Incentive Structures Research Articles

Short- and intermediate-term impact of DTC telemedicine consultations on subsequent healthcare consumption

AimThe use of direct-to-consumer (DTC) telemedicine consultations in primary healthcare has increased rapidly, in Sweden and internationally. Such consultations may be a low-cost alternative to face-to-face visits, but there is limited evidence on their effects on overall healthcare consumption. The aim of this study was to assess the short- and intermediate-term impact of DTC telemedicine consultations on subsequent primary healthcare consumption, by comparing DTC telemedicine users to matched controls in a Swedish setting.MethodsWe constructed a database with individual-level data on healthcare consumption, for all residents of Region Stockholm in 2018, by linking national and regional registries. The study population included all individuals who had ≥ 1 physician consultation (telemedicine or face-to-face) during the first half of 2018. DTC telemedicine users were matched 1:2 to controls who were non-users of DTC telemedicine but who had a traditional face-to-face consultation during the study period. The matching criteria were diagnosis and demographic and socioeconomic variables. An interrupted time series analysis was performed to compare the healthcare consumption of DTC telemedicine users to that of the control group.ResultsDTC telemedicine users increased their healthcare consumption more than controls. The effect seemed to be mostly short term (within a month), but was also present at the intermediate term (2–6 months after the initial consultation). The results were robust across age and disease groups.ConclusionThe results indicate that DTC telemedicine consultations increase the total number of physician consultations in primary healthcare. From a policy perspective, it is therefore important to further investigate for which diagnoses and treatments DTC telemedicine is suitable so that its use can be encouraged when it is most cost-efficient and limited when it is not. Given the fundamentally different models for reimbursement, there are reasons to review and possibly harmonise the incentive structures for DTC telemedicine and traditional primary healthcare.

Game theory and governance of protected areas – Peneda-Gerês National Park

The literature shows that integrating tourism management with place governance practices is conducive to harmony and development in urban areas. However, protected areas face peculiar governance and management challenges. This article offers an in-depth study of the governance of the Peneda-Gerês National Park in Portugal. We model the incentive structure of some of its stakeholders through game theoretical techniques and find that early phases were not conducive to cooperation among relevant stakeholders, potentially leading to outcomes that were less than optimal, both to them and to the park. The most recent, co-management, model seems much more promising.

Cost-sharing or rebate: The impact of health insurance design on reducing inefficient care

This paper investigates how the design of health insurance plans influences individuals' treatment decisions. We derive several hypotheses how the framing of incentives in a plan affects behavior and test these hypotheses in a laboratory experiment. Our results show that rebates are more effective in containing costs, as individuals request significantly less inefficient low-value care under rebates than under cost-sharing. We elicit individuals' degree of loss aversion but find no evidence that loss aversion influences utilization rates. Instead, our results suggest that relative thinking and the difficulty of understanding the dynamic incentive structure drive the design effect.JELI13, I18, D02, D91

Are avocados toast? A framework to analyze decision-making for emerging epidemics, applied to laurel wilt

CONTEXTWhen emerging pathogens threaten global food security, collective action for disease management is key for protecting food systems. We evaluate how the informal exchange of information about epidemic and economic outcomes can influence the management decisions of individuals and the resulting epidemics, in the context of the avocado laurel wilt epidemic in south Florida. OBJECTIVESIn scenario analyses, we addressed how socioeconomic networks, laurel wilt epidemic networks, policy incentive structures, and social behaviors combine to influence (a) information exchange across this region, (b) growers' decisions about disease management, and (c) epidemic spread and yield loss. We identified the scenarios in which regional avocado health fared best. METHODSWe built an agent-based model to simulate laurel wilt epidemic expansion and establishment across south Florida over a 10-year period. The model used parameters specific to patterns observed and quantified from the laurel wilt epidemic in south Florida. Based on the locations and sizes of avocado orchards there, we simulated disease expansion and information dissemination through multilayer socioeconomic and epidemic networks and evaluated the effects of “carrot” and “stick” policy incentive structures and behaviors like “stubbornness” in decision making. Scenarios were simulated for multiple parameters across a 10-year time period, and the regional health of avocado and management decisions of growers were analyzed. RESULTS AND CONCLUSIONSIncreased social connections led to lower regional crop health due to increased exchange of information reinforcing selection of less expensive but less effective management choices. This information exchange was particularly impactful during the lag phase of epidemic expansion, when the cost of disease management outweighed the cost of disease. Managers who were resistant or “stubborn” against adopting these less expensive and less effective management strategies, particularly during the lag phase of epidemic expansion, contributed to greater regional health. In these scenarios, growers responded more to policies which penalized individuals than to policies which rewarded individuals. SIGNIFICANCEBy quantifying varying degrees of stubbornness, and how growers may weight past experiences and new information, we represented key aspects of decision making and its many influences on regional collective action in this novel agent-based model. The model demonstrates the caveats of information exchange across social networks during epidemics, and the valuable role that policy makers and informed educators can have, particularly during the lag phase of epidemic expansion. Decision makers and stakeholders must understand the influences of information exchange to overcome the challenges of collective action for crop health.

Smart contract-enabled consortium blockchains for the control of supply chain information distortion

Conflicts between supply chain members emerge because individual strategic actions may not be jointly optimal. Efforts to forecast consumer demand represent a source of conflict. The coordination of forecasts requires a powerful incentive alignment approach. This work proposes a smart contract equipped consortium blockchain system that creates an incentive structure that makes coordination with respect to forecasts economically appealing. Distortions of demand information due to uncoordinated forecasting are captured by a bullwhip measure that factors both forecast error and variance. Cooperation under the system is shown to help minimize this bullwhip measure, thus generating new outcomes for the participants that allow for a higher reward. Under a fixed payout structure, the system achieves credibility of continued cooperation, thus promoting an optimally coordinated equilibrium between the retailer and supplier. Blockchain technology represents a novel information system and consensus formation mechanism that can intermediate the behavior of a supply chain network.

Learnings Networks and Professional Development in Building Energy Management Systems Industry

The energy management systems industry in the built environment is currently an important topic. Buildings use about 40% of the total global energy worldwide. Therefore, the energy management system’s sector is one of the most influential sectors to realize changes and transformation of energy use. New data science technologies used in building energy management systems might not only bring many technical challenges, but also they raise significant educational challenges for professionals who work in the field of energy management systems. Learning and educational issues are mainly due to the transformation of professional practices and networks, emerging technologies, and a big shift in how people work, communicate, and share their knowledge across the professional and academic sectors. In this study, we have investigated three different companies active in the building services sector to identify the main motivation and barriers to knowledge adoption, transfer, and exchange between different professionals in the energy management sector and explore the technologies that have been used in this field using the boundary-crossing framework. The results of our study show the importance of understanding professional learning networks in the building services sector. Additionally, the role of learning culture, incentive structure, and technologies behind the educational system of each organization are explained. Boundary-crossing helps to analyze the barriers and challenges in the educational setting and how new educational technologies can be embedded. Based on our results, future studies with a bigger sample and deeper analysis of technologies are needed to have a better understanding of current educational problems.

China’s climate and energy policy paradox revisited – domestic and international implications of a carbon lock-in ‘with Chinese characteristics’

ABSTRACT Juxtaposing China’s current situation and policies toward coal and renewables at home and abroad, we argue that China remains in a paradoxical state of carbon lock-in. We analyze the techno-economic, institutional and political factors that contribute to China’s coal-related policies following a novel approach that blends different theories and frameworks to establish an interdisciplinary dialogue between various strands of research that were hitherto unconnected. This is accomplished by applying a political economy framework through the lens of techno-institutional carbon lock-in theory in three case studies encompassing China itself, as well as China’s climate and energy policy abroad in Pakistan and Mozambique. The article draws four major conclusions about China’s energy paradox: 1) An imperative for economic growth lies at the heart of the Chinese governance system’s incentive structure, which has resulted in a coal-based energy and industrial policy. 2) China’s government should use the experimental, decentralized nature of its regionally-decentralized regime and energy sector to their advantage by promoting disruption rather than incumbency. 3) To address the structural and institutional deficiencies that maintain or even strengthen carbon lock-in, energy governance should be shaped around the primary challenge of strengthening renewable energy advocates throughout all levels of government. 4) The discussion of coal financing abroad must now go beyond the discontinuation of new projects; the building of alternative cleaner projects should be considered and the ones in progress should be halted.

Reviewing the potentials of MMOGs as research environments: A case study from the strategy game Travian.

Massively Multiplayer Online Games (MMOGs) provide many opportunities for scientists. Previous research ranges from personality trait prediction to alternative cancer treatments. However, there is an ongoing debate on whether these virtual worlds are able to represent real world scenarios. The mapping of online and offline findings is key to answering this question. Our work contributes to this discussion by providing an overview of the findings from network-based team and leadership research and by matching them with concrete results from our MMOG case study. One major finding is that team size matters. We show that high diversity in the type of teams is a major challenge, especially when combined with the immense amount of data in MMOGs. In our work, we discuss these issues and show that a well-grounded understanding of the data and the game environment makes it possible to overcome these limitations. Besides the team size, the aggregation periods play an important role. Regarding MMOGs as research environments, we show that it is important to pay close attention to the specific game-related contexts, the incentive structures, and the downside risks. Methodologically, we apply support and communication networks to show the influence of certain group-based measures (e.g., density, transitivity) as well as leadership-centered characteristics (e.g., k-core, group centrality, betweenness centralization) on team performance. Apart from our findings on centralization in communication networks, we are able to demonstrate that our results confirm the theoretical predictions which suggest that the behavioral patterns observed in MMOG teams are comparable to those observed in offline work teams.

Transformational leadership and work engagement in public organizations: promotion focus and public service motivation, how and when the effect occurs

Transformational leadership and work engagement in public organizations: promotion focus and public service motivation, how and when the effect occurs

Labor Migration as a Source of Institutional Change: Danish and Australian Construction Sectors Compared

In this article, the authors examine the role of labor immigration as a source of institutional change. They use a “most different systems” comparative case study analysis of the Danish and Australian construction sectors to examine the impact of increased labor migration on skill-sourcing practices in countries with distinct national skill formation and industrial relations institutions. Drawing on 73 interviews with industry stakeholders, the authors find that labor migration has produced liberalizing pressures in both Denmark and Australia, albeit in ways that differ from each other. The article contributes to comparative institutional scholarship by illustrating how labor migration can promote or support institutional change in a liberalizing direction by disincentivizing coordinated skill formation. Findings suggest that while national institutions mediate external pressures, such as labor migration, such pressures may affect the incentive structures that can either maintain or erode national institutions.

Legal and Institutional Impediments to Sharing Economy: Case of Uber’s Non-Uptake in Hong Kong

Abstract Technological innovations can significantly impact market structures and the behavior of actors, necessitating legal changes. However, in the face of technological changes brought by sharing economy, there is a differential in the responsiveness of rule-making institutions across different jurisdictions. This article analyses the rule-making institutions that allow for the regulatory changes procured by Uber and the institutional impediments that may restrict jurisdiction in accommodating this type of crowd-based technological disrupters. Uber’s non-adoption in Hong Kong is compared to its success in the United States to evaluate the limitations of rule-making institutions in responding to the legal change required by sharing economy companies. Changes in the rule-making institutions themselves may be needed to accelerate technological innovations and economic growth. This article suggests that there is a lack of institutional adaptability in Hong Kong, where the rule-making institutions are unable to facilitate potential regulatory reform. While the feasibility of changing a particular jurisdiction’s electoral system and political systems may be low, jurisdictions can improve the accountability of their executive regulators by modifying the incentive structure.

A review of commercialisation mechanisms for carbon dioxide removal

The deployment of carbon dioxide removal (CDR) needs to be scaled up to achieve net zero emission pledges. In this paper we survey the policy mechanisms currently in place globally to incentivise CDR, together with an estimate of what different mechanisms are paying per tonne of CDR, and how those costs are currently distributed. Incentive structures are grouped into three structures, market-based, public procurement, and fiscal mechanisms. We find the majority of mechanisms currently in operation are underresourced and pay too little to enable a portfolio of CDR that could support achievement of net zero. The majority of mechanisms are concentrated in market-based and fiscal structures, specifically carbon markets and subsidies. While not primarily motivated by CDR, mechanisms tend to support established afforestation and soil carbon sequestration methods. Mechanisms for geological CDR remain largely underdeveloped relative to the requirements of modelled net zero scenarios. Commercialisation pathways for CDR require suitable policies and markets throughout the projects development cycle. Discussion and investment in CDR has tended to focus on technology development. Our findings suggest that an equal or greater emphasis on policy innovation may be required if future requirements for CDR are to be met. This study can further support research and policy on the identification of incentive gaps and realistic potential for CDR globally.

Do changes in distributors' incentive structure drive mutual fund flows?

PurposeThis study estimates the impact of changes in the mutual fund distributor incentive structure on distributor-advised mutual fund flows. The authors employ two recent major policy interventions by the Indian self-regulatory authority and the financial market regulator – one partial ban and another complete ban on upfront commissions – paid to mutual fund distributors on distributor-advised mutual fund flows.Design/methodology/approachThe authors use novel distributor-level data across the 198 largest distributors in India between 2013 and 2020 and a series of pooled panel random-effect generalized least squares models with robust standard errors to explore the effect of changes of distributor commissions on distributor assets-under-management (AUM), gross sales, commissions and changes (%) in the number of investors in alternate investment avenues like portfolio management services (PMS).FindingsChanges in the incentive structure have a significant negative effect on mutual fund flows at an aggregate level and within MF distributor categories. A significant diversion of investor funds toward PMS is noted, which paid higher upfront commissions to distributors during the same period.Practical implicationsThe authors posit that these two developments are not mutually independent and that both fall out of the aforementioned policy changes by Securities and Exchange Board of India and Association of Mutual Funds in India. The study findings have implications for all stakeholders in the Indian mutual fund industry and, by extension, for Indian and global alternative investment avenues.Originality/valueThis study is the first to explore the effects of these two major policy interventions by regulators on mutual fund flows in India.

Humans as intuitive classifiers.

Mainstream decision research rests on two implicit working assumptions, inspired by subjective expected utility theory. The first assumes that the underlying processes can be separated into judgment and decision-making stages without affecting their outcomes. The second assumes that in properly run experiments, the presentation of a complete description of the incentive structure replaces the judgment stage (and eliminates the impact of past experiences that can only affect judgment). While these working assumptions seem reasonable and harmless, the current paper suggests that they impair the derivation of useful predictions. The negative effect of the separation assumption is clarified by the predicted impact of rare events. Studies that separate judgment from decision making document oversensitivity to rare events, but without the separation people exhibit the opposite bias. The negative effects of the assumed impact of description include masking the large and predictable effect of past experiences on the way people use descriptions. We propose that the cognitive processes that underlie decision making are more similar to machine learning classification algorithms than to a two-stage probability judgment and utility weighting process. Our analysis suggests that clear insights can be obtained even when the number of feasible classes is very large, and the effort to list the rules that best describe behavior in each class is of limited value.

The end of negative market integration: 60 years of free movement of goods litigation in the EU (1961–2020)

ABSTRACT The free movement of goods is widely believed to be a prime example of the negative integration paradigm. Its defining characteristic is a strong judicial process, fuelled by – and fuelling – litigation, which eclipses the weak(er) political process. The article argues that this dominant narrative is no longer accurate. Based on a new dataset of all Article 34 TFEU cases decided by the CJEU between 1961 and 2020, it shows that goods litigation has been disappearing from the Court’s docket since the mid-1980s. The reasons for this, it is argued, lie in changing incentive structures for both litigants and national courts, which have reduced the appeal of bringing goods cases, as well as a rise in EU legislation. The consequence is a demise of negative and a turn towards positive integration.

Culture Change Requires Personal and Organizational Changes: Lessons from the Shared Equity Leadership Model

In Short This article presents a model of shared equity leadership that helps transform campus cultures so that students, faculty, staff, and administrators from all backgrounds experience greater inclusion and ameliorates equity gaps. The key to success is the combination of personal- and organizational-level changes that create a critical mass of employees dedicated to the work of diversity, equity, and inclusion. The findings also showed that each faculty, staff and administrator must first turn inwards and do their own personal work in order to then turn outwards to transform their institutions. Organizational-level changes (such as hiring diverse leaders, revising reward and incentive structures, and expanding accountability systems to include a focus on DEI) were simultaneously enacted as campus change agents worked on their personal journeys.

Hidden inefficiency: Strategic inflation of project schedules

Establishing realistic project plans and completing the resulting business projects on schedule is crucial for organizations striving to effectively utilize their resources. However, incentivizing on-time project delivery may result in moral hazard, as people could respond to estimation accuracy incentives by strategically inflating duration estimates and subsequently prolonging project execution. While the project is delivered on time, the resources are underutilized. We conjecture that the possibility of moral hazard can be mitigated by introducing speed incentives in addition to the schedule accuracy incentives. We conduct a diagnostic test of the effect of accuracy and speed incentives on the process of project estimation and delivery. Our study presents direct empirical evidence that the incentive structure rewarding solely the estimation accuracy can result in hidden inefficiency due to inflated estimates and deliberately slower project execution. When speed incentives are implemented alongside estimation accuracy incentives, the estimates are significantly lower and the project is completed more quickly, without compromising the schedule accuracy or output quality. Aligning the objectives of a project owner with those of planners, by incentivizing the planners for both estimation accuracy and quick project completion, fosters more compressed but still accurate and reliable project schedules, and accelerated project delivery.

Imbalanced Incentives: A Content Analysis of research Participant Incentive Structures in Clinical and Translational Science.

In conducting research with underserved and vulnerable populations, incentives for research participants can improve recruitment efforts. However, incentives lose influence if researchers treat them as merely transactional. This study seeks to identify how researchers describe research participant incentives and incentive structures, with a focus on populations that experience health disparities. This study is a content analysis of research publications from peer-reviewed clinical journals. Although researchers share information about procedures through conference proceedings and grey literature, the most common mechanism for disseminating details about research studies is peer-reviewed literature. Sampling included research manuscripts from four journals (Annals of Family Medicine, Annals of Internal Medicine, American Journal of Emergency Medicine, American Journal of Obstetrics and Gynecology) within 2017-19. Within each issue, coders coded all manuscripts that the journal categorized as research. Using a deductive coding scheme, four authors sorted papers by research that enrolled participants versus other methods and then coded papers for variables of interest. Of 519 articles reviewed, 204 reported results to studies that enrolled human participants. Nine of these targeted populations that were vulnerable or experience disparities. Of 204 studies, 12 (5.9%) described an incentive for research participation. Participant type was significantly associated with offering a participant incentive, p < .001. Healthcare workers and online participants were more likely to receive an incentive than clinical research participants. Funding was also significantly associated with offering a participant incentive, p < .001, regardless of funding source. Of the 12 papers that disclosed incentive information, two focused on vulnerable populations. Findings here show few publications describe incentive structures, which indicates that either 1) incentives are underutilized in recruitment efforts or 2) studies are not publishing incentive information. Furthermore, incentives are more frequently used to recruit healthcare worker populations than community or clinical participants, which may indicate a transactional approach in contrast to a community or patient-oriented approach to research participation. A standardized approach to describing incentives could help researchers and clinicians contextualize a study's findings.

Impact of different financial incentive structures on a web-based health survey: do timing and amount matter?

Financial incentives improve response to electronic health surveys, yet little is known about how unconditional incentives (guaranteed regardless of survey completion), conditional incentives, and various combinations of incentives influence response rates. We compared electronic health survey completion with two different financial incentive structures. We invited women aged 30-64 years enrolled in a U.S. healthcare system and overdue for Pap screening to complete a web-based survey after receiving a mailed human papillomavirus (HPV) self-sampling kit in a pragmatic trial. HPV kit returners (n = 272) and non-returners (n = 1,083) were allocated to one of two different incentive structures: (1) Unconditional: $5 pre-incentive only (n = 653); (2) Combined: $2 pre-incentive plus $10 post-incentive conditional on completion (n = 702). Chi-square tests evaluated whether survey completion differed by incentive structure within kit return groups or was modified by kit return status. For each incentive-by-kit status group, the cost-per-survey response was calculated as: ([number invited*pre-incentive amount] + [number responses*post-incentive amount]) / number responses. Overall, survey response was higher in kit returners vs. kit non-returners (42.6% vs. 11.0%, P < 0.01), and survey response was higher in the combined (20.1%) vs. unconditional (14.4%) incentive group (P = 0.01). Kit return status did not modify the association between incentive type and survey response (P = 0.52). Among respondents, time to survey completion did not differ by incentive type among either kit returners or non-returners. Among returners, the cost-per-survey response was similar between groups ($13.57 unconditional; $14.15 combined); among non-returners, the cost was greater in the unconditional ($57.78) versus the combined ($25.22) group. A combined incentive can be cost-effective for increasing survey response in health services research, particularly in hard-to-reach populations.

Crowds and Crowd-Pleasing in Plato

AbstractPlato's antipathy to crowds is a commonplace that reinforces a prevailing portrait of the Socratic method as a practice that centers on individuals, to the exclusion of crowds and the many. This canonical view, however, comes into tension with the tendency of Plato's Socrates to conduct his dialogues in the presence of collective audiences. I argue that Plato's position on crowds is at once more complex and more ambivalent than has been commonly accepted. I distinguish between two distinct lines of critique that Plato develops against crowds: the argument that the incentive structures that move crowds are unconducive to philosophy; and a more ambiguous argument that crowds tend not to be as amenable to control as their portrayal in the Athenian democratic imaginary seems to promise. Plato's depiction of Socratic practice can be understood as an effort to explore an alternative vision of crowd control.