Search results

This paper analyzes economic, legal, behavioral and public policy issues pertaining to the accounting for employee stock options. The paper explains why employee stock options (ESOs) are superior to other forms of incentive compensation, why ESOs in their present form are inefficient and why particular accounting, legal and tax treatments will provide the optimal results for the economy, the government, management/employees and shareholders. The issues discussed in this article are relevant in ESO accounting, regulation of ESOs, incentive compensation, human resources analysis, tax policy, corporate governance, fraud, valuation of companies, derivatives regulation, behavioral analysis of law/rules, portfolio management and management strategy.

Purpose: While COVID-19 has upended lives, it has also catalyzed innovation with potential to advance health delivery. Yet, we know little about how the delivery system, and primary care in particular, has responded and how this has impacted vulnerable patients. We aimed to understand the impact of COVID-19 on primary care practice sites and their vulnerable patients and to identify explanations for variation. Approach: We developed and administered a survey to practice managers and physician leaders from 173 primary care practice sites, October-November 2020. We report and graphically depict results from univariate analysis and examine potential explanations for variation in practices' process innovations in response to COVID-19 by assessing bivariate relationships between seven dependent variables and four independent variables. Findings: Among 96 (55.5%) respondents, primary care practice sites on average took more safety (8.5 of 12) than financial (2.5 of 17) precautions in response to COVID-19. Practice sites varied in their efforts to protect patients with vulnerabilities, providing care initially postponed, and experience with virtual visits. Financial risk, practice size, practitioner age, and emergency preparedness explained variation in primary care practices' process innovations. Many practice sites plan to sustain virtual visits, dependent mostly on patient and provider preference and continued reimbursement. Value: While findings indicate rapid and substantial innovation, conditions must enable primary care practice sites to build on and sustain innovations, to support care for vulnerable populations, including those with multiple chronic conditions and socio-economic barriers to health, and to prepare primary care for future emergencies.

This study aims to scrutinize existing end-user comprehension regarding e-wallet technology through an examination of apparent usefulness, ease of use and levels of trust, and how these factors may influence a consumer’s attitudes toward the adoption of this new payment method.

The quota sampling method was used, and residents over the age of 22 years were targeted in online and offline questionnaires, and partial least squares-structural equation modeling was used to analyze the data.

This study indicates that existing consumer mindsets and intentions to adopt new technology, such as the e-wallet, are greatly influenced by their perception of the practicality of the product, its ease of use and their levels of trust in the technology to protect their online safety, privacy and economic affairs. Contrastingly, those participants who were offered deferred reimbursements and those given no information were demonstrably less likely to adopt the new service.

The study sample was from a developing nation – Saudi Arabia. Similar cohorts from developing and developed countries could provide a unique cross-nation comparison.

This study stresses the importance of thoroughly explaining and demonstrating an innovative technology to customers while simultaneously promoting the product. Consumers can be encouraged to use and evaluate the new technology by providing inducements, such as effective reimbursement policies.

This paper contributes to literature by critically reflecting on the question: What are the factors influencing customer intentions to adopt the e-wallet, and how do the guarantee of reimbursement and the time frame following unauthorized use influence consumer adoption intentions when deciding to use the new payment technology?

Public hospitals in China usually rely on revenues from medical services and medications to compensate for major costs given their nonprofit nature. The lack of government subsidies and unreasonable prices of medical services have led to high medical costs and unbalanced reimbursement system for public hospitals. There is a critical need of research on improvement of reimbursement system that will create positive effect on China’s health-care system. This paper aims to focus on four dimensions of stakeholders (government, patients, medical insurance agencies and social organization) and six major expenditures to explore reimbursement scheme for public hospitals in China with the purpose of relieving unbalanced income and expenditure of hospitals, avoiding medication markups and reducing medical expenses from patients.

In this paper, the authors study reimbursement scheme for public hospitals from the perspective of four dimensions of stakeholders and how stakeholders reimburse six major expenditures of hospitals. A total of 128 effective samples were collected from financial data of 32 public hospitals through 2009-2012. This paper analyzes the econometric models of the selected revenue and expenditure. This paper analyzes the econometric models of the selected revenue and expenditure using linear regression. The linear relationship between each cost and different types of incomes (i.e. reimbursements from government, patients, insurance agencies and social organization) is analyzed before and after cancelling the medication markups.

Results from empirical research verify that government reimbursement is insufficient, and using medication markups to compensate for medical service costs has become a serious problem for China’s public hospitals. To avoid the medication markups and improve the reimbursement scheme, government should reimburse labor cost, fixed assets cost and research cost; patients and medical insurance agencies should reimburse the costs of medical service, medication and administration/operations; and social organization should supplement the fixed assets cost.

In this study, the authors defined and classified stakeholders of reimbursement scheme for public hospitals in China, which help understand the roles and effects that different stakeholders can play in compensation. Along with the proposed reimbursement scheme framework, this study will help make effective implementation of new health-care reform program in China.

The purpose of this paper is to briefly review the history of healthcare‐associated infection (HAI) prevention programs in the USA since the early 1970s until today, and provide suggestions how other countries (and Canada specifically) may learn from this experience to accelerate HAI prevention and patient safety improvements in their counties.

The paper is a narrative review of literature and personal experience.

US hospitals have had healthcare‐associated infection (HAI) prevention programs, including surveillance for selected HAIs, since the late 1960s‐early 1970s. Such programs began with active surveillance for HAIs based upon the Centers for Disease Control and Prevention's (CDCs) National Nosocomial Infections Surveillance (NNIS) system. This system included standardized definitions and surveillance protocols. Since the 1980s, the CDC has developed HAI prevention guidelines, with categorized recommendations for HAI prevention. In the early 2000s, the Institute of Medicine published a report outlining the harm caused by HAIs. This led to increased attention to HAI prevention by an increasingly wide variety of organizations. The Joint Commission and the Centers for Medicare and Medicaid Services (CMS) initiated HAI prevention efforts. Many studies documented the failure of hospitals to fully implement evidence‐based practices. The increased attention to HAIs and their morbidity and mortality led to media reports and ultimately an initiative by the Consumer's Union for mandatory reporting of HAI rates by hospitals in all states. Subsequently, the CMS introduced decreased reimbursement for the additional costs directly related to HAIs (and other critical incidents) and linkage of reimbursement levels to hospital HAI rates. Together, mandatory reporting and reduced reimbursement for HAIs has led hospital executives to focus more attention on infection control programs to decrease HAI rates. Progress on preventing HAIs seems to be related to standardizing evidence‐based HAI prevention bundles, mandatory reporting, and paying for performance (or not paying for preventable HAI complications). Given that voluntary HAI prevention programs have existed since the 1970s, it appears that regulation, reporting, and decreased reimbursement has resulted in more rapid implementation of HAI prevention programs and improved patient safety.

The different major activities enhancing HAI prevention in the USA are outlined in an historic context.

Understanding the history of progress in hospital infection control efforts provides an essential perspective for policy makers and for the interdisciplinary team required to evaluate HAI mandatory public reporting in a comprehensive manner.

Maladaptive daydreaming (MD) has yet to be recognized as a formal condition. This paper aims to shed light on the phenomenon of daydreaming, its potential maladaptive nature and the characteristics of MD, as well as potential interventions that may be implemented to address it.

The present paper is a general conceptual review of the condition of MD. It provides a historical overview of the phenomenon and attempts to draw meaningful inferences from the scientific work pertaining to the development of diagnostic criteria, the assessment and interventions developed to treat MD.

Studies have shown that MD can cause distress and impair an individual's typical functioning, and specific diagnostic criteria and symptoms have been identified. Scheduled clinical interviews, self-report measures and derivative treatment modules are currently utilized to understand, assess and treat the symptoms related to MD.

Formal recognition of the condition ensures that the individuals receiving treatment for the condition are provided with insurance coverage and reimbursement for treatment.

Authors also hope for MD recognition, awareness, reduced stigma and acceptance.

This review offers a fair overview of the recent scientific findings pertaining to MD and attempts to open a channel of discourse to enhance the inclusivity of relevant psychopathological conditions in the existing classifications.

Due to recent Affordable Care Act reforms, prevention of readmissions is a salient issue for hospitals that participate in Medicare, as they are now held accountable for patients who receive post-acute care in facilities over which hospitals have little influence to monitor care. Using resource dependence and transaction cost economics to describe the theoretical advantages of hospital ownership of post-acute care facilities (PACs), we empirically test whether hospitals that own PACs experience reduced readmissions. Our findings indicate partial support for the predicted relationship between PAC ownership and readmission rates. We found that hospital ownership of a skilled-nursing facility (SNF) was related to a lower readmissions rate for some patients, while ownership of other types of PACs did not result in significant findings. Our results offer support for the theoretical advantages of ownership, however, the savings realized by ownership may not merit the ownership investment.

The purpose of this paper is to explore in a specific hospital care process the applicability in practice of the theories of quality costing and value chains.

In a retrospective case study an in‐depth evaluation of the use of a quality cost model (QCM) and the applicability of Porter's care delivery value chain (CDVC) was performed in a specific care process: glaucoma care over the period 2001 to 2006 in the Rotterdam Eye Hospital in The Netherlands.

The case study shows a reduction of costs per product by increasing the number of outpatient visits and surgery combined with a higher patient satisfaction. Reduction of costs of non‐compliance by using the QCM is small, due to the absence of (external) financial incentives for both the hospital and individual physicians. For CDVC to be supportive to an integrated quality and cost management the notion “patient value” needs far more specification as mutually agreed on by the stakeholders involved and related reimbursement needs to depend on realised outcomes.

The case study just focused on one specific care process in one hospital. To determine effects in other areas of health care, it is important to study the use and applicability of the QCM and the CDVC in other care processes and settings.

QCM and a CDVC can be useful tools for hospital management to manage the outcomes on both quality and costs, but impact is dependent on the incentives in the context of the existing organisational and reimbursement system and asks for an agreed on operationalisation among the various stakeholders of the notion of patient value.

The purpose of this paper is to provide commentary on the state of affairs regarding implementation of Dutch health insurance reform, focusing on whether such reform is conducive to pharmaceutical innovation.

The general characteristics of the Dutch healthcare system is outlined, together with a brief synopsis of the 2006 health insurance reform initiative. This is followed by a description of the four market intervention mechanisms and their implications for pharmaceutical innovation. Finally, these implications and the potential for policy transfer to other European countries are discussed.

The new Dutch health insurance system represents a novel approach that closely follows Enthoven's managed competition model. Certain features of the new system are conducive to pharmaceutical innovation. These positive features include more flexibility on the part of private insurers to deviate from the national formulary, speedier reimbursement appraisals, and more earmarked funding for certain highly innovative pharmaceutical products. Other features, however, appear detrimental to drug innovation. These include direct price controls, reference pricing, and the still highly centralized nature of decision making with respect to drug reimbursement. On the whole, one could say that, despite many challenges, Dutch health insurance reform is a step in the right direction that may prove to be a boon to biopharmaceutical innovation if further steps are taken to remove obstacles.

It is premature to draw firm conclusions on whether Dutch health insurance reform is conducive to pharmaceutical innovation. The new system is at an early stage in its evolution. Further, one should be cautious about the extent to which lessons can be drawn from the new Dutch system for other European countries, given the limited size of the Dutch biopharmaceutical industry relative to some of its European neighbors.

While much is known about how changes in the drug regulatory framework impact pharmaceutical innovation, very little is known about how changes in health care insurance impact pharmaceutical innovation. This paper aims to fill that void by examining the impact of the new Dutch health insurance system on drug innovation.

Over the last decades, the Czech health care system has undergone significant reforms. Regardless of its good performances in terms of health care spending and improved population's health, the sustainability and functionality of the Czech system still faces important challenges. It is particularly vulnerable to economic shocks and an ageing society; it suffers from inefficiencies in hospital management and experiences profound changes in the health workforce. To tackle these problems, policy makers have been working to reform the system, but these challenges have not yet been overcome. The present chapter provides an overview of selected reforms and their outcomes. First, we describe the main features of the health care system in the Czech Republic. Then, we discuss its main sustainability problems and the policy interventions that have been implemented to tackle these problems with a particular focus on evidence provided by the health economics literature on the actual effects of the reforms.