Referral Fees Research Articles

Assessment of the understanding and awareness of bioethics among healthcare professionals in all public and private hospitals of Haripur district, Pakistan: a multicentre cross-sectional study

ObjectiveTo assess the level of bioethics awareness among healthcare professionals in Pakistan, focusing on the associations with sociodemographic characteristics, training and teaching of ethics, medical ethics practice and specific ethical...

Platform financing vs. bank financing: Strategic choice of financing mode under seller competition

Third-party sellers on online platforms primarily rely on banks to meet their financing requirements and are often constrained by the lack of sufficient working capital. Online platforms such as Amazon and Alibaba have ushered new dynamics in the e-commerce financing landscape by offering working capital loans to these sellers, thereby directly competing with banks and influencing market competition. This paper analytically studies how the competition between third-party sellers on platforms affects the strategic financing choices of sellers, namely, platform financing (P) vs. bank financing (B). We examine how the financing choice influences sellers’ pricing decisions in the competitive product market. Based on the sellers’ financing choices, four lending modes are possible: BB, PP, BP, and PB. Our analyses provide critical insights on the optimal financing choices and uncover the interplay of pricing, product substitution, referral fees, and production costs. We show that any seller deviating from PP to a hybrid mode (BP/PB) leads to a higher platform interest rate and a lower seller profit. We find that the competing sellers choose a hybrid lending mode when the unit production cost is low. However, the platform always prefers PP, leading to an all-win outcome in the supply chain when the production cost is high. Furthermore, for products with low referral fees and high substitution effect, BP/PB emerges as the equilibrium mode, while for products with low referral fees and low substitution effect, PP is the equilibrium outcome. Interestingly, we find that both sellers may choose bank financing when their working capital levels are high.

Selling exclusively or widely? Optimal strategic responses under online platform power asymmetry and competition

AbstractWe study an e‐commerce marketplace consisting of a third‐party seller, a dominant platform, and a competing platform. The seller pays referral fees to sell on the platforms. The dominant platform has a larger consumer base and offers an exclusive program. We formulate a game theoretic model to study strategic responses for all parties involved. The research questions are: How would the seller optimally choose between the two selling options: “go exclusive” with the dominant platform or “go wide” with both the dominant and the competing platforms? How would the dominant platform optimally adjust the referral fee in the exclusive program? How would the competing platform optimally discount the referral fee to compete with the dominant platform? We find that it is optimal for the seller to sell exclusively on the dominant platform if the referral fee adjustment in the exclusive program is lower than a threshold value. For the dominant platform, we identify the optimal value of the referral fee adjustment so that the seller can be enticed to choose the selling strategy that benefits the dominant platform as well. For the competing platform, we prove that there exists an optimal value of the referral fee discount. We also identify the market conditions that it is optimal for the competing platform to discount the referral fee or to set the referral fee the same as the dominant platform. We contribute to the e‐commerce literature by studying exclusive selling and platform competition while incorporating base demand asymmetry and referral fee asymmetry.

Marketplace Leakage

A key issue for the design of online marketplaces is addressing leakage. Buyers may use the marketplace to discover a seller or to obtain certain conveniences, but the seller may then want to take transactions off the marketplace to avoid transaction fees. Assuming buyers are heterogenous in their switching cost or inconvenience cost of purchasing directly, we provide a model in which there is partial leakage in equilibrium. We use the model to analyze the trade-offs associated with different strategies the marketplace can use to attenuate the effects of leakage: investing in transaction benefits, limiting communication, charging referral fees, using price-parity clauses, introducing seller competition on the marketplace, and hiding sellers that try to induce too much leakage. This paper was accepted by Joshua Gans, business strategy. Supplemental Material: The online appendix is available at https://doi.org/10.1287/mnsc.2023.4757 .

Capturing Value in Platform Business Models That Rely on User-Generated Content

Business models increasingly depend on inputs from outside traditional organizational boundaries. For example, platforms that generate revenue from advertising, subscription, or referral fees often rely on user-generated content (UGC). But there is considerable uncertainty on how UGC creates value—and who benefits from it—because voluntary user contributions cannot be mandated or contracted or its quality assured through service-level agreements. In fact, high valuations of these platform firms have generated significant interest, debate, and even euphoria among investors and entrepreneurs. Network effects underlie these high valuations; the value of participation for an individual user increases exponentially as more users actively participate. Thus, many platform strategies initially focus on generating usage with the expectation of profits later. This premise is fraught with uncertainty because high current usage may not translate into future profits when switching costs are low. We argue that the type of user-generated content affects switching costs for the user and, thus, affects the value a platform can capture. Using data about the valuation, traffic, and other parameters from several sources, empirical results indicate greater value uncertainty in platforms with user-generated content than in platforms based on firm-generated content. Platform firms are unable to capture the entire value from network effects, but firms with interaction content can better capture value from network effects through higher switching costs than firms with user-contributed content. Thus, we clarify how switching costs enable value for the platform from network effects and UGC in the absence of formal contracts.

An experiment on referrals in health care

Abstract How referral fees affect primary care physicians’ behavior is not well understood. We conduct a behavioral experiment on referral fees in which subjects take on the role of physicians. An illustrative theoretical model guides our experimental design and the formulation of behavioral hypotheses for heterogeneously altruistic physician-types. We exogenously vary the level of referral fees paid by specialists to primary care physicians and study the impact of these fees on primary care physicians’ diagnostic effort and referrals. In a separate experimental task, we evaluate primary care physicians’ altruism. In line with our model, introducing medium-sized referral fees significantly increases referrals made by barely altruistic primary care physicians of patients who need specialist treatment, when compared to the baseline without referral fees. High referral fees significantly increase referrals irrespective of physicians’ level of altruism. Surprisingly, diagnostic effort is not significantly affected by referral fees. Implications for economic efficiency are discussed.

Distribution Contract Analysis on e-Platform by Considering Channel Role and Good Complementarity

Although suppliers can sell their goods on e-retailers’ e-platforms through either a wholesale or agency contract, suppliers that produce complementary goods and have different channel roles have been confused as to how to choose an optimal distribution contract. This paper aims to study this problem by considering the combined impacts of suppliers’ channel roles, e-retailer’s referral fees, goods’ differences in the level of complementarity and goods’ differences in potential demand. Our results show that, regardless of one supplier’s distribution contract choice, the other supplier always prefers agency contract, which is independent of two suppliers’ channel roles, the e-retailer’s referral fees, two goods’ differences in the level of complementarity and two goods’ differences in the potential demand. Moreover, when two suppliers use different distribution contracts to sell goods with different levels of complementarity on the same e-retailer’s e-platform, low-complementarity goods have a larger optimal retail price only if the two goods’ differences in the level of complementarity are sufficiently high, and the supplier can obtain more profits by producing low-complementarity goods regardless of the supplier’s distribution contract and channel role.

Mechanism Design for Managing Hidden Rebates and Inflated Quotes of a Procurement Service Provider

Problem definition : When sourcing through a procurement service provider (PSP), the PSP often collects rebates from unethical manufacturers in developing countries (as referral fees) that are “hidden” from the retailers. Recognizing that a PSP has a strong incentive to solicit quotes from unethical manufacturers, we examine a situation in which the retailer insists on soliciting a quote from a manufacturer designated by the retailer and a separate quote from an unethical manufacturer selected by the PSP. However, when the designated manufacturer is ethical, the PSP has an incentive to inflate the quote from this ethical manufacturer in order to help the unethical manufacturer to win. Facing this situation, is there a mechanism for the retailer to control hidden rebates? Academic/practical relevance : The issue of hidden rebates is a “known secret” in global supply chain practice. Also, hidden rebates increase the customs duty for U.S. importers because of the first sales rule for customs valuation of U.S. imports. Therefore, there is a need to understand the implications of hidden rebates and to control this unethical practice. Methodology : To circumvent the issue of hidden rebates and quote inflations, we develop a deterministic, incentive-compatible mechanism that is based on a simple selection rule (for selecting a manufacturer) and a contingent service fee (as a reward for the service provided by the PSP). Results : Our optimal mechanism creates incentives to (1) deter the PSP from inflating the quote submitted from the ethical manufacturer, (2) reduce the incidence of hidden rebates, and (3) reduce the retailer’s procurement cost and the corresponding import tax significantly. More importantly, relative to the “lowest quote wins” selection rule, the optimal mechanism is Pareto-improving for the retailer and the service provider when the hidden rebate is below a certain threshold. Furthermore, we extend our analysis to the case in which (1) the retailer is not sure whether the designated manufacturer is ethical or not, (2) the retailer does not know the exact value of hidden rebate (but it follows a two-point distribution), and (3) the retailer may verify the quote with its designated manufacturer before a formal contract. We also explore the stochastic incentive-compatible mechanism for the cases in which the penalty is unenforceable or enforceable. Managerial implications : When law enforcement is inconsistent in developing countries, retailers should beware of the existence and implications of hidden rebates. We provide a simple mechanism that a retailer can consider as a practical way to deter the PSP from inflating certain quotes and put hidden rebates under control.

BENTUK KOMUNIKASI BIMBINGAN PERKAWINAN (BINWIN) TERHADAP CALON PENGANTIN

This study seeks to describe the form of communication of marriage guidance to prospective brides, the purpose of this research is to educate readers and organizers of marriage guidance to conduct a thorough evaluation so that in the future the implementation of marriage guidance can be carried out optimally. This type of research is a qualitative research that seeks to describe social phenomena that are developing in the current mass and then described scientifically by following the applicable research principles. From the results of this study, it was found that the implementation of marriage counseling was carried out for two days, the budget for marriage guidance activities was obtained from the Non-Tax State Revenue for Marriage and Referral fees, the resource persons came from the District KUA and health workers from the District Health Center who have competence in the field of sakinah family and reproductive health. The obstacle is that the implementation of guidance held for two days is considered insufficient, the budget for implementing marriage guidance is limited. The minimum number of participants attending marriage counseling.

How to choose online sales formats for competitive e‐tailers

AbstractCurrently, many e‐tailers can sell manufacturers' products on their online platforms through reselling or agency selling formats. However, how to choose the optimal online sales formats has puzzled competitive e‐tailers with different channel roles. This paper uses stylized theoretical models to study this problem by considering the combined effects of e‐tailers' channel roles, each e‐tailer's referral fees, and the difference in e‐tailers' market shares. Our results show that if two e‐tailers sell the common manufacturer's products on their online platforms, no matter what sales format one e‐tailer adopts, the other e‐tailer's best choice depends on the two e‐tailers' referral fees and the difference in the two e‐tailers' market shares, whereas the manufacturer's best action is always to let the other e‐tailer adopt agency selling format regardless of the two e‐tailers' referral fees and channel roles and the difference in the two e‐tailers' market shares. Moreover, if two e‐tailers sell the common manufacturer's products on their online platforms, it is most profitable for the manufacturer when both e‐tailers adopt agency selling format and charge equal referral fees to the manufacturer, and the same is true for the whole supply chain, which is independent of the two e‐tailers' channel roles and the difference in the two e‐tailers' market shares.

Mechanism Design for Managing Hidden Rebates and Inflated Quotes of a Procurement Service Provider

Problem Definition. When sourcing through a procurement service provider (PSP), the PSP often collects rebates from unethical manufacturers in developing countries (as referral fees) that are hidden'' from the retailers. Recognizing that PSP has a strong incentive to solicit quotes from unethical manufacturers, we examine a situation in which the retailer insists on soliciting a quote from a manufacturer designated by the retailer and a separate quote from an unethical manufacturer selected by the PSP. However, when the designated manufacturer is ethical, the PSP has an incentive to inflate the quote from this ethical manufacturer in order to help the unethical manufacturer to win. Facing this situation, is there a mechanism for the retailer to control hidden rebates? Academic/Practical Relevance. The issue of hidden rebates is a ``known secret'' in global supply chain practice. Also, hidden rebates will increase the customs duty for U.S. importers because of the First Sales Rule for Customs Valuation of U.S. Imports. Therefore, there is a need to understand the implications of hidden rebates and to control this unethical practice. Methodology. To circumvent the issue of hidden rebates and quote inflations, we develop a deterministic incentive-compatible mechanism that is based on a simple selection rule (for selecting a manufacturer) and a contingent service fee (as a reward for the service provided by the PSP). Results. Our optimal mechanism creates incentives to: (1) deter the PSP from inflating the quote submitted from the ethical manufacturer; (2) reduce the incidence of hidden rebates, and (3) reduce the retailer's procurement cost and the corresponding import tax significantly. More importantly, relative to the ``lowest quote wins selection rule, the optimal mechanism is Pareto-improving for the retailer and the service provider when the hidden rebate is below a certain threshold. Furthermore, we extend our analysis to the case when: (1) the retailer is not sure whether the designated manufacturer is ethical or not, (2) the retailer does not know the exact value of hidden rebate (but it follows a two-point distribution), and (3) the retailer may verify the quote with his designated manufacturer before a formal contract. We also explore the stochastic incentive-compatible mechanism for the cases when the penalty is unenforceable or enforceable. Managerial Implications. When law enforcement is inconsistent in developing countries, retailers should beware of the existence and implications of hidden rebates. We provide a simple mechanism that a retailer can consider as a practical way to deter the PSP from inflating certain quotes and put hidden rebates under control.

Optimal Channel Choice of Firms with New and Remanufactured Products in the Contexts of E-Commerce and Carbon Tax Policy

This paper is motivated by the dilemma faced by firms who sell new and remanufactured products offline that need to consider whether to enter e-commerce platforms considering that more and more consumers are shopping online on e-commerce platforms rather than shopping offline. Our paper aims to help firms with new and remanufactured products make a channel choice and determine product pricing strategies in the contexts of e-commerce and carbon tax policy. Our paper uses optimization theory, game theory, utility functions and profit-maximization models to investigate the optimal channel choice of whether a firm should enter an e-commerce platform; it also investigates the optimal prices of new and remanufactured products and referral fees in two cases—the firm does not enter the platform (N) and the firm enters the platform (Y). Some insights are presented as follows: We found that the firm should enter the platform if the annual service fee is relatively low, otherwise, the firm should not enter the platform. Interestingly, in the case of a firm with an offline store with relatively large operational costs or hassle costs, the firm is more reluctant to enter the platform. In the extension, we considered some consumers who only purchase offline products, and found that the firm considering these consumers is more likely to choose not to enter the platform. Moreover, we argue that the carbon tax policy has a positive effect on product prices but a negative effect on referral fees charged by the platform, and the choice of Y hurts the environment due to a relatively high total carbon emission.

Interactions of competing manufacturers’ leader-follower relationship and sales format on online platforms

Currently, manufacturers can sell products on e-tailers’ online platforms through agency sales format or reselling format. However, how to choose the best sales formats has puzzled competing manufacturers in practice. The main purpose of this paper is to answer this problem by considering the combined effects of manufacturers’ leader-follower relationships, the e-tailer’s referral fees, the difference in products’ substitutable degrees and the difference in products’ market bases. Our results show that, if demand functions are linearly price-dependent, when two manufacturers sell substitutable products on the same e-tailer’s online platform, the e-tailer’s best action is always to let both manufacturers adopt reselling format; regardless of one manufacturer’s sales format, the other manufacturer always prefers agency sales format, which are independent of the e-tailer’s referral fees, the difference in two products’ substitutable degrees and the difference in two products’ market bases. Whether demand functions are linear or nonlinear in retail prices, the e-tailer’s best action is to let both manufacturers whose products are symmetric adopt reselling format; no matter what sales format one manufacturer adopts, the other manufacturer always prefers agency sales format, which are independent of the two manufacturers’ leader-follower relationships. Moreover, if two manufacturers adopt same sales format to sell symmetric products, leader role enables a manufacturer to charge higher optimal wholesale/retail price when demand functions are linear in retail prices, but the two products have equal optimal wholesale/retail prices regardless of the two manufacturers’ leader-follower relationships when demand functions are nonlinear in retail prices.

Exploratory qualitative study to understand the underlying motivations and strategies of the private for-profit healthcare sector in urban Bangladesh

ObjectivesThis paper explores the underlying motivations and strategies of formal small and medium-sized formal private for-profit sector hospitals and clinics in urban Bangladesh and their implications for quality and access.MethodsThis...

Differences among Ophthalmology Patients Referred to Tertiary Medical Centers according to Referral Hospital

PurposeThis study aimed to investigate the diagnosis and severity of patients who were referred to tertiary medical centers according to the type and function of the referral hospitals.MethodsFirst-visit patients referred from July 2015 to June 2016 were retrospectively reviewed with regard to referral hospital, final diagnosis, treatment necessity, and medical fees for the six months after their first hospital visit. Based on these data, differences in type and function of medical institution were examined.ResultsIn a comparison of hospitals according to their number of beds, clinics, hospitals and, tertiary hospitals had no differences in the ratio of patients who needed treatment (p = 0.075) and their medical fees over six months (p = 0.372). When hospitals were classified by functional capability in terms of doctors' medical specialty, increasing ratios of patients requiring medical treatment (p < 0.001) and medical fees for six months (p < 0.001) were found in the order of non-eye specialists, eye specialists, and eye specialists in trainee hospital.ConclusionsEfficient healthcare delivery systems should classify medical institutions by functionality capability based on medical specialties rather than hospital size according to the number of beds.

Managing Consumer Referrals on a Chain Network

AbstractWe consider a monopoly that sets a price and differentiated referral fees to spread product information along a simple consumer communication network (a chain). The profit-maximizing solution involves standard monopoly pricing and referral fees that provide consumers with strictly positive referral incentives. Effective price discrimination among consumers based on their positions in the chain occurs both in the case of differentiated referral fees and in the case of uniform referral fees.

A Theory of Consumer Referral: Revisited

Jun and Kim (2008) consider the optimal pricing and referral strategy of a monopoly that uses a consumer communication network to spread product information. They show that for any finite referral chain, the optimal policy involves a referral fee that provides strictly positive referral incentives and effective price discrimination among consumers based on their positions in the chain. We revisit this problem to strengthen Jun and Kim's results by weakening their referral condition. Moreover, we characterize the first-best policy when individual-specific referral fees are available and show that it is qualitatively similar to the second-best solution of Jun and Kim (2008).

Designing Ethics Indicators for Legal Services Provision

Market liberalisation of legal services is being accompanied by key changes in professional regulation, notably outcome focused regulation, prioritised through risk-assessment and invoking stronger elements of relationship management. These suggest changes in the nature of professionalism. For some at least, market liberalisation in particular threatens to weaken professional ethics. Because of the transitions underway in the legal services market, there is a need to better understand the ethics of legal service providers. This report examines ways of doing that. Regulators (and businesses) in other fields and jurisdictions have begun to recognise the limitations of command and control regulation and as a result, an interest in tools which seek to deepen understandings of ethics has grown. Systematic understanding of ethics in the legal services market is remarkably thin. Debate about ethics is often based on anecdote and argument and where it is evidenced at all it usually derives from data on complaints and regulatory enforcement. These are limited sources, subject to limited analysis. Some more detailed specific analyses have been undertaken relevant to particular market sectors (wills) or themes (referral fees). This document reviews how empirical research can be used to track ethics across a legal services market consisting of a range of different markets and provider types, both professional and non-professional.

Referral fees – the business of access to justice

The paper examines the controversial issue of referral fees for personal injury claims. It looks at the function of referral fees in the civil justice system, their relationship to the guarantees of access to court and the right to seek legal assistance in ECHR Art 6, and the debate about promoting access to justice or a litigious society. It examines the experience of the referral fees market in England and Wales, where the costs of referrals have risen dramatically and there is concern that referrers are auctioning their customers to the highest bidder rather than helping them find competent lawyers. Sir Rupert Jackson recommended banning referral fees in his report on the costs of civil litigation, and the Government has announced it will implement this recommendation. The paper considers the potential effects of a ban on competition in the legal services market and its compatibility with UK and EU competition law. The paper argues that a combination of better regulation of the industry and proper regulation of costs rules is a better and more proportionate way of controlling legal costs and the quality of legal services than an outright ban. While referral fees have not delivered all the benefits one would expect from a for-profit independent referrals service, they can help people obtain information about their legal rights, and competent lawyers to enforce them. This service is particularly valuable given that the state has substantially cut public funding of the civil justice system in recent years.

Woman pullers: pimping and sex trafficking in a Mexican Border City

Much has been written about sex trafficking in the past decade, although empirical studies have remained few. Even less research has been done on those who make a living by facilitating the movement of women and children in the sex industry. This paper is based on a three-year study in Tijuana, Mexico, in which 92 sex trade facilitators were interviewed. Findings suggest a far more complex social process than portrayed by the anti-trafficking literature. Men and women of diverse backgrounds developed niches in Tijuana’s sex industry, by bringing women into contact with customers. This business appeared to be dominated by Mexican entrepreneurs, with no evidence of any systematic collaborations with either local criminal organizations or foreign traffickers. There appeared to be no shortage of women willing to work in the sex industry, suggesting limited prospect for coerced prostitution. Still, a small number of pimps reported using “persuasion” to recruit women of particular types from interior Mexico. Commissions or referral fees were the most common form of income received by pimps for their services, and the rules on how money was to be made and split between sex workers and venue owners appeared well established. While a few respondents could sustain a livelihood through pimping, the majority held other jobs.