Reduction In Payments Research Articles

Recourse as Shadow Equity: Evidence from Commercial Real Estate Loans

<ns3:p>We study the role that recourse plays in the commercial real estate loan contracts of the largest U.S. banks. We find that recourse is valued by lenders and is treated as a substitute for conventional equity. At origination, recourse loans have rate spreads that are at least 20 basis points lower and loan-to-value ratios that are around 3 percentage points higher than non-recourse loans. Dynamically, recourse affects loan modification negotiations by providing additional bargaining power to the lender. Recourse loans were half as likely to receive accommodation during the COVID-19 pandemic, and the modifications that did occur entailed a relatively smaller reduction in payments.</ns3:p>

Association of Participation in the Oncology Care Model With Medicare Payments, Utilization, Care Delivery, and Quality Outcomes

In 2016, the US Centers for Medicare & Medicaid Services initiated the Oncology Care Model (OCM), an alternative payment model designed to improve the value of care delivered to Medicare beneficiaries with cancer. To assess the association of the OCM with changes in Medicare spending, utilization, quality, and patient experience during the OCM's first 3 years. Exploratory difference-in-differences study comparing care during 6-month chemotherapy episodes in OCM participating practices and propensity-matched comparison practices initiated before (January 2014 through June 2015) and after (July 2016 through December 2018) the start of the OCM. Participants included Medicare fee-for-service beneficiaries with cancer treated at these practices through June 2019. OCM participation. Total episode payments (Medicare spending for Parts A, B, and D, not including monthly payments for enhanced oncology services); utilization and payments for hospitalizations, emergency department (ED) visits, office visits, chemotherapy, supportive care, and imaging; quality (chemotherapy-associated hospitalizations and ED visits, timely chemotherapy, end-of-life care, and survival); and patient experiences. Among Medicare fee-for-service beneficiaries with cancer undergoing chemotherapy, 483 319 beneficiaries (mean age, 73.0 [SD, 8.7] years; 60.1% women; 987 332 episodes) were treated at 201 OCM participating practices, and 557 354 beneficiaries (mean age, 72.9 [SD, 9.0] years; 57.4% women; 1 122 597 episodes) were treated at 534 comparison practices. From the baseline period, total episode payments increased from $28 681 for OCM episodes and $28 421 for comparison episodes to $33 211 for OCM episodes and $33 249 for comparison episodes during the intervention period (difference in differences, -$297; 90% CI, -$504 to -$91), less than the mean $704 Monthly Enhanced Oncology Services payments. Relative decreases in total episode payments were primarily for Part B nonchemotherapy drug payments (difference in differences, -$145; 90% CI, -$218 to -$72), especially supportive care drugs (difference in differences, -$150; 90% CI, -$216 to -$84). The OCM was associated with statistically significant relative reductions in total episode payments among higher-risk episodes (difference in differences, -$503; 90% CI, -$802 to -$204) and statistically significant relative increases in total episode payments among lower-risk episodes (difference in differences, $151; 90% CI, $39-$264). The OCM was not significantly associated with differences in hospitalizations, ED visits, or survival. Of 22 measures of utilization, 10 measures of quality, and 7 measures of care experiences, only 5 were significantly different. In this exploratory analysis, the OCM was significantly associated with modest payment reductions during 6-month episodes for Medicare beneficiaries receiving chemotherapy for cancer in the first 3 years of the OCM that did not offset the monthly payments for enhanced oncology services. There were no statistically significant differences for most utilization, quality, and patient experience outcomes.

Prioritization of Hospital Information System’s Executive Barriers to Patient Payment Reduction and Visitation Quality Improvement Packages of Health System Reform Plan from the Perspectives of Users and Experts in Hospitals of Yazd

Background: Healthcare facilities are dependent on hospital information systems due to the high volume and variation of information in different fields. These systems are a prerequisite for effective and high-quality healthcare provision in hospitals.
 Objectives: The present study intended to prioritize the executive barriers to these systems in patient payment reduction and visitation quality improvement packages of the health system reform plan (HSRP) from the perspectives of users and experts in selected university hospitals of Yazd, Iran, in 2019.
 Methods: The population of this descriptive-analytical study included 110 participants, including experts of information technology (IT) unit, hospital managers, and personnel of the administrative and medical units dealing with the hospital information system. The data collection tool was a researcher-made questionnaire based on similar studies, the validity of which was evaluated by a committee of experts. Also, the reliability of the questionnaire was investigated and confirmed before the study using the Cronbach’s alpha method and a sample of 30 participants. Data analysis was performed using SPSS software version 21.
 Results: Among the six barrier dimensions, the highest mean score belonged to the professional factors (3.46 ± 1.03), followed by human barriers (3.44 ± 0.83). Among professional barriers, the lack of motivation of the personnel in IT learning and get training on the IT-related skills had the highest mean score of 3.67.
 Conclusions: According to the results, outsourcing such services and special budget allocation for hardware and software update and support, holding conferences, and provision of practical training in this field are suitable strategies for better implementation of such systems.

ОПОДАТКУВАННЯ ГОТІВКОВИХ РОЗРАХУНКІВ ЯК ЗАСІБ ОБМЕЖЕННЯ ПОПИТУ НА ГОТІВКУ І ДЕТІНІЗАЦІЇ ЕКОНОМІКИ

Studies have shown that the policy of the National Bank of Ukraine to reduce cash in circulation is not consistent. Its priority is to meet the growing demand for cash, rather than taking measures to limit cash flow. This opinion is confirmed by the data for 2020, when there was a rapid growth of cash in circulation, the ratio of which to GDP increased from 9.7% (at the level agreed with the IMF at 9.5%) to 12.3%. In Ukrainian realities, there is a direct relationship between the amount of cash in circulation and the level of the shadow economy. The more cash in circulation, the larger the shadow economy, the higher the level of corruption, the greater the number of criminal offenses. The NBU has in fact become an institution that forms the main condition of the shadow economy: it supplies a sufficient amount of cash for shadow circulation. Responding to the growing demand for cash requires significant funds to produce new cash. Such expenses are included in the NBU's administrative expenses estimate. In case of lack of own revenues of the NBU, financing of its losses should be carried out from the budget of the next year. To cover the possible deficit of the NBU, it is proposed to introduce a fee for cash payments. Its introduction is seen as a tool to limit the demand for cash in economic turnover, rather than as an ever-growing source of filling the budget. The payers of the fee will be persons who pay for the purchased goods in cash. The introduction of such a fee will stimulate the reduction of cash payments, and hence the shadow economy.

Analyzing the Moderating role of Board Structure in Relation between Tax Avoidance and Business Strategy: New Insight from Emerging Economy

Purpose: Taxation basically occupies an important place in the strategic decisions of companies, therefore, business are thinking to adopt a dynamic and active method for tax management. This study examine the moderating role of board independence, and board size in the relation between tax avoidance, and business strategy in developing economy of the Pakistan.
 Design/Methodology/Approach: The sample of study consist of 125 non-financial companies listed on Pakistan stock exchange with time period of 5 years from 2013 to 2017 on annual basis. Study uses static (fixed effect, & random effect) and dynamic (GMM) panel data estimation techniques.
 Findings: The result shows that increase in board size of a prospector firm will increase its trend to avoid taxes. The finding also reveals that an increase in the independent directors in prospector firms will decreases tax avoidance activities in emerging economies. Additionally, result shows that firm profitability and leverage are negatively related to tax payments while firm size show positive association with tax payments.
 Implications/Originality/Value: Among others, this study suggests that tax authorities should advocate the prospector firms to increase the number of independent directors on board because there presence cause a reduction in tax avoidance activities and increase tax payments.

CMS Proposes Permanent Payment for Telehealth Services Allowed During Pandemic

CMS Proposes Permanent Payment for Telehealth Services Allowed During Pandemic

BUDGET NEUTRALITY UNDERCUTS PAYMENT IN 2022 PROPOSED MPFS

A possible reduction in physician payment toplines a new AAFP summary of the proposed rule for the 2022 Medicare physician fee schedule (MPFS), available at <https://www.aafp.org/dam/AAFP/documents/advocacy/payment/medicare/feesched/ES-2022MPFSProposedRule-072221.pdf>, which the Centers for Medicare

Tri-Level Scheduling Model Considering Residential Demand Flexibility of Aggregated HVACs and EVs Under Distribution LMP

Residential loads, especially heating, ventilation and air conditioners (HVACs) and electric vehicles (EVs), have great potentials to provide demand flexibility which is an attribute of grid-interactive efficient buildings (GEB). Under this new paradigm, EV and HVAC aggregator models are first developed in this paper to represent the fleet of GEBs, in which the aggregated parameters are obtained based on a new approach of data generation and least squares parameter estimation (DG-LSPE), which can deal with heterogeneous HVACs. Then, a tri-level bidding and dispatching framework is established based on competitive distribution operation with distribution locational marginal price (DLMP). The first two levels form a bilevel model to optimize the aggregators' payment and to represent the interdependency between load aggregators and the distribution system operator (DSO) using DLMP, and the third level is to dispatch the optimal load aggregation to all residents by the proposed priority list-based demand dispatching algorithm. Finally, case studies on a modified IEEE 33-Bus system illustrate three main technical reasons of payment reduction due to demand flexibility: load shifts, DLMP step changes, and power losses. They can be used as general guidelines for better decision-making for future planning and operation of demand response programs.

Leaving A No-Risk 36 Percent Return On The Table: Supply Chain Finance Opportunities Managing Payables Discounts

Supply chain management has traditionally emphasized managing the physical flow of parts and finished goods. The next natural evolutionary step is developing the management of supply chain finance across multiple trading partners. One of these opportunities requires investigation of managing payment discounts. Traditionally, suppliers offer a discount to buyers to encourage earlier payment. Terms such as 2/10 n/30 allow for a 2% discount if the entire purchase is paid in full within the 10-day discount period instead of the customary 30 days. This 2% payment reduction translates into the equivalent of an annual return of 36%, resulting in the traditional rule of thumb to take the discount whenever possible. For a variety of reasons, only a small percentage of buyers actually are capturing these high returns. There is a disconnect between trading partners for using discounts for managing working capital across the supply. This paper explores the beneficial impact of participating in early payment discount programs, potential reasons for failing to capture discounts and possible solutions and offers research questions to guide future research to aid in improving this supply chain finance opportunity.

Care Coordination for Dialysis Patients During and After Hospitalization: A Pilot Study

In the United States, 34% of hospital discharges among patients receiving dialysis are followed by a 30-day readmission,1 and both dialysis clinics2 and hospitals3 are held accountable for readmissions (through potential payment reductions). Although improved care coordination between hospitals and dialysis clinics may play an important role in reducing hospital readmissions and improving other patient outcomes, the fragmented US health care system does not facilitate this coordination. Particularly the lack of interoperability of electronic health records remains a key barrier for most dialysis clinic–hospital dyads.

Year 1 of the Bundled Payments for Care Improvement–Advanced Model

BackgroundThe Center for Medicare and Medicaid Innovation launched the Medicare Bundled Payments for Care Improvement–Advanced (BPCI-A) program for hospitals in October 2018. Information is needed about the effects of the program on health care utilization and Medicare payments.MethodsWe conducted a modified segmented regression analysis using Medicare claims and including patients with discharge dates from January 2017 through September 2019 to assess differences between BPCI-A participants and two control groups: hospitals that never joined the BPCI-A program (nonjoining hospitals) and hospitals that joined the BPCI-A program in January 2020, after the conclusion of the intervention period (late-joining hospitals). The primary outcomes were the differences in changes in quarterly trends in 90-day per-episode Medicare payments and the percentage of patients with readmission within 90 days after discharge. Secondary outcomes were mortality, volume, and case mix.ResultsA total of 826 BPCI-A participant hospitals were compared with 2016 nonjoining hospitals and 334 late-joining hospitals. Among BPCI-A hospitals, the mean baseline 90-day per-episode Medicare payment was $27,315; the change in the quarterly trends in the intervention period as compared with baseline was −$78 per quarter. Among nonjoining hospitals, the mean baseline 90-day per-episode Medicare payment was $25,994; the change in quarterly trends as compared with baseline was −$26 per quarter (difference between nonjoining hospitals and BPCI-A hospitals, $52 [95% confidence interval {CI}, 34 to 70] per quarter; P<0.001; 0.2% of the baseline payment). Among late-joining hospitals, the mean baseline 90-day per-episode Medicare payment was $26,807; the change in the quarterly trends as compared with baseline was $4 per quarter (difference between late-joining hospitals and BPCI-A hospitals, $82 [95% CI, 41 to 122] per quarter; P<0.001; 0.3% of the baseline payment). There were no meaningful differences in the changes with regard to readmission, mortality, volume, or case mix.ConclusionsThe BPCI-A program was associated with small reductions in Medicare payments among participating hospitals as compared with control hospitals. (Funded by the National Heart, Lung, and Blood Institute.)

Estimating the broader fiscal consequences of acute hepatic porphyria (AHP) with recurrent attacks in Belgium using a public economic analytic framework

BackgroundAcute hepatic porphyria (AHP) is a rare, debilitating disease characterized by potentially life-threatening attacks often resulting in chronic symptoms that negatively impact daily functioning and quality of life. Symptoms of AHP prevent many individuals from working and achieving lifetime work averages. The aim of this study was to apply a public economic framework to evaluate AHP in Belgium, taking into consideration a broad range of costs that are relevant to government in relation to social benefit payments and lifetime taxes paid.MethodologyA public economic framework was developed exploring lifetime costs for government attributed to an individual with AHP and recurrent attacks in Belgium. Work-activity and lifetime direct taxes paid, indirect consumption taxes and requirements for public benefits were estimated based on established clinical pathways for AHP and compared to the general population (GP). The model includes AHP-related healthcare costs and non-AHP healthcare costs for the GP.ResultsLifetime earnings are reduced in an individual with AHP by €347,802 per person (p.p.), translating to reduced lifetime taxes paid of €183,187 for an AHP individual compared to the GP. We estimate increased lifetime disability benefit support of €247,242 for an AHP individual compared to GP. Lifetime healthcare costs for a person with AHP were estimated to be €3,030,316 due to frequent hospitalisations associated with porphyria attacks compared to the GP. The lifetime costs for a person with 12 attacks per annum factoring in transfers, taxes and healthcare costs are estimated to be €3,460,745 p.p. Eliminating AHP attacks after 10 years of active disease, thus, enabling a person to return to work increases lifetime earnings by €224,575 p.p. Increased work activity in such individuals would generate an estimated €118,284 p.p. over their lifetime. The elimination of AHP attacks could also lead to reductions in disability payments of €179,184 p.p. and healthcare cost savings of €1,511,027 p.p.ConclusionsDue to severe disability resulting from constant attacks, AHP patients with recurrent attacks incur significant public costs. Lifetime taxes paid are reduced as these attacks occur during peak earning and working years. In those patients, reducing AHP attacks can confer significant fiscal benefits for government, including reduced healthcare costs, reduced disability payments and improved tax revenue.

Effects of direct payments on rice income variability in Japan*

The effects of direct payments on rice income variability in Japan are analysed based on a balanced panel dataset of Japanese rice farms for 2012–2016. Firstly, the contribution of income components to rice income variability and the effects of a direct payment reduction are discussed by applying variance decomposition. Secondly, robust regression techniques are used to measure the correlation between direct payments and rice income variability. The originality of this paper is that it disaggregates the effects of payments using a regression analysis of the effects of direct payments on income variability for Japan. This contrasts with the existing literature on this topic, which has largely focused on European Union countries. This paper discusses to what degree the reduction in direct payments increases income variability. The results reveal that direct payments decrease Japanese rice income variability. Indeed, after controlling for various farm characteristics, we find a negative relationship between the amount of direct payments linked to rice production and rice income variability. Finally, the results suggest that reducing direct payments when the rice price is falling would increase rice income variability.

Long-run growth of ambulatory surgery centers 1990-2015 and Medicare payment policy.

To examine long-run growth in the ambulatory surgery center (ASC) industry and potential factors influencing its trajectory. National data for all Medicare-certified ASCs (1990-2015) and outpatient discharge records from the state of Florida in 2007. We documented the number of ASCs in the United States over time and decomposed the trend into underlying ASC market entry and exit behavior. We then examined the plausibility of 2008 Medicare payment reforms to influence the trend changes. Data on ASC openings and closures are obtained from the Centers for Medicare and Medicaid Services Provider of Service files. Secondary data on ASC volume in Florida are obtained from the Florida Agency for Health Care Administration. The number of ASCs in the United States grew 5%-10% annually between 1990 and 2007 but by 1% or less beginning in 2008. This change coincided with substantive reductions in Medicare payments for key ASC services. The annual number of new ASCs was as much as 50% lower following the payment change. ASCs are an important competitor for outpatient services, but growth has slowed dramatically. Sharp changes in new ASC entry align with less generous Medicare fees.

Policy Throughout The Pandemic

Policy Throughout The Pandemic

Avoiding COVID-19 Related Foreclosures by Implementing Cost-Effective Mortgage Modifications for Federally-Backed Loans

Millions of homeowners are having difficulty paying their mortgage because of the COVID-19 emergency, and those suffering from a sustained income loss will be unable to afford their original monthly payments. Research based on post-Great Recession defaults provide compelling evidence that a mortgage modification that delivers substantial payment reduction is the right tool to keep borrowers in their home and avoid foreclosures. Based on this research, I establish the steps of an “optimized” mortgage modification waterfall that offers substantial payment reduction to the borrower while minimizing the financial impact on the lender. I then compare the optimized waterfall to the GSE, FHA, and VA mortgage modification options and provide specific recommendations that, if implemented, would allow the Federal agencies to offer deeper payment reductions and broaden the availability to modifications to help more homeowners in need while minimizing the cost to lenders.

ПОДАТКОВЕ РЕГУЛЮВАННЯ ТА СТИМУЛЮВАННЯ СОЦІАЛЬНОЇ СФЕРИ УКРАЇНИ

Анотація. Податкове регулювання скорочує невизначеність майбутніх податкових витрат економічних суб’єктів і ступінь їхньої адаптації до агресивного зовнішнього середовища. Саме тому особливості процесу оподаткування, його значущість для економіки країни в цілому та кожного платника податків зокрема викликають необхідність виділення системи управління податковими платежами в самостійну галузь фінансового менеджменту та окремий науково-практичний напрям економічної думки в Україні. На даний час в Україні застосовуються окремі елементи і прийоми податкового регулювання, але відсутня цілісна теоретична і методологічна база, на якій повинна будуватися система відповідних практичних рішень, заходів і механізмів управління податками як на рівні суб’єктів господарювання, так і всього податкового процесу країни. Тому необхідність виділення системи управління податками в особливу галузь наукових знань очевидна. Складність і мінливість сучасного економічного середовища, невизначеність і ризиковість функціонування підприємств і державного фінансового господарства примушують підвести наукове підґрунтя під процес податкового регулювання з урахуванням реалій ринкової економіки. Причому, з ускладненням податкових систем і економічних зв’язків під впливом процесів глобалізації роль податкового регулювання зростає. Особливо це стосується сучасної України, де ринкові відносини та інститути ще остаточно не сформовані. Регулювання податкових платежів українськими підприємствами також вимагає свого методологічного обґрунтування і практичного розвитку. Корпоративне податкове регулювання повинно стати однією з найважливіших функцій управління підприємством, яка, на жаль, поки що застосовується безсистемно і здебільшого в цілях мінімізації (замість оптимізації) податкових платежів. Зазначене свідчить про надзвичайну важливість наукового розв’язання проблеми податкового регулювання в контексті організації управління податками на підприємстві. Податкова політика України, як основний напрям реалізації її фінансової діяльності, є ключовим чинником державотворення. Регулювання соціальної сфери засобами податкової політики є одним із найважливіших напрямів державного регулювання, насамперед, в умовах нестабільної економіки. Ознайомлено з ключовими напрямами податкової політики держави відповідно до пріоритетів соціальної сфери. Основне завдання полягає в аналізі тенденцій податкового регулювання у контексті соціальних процесів. Запропоновано кілька дієвих інструментів податкового регулювання соціальної сфери України. Проведено порівняльний аналіз особливостей застосування інструментів податкового регулювання соціальних процесів у вітчизняній практиці. Наведено порівняльну характеристику механізмів зниження податкових платежів. Виявлено тенденції розвитку податкової системи України в контексті соціальних процесів. Визначено соціальні аспекти реалізації антикризової податкової політики. Розроблено науково-методичні та практичні рекомендації щодо підвищення ефективності податкового регулювання соціального розвитку. Ключові слова: податкове регулювання, соціальна сфера, податок, оподаткування, державні гарантії. Формул: 0; рис.: 0; табл.: 2; бібл.: 11.

Potential Changes to the FHA COVID-19 Modification Options to Keep More Borrowers in Their Homes

Millions of homeowners are having difficulty affording their monthly mortgage payments because of the COVID-19 pandemic. The most vulnerable group of borrowers is concentrated within the Federal Housing Administration (FHA) program, with over 900,000 borrowers who are more than 90 days delinquent. Research provides clear evidence that immediate and substantial payment reduction is the most effective mortgage default prevention tool available. This paper suggests several changes to the FHA COVID-19 Home Retention Options that FHA should consider to provide more borrowers with deeper payment reductions, many at no cost to the Mutual Mortgage Insurance Fund, that would provide borrowers in need of financial assistance with greater eligibility as well as more substantial payment reductions that help them retain their home and avoid foreclosure. We estimate the incremental payment relief and resulting reduction in foreclosures that would be created by each of our proposed changes, and demonstrate how our suggestions would increase the availability of mortgage modifications for borrowers with lower incomes and higher debt-to-income ratios, particularly Black and Hispanic borrowers.

THE ROLE OF BUSINESS EDUCATION IN REPOSITIONING THE AILING GLOBAL ECONOMY CAUSED BY COVID-19 PANDEMIC

The sudden outbreak of covid-19 pandemic was indeed a phenomenal disaster that crippled the productive sectors and economic activities of nations. The incremental and consequential economic effects placed the global economy on a depressed position, as the world is presently witnessing the greatest economic recession and depression as never experienced in the economic history of the world. The overall aftermath was high business mortality rate, increasing rate of unemployment, reduction in, and irregular payment of workers salaries, high retrenchment of workers, increase in poverty lines leading to organized crimes, and sundry. However, the main thrust of this academic discourse was to examine the role of Business Education (BE) in repositioning the ailing global economy caused by covid-19, via review of related research literature. BE as an academic programme is strategically positioned to inculcate the economic orientation, survival and functional skills necessary in raising the relevant manpower that will in turn serve as key drivers in the repositioning of global economy. In lieu of the above, this study explicates on conceptual clarifications, BE as economic survival strategy, and in global economic repositioning in covid-19 era, issues in BE were also illuminated upon and a few recommendations made.

The methodology for calculating lease payments for construction companies based on the parametric model

The article analyzes problems of leasing planning in order to improve its efficiency. The technique of optimization of lease payments taking into account the reduction factor is described. An example of construction and implementation of the parametric model for optimizing the structure of lease payments is provided. The scheme of construction and implementation of the parametric model for optimizing the structure of lease payments is presented. The article presents a methodology for calculating lease payments based on the parametric model and using the reduction factor, which improves the efficiency of the process of updating fixed assets of construction organizations. The results of lease payment modeling are presented taking into account the payment dynamics. The article describes the dynamics of lease payments whose result is a decreasing function described by the exponential equation. To optimize lease payments, two models can be applied: the parametric model that takes into account the amount paid to the leasing company for the previous period, and the model based on the lease payment reduction coefficient.