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Decades of research have demonstrated that Hospital at Home (HaH) safely delivers hospital-level care in a patient's home. More recently, research has informed the development of a value-based payment model to disseminate HaH. The COVID-19 pandemic enabled regulatory changes leading to the enactment of a payment for HaH in the Medicare program, the Acute Hospital Care at Home (AHCAH) waiver. This article highlights the crucial role of health policy research in advancing HaH and its role in enabling AHCAH before discussing ongoing research that will guide the future of HaH. [ABSTRACT FROM AUTHOR]

Outpatient parenteral antimicrobial therapy (OPAT) relies on substantial uncompensated provider time. In this study of a large academic OPAT program, the median amount of unbilled OPAT management time was 27 minutes per week, per OPAT course. These data should inform benchmarks in pursuing novel payment approaches for OPAT. [ABSTRACT FROM AUTHOR]

Background: Individuals dually eligible for Medicare and Medicaid (duals) may face greater obstacles to access to disease-modifying Alzheimer's treatments in spite of their higher disease burden, because of clinicians' reluctance to accept Medicaid and the so-called "lesser of" policy, under which Medicaid may pay providers lower rates. Objective: To project differential wait times for duals compared to Medicare-only beneficiaries by state. Methods: We used State Medicaid payment policy and Medicare enrollment data and a Markov model to predict differential wait times for duals and non-duals from 2023 to 2050. We estimated available diagnostic appointments by state for both groups based on reluctance of clinicians to accept Medicaid and the "lesser of" policy for each year. Results: We estimate overall average wait times of almost two years (22.9 months) but almost three times as long for duals (59.8 months) than non-duals (20.7 months) because of higher disease burden. The effects of Medicaid payment policy would increase average wait times for duals to 89 months with 20 states having wait times of 99 months or more, which would effectively deprive duals of access. Conclusions: The added average wait times in many states would effectively deprive duals from access to treatment and translate into avoidable disease progression and mortality. Policy interventions to reduce financial and nonfinancial obstacles are dearly needed to avoid deepening disparities. Examples are coverage arrangements that integrate Medicare and Medicaid coverage, covering the co-payment for physician services in full, and stricter network adequacy requirements for Medicaid Managed Care plans. [ABSTRACT FROM AUTHOR]

Payment and selling are two important policies for a supply chain management. All participating supply chain players can earn profit based on the successful implementation of these two policies. The payment policy provides buyers some extra time to pay for the product. This research introduces a single-supplier, a single-manufacturer, and multi-retailer-based three-echelon supply chain management under advertising and payment policies. Product delivery among supply chain players is made with the help of a transportation policy. The transportation policy is environment-friendly and helps retailers with their cost management. It is demonstrated that advertising positively influences sales through an advertisement-driven market demand for the product. The model aims to reduce supply chain cost and maximizes profit by considering a single-setup multiple-delivery policy, variable transportation cost, variable carbon emissions costs, and trade-credit policy. The objective function is optimized for cases: Case 1 and Case 2, based on the payment period. A classical optimization method is employed to obtain the solution of the model. A numerical example, sensitivity analysis, and graphical representations are given to illustrate the model. Results show that Case 2, where cycle time is greater than the payment period, is 45.36% more profitable than Case 1. [ABSTRACT FROM AUTHOR]

The current Medicaid system is ill equipped to handle the anticipated approvals of new gene and cell therapy products. These advanced therapies tend to be single-dose, potentially durable options for a variety of indications spanning oncology, rare disease, and more. The up-front cost of these therapies contrasts with chronic care treatment, which may incur cost over the life of a patient. The cost of these innovative treatments, along with the anticipated larger patient pools, can limit patient access as Medicaid programs operate on limited or fixed budgets. Given the value of these therapies for diseases that may have large Medicaid populations, the system will need to grapple with the existing barriers to access to ensure equitable patient care. This review focuses on one such barrier, discrepancies between product indications and state Medicaid and Medicaid Managed Care Organization coverage policies, and it proposes federal policy solutions to this barrier to better accommodate the exponential growth of the gene and cell therapy pipeline.

The 1983 implementation of the Medicare Inpatient Prospective Payment System (IPPS) was successful in controlling Medicare inpatient costs because it was designed as a clinically credible management tool that facilitated real behavior change and performance improvement. The next phase of IPPS should expand the inpatient payment bundle to a hospital episode-of-care performance bundle that explicitly links episode cost and quality. A uniform, comparable, and transparent episode performance bundle that highlights the tradeoffs between episode cost and quality can expand the incentives to control costs and provide hospitals the management information to improve performance. [ABSTRACT FROM AUTHOR]

Introduction: In order to improve the quality of raw sugar in the sugar industry and to increase the investment efficiency related to the alternative production of torula yeast, an analysis of the effect and cost of cane payment for its quality is carried out. This is determined, by the results obtained in the laboratory, from the calculation of the yield per cane (RPC). Objective: To determine the effect of cane payment on raw sugar quality and on the investment efficiency of a torula yeast plant in two Cuban sugar mills A and B. Materials and Methods: The global process modeling method is used by means of matrix aggregation of the models of the technological processes’ stages of raw sugar and final molasses production, in two different industrial facilities, using Statgraphics Centurion Software. The evaluation of alternatives of per cent extraction of the juice from the filters in the investments is included. Results and Discussion: When analyzing two types of sugarcane, it is observed that increasing its quality improves both the levels of raw sugar production and the brix of the final honey. This raises profits in the yeast plant in both sugar mills. Conclusions: The importance of cane payment for its quality was demonstrated by increasing the profits of the yeast plant and the sugar mill by1604101.69 USD/year, which exceeds the increase in cane payment, which is 447210.44 USD/year. [ABSTRACT FROM AUTHOR]

In 2007, the Centers for Medicaid and Medicare Services (CMS) created a novel payment program to create incentives for physician’s to focus on quality of care measures and report quality performance for the first time. Initially termed “The Physician Voluntary Reporting Program,” various Congressional actions, including the Tax Relief and Health Care Act of 2006 (TRHCA) and Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) further strengthened and ensconced this program, eventually leading to the quality program termed today as the Physician Quality Reporting System (PQRS). As a result of passage of the Affordable Care Act of 2010, the PQRS program has expanded to include both the “traditional PQRS” reporting program and the newer “Value Modifier” program (VM). For the first time, these programs were designed to include pay-for-performance incentives for all physicians providing care to Medicare beneficiaries and to measure the cost of care. The recent passage of the Medicare Access and Children’s Health Insurance Program (CHIP) Reauthorization Act in March of 2015 includes changes to these payment programs that will have an even more profound impact on emergency care providers. We describe the implications of these important federal policy changes for emergency physicians.

The Home Affordable Modification Program's (HAMP's) Principal Reduction Alternative (PRA) is a government-sponsored program to reduce the principal balances and monthly mortgage payments of troubled borrowers. We examine the effect of principal forgiveness on borrowers' subsequent mortgage default. The program's rules imply a kink in the relationship between principal forgiveness and a borrower's initial equity level. Our identification strategy exploits the quasi-experimental variation in principal forgiveness generated by this kink using a regression kink design (RKD), which compares the relationship between initial equity and default on either side of the kink. We estimate that HAMP PRA reduced the quarterly default hazard from 3.8% to 3.1%. [ABSTRACT FROM AUTHOR]

CMS is testing a range of payment policy options, including pay for performance, bundled payments, and shared savings through accountable care organizations. Radiologists can anticipate that the basis for how they are paid by Medicare will change and that they will need to play a greater role than has been required of them in the traditional fee-for-service payment system to demonstrate that imaging studies are used safely and efficiently.

Abstract Background Telemedicine is a valuable tool to improve access to specialty care in emergency departments (EDs), and states have passed telemedicine parity laws requiring insurers to reimburse for telemedicine visits. Our objective was to determine if there is an association between such laws and the use of telemedicine in an ED. Methods As part of the 2016 and 2017 National ED Inventory–USA surveys, directors of all 5404 EDs in the United States were surveyed on the use of telemedicine. States were divided into those with any form of telemedicine parity law and those without (as of January 2016). We investigated the association between a telemedicine parity law and the use of telemedicine controlling for ED characteristics; state was included as a random intercept. Results In 2016, among the 50 states and the District of Columbia (DC), 21 (41%) had a telemedicine parity law, whereas 30 (59%) did not. Among the 4418 ED respondents to the telemedicine question (82% response rate), 2352 (53%) received telemedicine. The proportion of EDs receiving telemedicine varied widely across the states and DC, ranging from 13% in DC to 89% in Maine. Neither the presence nor duration of state telemedicine parity laws were independently associated with ED receipt of telemedicine in 2016 nor the adoption of telemedicine from 2016 to 2017. Conclusion Telemedicine parity laws were not associated with use of telemedicine in the ED. These results suggest that other factors are driving the wide variation in ED use of telemedicine across states.

Achieving a high-quality health system is a complicated journey. Countries employ distinct approaches and build upon lessons learned along the way. Several wealthy industrialized countries have had measurable success advancing the quality of health care provided to their people. In contrast, many developing countries are still endeavoring to identify and implement robust strategies to promote quality health care. By observing the challenges and successes experienced by industrialized nations, developing countries can identify effective methods to advance the quality of their health care systems while avoiding known obstacles. This article describes approaches pursued by the United States and Egypt to advance the quality of their respective health care systems. Contrasting each country's health care initiatives highlights various quality improvement methods that have been undertaken and how one country's experience can inform other countries striving to implement similar efforts. [ABSTRACT FROM AUTHOR]

Incentive mechanism is the key to improve the quality and efficiency of information network service,and is widely used in crowdsensing applications,P2 P VoD streaming,opportunistic networks and so on.The existing incentive mechanisms usually rely on trusted centers like banks,but the trusted centers may have the problems of a lack of trust and privacy leakage due to the systems’ vulnerability and the trusted centers’ opacity.The incentive mechanism based on blockchain can be used as a solution to the above problems.For one reason,blockchain is decentralized,open,tamper-resistant and semi-anonymity,and it can establish a trust among multiple parties who do not know each other.Moreover,the cryptocurrency based on blockchain has been paid more and more attentions and has been gradually accepted by people.This paper firstly summarized the blockchain technology and the differences of cryptocurrencies,then presented the research stratus of incentive mechanisms based on blockchain including the incentive mechanism transactions,the common incentive mechanisms and the evaluation of the incentive mechanisms.Finally,it summarized and looked forward to the research of the existing incentive mechanism. [ABSTRACT FROM AUTHOR]

On the basis of modern literary resources and factual materials, current article focuses on a value-added tax (VAT) due to the fact that the country follows the strategy of approaching European Union and further - gaining membership of it. One of the fundamental requirements of EU integration is existence of a value-added tax (VAT). Another circumstance that should be taken into account is the fact that there is Assosiacion Agreement formed between European Union and Georgia that will strengthen relationship between Georgia and EU from the point of development of optimal payment policy. Association agreement consists of 8 titles. The article draws our attention upon articles of chapter 3 of title 5 which are concerning taxation, in particular, Article 282 which implies that parties are obliged to cooperate in terms of tax collect and monitoring, mechanisms of tax avoidance, especially, the issue of tax evasion (carousel fraud). [ABSTRACT FROM AUTHOR]

Offering patients medications for opioid use disorder (MOUD) is the standard of care for opioid use disorder (OUD), but an estimated 75%-90% of people with OUD who could benefit from MOUD do not receive medication. Payment policy, defined as public and private payers' approaches to covering and reimbursing providers for MOUD, is 1 contributor to this treatment gap. We conducted a policy analysis and qualitative interviews ( n = 21) and surveys ( n = 31) with US MOUD payment policy experts to characterize MOUD insurance coverage across major categories of US insurers and identify opportunities for reform and innovation. Traditional Medicare, Medicare Advantage, and Medicaid all provide coverage for at least 1 formulation of buprenorphine, naltrexone, and methadone for OUD. Private insurance coverage varies by carrier and by plan, with methadone most likely to be excluded. The experts interviewed cautioned against rigid reimbursement models that force patients into one-size-fits-all care and endorsed future development and adoption of value-based MOUD payment models. More than 70% of experts surveyed reported that Medicare, Medicaid, and private insurers should increase payment for office- and opioid treatment program-based MOUD. Validation of MOUD performance metrics is needed to support future value-based initiatives., Competing Interests: Conflicts of interest Please see ICMJE form(s) for author conflicts of interest. These have been provided as supplementary materials., (Published by Oxford University Press on behalf of Project HOPE - The People-To-People Health Foundation, Inc. 2024.)

Skilled nursing facility (SNF) spending has been one of the fastest growing categories of Medicare spending over the past few decades, and reductions in SNF payments are often recommended as part of Medicare cost containment efforts. Using a quasi-experiment resulting from a policy-driven and facility-specific Medicare payment change, we provide new evidence on how Medicare payment changes affect the amount of SNF care provided to Medicare patients. Specifically, we examine a one-time, plausibly exogenous change in the hospital wage index, an area-level adjustment to SNF payments that affected the majority of SNFs nationwide. Using a panel dataset of SNFs, we model the effects of these payment changes on more than 12,000 SNFs across the United States. We find that increases in Medicare payment rates to SNFs increased the total number of Medicare resident days at SNFs. Specifically, a 5% payment increase raised Medicare resident days by 2.33% at facilities with a 10% Medicare share relative to 0%. Further, the effects were asymmetric: Although Medicare payment increases affected Medicare days, payment decreases did not. Our results have important implications for policies that alter the Medicare base payment rates to SNFs and other health care providers. [ABSTRACT FROM AUTHOR]

Motivated by the observation that the down payment policy in China is government-controlled and pro-cyclical based on the housing market, I construct a heterogeneous DSGE model to study the relationship between China's down payment policy, property tax, and economic fluctuations. The results indicate that an increasing down payment ratio suppresses the speculative belief and decreases household's housing demand. This in turn pulls housing prices down and smoothes the economic fluctuations. By way of counterfactual exercises, I also find that the down payment policy and the property tax can be substitutes for each other. If there is an active down payment policy, the implementation of property tax shall be prudently deliberated by the Chinese government. [ABSTRACT FROM AUTHOR]

Background: Although collaborative care (CoCM) is an evidence-based and widely adopted model, reimbursement challenges have limited implementation efforts nationwide. In recent years, Medicare and other payers have activated CoCM-specific codes with the primary aim of facilitating financial sustainability.Objective: To investigate and describe the experiences of early adopters and explorers of Medicare's CoCM codes.Design and Participants: Fifteen interviews were conducted between October 2017 and May 2018 with 25 respondents representing 12 health care organizations and 2 payers. Respondents included dually boarded medicine/psychiatry physicians, psychiatrists, primary care physicians (PCPs), psychologists, a registered nurse, administrative staff, and billing staff.Approach: A semi-structured interview guide was used to address health care organization characteristics, CoCM services, patient consent, CoCM operational components, and CoCM billing processes. All interviews were recorded, transcribed, coded, and analyzed using a content analysis approach conducted jointly by the research team.Key Results: Successful billing required buy-in from key, interdisciplinary stakeholders. In planning for CoCM billing implementation, several organizations hired licensed clinical social workers (LICSWs) as behavioral health care managers to maximize billing flexibility. Respondents reported a number of consent-related difficulties, but these were not primary barriers. Workflow changes required for billing the CoCM codes (e.g., tracking cumulative treatment minutes, once-monthly code entry) were described as arduous, but also stimulated creative solutions. Since CoCM codes incorporate the work of the psychiatric consultant into one payment to primary care, organizations employed strategies such as inter-departmental ledger transfers. When challenges arose from variations in the local payer mix, some organizations billed CoCM codes exclusively, while others elected to use a mixture of CoCM and traditional fee-for-service (FFS) codes. For most organizations, it was important to demonstrate financial sustainability from the CoCM codes.Conclusions: With deliberate planning, persistence, and widespread organizational buy-in, successful utilization of newly available FFS CoCM billing codes is achievable. [ABSTRACT FROM AUTHOR]

Consumer spending on organic food products has grown rapidly. Some claim that organics have ecological, equity, and health advantages over conventional food and therefore should be subsidized. Here we explore the distributive impacts of an organic fruit subsidy that reduces the retail price of organic fruit in the US by 10 percent. We estimate the impact of the subsidy on organic fruit demand in a representative poor, middle income, and rich US household using three analytical methods; including two econometric and one machine learning. We do not find strong evidence of regressive redistribution due to our simulated organic fruit subsidy; the poor household’s relative reaction to the subsidy is not much different than the reaction at the other two households. However, the infra-marginal savings from the subsidy tend to be larger in richer households. [ABSTRACT FROM AUTHOR]

Highlights • In rural Brazil, women often save monthly conditional cash transfer by using the money to buy durable household assets. • When these women receive a lump sum maternity benefit, they typically use the money to buy productive agricultural assets. • Lump sum payments thus help women defy local stereotypes that assign ownership of agricultural assets to men. • Monthly money is spent differently than lump sum money. This is because payment schedules affect mental accounting habits. • Lump sum payments may be an effective way to combat gender inequality in asset ownership. Abstract Can cash assistance have an influence on gender relations inside a household? What are the processes through which this influence occurs? The present article investigates the everyday uses of money that women receive from two gender-targeted social programs in rural Brazil. Bolsa Família is a conditional cash transfer that disburses money to women every month. The Maternity Wage is a program that gives a sizeable lump sum to women when they become pregnant. Drawing from two years of ethnographic research in two villages in Northeastern Brazil, I show how these different payment schedules can lead to different patterns of investment in assets. I find that women typically spend monthly cash assistance on items, like clothing and furniture, that correspond to local stereotypes about feminine property. By contrast, lump sums are used by women to purchase income-generating assets, like cows and fields, that would normally be held by men. Monthly money reinforces gendered stereotypes about assets, while lump-sum money challenges those stereotypes. Lump sums thereby enable women to become the owners of wealth that generates a flow of income over time. I identify two key qualities that underlie this change: a payment's large size and its unpredictability. These qualities affect the mental accounting that beneficiaries use to understand their money and the institutions through which they save it. By outlining such processes, the article brings the literature on conditional cash transfers into dialogue with studies on the gender asset gap. Lump sums can help to re-gender a household's assets. This finding suggests that cash assistance policy, particularly in the case of conditional cash transfers, might be able to have an effect on gender equity by making use of targeted lump sums. [ABSTRACT FROM AUTHOR]

Objective: To examine relationships between penalties assessed by Medicare's Hospital Readmission Reduction Program and Value-Based Purchasing Program and hospital financial condition.Data Sources/study Setting: Centers for Medicare and Medicaid Services, American Hospital Association, and Area Health Resource File data for 4,824 hospital-year observations.Study Design: Bivariate and multivariate analysis of pooled cross-sectional data.Principal Findings: Safety net hospitals have significantly higher HRRP/VBP penalties, but, unlike nonsafety net hospitals, increases in their penalty rate did not significantly affect their total margins.Conclusions: Safety net hospitals appear to rely on nonpatient care revenues to offset higher penalties for the years studied. While reassuring, these funding streams are volatile and may not be able to compensate for cumulative losses over time. [ABSTRACT FROM AUTHOR]

Both cash and credit sale are common. Considering the upsides and downsides of these two payment policies, in this paper, we study how a firm should choose between them. In particular, based on the relationship between demand and the inventory level, four strategies are considered for the case of credit sale: only selling to high-quality buyers (S1); selling to high-quality buyers when demand is high and selling to both low- and high-quality buyers otherwise (S2); selling to both when the demand is moderate and selling only to high-quality buyers otherwise (S3); and selling to both when demand is low and selling only to high-quality buyers otherwise (S4). What we find is that credit sale strictly dominates cash sale except when the expected profit from selling to low-quality buyers is less than the salvage value and the demand coefficient of variation is extremely high. Further, under credit sale, two counterintuitive observations are obtained if the demand coefficient of variation is small. The first is that the analysis reveals that the firm may not serve the low-quality buyers despite that doing so offers profits, i.e., S3 is the most preferable strategy for the firm. The second is that the firm may also serve the low-quality buyers despite incurring a loss by doing so, i.e., S4 is the most attractive strategy. In addition, we demonstrate that when the credit sale is employed, the firm’s optimal expected profit decreases both in the proportion of high-quality buyers in the market and in the low-quality buyers’ payment probability when the demand coefficient of variation is significantly small, which is quite different from our conjecture. All of these results provide some distinct insights into the question of what the firm’s best payment policy is and how credit should be extended when credit sale is used. [ABSTRACT FROM AUTHOR]

Abstract: Payments to private landholders for providing biodiversity land can improve conservation outside protected areas. Input‐based payments are widely used despite evidence they are often ineffective at improving biodiversity outcomes. Meanwhile, little has been done to assess how to use outcome‐based payments to maximize biodiversity, despite growing academic interest. We compare different outcome‐based allocation methods to assess which returns the greatest benefits for biodiversity. We predicted the likely landholder actions in response to outcome‐based payments. We incorporated strategic interactions between landholders under four different funding allocation methods: the commonly applied “set‐price” allocation method; capacity‐based payments; proportional payment; and payment for change. We compared biodiversity outcomes (percentage change in abundance of a species of conservation interest), return on investment and cost‐effectiveness of each method. The set‐price allocation method, despite its common usage, is the least cost‐effective method that we test. Regardless of cost, it only results in better biodiversity outcomes than other methods under a very narrow range of conditions (high initial target species abundance and low profitability). The profitability of the property, and to a lesser degree initial population size, will influence which allocation method will perform best. Most perform well when the initial population of the species of conservation interest is very small and profitability negligible. Only one method—based on change in population—performs well across all scenarios. This method outperforms the others particularly when the property has a higher profitability and low initial numbers of animals. Policy implications. Pursuing conservation on private land using outcome‐based payments for biodiversity can result in varied levels of success depending on the allocation methods used to support payment decisions. Allocation method choice should be based on a transparent analysis that incorporates both the dynamics of the ecological system and interactions between individual landholders. This analysis can guide adoption of funding allocation methods that greatly increase biodiversity outcomes. [ABSTRACT FROM AUTHOR]

Purpose The authors position security measures and payment culture as key determinants of perceived security (PS) and trust. The purpose of this paper is to empirically investigate how PS and trust affect users’ attitude toward mobile payment use and why mobile payment has developed differently in the USA and in China.Design/methodology/approach Empirical data were collected from a survey conducted both in China and in the USA. The whole sample consists of 186 Chinese and 196 Americans. Partial least squares analysis was conducted to test the proposed relationships and multigroup comparison analysis was performed to examine the differences in the coefficients of those relationships between Chinese and the US model.Findings The findings show that payment culture (measured by coverage of mobile payment context (CMPC) and uncertainty avoidance (UA)) and security measures (measured by security technology protection (STP), security rules and policies (SRP), and security responsibility commitment (SRC)) have significantly positive impacts on the PS and trust, except that the positive impact of security on trust is not supported. The impacts of CMPC and PS on trust in the USA are significantly smaller than those in China, whereas the impacts of security measures and UA on PS and trust do not show significant differences between the two countries.Research limitations/implications Respondents of this study are selected from young educated population, the major users of mobile payment in 2015. However, recently with the increasing penetration of mobile payment, major mobile payment users are not only limited to young educated population, and thus there may be new findings after extending the range of respondents’ age. Since the research subjects in this study are the mobile payment of China and the USA, the authors could also expect different findings when the research subjects are extended or changed to other countries because of different mobile payment cultures across countries.Practical implications Findings in this paper will help mobile payment service providers to know the determinants of their users’ behavior intention and to take measures to improve these determinants, and these findings can also provide mobile payment service providers with insights into the differences in mobile payment use between the two countries and suggestions of measures that they can take to increase users’ attitude toward mobile payment use. Furthermore, the findings of this paper also help these providers globalize efficiently by paying more attention to those antecedents.Social implications The findings in this paper show that there is no difference in the impacts of UA and security measures on PS and trust between China and the USA. However, the impacts of PS and CMPC on trust in China are significantly higher than those in the USA. This is because that globalization has made people from different countries hold similar UA, whereas the CMPC, a construct refers to the business environment of mobile payment, is still very different between China and the USA.Originality/value This study extends prior studies of attitude toward mobile payment use through proposing that security measures and payment culture are key determinants of PS and trust and examining the role of PS and trust on the attitude. Furthermore, the empirical findings will not only provide mobile payment service providers with important insights into the differences in mobile payment adoption between the two countries, but also help these providers globalize efficiently by paying more attention to those antecedents. [ABSTRACT FROM AUTHOR]

Purpose Response to suggestion that EU-wide cash payment limits would assist in the control of terrorism finance and money laundering.Design/methodology/approach Desk review and interviewsFindings The inception impact assessment (IIA) is ill-conceived, not grounded on firm empirical evidence and harmful to both crime control and the legitimate interests and rights of the EU citizens. The action under discussion is presented as a measure against terrorism finance, serious crime and tax evasion. The problem is that these criminal acts correspond to very different methods, volumes, perpetrators, causes and control challenges. Cash payment limitations (CPLs) are nowhere near a panacea that can address all of them and cannot make any of them go away magically. Even when each of these crime challenges are considered on their own, the empirical linkage of CPLs to effective controls is not there. The evidence from EU countries with CPLs in place shows higher levels of informal economy, corruption, tax evasion and terrorism risks than those without. There is substantial evidence of non-cash, very serious and organized crime, while the amounts needed and used by terrorists in Europe are usually very small in cash transactions, way below the thresholds under consideration. In fact, determined offenders will shift to other methods and become more sophisticated, posing new problems to controllers. Displacement and incentives for better-organized crime may well be the main products of such measures.Originality/value It counters the argument that the cash payment limits can help reduce serious crime, while pointing to several adverse consequences on legitimate interests and human rights. [ABSTRACT FROM AUTHOR]

Background: Support for ongoing care management and coordination between office visits for patients with multiple chronic conditions has been inadequate. In January 2015, Medicare introduced the Chronic Care Management (CCM) payment policy, which reimburses providers for CCM activities for Medicare beneficiaries occurring outside of office visits.Objective: To explore the experiences, facilitators, and challenges of practices providing CCM services, and their implications going forward.Design: Semi-structured telephone interviews from January to April 2016 with 71 respondents.Participants: Sixty billing and non-billing providers and practice staff knowledgeable about their practices' CCM services, and 11 professional society representatives.Key Results: Practice respondents noted that most patients expressed positive views of CCM services. Practice respondents also perceived several patient benefits, including improved adherence to treatment, access to care team members, satisfaction, care continuity, and care coordination. Facilitators of CCM provision included having an in-practice care manager, patient-centered medical home recognition, experience developing care plans, patient trust in their provider, and supplemental insurance to cover CCM copayments. Most billing practices reported few problems obtaining patients' consent for CCM, though providers felt that CMS could better facilitate consent by marketing CCM's goals to beneficiaries. Barriers reported by professional society representatives and by billing and non-billing providers included inadequacy of CCM payments to cover upfront investments for staffing, workflow modification, and time needed to manage complex patients. Other barriers included inadequate infrastructure for health information exchange with other providers and limited electronic health record capabilities for documenting and updating care plans. Practices owned by hospital systems and large medical groups faced greater bureaucracy in implementing CCM than did smaller, independent practices.Conclusions: Improving providers' experiences with and uptake of CCM will require addressing several challenges, including the upfront investment for CCM set-up and the time required to provide CCM to more complex patients. [ABSTRACT FROM AUTHOR]

Purpose In 2006, the AMA/Specialty Society Relative Value Scale Update Committee (RUC) introduced ongoing relativity screens to identify potentially misvalued medical services for payment adjustments. We assess the impact of these screens upon the valuation of noninvasive diagnostic radiology services. Methods Data regarding relativity screens and relative value unit (RVU) changes were obtained from the 2016 AMA Relativity Assessment Status Report. All global codes in the 2016 Medicare Physician Fee Schedule with associated work RVUs were classified as noninvasive diagnostic radiology services versus remaining services. The frequency of having ever undergone a screen was compared between the two groups. Screened radiology codes were further evaluated regarding the RVU impact of subsequent revaluation. Results Of noninvasive diagnostic radiology codes, 46.0% (201 of 437) were screened versus 22.2% (1,460 of 6,575) of remaining codes ( P < .001). Most common screens for which radiology codes were identified as potentially misvalued were (1) high expenditures (27.5%) and (2) high utilization (25.6%). The modality and body region most likely to be identified in a screen were CT (82.1%) and breast (90.9%), respectively. Among screened radiology codes, work RVUs, practice expense RVUs, and nonfacility total RVUs decreased in 20.3%, 65.9%, and 75.3%, respectively. All screened CT, MRI, brain, and spine codes exhibited decreased total RVUs. Conclusion Policymakers’ ongoing search for potentially misvalued medical services has disproportionately impacted noninvasive diagnostic radiology services, risking the introduction of unintended or artificial shifts in physician practice. [ABSTRACT FROM AUTHOR]

States are increasingly paying refugees to repatriate, hoping to decrease the number of refugees residing within their borders. Drawing on in-depth interviews from East Africa and data from Israeli Labour Statistics, I provide a description of such payment schemes and consider whether they are morally permissible. In doing so, I address two types of cases. In the first type of case, governments pay refugees to repatriate to high-risk countries, never coercing them into returning. I argue that such payments are permissible if refugees' choices are voluntary and if states allow refugees to return to the host country in the event of an emergency. I then describe cases where states detain refugees, and non-governmental organisations provide their own payments to refugees wishing to repatriate. In such cases, non-governmental organisations are only permitted to provide payments if the funds are sufficient to ensure post-return safety and if providing payments does not reinforce the government's detention policy. [ABSTRACT FROM AUTHOR]

Increasing patient demand following health care reform has led to concerns about provider shortages, particularly in primary care and for Medicaid patients. Nurse practitioners (NPs) represent a potential solution to meeting demand. However, varying state scope of practice regulations and Medicaid reimbursement rates may limit efficient distribution of NPs. Using a national sample of 252,657 ambulatory practices, we examined the effect of state policies on NP employment in primary care and practice Medicaid acceptance. NPs had 13% higher odds of working in primary care in states with full scope of practice; those odds increased to 20% if the state also reimbursed NPs at 100% of the physician Medicaid fee-for-service rate. Furthermore, in states with 100% Medicaid reimbursement, practices with NPs had 23% higher odds of accepting Medicaid than practices without NPs. Removing scope of practice restrictions and increasing Medicaid reimbursement may increase NP participation in primary care and practice Medicaid acceptance. [ABSTRACT FROM AUTHOR]

Medicare Part D has improved access to prescription drugs for Medicare beneficiaries. However, the program has raised certain issues that threaten the viability of pharmacies. After a decade of Part D, we assess these issues as they concern rural pharmacies using survey responses. Independent rural pharmacies, the only retail pharmacy outlets in their communities, were surveyed. Email-based surveys were returned by 118 respondents. Rural pharmacies ranked two issues – direct and indirect remuneration (DIR) fees and delayed maximum allowable cost (MAC) adjustment – highest on scales of magnitude and immediacy of the challenge they posed to sustainability. 80% of respondents reported DIR fees as a challenge of very large magnitude and 83% reported it as a very immediate challenge. 78% of respondents reported MACs not being updated quickly enough as a very large magnitude challenge, with 80% indicating it is a very immediate challenge. Exclusion from the preferred networks of Part D plans was reported as a challenge of very large magnitude and immediacy by about 60% of pharmacies. Pharmacy staffing, competition from pharmacy chains, and contracts for services rendered to Medicaid patients were less likely to be reported as significant or immediate challenges. Policies that address the issues of delayed MAC adjustment and DIR fees could go a long way in ensuring the viability of these critical sources of pharmaceutical services. [ABSTRACT FROM AUTHOR]

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Reducing the number of preterm births is a high public health priority in the U.S. Preterm birth, affecting an estimated 380,000 infants annually, is a leading cause of infant mortality and morbidity and is associated with individual and systemic characteristics. Preterm birth is estimated to cost society $26 billion annually. Despite an elevated financial burden caused by preterm birth, very little is known about who bears these costs. This study seeks to understand the relationship between Medicaid and private insurance payment for preterm birth, using multiple years of vital statistics data, which for the first time since 2010 include information on payment source. The nationwide data cover births that occur in all settings, including non-hospital settings, and many maternal characteristics not available in other datasets, improving upon previous analyses. These data can be used to promote better Medicaid coverage of interventions known to be effective in reducing preterm births. [ABSTRACT FROM PUBLISHER]

The current Medicaid system is ill equipped to handle the anticipated approvals of new gene and cell therapy products. These advanced therapies tend to be single-dose, potentially durable options for a variety of indications spanning oncology, rare disease, and more. The up-front cost of these therapies contrasts with chronic care treatment, which may incur cost over the life of a patient. The cost of these innovative treatments, along with the anticipated larger patient pools, can limit patient access as Medicaid programs operate on limited or fixed budgets. Given the value of these therapies for diseases that may have large Medicaid populations, the system will need to grapple with the existing barriers to access to ensure equitable patient care. This review focuses on one such barrier, discrepancies between product indications and state Medicaid and Medicaid Managed Care Organization coverage policies, and it proposes federal policy solutions to this barrier to better accommodate the exponential growth of the gene and cell therapy pipeline., Competing Interests: J.W. is an Independent Director on the Board of Atsena Therapeutics, Inc., and sits on the Board of Directors at ASGCT. R.R. has consulting agreements with and receives honoraria from Pfizer Inc., sits on ASGCT’s Board of Directors, receives research funding from Tessa Therapeutics, and receives honoraria from Kite-Gilead Sciences. The content of this article represents the authors’ opinions and may not necessarily represent the views of their employers., (© 2023 The Authors.)

Payment is the main way of discharging civil obligations. The Romanian Civil Code regulates in detail all these aspects: the notion of payment, the subjects of the payment, the terms and conditions of payment, the proof of payment, payment imputation, the formal notice to the creditor. The payment has the effect of extinguishing the legal relation of obligations as a result of the performance of the object of the legal relation in question. It involves the voluntary performance of the object of the obligation. So that the obligation can be discharged by payment, the debtor must perform exactly the obligation he owes. [ABSTRACT FROM AUTHOR]

We offer our apology and condolences to the victims' families. We accept full responsibility for what happened in the hospital and will pay blood money for the victims' families [ABSTRACT FROM AUTHOR]

Consumer decisions regarding retail payment instruments entail private and social costs. Due to these social costs, policymakers are increasingly trying to understand the determinants of consumer payment choices as documented by the European Central Bank’s regular publications. This article contributes to this understanding by investigating the role of perceived risk. Based on an original survey of French consumers, we measure the effects of perceived risk on the decisions to hold and use the main retail payment instruments: cash, card and cheque. We point to the sequential dependence of the decisions to hold and use a payment instrument, and study jointly both decisions. The bivariate analysis based on risk factors shows that unavailability risk and time risk have the greatest transverse influence on holding and using payment instruments. Our results, robust to controlling for consumer characteristics, confirm their propensity for a quick-to-use and constantly available payment instrument. We discuss the relevance of our results for policy making purposes. [ABSTRACT FROM AUTHOR]

Background: Many low and middle income countries have initiated maternity fee exemption and removal policies to promote use of skilled maternity care. After two and a half decades of these policies, uptake of skilled birth care remains low and inequalities continue to exist in many low and middle income countries. This study uses 2 decades of birth histories data to examine four maternity fee paying policies enacted in Ghana over the past 3 decades and their geospatial impacts on uptake of skilled delivery care.Methods: Bayesian Geoadditive Semiparametric regression techniques were applied on four conservative rounds of Demographic and Health Surveys in Ghana to examine the extent of geospatial dependence in skilled birth care use at the district level and their associative relationships with maternity fee paying policies focusing on the temporal trends when the policies were functional.Results: The results show that at the country-level, the policies had a positive influence on use of skilled delivery care; however their impacts on reducing between-district inequalities were trivial.Conclusions: The findings suggest that targeted interventions at the district level are essential to strengthen maternal health programmes in Ghana. [ABSTRACT FROM AUTHOR]