evaluation model. Samples were taken from the Institute of Skills and Training in the areas of Jakarta, Bogor, Depok, Bekasi, and Tangerang. The results of the evaluation components that meet the evaluation criteria are all aspects of the context component, discipline and learning process, while the components of batik teachers' education qualifications, the use of educational facilities and infrastructure standards, curriculum components, program financing, evaluation of learning outcomes, mastery of theoretical competencies, practices, and impacts to program participants have not been met. The batik skills training program needs to be continued with some improvement. It is recommended for the product components, especially on the impact aspects felt by graduates, to be improved.

Programming Regulation and Strategic Planning in the Health Care Sector

The article deals with the legal characteristics of forecasting and strategic planning in the health care sector through program regulatory acts, their rationality and effectiveness of application, revealing the main characteristics and regularities of such regulation and the place in the system of national legislation, as well as identifying problems and shortcomings of program regulation of the health care sector in Ukraine, the formulation of propositions to eliminate the relevant complications in domestic practice.
 The objective of the article is to analyze the problems of program regulation of legal relations in the health care management system in Ukraine and its legal provision.
 The methodological basis of the article is a set of generally scientific and special research methods. In particular, through the dialectical method, the set tasks are considered in the unity of their social content and legal form.
 The author of the article discusses the development and implementation of regulatory programs in the health care sector in Ukraine. It has been found out that the draft target-oriented program should be developed on the basis of forecasts of economic and social development of Ukraine, forecasts of the development of the health care sector for the medium-term period of the approved concept by the state customer or its designated developer. Accordingly, health regulatory programs are used at the interstate, nationwide, governmental, departmental and regional levels.
 The authorities of state agencies in this field have been revealed; the system, content and orientation of the main legal programs in the health care sector have been analyzed. In particular, the Program of Medical Guarantees and State Health Strategies, approved by the Cabinet of Ministers in November 2019, becomes particularly important in the context of the health care sector reform. The content of existing programs in the health care management system has been studied and the need for their widespread use has been proved.
 The main problems of program regulation in the health care sector have been distinguished. These are disadvantages of both the general system of organization and effectiveness of the programs, as well as of certain mechanisms of the implementation, in particular financing of programs on a residual principle (underfunding, and sometimes even its absence); unclear formulation of the purpose and objectives of the programs, which indicate the process rather than the final result; the absence of clearly identified performers and obligated entities; insufficient analytical activity; lack of responsibility for non-compliance with mandatory measures and action plan; insufficient control over funds spending; declarative nature, etc.

Results and Prospects of Developing Innovation Aerospace Cluster in Samara Region

Cluster policy is increasingly the core of strategies of socio-economic and innovative development of regions. In this regard, it is important to monitor the current state of clusters, identify cluster effects, which will determine prospects for their further development more accurately. The purpose of the article is to evaluate the results of the innovation cluster of Samara region and identify prospects for its further development. For this, the authors suggest the methodical approach to evaluating economic effects of cluster functioning, conduct the data analysis. On the basis of generalizing the array of scientific and statistical data, reports of enterprises, evidence of facts of economic activity of cluster members, the authors find a number of positive effects of the innovative aerospace cluster of Samara region. The article reveals a new “corporate effect”, in which an enterprise-cluster member seeks to become a part of the cluster architecture of a higher level in order to ensure guaranteed ordering and financing of modernization programs. The article also complements scientific discussions on the synergetic effect of the cluster and the expansion of markets in other sectors due to new technologies and ideas for business. The performed SWOT-analysis suggests promising areas and activities for the development of the aerospace cluster of Samara region for high growth high-tech enterprises, spread of digital economy.

Social Policies and the Financing of Social Development Programs in Ecuador

This article explores and examines the social policies implemented in Ecuador, aiming to determine how social programs of education, health and housing impact on social development programs and beneficiary population. For analysis, an econometric model of multiple linear regression is applied, which allows to analyze and demonstrate the relationship between studied variables, in turn, is accompanied by a survey of 146 beneficiaries in communities receiving the programs. The effect of financing such policies – implemented through social programs – has had significant impact on social development programs, as well as on the population receiving them, contributing to well-being and quality of life improvement.

Sporting programs aimed at inactive population groups in the Netherlands: factors influencing their long-term sustainability in the organized sports setting

BackgroundThe organized sports sector has received increased interest as a setting to stimulate physical activity among inactive target groups. To include many inactive people and to obtain population health benefits, it is important that effective sporting programs are sustained (i.e. continuation of program activities) over a long period of time. This study identified the factors influencing the long-term sustainability of these kind of sporting programs located within local sports clubs in the Netherlands.MethodsFourteen Dutch sporting programs aimed at increasing physical activity levels of inactive population groups and funded within the National Action Plan for Sport and Exercise (NAPSE) were the focus of this study. The programs were developed by ten Dutch National Sports Federations (NSFs) and implemented by different sports clubs in the Netherlands within a three-year funded implementation period (2008–2011). This research consisted of semi-structured face-to-face interviews with the program coordinators of the NSFs (n = 14) and semi-structured telephone interviews with representatives of sports clubs that provided the programs (n = 17 continued the program, n = 11 discontinued the program) six and a half years after the funding period ended (November 2017–March 2018). A sustainability framework with five pre-specified main themes (i.e. program design, implementation, trainer/coach, organizational setting, broader community environment) guided data collection and (deductive) thematic analysis.ResultsTen of the fourteen NAPSE funded sporting programs were sustained at the level of the NSFs. Most factors facilitating (+) and impeding (−) the long-term sustainability of the programs were common to both NSFs and sports clubs, like program adaptation (+) and a lack of program financing (−). Program evaluation (+) and high program costs (−) were specific factors mentioned by NSFs, while factors related to human resources (e.g. lack of volunteers (−)) or the sports club nature (e.g. social aspect in program design (+)) applied to sports clubs. The factors were summarized in the form of a checklist.ConclusionsKey factors influencing the long-term sustainability of the sporting programs were identified. The results can be used to develop strategies to promote long-term sustainability of these kind of programs and inform funding guidelines in countries with a similar organized sports infrastructure.

Program-target management as a tool of financial implementation of special federal programs

The article investigates the program-target method of management in the field of budget financing as one of the effective tools for the implementation of economic and social policy of the state. The analysis of interpretations of program-target management within which absence of unambiguous definition of this phenomenon is shown is carried out. Statistical data on budget financing of special federal programs, in particular in the direction of «Development of high technologies» are considered. Analyzed special federal programs «Research and development on priority directions of development of scientific-technological complex of Russia» 2007–2013 and 2014–2020 shows the existence of differences in their implementation, such as the kind supported by research, the volume of attracted extra-budgetary co-financing, method of formation of subjects. It was noted that during the implementation of the current special federal programs there are such negative phenomena as the absence of real mechanisms for the transfer of science into national programs implemented by other ministries, reducing the efficiency of the mechanism of public-private partnerships and the risks of formation of subjects «under the artist» without examination of the proper quality.

State regulation of development of investment programs in the sphere of construction in the conditions of cyclicality of the economy

The article is devoted to determining the effect of cyclicality on the development of the Ukrainian economy and the implementation of state investment programs in construction.The purpose of the article is to substantiate the feasibility of state anti-cyclical regulation of construction through the implementation of state investment programs and to develop proposals for the structure and order of formation of the appropriate organizational and economic mechanism. To do this, the impact of cyclicality on the development indicators of the construction industry should be determined, and the nature of the relationship between Ukraine's GDP of construction and investment activity and the list of public investment programs related to construction should be considered. The main indicators chosen to determine the economic cycles are GDP, GDP of construction. The state investment programs, which are directly or indirectly related to construction, are reviewed, ways and methods of their state regulation are determined. State support for the implementation of investment projects is provided by: co-financing at the expense of the state budget, providing state guarantees in accordance with the law on credit funds for the implementation of investment projects, crediting at the expense of the state budget funds, offsetting from the state budget interest on loans necessary for the implementation of investment projects .The analysis of sources of financing of capital investments in Ukraine for the years 2002-2018 was carried out, we determined that the share of state and local budgets in the sources of financing was the largest in 2014 (15%), 2010, 2017 and 2018 (more than 10% ). Moreover, the share of public investments is gradually decreasing, while the financing of investment projects at the expense of local budgets increases annually.It is determined that increasing the financing of state investment programs at the bottom of the economic cycle can stimulate the growth of the economy in the next phase. State regulation of investment programs in the construction sector is an effective tool for counter-cyclical economic management.

Foresight as an instrument of industrial strategic development

The development and implementation of the strategy has long been the focus of scientists and practitioners. But, despite the extensive scientific Arsenal, the tasks facing economic managers do not become easier. In many ways, this situation is due to the fact that in the face of growing uncertainty, which is typical for any, both developed and developing markets, it is increasingly difficult to imagine the «image of the future» and formulate the strategy goals to subordinate the company’s activities to the achievement of these very goals. In a sense, the correct formulation of the problem of long-term development can serve as a foresight, which is used to identify factors that can have an impact on the economy and society in the medium and long term. However, what is the connection of foresight with the setting of goals of the strategy of the industrial enterprise and the choice of mechanisms for the implementation of the chosen strategy – these questions require answers, without which the scientific base of strategic management will not be complete. An attempt is made to find an answer to the question of what hinders industrial development under conditions when the scale of technological modernization is not accompanied by a change in the structure of production. The solution to this problem is proposed to be sought in institutional transformations, on the basis of a theoretical understanding of the laws that determine the technological development of modern industry and the application of the methods of the theory of artificial intelligence systems. The proposed approaches of economic and technological development of territories, states, industries and individual industrial enterprises will allow the most effective financing of investment programs for industrial development.

Assessment of budgetary programs for organizational support of technological updating of production in agricultural enterprises

Introduction. Effective functioning of agricultural enterprises at the current stage of economic development is possible only in an intensive way, which involves making and implementing innovative decisions to improve production, management and marketing activities. One of the directions of innovative development of the enterprise is technological modernization of production. Considering the huge expenses of implementation of this process, connected with the costs of material and technical, information support, training of personnel, etc., the state financial support for innovation is important and desirable. It is manifested in the financing of relevant budget programs aimed not only at the direct implementation of technological modernization of production, but also the organizational support for its implementation. The purpose of the article is to identify and evaluate budget programs for organizational support of technological upgrading of agricultural enterprises’ production. Methods. Methods of generalization, systematization, analysis, abstraction, comparison, absolute and relative values are used in the process of research to identify and evaluate budget programs for organizational support of technological upgrading of production in agricultural enterprises. Results. The importance and necessity of measures for research and experimental development in the process of technological renovation of agricultural enterprises' production are substantiated. Training, retraining and advanced training of personnel; advisory assistance; some agro-technical and zoo-technical measures that are a function of the state and financed by the relevant budget programs are substantiated. It was found out that during 2009-2018, funds were allocated from the state budget for measures of organizational support of technological renovation of agricultural enterprises’ production within the framework of financing of relevant budget programs. However, in the recent years the number of budget support programs for the agro-industrial complex and their funding have decreased compared to 2009, and individual programs have ceased to operate separately and combined with other programs. Thus, this situation will not improve the efficiency of the process of technological upgrading of agricultural enterprises’ production. Discussion. It is important and necessary in the future to include the funds in the state budget aimed at financing the programs of innovative development of agricultural enterprises, in particular for technological updating of production. Keywords: technological updating of production; agricultural enterprises; budget programs; organizational support.

Putting Time in Perspective: An Integrated Graduate Medical Education Institutional Dashboard and Report Card.

ACGME-I requires sponsoring institutions (SIs) to have systematic oversight of program performance. This was initially carried out through annual review, however, maintaining compliance became a challenge for a large SI like Singapore Health Services (SingHealth) as the number of residency programs grew from 5 to 34 in 3 years. We assessed the impact of quarterly monitoring using a dashboard on graduate medical education (GME) program performance and institutional oversight. In 2014, the SingHealth GME Committee (GMEC) approved the dashboard covering 13 indicators with implication on program performance, resident/faculty performance, and finance. Indicators were given color-coded scoring for compliance, borderline compliance, or concern. From annual reporting, periodicity was increased quarterly with reports distributed to program directors, head of department, and academic clinical programs. Since implementation, programs consistently met or exceeded compliance standards in 11 of 13 indicators (84%), with 7 indicators (63%) showing upward trends. Programs with borderline scores in particular quarters showed improvement in subsequent quarters. By 2015, percentage compliance for the 3 dimensions of residents' perspectives were 1 to 2 points higher than the national compliance average. Of 19 programs undergoing ACGME-I accreditation in 2014, only 4 had citations in the foundational requirement. Institutional citations were resolved, with 0 citations in the reaccreditation site visit in 2015. For a large SI, increased periodicity of program performance reporting from annual to quarterly effectively addressed the gaps in a timely fashion. Institutional performance also improved through the use of quantitative data aligned with institution and national performance indicators.

Participation of a Head of the United Territorial Community in the Budget Process of the United Territorial Community

Administrative decentralization is identified as an important direction in the reform of local self-government bodies. The financial autonomy of local self-government budgets has been highlighted. It is emphasized on receipt of additional revenues from the redistribution of financial resources by the budgets of local self-government. The sequence of adoption of normative legal acts for ensuring the processes of decentralization in Ukraine is traced. A new institution in local self-government bodies is shown. It is a head of united territorial community. Scientific approaches to the historical origin of the position of a head of united territorial community are generalized. The historical position of a head of united territorial community in local self-government bodies is emphasized. The historical experience of realization of fiscal powers of a head of united territorial community is generalized. The historical hierarchy in the powers of a head of united territorial community is given. The historical role of a head of united territorial community in the supervision of the collection of taxes and fees is shown. The content of the concept of «Vogt» is revealed and its role in the organization of taxes and duties collection is substantiated. The main powers of a head of united territorial community according to domestic legislation are singled out. The existence of budget powers in the work of a head of united territorial community is proved. The participation of a head of united territorial community in the budget process is substantiated. There is a lack of legal grounds as for a head of united territorial community participation in the drafting of the local budget in the planning of incomes. It has been determined that it is inappropriate to exclude a head of united territorial community from the formation of a revenue part when preparing a draft of a local budget. The expediency of full participation of a head of united territorial community in the budget process is argued. The importance of interaction between a head of united territorial community and financial services in the conditions of the formation of local budget revenues is emphasized. The advantages of interaction of a head of united territorial community with financial services with attraction of payers before taxes and fees are shown. The necessity of interaction on the level of all services of local self-government bodies concerning mobilization of local budget revenues is emphasized. The necessity of observing the balance of the interests of a head of united territorial community between the filling of the revenue part of the local budget and the financing of budget programs is emphasized. The approaches to further expediency of centralization of tax control and introduction of the decentralization of fiscal cooperation with controlling bodies at the level of territorial communities are differentiated. Proposed changes to the current legislation concerning the expansion of budget powers of a head of united territorial community and their advantages are grounded.