Suchergebnisse

Physicians, health plans, and health systems are increasingly evaluated and rewarded based on Health Plan Effectiveness Data and Information Set (HEDIS) and HEDIS-like performance measures. Concurrently, employers and health plans continue to try to control expenditures by increasing out-of-pocket costs for patients. The authors use fixed-effect logit models to assess how rising copayment rates for physician office visits and prescription drugs affect performance on HEDIS measures. Findings suggest that the increase in copayment rates lowers performance scores, demonstrating the connection between financial aspects of plan design and quality performance, and highlighting the potential weakness of holding plans and providers responsible for performance when payers and benefit plan managers also influence performance. Yet the effects are not consistent across all domains and, in many cases, are relatively modest in magnitude. This may reflect the HEDIS definitions and suggests that more sensitive measures may capture the impact of benefit design changes on performance.

This study was conducted to propose the Green Economic Development Plan for Manufacturing S.M.E.s based on financial performance and operations thru Green Initiatives. The descriptive survey method used to gather data to determine the green initiative's implementation of small and medium (S.M.E.s) manufacturing enterprises. Green initiatives use as a basis for crafting a green economic development plan. Document analysis was also employed to obtain data from any available printed materials and records provided by the respondents. Such methods of gathering information used to validate data gathered from local and foreign-related literature. The observation also employed to survey the assets owned and validate any green initiatives practiced, including their implementation. The study's findings show that among the green initiatives implemented by SMMEs, which resulted in the reduction of total costs and expenses, were the proper disposal and segregation of waste materials, water management by recycling wastewater and using water-efficient equipment, natural resources, and raw materials management. SMMEs should encourage active participation and support of suppliers and customers in achieving G.E.D.'s objectives by developing incentive schemes. Furthermore, SMMEs should continue to benchmark with G.E.D. Practitioners are operating locally and abroad to adopt best greening strategies and regularly network with concerned government agencies for continuous updating on G.E.D. Initiatives that may benefit the firm. Further research may be conducted on green initiatives implemented by small and medium enterprises in other industry sectors.

[EN] This study was conducted to propose the Green Economic Development Plan for Manufacturing S.M.E.s based on financial performance and operations thru Green Initiatives. The descriptive survey method used to gather data to determine the green initiative's implementation of small and medium (S.M.E.s) manufacturing enterprises. Green initiatives use as a basis for crafting a green economic development plan. Document analysis was also employed to obtain data from any available printed materials and records provided by the respondents. Such methods of gathering information used to validate data gathered from local and foreign-related literature. The observation also employed to survey the assets owned and validate any green initiatives practiced, including their implementation. The study's findings show that among the green initiatives implemented by SMMEs, which resulted in the reduction of total costs and expenses, were the proper disposal and segregation of waste materials, water management by recycling wastewater and using water-efficient equipment, natural resources, and raw materials management. SMMEs should encourage active participation and support of suppliers and customers in achieving G.E.D.'s objectives by developing incentive schemes. Furthermore, SMMEs should continue to benchmark with G.E.D. Practitioners are operating locally and abroad to adopt best greening strategies and regularly network with concerned government agencies for continuous updating on G.E.D. Initiatives that may benefit the firm. Further research may be conducted on green initiatives implemented by small and medium enterprises in other industry sectors. ; Alfaro, MTB.; Diaz, RA. (2021). Impact of Green Initiatives on the Financial Performance of Small and Medium Enterprises: The Case of Manufacturing Firm in Central Luzon. WPOM-Working Papers on Operations Management. 12(1):28-41. https://doi.org/10.4995/wpom.14517 ; OJS ; 28 ; 41 ; 12 ; 1 ; Baines, T., Brown, S., Benedettini, O., & Ball, P. (2012). Examining Green production ...

Surprisingly little is known about long-term spending patterns in the under-65 population. Such information could inform efforts to improve coverage and control costs. Using the MarketScan claims database, we characterize the persistence of health care spending in the privately insured, under-65 population. Over a 6-year period, 69.8% of enrollees never had annual spending in the top 10% of the distribution and the bottom 50% of spenders accounted for less than 10% of spending. Those in the top 10% in 2003 were almost as likely (34.4%) to be in the top 10% five years later as one year later (43.4%). Many comorbid conditions retained much of their predictive power even 5 years later. The persistence at both ends of the spending distribution indicates the potential for adverse selection and cream skimming and supports the use of disease management, particularly for those with the conditions that remained strong predictors of high spending throughout the follow-up period.

Results of data from a 2003 national computer-assisted telephone interview random sample survey (n = 478 completed surveys were returned) are reported. Adult respondents living in Colorado, Iowa, and Pennsylvania were eligible for participation. Of respondents 55 and older, 49% had a home computer, 46% used e-mail, and 43% used the Internet. For seniors 75 and older, 19% had a home computer, 15% used e-mail, and 19% used the Internet. A fully saturated structural equation model with observed variables was estimated. Our survey results leave little doubt that demographics (age, education), attitudes toward the role of technology (IT advantages, computer apathy), and behavior (use of technology in daily life) play a role in determining patterns of electronic citizenship. Most (74%) of the negative total effect of age on e-politics was indirect, as was nearly half (47%) of the effect of education on e-politics. Since attitudes toward technology are formative barriers to digital citizenship, service-learning may be a key ingredient in challenging technological attitudes and increasing electoral participation of marginalized groups. Adapted from the source document. COPIES ARE AVAILABLE FROM: HAWORTH DOCUMENT DELIVERY CENTER, The Haworth Press, Inc., 10 Alice Street, Binghamton, NY 13904-1580

Some states have adopted Accountable Care Organization (ACO) models to transform their Medicaid programs, but little is known about their impact on health care outcomes and costs. Medicaid ACOs are uniquely positioned to improve childbirth outcomes because of the number of births covered by Medicaid. Using Healthcare Cost and Utilization Project hospital data, we examined the relationship between ACO adoption and (a) neonatal and maternal outcomes, and (b) cost per birth. We compared outcomes in states that have adopted ACO models in their Medicaid programs with adjacent states without ACO models. Implementation of Medicaid ACOs was associated with a moderate reduction in hospital costs per birth and decreased cesarean section rates. Results varied by state. We found no association between Medicaid ACOs and several birth outcomes, including infant inpatient mortality, low birthweight, neonatal intensive care unit utilization, and severe maternal morbidity. Improving these outcomes may require more time or targeted interventions.

Medicare Advantage plans have incentives and tools to optimize patient care. Therefore, Medicare Advantage hospitalizations may have lower cost and higher quality than similar traditional Medicare hospitalizations. We applied a coarsened matching approach to 2013 Healthcare Cost and Utilization Project hospital discharge data from 22 states to compare hospital cost, length of stay, and readmissions for Traditional Medicare and Medicare Advantage. We found that Medicare Advantage hospitalizations were substantially less expensive and shorter for mental health stays but costlier and longer for injury and surgical stays. We found little difference in the cost and length of medical stays and in readmission rates. One explanation is that Medicare Advantage plans use outpatient settings for many patients with behavioral health conditions and for injury and surgical patients with less complex health needs. Alternatively, the observed differences in behavioral health cost and length of stay may represent skimping on appropriate care.

The hypocholesterolemic peptide, LPYPR, was successfully introduced into the VR-1, VR-2, and VR-5 regions of the mung bean 8Sα globulin. The mutant protein (MP) has 96.69% structural homology and 97% sequence homology compared to the wild type (WT). Expression of the mutant protein in E. coli HMS174(DE3) was 40.66%, which was 144.42% higher than that of the WT. The WT protein and MP had MWs of about 48.4 and 48.7 kDa, respectively. These were purified using HIC and digested with trypsin. UPLC analysis of the tryptic digests of the MP revealed the successful release of the LPYPR peptide. Unlike the WT protein, cholesterol-binding capacity (mg/g sample) of the MP increased over time of tryptic digestion (average growth rate of 9.5% for crude MP and 12.5% for HIC-purified MP) for its undigested form (crude: 220.96 ± 8.65, purified: 214.71 ± 11.91), with maximum values of 380.76 ± 6.61 and 434.44 ± 10.88 were obtained for the 24-h digests of the crude and purified proteins, respectively. Similarly, the sodium taurocholate binding capacity (%) was also found to increase over time of tryptic digestion (average growth rate of 4% for crude MP and 5.67% for HIC-purified MP) for the tryptic digests of the MP. Minimum values for % bound sodium taurocholate was obtained with the undigested samples (crude: 46.71 ± 0.42, purified: 44.49 ± 0.13), while maximum values thereof were obtained with the 24-h digest samples (crude: 59.75 ± 0.30, purified 61.95 ± 0.51).