Sample records for cost sharing

  1. 14 CFR 1260.54 - Cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... cash and non-cash contributions shall be governed by § 1260.123, Cost Sharing or Matching. The... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Cost sharing. 1260.54 Section 1260.54... Special Conditions § 1260.54 Cost sharing. Cost Sharing October 2000 (a) NASA and the Recipient will share...

  2. 36 CFR 230.6 - Project costs and cost share requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 2 2013-07-01 2013-07-01 false Project costs and cost share... Project costs and cost share requirements. (a) The CFP Federal contribution cannot exceed 50 percent of the total project costs. (b) Allowable project and cost share costs will include the purchase price...

  3. 36 CFR 230.6 - Project costs and cost share requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 2 2014-07-01 2014-07-01 false Project costs and cost share... Project costs and cost share requirements. (a) The CFP Federal contribution cannot exceed 50 percent of the total project costs. (b) Allowable project and cost share costs will include the purchase price...

  4. 36 CFR 230.6 - Project costs and cost share requirements.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 36 Parks, Forests, and Public Property 2 2012-07-01 2012-07-01 false Project costs and cost share... Project costs and cost share requirements. (a) The CFP Federal contribution cannot exceed 50 percent of the total project costs. (b) Allowable project and cost share costs will include the purchase price...

  5. Coping with Prescription Drug Cost Sharing: Knowledge, Adherence, and Financial Burden

    PubMed Central

    Reed, Mary; Brand, Richard; Newhouse, Joseph P; Selby, Joe V; Hsu, John

    2008-01-01

    Objective Assess patient knowledge of and response to drug cost sharing. Study Setting Adult members of a large prepaid, integrated delivery system. Study Design/Data Collection Telephone interviews with 932 participants (72 percent response rate) who reported knowledge of the structures and amounts of their prescription drug cost sharing. Participants reported cost-related changes in their drug adherence, any financial burden, and other cost-coping behaviors. Actual cost sharing amounts came from administrative databases. Principal Findings Overall, 27 percent of patients knew all of their drug cost sharing structures and amounts. After adjustment for individual characteristics, additional patient cost sharing structures (tiers and caps), and higher copayment amounts were associated with reporting decreased adherence, financial burden, or other cost-coping behaviors. Conclusions Patient knowledge of their drug benefits is limited, especially for more complex cost sharing structures. Patients also report a range of responses to greater cost sharing, including decreasing adherence. PMID:18370979

  6. 10 CFR 603.530 - Acceptable cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Evaluation Cost Sharing § 603.530 Acceptable cost sharing. The contracting officer may accept any cash or in... 10 Energy 4 2010-01-01 2010-01-01 false Acceptable cost sharing. 603.530 Section 603.530 Energy..., they represent meaningful cost sharing that demonstrates the recipient's commitment to the success of...

  7. 75 FR 54590 - Notice of 2010 National Organic Certification Cost-Share Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-08

    ...] Notice of 2010 National Organic Certification Cost-Share Program AGENCY: Agricultural Marketing Service... Certification Cost-Share Funds. The AMS has allocated $22.0 million for this organic certification cost-share... National Organic Certification Cost- Share Program is authorized under 7 U.S.C. 6523, as amended by section...

  8. 78 FR 5781 - Cost-Sharing Rates for Pharmacy Benefits Program of the TRICARE Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-28

    ... DEPARTMENT OF DEFENSE Office of the Secretary Cost-Sharing Rates for Pharmacy Benefits Program of... to cost-sharing rates to the TRICARE Pharmacy Benefits Program. SUMMARY: This notice is to advise interested parties of cost-sharing rate change for the Pharmacy Benefits Program. DATES: The cost-sharing...

  9. 42 CFR 447.53 - Cost sharing for drugs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Cost sharing for drugs. 447.53 Section 447.53... and Cost Sharing § 447.53 Cost sharing for drugs. (a) The agency may establish differential cost sharing for preferred and non-preferred drugs. The provisions in § 447.56(a) shall apply except as the...

  10. 14 CFR 151.43 - United States share of project costs.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false United States share of project costs. 151... United States share of project costs. (a) The United States share of the allowable costs of a project is... part, the United States share of the costs of an approved project for airport development (regardless...

  11. 14 CFR 151.43 - United States share of project costs.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false United States share of project costs. 151... United States share of project costs. (a) The United States share of the allowable costs of a project is... part, the United States share of the costs of an approved project for airport development (regardless...

  12. 14 CFR 151.43 - United States share of project costs.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false United States share of project costs. 151... United States share of project costs. (a) The United States share of the allowable costs of a project is... part, the United States share of the costs of an approved project for airport development (regardless...

  13. 14 CFR 151.43 - United States share of project costs.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false United States share of project costs. 151... United States share of project costs. (a) The United States share of the allowable costs of a project is... part, the United States share of the costs of an approved project for airport development (regardless...

  14. 14 CFR 151.43 - United States share of project costs.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false United States share of project costs. 151... United States share of project costs. (a) The United States share of the allowable costs of a project is... part, the United States share of the costs of an approved project for airport development (regardless...

  15. Cost Sharing in Medicaid: Assumptions, Evidence, and Future Directions.

    PubMed

    Powell, Victoria; Saloner, Brendan; Sabik, Lindsay M

    2016-08-01

    Several states have received waivers to expand Medicaid to poor adults under the Affordable Care Act using more cost sharing than the program traditionally allows. We synthesize literature on the effects of cost sharing, focusing on studies of low-income U.S. populations from 1995 to 2014. Literature suggests that cost sharing has a deterrent effect on initiation of treatments, and can reduce utilization of ongoing treatments. Furthermore, cost sharing may be difficult for low-income populations to understand, patients often lack sufficient information to choose medical treatment, and cost sharing may be difficult to balance within the budgets of poor adults. Gaps in the literature include evidence of long-term effects of cost sharing on health and financial well-being, evidence related to effectiveness of cost sharing combined with patient education, and evidence related to targeted programs that use financial incentives for wellness. Literature underscores the need for evaluation of the effects of cost sharing on health status and spending, particularly among the poorest adults. © The Author(s) 2015.

  16. Cost-sharing in Medicaid: Assumptions, Evidence, and Future Directions

    PubMed Central

    Powell, Victoria; Saloner, Brendan; Sabik, Lindsay M.

    2015-01-01

    Several states have received waivers to expand Medicaid to poor adults under the Affordable Care Act using more cost-sharing than the program traditionally allows. We synthesize literature of the effects of cost-sharing, focusing on studies of low-income US populations from 1995–2014. Literature suggests cost-sharing has a deterrent effect on initiation of treatments, and can reduce utilization of ongoing treatments. Further, cost-sharing may be difficult for low-income populations to understand; patients often lack sufficient information to choose medical treatment; and cost-sharing may be difficult to balance within the budgets of poor adults. Gaps in the literature include evidence of long-term effects of cost-sharing on health and financial wellbeing, evidence related to effectiveness of cost-sharing combined with patient education, and evidence related to targeted programs that use financial incentives for wellness. Literature underscores the need for evaluation of the effects of cost-sharing on health status and spending, particularly among the poorest adults. PMID:26602175

  17. 32 CFR 37.535 - How do I value cost sharing related to real property or equipment?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false How do I value cost sharing related to real... Evaluation Cost Sharing § 37.535 How do I value cost sharing related to real property or equipment? You rarely should accept values for cost sharing contributions of real property or equipment that are in...

  18. Consumer Cost-Sharing in Marketplace vs. Employer Health Insurance Plans, 2015.

    PubMed

    Gabel, Jon; Whitmore, Heidi; Green, Matthew; Stromberg, Sam; Oran, Rebecca

    2015-12-01

    Using data from 49 states and Washington, D.C., we analyzed changes in cost-sharing under health plans offered to individuals and families through state and federal exchanges from 2014 to 2015. We examined eight vehicles for cost-sharing, including deductibles, copayments, coinsurance, and out-of-pocket limits, and compared findings with cost-sharing under employer-based insurance. We found cost-sharing under marketplace plans remained essentially unchanged from 2014 to 2015. Stable premiums during that period do not reflect greater costs borne by enrollees. Further, 56 percent of enrollees in marketplace plans attained cost-sharing reductions in 2015. However, for people without cost-sharing reductions, average copayments, deductibles, and out-of-pocket limits under catastrophic, bronze, and silver plans are considerably higher than under employer-based plans on average, while cost-sharing under gold plans is similar employer-based plans on average. Marketplace plans are far more likely than employer-based plans to require enrollees to meet deductibles before they receive coverage for prescription drugs.

  19. How might immunization rates change if cost sharing is eliminated?

    PubMed

    Shen, Angela K; O'Grady, Michael J; McDevitt, Roland D; Pickreign, Jeremy D; Laudenberger, Laura K; Esber, Allahna; Shortridge, Emily F

    2014-01-01

    There is a debate regarding the effect of cost sharing on immunization, particularly as the Affordable Care Act will eliminate cost sharing for recommended vaccines. This study estimates changes in immunization rates and spending associated with extending first-dollar coverage to privately insured children for four childhood vaccines. We used the 2008 National Immunization Survey and peer-reviewed literature to generate estimates of immunization status for each vaccine by age group and insurance type. We used the Truven Health Analytics 2006 MarketScan Commercial Claims and Encounters Database of line-item medical claims to estimate changes in immunization rates that would result from eliminating cost sharing, and we used the Kaiser Family Foundation/Health Research and Educational Trust Employer Health Benefits Survey to determine the prevalence of coverage for patients with first-dollar coverage, patients who face office visit cost sharing, and patients who face cost sharing for all vaccine cost components. We assumed that once cost sharing is removed, coverage rates in plans that impose cost sharing will rise to the level of plans that do not. We estimate that immunization rates would increase modestly and result in additional direct spending of $26.0 million to insurers/employers. Further, these payers would have an additional $11.0 million in spending associated with eliminating cost sharing for children already receiving immunizations. The effects of eliminating cost sharing for vaccines vary by vaccine. Overall, immunization rates will rise modestly given high insurance coverage for vaccinations, and these increases would be more substantial for those currently facing cost sharing. However, in addition to the removal of cost sharing for immunizations, these findings suggest other strategies to consider to further increase immunization rates.

  20. Effects of cost sharing on seeking outpatient care: a propensity-matched study in Germany and Switzerland.

    PubMed

    Huber, Carola A; Rüesch, Peter; Mielck, Andreas; Böcken, Jan; Rosemann, Thomas; Meyer, Peter C

    2012-08-01

    Several studies have assessed the effect of cost sharing on health service utilization (HSU), mostly in the USA. Results are heterogeneous, showing different effects. Whereas previous studies compared insurants within one health care system but different modes of insurance, we aimed at comparing two different health care systems in Europe: Germany and Switzerland. Furthermore, we assessed the impact of cost sharing depending on socio-demographic factors as well as health status. Two representative samples of 5197 Swiss insurants with and 5197 German insurants without cost sharing were used to assess the independent association between cost sharing and the use of outpatient care. To minimize confounding, we performed cross-sectional analyses between propensity score matched Swiss and German insurants. We investigated subgroups according to health and socio-economic status to assess a potential social gradient in HSU. We found a significant association between health insurance scheme and the use of outpatient services. German insurants without cost sharing (visit rate: 4.8 per year) consulted a general practitioner or specialist more frequently than Swiss insurants with cost sharing (visit rate: 3.0 per year; P < 0.01). Subgroup analyses showed that vulnerable populations were differently affected by cost sharing. In the group of respondents with poor health and low socio-economic status, the cost-sharing effect was strongest. Cost-sharing models reduce HSU. The challenge is to create cost-sharing models which do not preclude vulnerable populations from seeking essential health care. © 2011 Blackwell Publishing Ltd.

  1. 76 FR 55000 - Notice of Agricultural Management Assistance Organic Certification Cost-Share Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-06

    ...] Notice of Agricultural Management Assistance Organic Certification Cost-Share Program AGENCY... Departments of Agriculture for the Agricultural Management Assistance Organic Certification Cost-Share Program... organic certification cost-share funds. The AMS has allocated $1.5 million for this organic certification...

  2. 78 FR 5164 - Notice of Agricultural Management Assistance Organic Certification Cost-Share Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-24

    ...] Notice of Agricultural Management Assistance Organic Certification Cost-Share Program AGENCY... Departments of Agriculture for the Agricultural Management Assistance Organic Certification Cost-Share Program... organic certification cost-share funds. The AMS has allocated $1.425 million for this organic...

  3. 76 FR 54999 - Notice of 2011 National Organic Certification Cost-Share Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-06

    ...] Notice of 2011 National Organic Certification Cost-Share Program AGENCY: Agricultural Marketing Service... for the National Organic Certification Cost- Share Program. SUMMARY: This Notice invites all States of...) for the allocation of National Organic Certification Cost-Share Funds. Beginning in Fiscal Year 2008...

  4. 42 CFR 457.560 - Cumulative cost-sharing maximum.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Cumulative cost-sharing maximum. 457.560 Section... State Plan Requirements: Enrollee Financial Responsibilities § 457.560 Cumulative cost-sharing maximum... writing and orally if appropriate of their individual cumulative cost-sharing maximum amount at the time...

  5. Perceived affordability of health insurance and medical financial burdens five years in to Massachusetts health reform.

    PubMed

    Zallman, Leah; Nardin, Rachel; Sayah, Assaad; McCormick, Danny

    2015-10-29

    Under the Massachusetts health reform, low income residents (those with incomes below 150 % of the Federal Poverty Level [FPL]) were eligible for Medicaid and health insurance exchange-based plans with minimal cost-sharing and no premiums. Those with slightly higher incomes (150 %-300 % FPL) were eligible for exchange-based plans that required cost-sharing and premium payments. We conducted face to face surveys in four languages with a convenience sample of 976 patients seeking care at three hospital emergency departments five years after Massachusetts reform. We compared perceived affordability of insurance, financial burden, and satisfaction among low cost sharing plan recipients (recipients of Medicaid and insurance exchange-based plans with minimal cost-sharing and no premiums), high cost sharing plan recipients (recipients of exchange-based plans that required cost-sharing and premium payments) and the commercially insured. We found that despite having higher incomes, higher cost-sharing plan recipients were less satisfied with their insurance plans and perceived more difficulty affording their insurance than those with low cost-sharing plans. Higher cost-sharing plan recipients also reported more difficulty affording medical and non-medical health care as well as insurance premiums than those with commercial insurance. In contrast, patients with low cost-sharing public plans reported higher plan satisfaction and less financial concern than the commercially insured. Policy makers with responsibility for the benefit design of public insurance available under health care reforms in the U.S. should calibrate cost-sharing to income level so as to minimize difficulty affording care and financial burdens.

  6. 78 FR 52131 - Notice of Funds Availability: Agricultural Management Assistance Organic Certification Cost-Share...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-22

    ...] Notice of Funds Availability: Agricultural Management Assistance Organic Certification Cost-Share Program... . SUPPLEMENTARY INFORMATION: This Organic Certification Cost-Share Program is part of the Agricultural Management... Wyoming. The AMS has allocated $1,352,850 for this organic certification cost- share program in Fiscal...

  7. 42 CFR 447.52 - Cost sharing.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... agency imposes cost sharing under § 447.54, the process by which hospital emergency room services are... State option, cost sharing imposed for any service (other than for drugs and non-emergency services... group under § 447.56(a), and (iii) For cost sharing imposed for non-emergency services furnished in an...

  8. 7 CFR 1467.10 - Cost-share payments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS WETLANDS RESERVE PROGRAM § 1467.10 Cost-share... easement, 30-year contract, or restoration cost-share agreement, NRCS will offer to pay at least 50 percent... entity may receive, directly or indirectly, for one or more restoration cost-share agreements, for any...

  9. 10 CFR 602.12 - Cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Cost sharing. 602.12 Section 602.12 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS EPIDEMIOLOGY AND OTHER HEALTH STUDIES FINANCIAL ASSISTANCE PROGRAM § 602.12 Cost sharing. Cost sharing is not required, nor will it be considered, as a criterion in...

  10. 7 CFR 634.27 - Cost-share payment.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... AGRICULTURE LONG TERM CONTRACTING RURAL CLEAN WATER PROGRAM Participant RCWP Contracts § 634.27 Cost-share... essential for meeting the water quality objectives in the project area. (c) Basis for cost-share payment. (1...) Average cost, or (ii) Actual cost not to exceed average cost. (2) If the average cost at the time of...

  11. 7 CFR 634.27 - Cost-share payment.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... AGRICULTURE LONG TERM CONTRACTING RURAL CLEAN WATER PROGRAM Participant RCWP Contracts § 634.27 Cost-share... essential for meeting the water quality objectives in the project area. (c) Basis for cost-share payment. (1...) Average cost, or (ii) Actual cost not to exceed average cost. (2) If the average cost at the time of...

  12. 7 CFR 634.27 - Cost-share payment.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... AGRICULTURE LONG TERM CONTRACTING RURAL CLEAN WATER PROGRAM Participant RCWP Contracts § 634.27 Cost-share... essential for meeting the water quality objectives in the project area. (c) Basis for cost-share payment. (1...) Average cost, or (ii) Actual cost not to exceed average cost. (2) If the average cost at the time of...

  13. 7 CFR 634.27 - Cost-share payment.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AGRICULTURE LONG TERM CONTRACTING RURAL CLEAN WATER PROGRAM Participant RCWP Contracts § 634.27 Cost-share... essential for meeting the water quality objectives in the project area. (c) Basis for cost-share payment. (1...) Average cost, or (ii) Actual cost not to exceed average cost. (2) If the average cost at the time of...

  14. 7 CFR 634.27 - Cost-share payment.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... AGRICULTURE LONG TERM CONTRACTING RURAL CLEAN WATER PROGRAM Participant RCWP Contracts § 634.27 Cost-share... essential for meeting the water quality objectives in the project area. (c) Basis for cost-share payment. (1...) Average cost, or (ii) Actual cost not to exceed average cost. (2) If the average cost at the time of...

  15. Communal Sharing and the Provision of Low-Volume High-Cost Health Services: Results of a Survey.

    PubMed

    Richardson, Jeff; Iezzi, Angelo; Chen, Gang; Maxwell, Aimee

    2017-03-01

    This paper suggests and tests a reason why the public might support the funding of services for rare diseases (SRDs) when the services are effective but not cost effective, i.e. when more health could be produced by allocating funds to other services. It is postulated that the fairness of funding a service is influenced by a comparison of the average patient benefit with the average cost to those who share the cost. Survey respondents were asked to allocate a budget between cost-effective services that had a small effect upon a large number of relatively well patients and SRDs that benefited a small number of severely ill patients but were not cost effective because of their high cost. Part of the budget was always allocated to the SRDs. The budget share rose with the number sharing the cost. Sharing per se appears to characterise preferences. This has been obscured in studies that focus upon cost per patient rather than cost per person sharing the cost.

  16. 7 CFR 636.7 - Cost-share payments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AGRICULTURE LONG TERM CONTRACTING WILDLIFE HABITAT INCENTIVE PROGRAM § 636.7 Cost-share payments. (a) NRCS may... costs to develop fish and wildlife habitat. The cost-share payment to a participant will be reduced...

  17. 7 CFR 636.7 - Cost-share payments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... AGRICULTURE LONG TERM CONTRACTING WILDLIFE HABITAT INCENTIVE PROGRAM § 636.7 Cost-share payments. (a) NRCS may... costs to develop fish and wildlife habitat. The cost-share payment to a participant will be reduced...

  18. 7 CFR 636.7 - Cost-share payments.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... AGRICULTURE LONG TERM CONTRACTING WILDLIFE HABITAT INCENTIVE PROGRAM § 636.7 Cost-share payments. (a) NRCS may... costs to develop fish and wildlife habitat. The cost-share payment to a participant will be reduced...

  19. 7 CFR 636.7 - Cost-share payments.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... AGRICULTURE LONG TERM CONTRACTING WILDLIFE HABITAT INCENTIVE PROGRAM § 636.7 Cost-share payments. (a) NRCS may... costs to develop fish and wildlife habitat. The cost-share payment to a participant will be reduced...

  20. How low can you go? The impact of reduced benefits and increased cost sharing.

    PubMed

    Lee, Jason S; Tollen, Laura

    2002-01-01

    Amid escalating health care costs and a managed care backlash, employers are considering traditional cost control methods from the pre-managed care era. We use an actuarial model to estimate the premium-reducing effects of two such methods: increasing employee cost sharing and reducing benefits. Starting from a baseline plan with rich benefits and low cost sharing, estimated premium savings as a result of eliminating five specific benefits were about 22 percent. The same level of savings was also achieved by increasing cost sharing from a 15 dollars copayment with no deductible to 20 percent coinsurance and a 250 dollars deductible. Further increases in cost sharing produced estimated savings of up to 50 percent. We discuss possible market- and individual-level effects of the proliferation of plans with high cost sharing and low benefits.

  1. Standard Terms and Conditions | NREL

    Science.gov Websites

    and Technical Services Subcontracts, Cost-Type (1) Cost Sharing (2) Cost Reimbursement (3) Cost Plus Than Foreign) (1) Cost Sharing (2) Cost Reimbursement (2) Cost Plus Fixed Fee. Appendix B-10 (12/15/16 /15/16) Standard Terms and Conditions for Travel Requirements (1) Cost Sharing (2) Cost Reimbursement

  2. 48 CFR 52.216-12 - Cost-Sharing Contract-No Fee.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ....216-12 Cost-Sharing Contract—No Fee. As prescribed in 16.307(f), insert the following clause in... nonprofit organization. Cost-Sharing Contract—No Fee (APR 1984) (a) The Government shall not pay to the... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Cost-Sharing Contract-No...

  3. 7 CFR 625.9 - 10-year restoration cost-share agreements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 6 2011-01-01 2011-01-01 false 10-year restoration cost-share agreements. 625.9... CONSERVATION SERVICE, DEPARTMENT OF AGRICULTURE WATER RESOURCES HEALTHY FORESTS RESERVE PROGRAM § 625.9 10-year... 10-year cost-share agreement and its terms are incorporated therein. (b) A 10-year cost-share...

  4. 14 CFR 152.205 - United States share of project costs.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false United States share of project costs. 152... share of project costs. (a) Airport development. Except as provided in paragraphs (b) and (c) of this section, the following is the United States share of the allowable cost of an airport development project...

  5. 14 CFR 152.205 - United States share of project costs.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false United States share of project costs. 152... share of project costs. (a) Airport development. Except as provided in paragraphs (b) and (c) of this section, the following is the United States share of the allowable cost of an airport development project...

  6. 14 CFR 152.205 - United States share of project costs.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false United States share of project costs. 152... share of project costs. (a) Airport development. Except as provided in paragraphs (b) and (c) of this section, the following is the United States share of the allowable cost of an airport development project...

  7. 14 CFR 152.205 - United States share of project costs.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false United States share of project costs. 152... share of project costs. (a) Airport development. Except as provided in paragraphs (b) and (c) of this section, the following is the United States share of the allowable cost of an airport development project...

  8. 14 CFR 152.205 - United States share of project costs.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false United States share of project costs. 152... share of project costs. (a) Airport development. Except as provided in paragraphs (b) and (c) of this section, the following is the United States share of the allowable cost of an airport development project...

  9. 40 CFR 35.6235 - Cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... § 35.6285 (c), (d), and (f) regarding credit, excess cash cost share contributions/over match, and... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Cost sharing. 35.6235 Section 35.6235... Cooperative Agreements § 35.6235 Cost sharing. A State must provide at least ten percent of the direct and...

  10. 42 CFR 600.520 - General cost-sharing protections.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... income. (b) Cost-sharing protections to ensure enrollment of Indians. A State must ensure that standard health plans meet the standards in accordance with 45 CFR 156.420(b)(1) and (d). (c) Cost-sharing... 156.420(c) and (e); and (2) The cost-sharing reduction standards in accordance with 45 CFR 156.420(a...

  11. 42 CFR 423.6 - Cost-sharing in beneficiary education and enrollment-related costs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Cost-sharing in beneficiary education and enrollment-related costs. 423.6 Section 423.6 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... BENEFIT General Provisions § 423.6 Cost-sharing in beneficiary education and enrollment-related costs. The...

  12. 47 CFR 27.1174 - Termination of Cost-Sharing Obligations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... § 27.1174 Termination of Cost-Sharing Obligations. The cost-sharing plan will sunset for all AWS and... AWS band (i.e., 2110-2150 MHz, 2160-2175 MHz, or 2175-2180 MHz) in which the relocated FMS link was located terminates. AWS or MSS (including MSS/ATC) entrants that trigger a cost-sharing obligation prior...

  13. 47 CFR 27.1174 - Termination of Cost-Sharing Obligations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... § 27.1174 Termination of Cost-Sharing Obligations. The cost-sharing plan will sunset for all AWS and... AWS band (i.e., 2110-2150 MHz, 2160-2175 MHz, or 2175-2180 MHz) in which the relocated FMS link was located terminates. AWS or MSS (including MSS/ATC) entrants that trigger a cost-sharing obligation prior...

  14. 36 CFR 1206.50 - What types of funding and cost sharing arrangements does the Commission make?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... opportunity announcements. (2) Cost sharing may include cash or in-kind contributions provided by the... cost sharing arrangements does the Commission make? 1206.50 Section 1206.50 Parks, Forests, and Public... RECORDS COMMISSION Applying for NHPRC Grants § 1206.50 What types of funding and cost sharing arrangements...

  15. 26 CFR 16A.126-1 - Certain cost-sharing payments-in general.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 14 2012-04-01 2012-04-01 false Certain cost-sharing payments-in general. 16A... CERTAIN CONSERVATION COST-SHARING PAYMENTS § 16A.126-1 Certain cost-sharing payments—in general. (a... average annual income derived from the affected property prior to receipt of the improvement or an amount...

  16. 26 CFR 16A.126-1 - Certain cost-sharing payments-in general.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 14 2013-04-01 2013-04-01 false Certain cost-sharing payments-in general. 16A... CERTAIN CONSERVATION COST-SHARING PAYMENTS § 16A.126-1 Certain cost-sharing payments—in general. (a... average annual income derived from the affected property prior to receipt of the improvement or an amount...

  17. 26 CFR 16A.126-1 - Certain cost-sharing payments-in general.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 14 2014-04-01 2013-04-01 true Certain cost-sharing payments-in general. 16A... CERTAIN CONSERVATION COST-SHARING PAYMENTS § 16A.126-1 Certain cost-sharing payments—in general. (a... average annual income derived from the affected property prior to receipt of the improvement or an amount...

  18. Cost Sharing, Health Care Expenditures, and Utilization: An International Comparison.

    PubMed

    Perkowski, Patryk; Rodberg, Leonard

    2016-01-01

    Health systems implement cost sharing to help reduce health care expenditure and utilization by discouraging the use of unnecessary health care services. We examine cost sharing in 28 countries in the Organisation for Economic Co-operation and Development from 1999 through 2009 in the areas of medical care, hospital care, and pharmaceuticals. We investigate associations between cost sharing, health care expenditures, and health care utilization and find no significant association between cost sharing and health care expenditures or utilization in these countries. © The Author(s) 2015.

  19. 32 CFR 37.545 - May I accept costs of prior research as cost sharing?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false May I accept costs of prior research as cost... DoD GRANT AND AGREEMENT REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Pre-Award Business Evaluation Cost Sharing § 37.545 May I accept costs of prior research as cost sharing? No, you may not count any...

  20. An Introduction to Cost Sharing: Why Good Deeds Do Not Go Unpunished.

    ERIC Educational Resources Information Center

    Seligman, Richard P.

    2000-01-01

    Examines the concept of cost sharing between grantor agencies and grantee institutions and identifies problems encountered, including use of cost sharing to leverage funds by both funding agencies and grantee institutions; and various grantee institution costing, accounting, and auditing issues, such as effort reporting, the Cost Accounting…

  1. Physician response to the United Mine Workers' cost-sharing program: the other side of the coin.

    PubMed Central

    Fahs, M C

    1992-01-01

    The effect of cost sharing on health services utilization is analyzed from a new perspective, that is, its effects on physician response to cost sharing. A primary data set was constructed using medical records and billing files from a large multispecialty group practice during the three-year period surrounding the introduction of cost sharing to the United Mine Workers Health and Retirement Fund. This same group practice also served an equally large number of patients covered by United Steelworkers' health benefit plans, for which similar utilization data were available. The questions addressed in this interinsurer study are: (1) to what extent does a physician's treatment of medically similar cases vary, following a drop in patient visits as a result of cost sharing? and (2) what is the impact, if any, on costs of care for other patients in the practice (e.g., "spillover effects" such as cost shifting)? Answers to these kinds of questions are necessary to predict the effects of cost sharing on overall health care costs. A fixed-effects model of physician service use was applied to data on episodes of treatment for all patients in a private group practice. This shows that the introduction of cost sharing to some patients in a practice does, in fact, increase the treatment costs to other patients in the same practice who remain under stable insurance plans. The analysis demonstrates that when the economic effects of cost sharing on physician service use are analyzed for all patients within a physician practice, the findings are remarkably different from those of an analysis limited to those patients directly affected by cost sharing. PMID:1563952

  2. Carbon Emission Reduction with Capital Constraint under Greening Financing and Cost Sharing Contract.

    PubMed

    Qin, Juanjuan; Zhao, Yuhui; Xia, Liangjie

    2018-04-13

    Motivated by the industrial practices, this work explores the carbon emission reductions for the manufacturer, while taking into account the capital constraint and the cap-and-trade regulation. To alleviate the capital constraint, two contracts are analyzed: greening financing and cost sharing. We use the Stackelberg game to model four cases as follows: (1) in Case A1, the manufacturer has no greening financing and no cost sharing; (2) in Case A2, the manufacturer has greening financing, but no cost sharing; (3) in Case B1, the manufacturer has no greening financing but has cost sharing; and, (4) in Case B2, the manufacturer has greening financing and cost sharing. Then, using the backward induction method, we derive and compare the equilibrium decisions and profits of the participants in the four cases. We find that the interest rate of green finance does not always negatively affect the carbon emission reduction of the manufacturer. Meanwhile, the cost sharing from the retailer does not always positively affect the carbon emission reduction of the manufacturer. When the cost sharing is low, both of the participants' profits in Case B1 (under no greening finance) are not less than that in Case B2 (under greening finance). When the cost sharing is high, both of the participants' profits in Case B1 (under no greening finance) are less than that in Case B2 (under greening finance).

  3. 43 CFR 404.40 - What is the non-Federal share of operation, maintenance, and replacement costs?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Cost-Sharing § 404.40 What is the non-Federal share of operation, maintenance, and replacement costs? You are required to pay 100 percent of the operation, maintenance, and replacement costs of any rural... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false What is the non-Federal share of operation...

  4. How Patient Cost-Sharing Trends Affect Adherence and Outcomes

    PubMed Central

    Eaddy, Michael T.; Cook, Christopher L.; O’Day, Ken; Burch, Steven P.; Cantrell, C. Ron

    2012-01-01

    Objective We sought to assess the relationship between patient cost sharing; medication adherence; and clinical, utilization, and economic outcomes. Methodology: We conducted a literature review of articles and abstracts published from January 1974 to May 2008. Articles were identified using PubMed, Ovid, medline, Web of Science, and Google Scholar databases. The following terms were used in the search: adherence, compliance, copay, cost sharing, costs, noncompliance, outcomes, hospitalization, utilization, economics, income, and persistence. Results: We identified and included 160 articles in the review. Although the types of interventions, measures, and populations studied varied widely, we were able to identify relatively clear relationships between cost sharing, adherence, and outcomes. Of the articles that evaluated the relationship between changes in cost sharing and adherence, 85% showed that an increasing patient share of medication costs was significantly associated with a decrease in adherence. For articles that investigated the relationship between adherence and outcomes, the majority noted that increased adherence was associated with a statistically significant improvement in outcomes. Conclusion: Increasing patient cost sharing was associated with declines in medication adherence, which in turn was associated with poorer health outcomes. PMID:22346336

  5. 48 CFR 716.303 - Cost-sharing contracts.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Cost-sharing contracts. 716.303 Section 716.303 Federal Acquisition Regulations System AGENCY FOR INTERNATIONAL DEVELOPMENT CONTRACTING METHODS AND CONTRACT TYPES TYPES OF CONTRACTS Cost Reimbursement Contracts 716.303 Cost-sharing...

  6. 48 CFR 716.303 - Cost-sharing contracts.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Cost-sharing contracts. 716.303 Section 716.303 Federal Acquisition Regulations System AGENCY FOR INTERNATIONAL DEVELOPMENT CONTRACTING METHODS AND CONTRACT TYPES TYPES OF CONTRACTS Cost Reimbursement Contracts 716.303 Cost-sharing...

  7. 23 CFR 505.13 - Federal Government's share of project cost.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 23 Highways 1 2012-04-01 2012-04-01 false Federal Government's share of project cost. 505.13... Government's share of project cost. (a) Based on engineering studies, studies of economic feasibility, and... eligible costs. (b) A FFGA for the project shall not exceed 80 percent of the eligible project cost. A...

  8. 23 CFR 505.13 - Federal Government's share of project cost.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 23 Highways 1 2014-04-01 2014-04-01 false Federal Government's share of project cost. 505.13... Government's share of project cost. (a) Based on engineering studies, studies of economic feasibility, and... eligible costs. (b) A FFGA for the project shall not exceed 80 percent of the eligible project cost. A...

  9. 23 CFR 505.13 - Federal Government's share of project cost.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 23 Highways 1 2013-04-01 2013-04-01 false Federal Government's share of project cost. 505.13... Government's share of project cost. (a) Based on engineering studies, studies of economic feasibility, and... eligible costs. (b) A FFGA for the project shall not exceed 80 percent of the eligible project cost. A...

  10. 23 CFR 505.13 - Federal Government's share of project cost.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 23 Highways 1 2011-04-01 2011-04-01 false Federal Government's share of project cost. 505.13... Government's share of project cost. (a) Based on engineering studies, studies of economic feasibility, and... eligible costs. (b) A FFGA for the project shall not exceed 80 percent of the eligible project cost. A...

  11. On Proportionate and Truthful International Alliance Contributions: An Analysis of IncentiveCompatible Cost Sharing Mechanisms to Burden Sharing

    DTIC Science & Technology

    2017-03-23

    Therefore, the mecha- nism induces a stable cost sharing scheme wherein a subset of colluding players will not all benefit . In a subset of colluding...goods are not divisible and are not excludable. Cost sharing mechanisms specific to public goods have been researched extensively in the literature...Jackson & Moulin [1992] consider the sharing of cost for an indivisible public project among many players, and their work was extended by Bag [1997] to

  12. 26 CFR 1.482-7A - Methods to determine taxable income in connection with a cost sharing arrangement.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... reasonable overhead costs attributable to the project. They also share the cost of a conference facility that... reasonable overhead costs attributable to the project. USP also incurs costs related to field testing of the... Unrelated Third Party (UTP) enter into a cost sharing arrangement to develop new audio technology. In the...

  13. 26 CFR 1.482-7A - Methods to determine taxable income in connection with a cost sharing arrangement.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... reasonable overhead costs attributable to the project. They also share the cost of a conference facility that... reasonable overhead costs attributable to the project. USP also incurs costs related to field testing of the... Unrelated Third Party (UTP) enter into a cost sharing arrangement to develop new audio technology. In the...

  14. 26 CFR 1.482-7A - Methods to determine taxable income in connection with a cost sharing arrangement.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... reasonable overhead costs attributable to the project. They also share the cost of a conference facility that... reasonable overhead costs attributable to the project. USP also incurs costs related to field testing of the... Unrelated Third Party (UTP) enter into a cost sharing arrangement to develop new audio technology. In the...

  15. 26 CFR 1.482-7A - Methods to determine taxable income in connection with a cost sharing arrangement.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... reasonable overhead costs attributable to the project. They also share the cost of a conference facility that... reasonable overhead costs attributable to the project. USP also incurs costs related to field testing of the... Unrelated Third Party (UTP) enter into a cost sharing arrangement to develop new audio technology. In the...

  16. 26 CFR 1.482-7A - Methods to determine taxable income in connection with a cost sharing arrangement.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... reasonable overhead costs attributable to the project. They also share the cost of a conference facility that... reasonable overhead costs attributable to the project. USP also incurs costs related to field testing of the... Unrelated Third Party (UTP) enter into a cost sharing arrangement to develop new audio technology. In the...

  17. 7 CFR 636.7 - Cost-share payments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... AGRICULTURE LONG TERM CONTRACTING WILDLIFE HABITAT INCENTIVES PROGRAM § 636.7 Cost-share payments. (a) NRCS... establishing conservation practices to develop fish and wildlife habitat. The cost-share payment to a...

  18. How Will the Affordable Care Act's Cost-Sharing Reductions Affect Consumers' Out-of-Pocket Costs in 2016?

    PubMed

    Collins, Sara R; Gunja, Munira; Beutel, Sophie

    2016-03-01

    Health insurers selling plans in the Affordable Care Act's market­places are required to reduce cost-sharing in silver plans for low- and moderate-income people earning between 100 percent and 250 percent of the federal pov­erty level. In 2016, as many as 7 million Americans may have plans with these cost-sharing reductions. In the largest markets in the 38 states using the federal website for marketplace enrollment, the cost-sharing reductions substantially lower projected out-of-pocket costs for people who qualify for them. However, the degree to which consumers' out-of-pocket spending will fall varies by plan and how much health care they use. This is because insurers use deductibles, out-of-pocket limits, and copayments in different combinations to lower cost-sharing for eligible enrollees. In 2017, marketplace insurers will have the option of offering standard plans, which may help simplify consumers' choices and lead to more equal cost-sharing.

  19. 7 CFR 634.24 - Cost sharing.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... AGRICULTURE LONG TERM CONTRACTING RURAL CLEAN WATER PROGRAM Participant RCWP Contracts § 634.24 Cost sharing... participant's water rights, cannot be considered a part of the participant's share of the cost. (b) The... offsite water quality, and (2) The matching share requirements would place a burden on the landowner or...

  20. 7 CFR 634.24 - Cost sharing.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... AGRICULTURE LONG TERM CONTRACTING RURAL CLEAN WATER PROGRAM Participant RCWP Contracts § 634.24 Cost sharing... participant's water rights, cannot be considered a part of the participant's share of the cost. (b) The... offsite water quality, and (2) The matching share requirements would place a burden on the landowner or...

  1. 7 CFR 634.24 - Cost sharing.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... AGRICULTURE LONG TERM CONTRACTING RURAL CLEAN WATER PROGRAM Participant RCWP Contracts § 634.24 Cost sharing... participant's water rights, cannot be considered a part of the participant's share of the cost. (b) The... offsite water quality, and (2) The matching share requirements would place a burden on the landowner or...

  2. 10 CFR 470.16 - Cost sharing and funds from other sources.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Cost sharing and funds from other sources. 470.16 Section... § 470.16 Cost sharing and funds from other sources. Proposers are encouraged to offer to share in the... other entities to obtain supplemental funding. ...

  3. Impact of Cost-Sharing Increases on Continuity of Specialty Drug Use: A Quasi-Experimental Study.

    PubMed

    Li, Pengxiang; Hu, Tianyan; Yu, Xinyan; Chahin, Salim; Dahodwala, Nabila; Blum, Marissa; Pettit, Amy R; Doshi, Jalpa A

    2017-07-24

    To examine the impact of cost-sharing increases on continuity of specialty drug use in Medicare beneficiaries with multiple sclerosis (MS) or rheumatoid arthritis (RA). Five percent Medicare claims data (2007-2010). Quasi-experimental study examining changes in specialty drug use among a group of Medicare Part D beneficiaries without low-income subsidies (non-LIS) as they transitioned from a 5 percent cost-sharing preperiod to a ≥25 percent cost-sharing postperiod, as compared to changes among a disease-matched contemporaneous control group of patients eligible for full low-income subsidies (LIS), who faced minor cost sharing (≤$6.30 copayment) in both the pre- and postperiods. Key variables were extracted from Medicare data. Relative to the LIS group, the non-LIS group had a greater increase in incidence of 30-day continuous gaps in any Part D treatment from the lower cost-sharing period to the higher cost-sharing period (MS, absolute increase = 10.1 percent, OR = 1.61, 95% CI 1.19-2.17; RA, absolute increase = 21.9 percent, OR = 2.75, 95% CI 2.15-3.51). The increase in Part D treatment gaps was not offset by increased Part B specialty drug use. Cost-sharing increases due to specialty tier-level cost sharing were associated with interruptions in MS and RA specialty drug treatments. © Health Research and Educational Trust.

  4. Carbon Emission Reduction with Capital Constraint under Greening Financing and Cost Sharing Contract

    PubMed Central

    Qin, Juanjuan; Zhao, Yuhui; Xia, Liangjie

    2018-01-01

    Motivated by the industrial practices, this work explores the carbon emission reductions for the manufacturer, while taking into account the capital constraint and the cap-and-trade regulation. To alleviate the capital constraint, two contracts are analyzed: greening financing and cost sharing. We use the Stackelberg game to model four cases as follows: (1) in Case A1, the manufacturer has no greening financing and no cost sharing; (2) in Case A2, the manufacturer has greening financing, but no cost sharing; (3) in Case B1, the manufacturer has no greening financing but has cost sharing; and, (4) in Case B2, the manufacturer has greening financing and cost sharing. Then, using the backward induction method, we derive and compare the equilibrium decisions and profits of the participants in the four cases. We find that the interest rate of green finance does not always negatively affect the carbon emission reduction of the manufacturer. Meanwhile, the cost sharing from the retailer does not always positively affect the carbon emission reduction of the manufacturer. When the cost sharing is low, both of the participants’ profits in Case B1 (under no greening finance) are not less than that in Case B2 (under greening finance). When the cost sharing is high, both of the participants’ profits in Case B1 (under no greening finance) are less than that in Case B2 (under greening finance). PMID:29652859

  5. 45 CFR 152.21 - Premiums and cost-sharing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Premiums and cost-sharing. 152.21 Section 152.21...-EXISTING CONDITION INSURANCE PLAN PROGRAM Benefits § 152.21 Premiums and cost-sharing. (a) Limitation on... benefits must be at least 65 percent of such costs. (2) The out-of-pocket limit of coverage for cost...

  6. 32 CFR 37.550 - May I accept intellectual property as cost sharing?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... the same cost of lost opportunity to a recipient as contributions of cash or tangible assets. The... 32 National Defense 1 2010-07-01 2010-07-01 false May I accept intellectual property as cost... Cost Sharing § 37.550 May I accept intellectual property as cost sharing? (a) In most instances, you...

  7. 33 CFR 239.8 - Cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... to provide additional cost sharing to reflect special local benefits or betterments. Such additional... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Cost sharing. 239.8 Section 239.8... RESOURCES POLICIES AND AUTHORITIES: FEDERAL PARTICIPATION IN COVERED FLOOD CONTROL CHANNELS § 239.8 Cost...

  8. 40 CFR 35.6235 - Cost sharing.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... ASSISTANCE Cooperative Agreements and Superfund State Contracts for Superfund Response Actions Core Program... indirect costs of all activities covered by the Core Program Cooperative Agreement. Indian Tribes are not required to share in the cost of Core Program activities. The State must provide its cost share with non...

  9. Impact of type 2 diabetes medication cost sharing on patient outcomes and health plan costs.

    PubMed

    Thornton Snider, Julia; Seabury, Seth; Lopez, Janice; McKenzie, Scott; Goldman, Dana P

    2016-06-01

    To study the association between cost sharing for diabetes medications, adherence, hospitalization rates, and healthcare costs, with relationship to patient risk. A retrospective claims analysis of data from 35 large, private, self-insured employers (2004 to 2012). We examined outcomes for 92,410 patients aged 18 to 64 years with a type 2 diabetes (T2D) diagnosis who filled at least 1 T2D prescription. First, we examined the relationship between adherence, measured as the proportion of days covered, and cost sharing, measured as the out-of-pocket cost to purchase a pre-specified bundle of T2D prescriptions. We then examined the association between adherence and hospital days. Simulations showed the effect of increased cost sharing on adherence and inpatient utilization. A $10 increase in out-of-pocket cost was associated with a 1.9% reduction in adherence (P < .01). In turn, a 10% reduction in adherence was associated with a 15% increase in per-patient hospital days (0.17 days; P < .01). For the average plan, switching from low to high cost sharing reduced per-patient medication costs by $242 and increased per-patient hospitalization costs by $342, for a net increase of $100 in plan costs. Increases in per-patient costs were greater for high-risk patients, such as those with heart failure ($1328). Increased cost sharing for T2D medication was associated with reductions in pharmacy costs, but higher total costs for patients with T2D. This problem is particularly acute for patients with 1 or more cardiovascular comorbidities. The results suggest that increased diabetes cost sharing may hamper efforts to lower the total cost of diabetes care.

  10. Recent proposals to limit Medigap coverage and modify Medicare cost sharing.

    PubMed

    Linehan, Kathryn

    2012-02-24

    As policymakers look for savings from the Medicare program, some have proposed eliminating or discouraging "first-dollar coverage" available through privately purchased Medigap policies. Medigap coverage, which beneficiaries obtain to protect themselves from Medicare's cost-sharing requirements and its lack of a cap on out-of-pocket spending, may discourage the judicious use of medical services by reducing or eliminating beneficiary cost sharing. It is estimated that eliminating such coverage, which has been shown to be associated with higher Medicare spending, and requiring some cost sharing would encourage beneficiaries to reduce their service use and thus reduce pro­gram spending. However, eliminating first-dollar coverage could cause some beneficiaries to incur higher spending or forego necessary services. Some policy proposals to eliminate first-dollar coverage would also modify Medicare's cost sharing and add an out-of-pocket spending cap for fee-for-service Medicare. This paper discusses Medicare's current cost-sharing requirements, Medigap insurance, and proposals to modify Medicare's cost sharing and eliminate first-dollar coverage in Medigap plans. It reviews the evidence on the effects of first-dollar coverage on spending, some objections to eliminating first-dollar coverage, and results of research that has modeled the impact of eliminating first-dollar coverage, modifying Medicare's cost-sharing requirements, and adding an out-of-pocket limit on beneficiaries' spending.

  11. 7 CFR 1410.40 - Cost-share payments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... such contract. (g) CCC may make cost-share payments for thinning of existing tree stands to benefit... 7 Agriculture 10 2010-01-01 2010-01-01 false Cost-share payments. 1410.40 Section 1410.40... OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CONSERVATION RESERVE PROGRAM § 1410.40 Cost...

  12. 7 CFR 1410.3 - General description.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... of the CRP are to cost-effectively reduce water and wind erosion, protect the Nation's long-term... addition to any payments under this part, receive cost-share assistance, rental or easement payments, tax.... However, a participant may not receive or retain CRP cost-share assistance if other Federal cost-share...

  13. 7 CFR 1410.3 - General description.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... of the CRP are to cost-effectively reduce water and wind erosion, protect the Nation's long-term... addition to any payments under this part, receive cost-share assistance, rental or easement payments, tax.... However, a participant may not receive or retain CRP cost-share assistance if other Federal cost-share...

  14. 7 CFR 1410.3 - General description.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... of the CRP are to cost-effectively reduce water and wind erosion, protect the Nation's long-term... addition to any payments under this part, receive cost-share assistance, rental or easement payments, tax.... However, a participant may not receive or retain CRP cost-share assistance if other Federal cost-share...

  15. 7 CFR 1410.3 - General description.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... of the CRP are to cost-effectively reduce water and wind erosion, protect the Nation's long-term... addition to any payments under this part, receive cost-share assistance, rental or easement payments, tax.... However, a participant may not receive or retain CRP cost-share assistance if other Federal cost-share...

  16. 7 CFR 1410.3 - General description.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... of the CRP are to cost-effectively reduce water and wind erosion, protect the Nation's long-term... addition to any payments under this part, receive cost-share assistance, rental or easement payments, tax.... However, a participant may not receive or retain CRP cost-share assistance if other Federal cost-share...

  17. 7 CFR 1467.10 - Cost-share payments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... restrictions on the costs of establishing or installing conservation practices or activities specified in the... easement, 30-year contract, or restoration cost-share agreement, NRCS will offer to pay at least 50 percent... entity may receive, directly or indirectly, for one or more restoration cost-share agreements, for any...

  18. 7 CFR 1484.50 - What cost share contributions are eligible?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... section, eligible contributions are: (1) Cash; (2) Compensation paid to personnel; (3) The cost of... 7 Agriculture 10 2010-01-01 2010-01-01 false What cost share contributions are eligible? 1484.50... MARKETS FOR AGRICULTURAL COMMODITIES Contributions and Reimbursements § 1484.50 What cost share...

  19. 45 CFR 2521.45 - What are the limitations on the Federal government's share of program costs?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... share are different—in type and amount—for member support costs and program operating costs. (a) Member support: The Federal share, including Corporation and other Federal funds, of member support costs, which... under § 2522.240(b)(1), and 85 percent of other member support costs. (2) If you are a professional...

  20. Option pricing: a flexible tool to disseminate shared savings contracts.

    PubMed

    Friedberg, Mark W; Buendia, Anthony M; Lauderdale, Katherine E; Hussey, Peter S

    2013-08-01

    Due to volatility in healthcare costs, shared savings contracts can create systematic financial losses for payers, especially when contracting with smaller providers. To improve the business case for shared savings, we calculated the prices of financial options that payers can "sell" to providers to offset these losses. Using 2009 to 2010 member-level total cost of care data from a large commercial health plan, we calculated option prices by applying a bootstrap simulation procedure. We repeated these simulations for providers of sizes ranging from 500 to 60,000 patients and for shared savings contracts with and without key design features (minimum savings thresholds,bonus caps, cost outlier truncation, and downside risk) and under assumptions of zero, 1%, and 2% real cost reductions due to the shared savings contracts. Assuming no real cost reduction and a 50% shared savings rate, per patient option prices ranged from $225 (3.1% of overall costs) for 500-patient providers to $23 (0.3%) for 60,000-patient providers. Introducing minimum savings thresholds, bonus caps, cost outlier truncation, and downside risk reduced these option prices. Option prices were highly sensitive to the magnitude of real cost reductions. If shared savings contracts cause 2% reductions in total costs, option prices fall to zero for all but the smallest providers. Calculating the prices of financial options that protect payers and providers from downside risk can inject flexibility into shared savings contracts, extend such contracts to smaller providers, and clarify the tradeoffs between different contract designs, potentially speeding the dissemination of shared savings.

  1. 23 CFR 646.210 - Classification of projects and railroad share of the cost.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 23 Highways 1 2010-04-01 2010-04-01 false Classification of projects and railroad share of the... ENGINEERING AND TRAFFIC OPERATIONS RAILROADS Railroad-Highway Projects § 646.210 Classification of projects and railroad share of the cost. (a) State laws requiring railroads to share in the cost of work for...

  2. 42 CFR 431.57 - Waiver of cost-sharing requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...-sharing amounts be nominal. (b) For nonemergency services furnished in a hospital emergency room, the... 42 Public Health 4 2010-10-01 2010-10-01 false Waiver of cost-sharing requirements. 431.57 Section... Requirements § 431.57 Waiver of cost-sharing requirements. (a) Sections 1916(a)(3) and 1916(b)(3) of the Act...

  3. 42 CFR 431.57 - Waiver of cost-sharing requirements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...-sharing amounts be nominal. (b) For nonemergency services furnished in a hospital emergency room, the... 42 Public Health 4 2012-10-01 2012-10-01 false Waiver of cost-sharing requirements. 431.57 Section... Requirements § 431.57 Waiver of cost-sharing requirements. (a) Sections 1916(a)(3) and 1916(b)(3) of the Act...

  4. 42 CFR 431.57 - Waiver of cost-sharing requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...-sharing amounts be nominal. (b) For nonemergency services furnished in a hospital emergency room, the... 42 Public Health 4 2011-10-01 2011-10-01 false Waiver of cost-sharing requirements. 431.57 Section... Requirements § 431.57 Waiver of cost-sharing requirements. (a) Sections 1916(a)(3) and 1916(b)(3) of the Act...

  5. 34 CFR 658.41 - What are the cost-sharing requirements?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false What are the cost-sharing requirements? 658.41 Section... PROGRAM What Conditions Must Be Met by a Grantee? § 658.41 What are the cost-sharing requirements? (a) The grantee's share may be derived from cash contributions from private sector corporations or foundations in...

  6. 42 CFR 423.782 - Cost-sharing subsidy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Cost-sharing subsidy. 423.782 Section 423.782... (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Premiums and Cost-Sharing Subsidies... cents. (c) When the out-of-pocket cost for a covered Part D drug under a Part D sponsor's plan benefit...

  7. Cost Sharing-Just When I Thought I Knew All the Answers.

    ERIC Educational Resources Information Center

    Paoletti, Charles R.

    2000-01-01

    Discusses issues in the recent debate on cost sharing within the federal government-university partnership, the historical roots of cost sharing, and limitations on the recovery of costs under federally funded research. Notes that the Presidential Review Directive process is working toward a set of guiding principles and recommendations to enhance…

  8. Boeing’s Integrated Defense Systems Restructuring: Significant and Preventable Cost Impacts to Army Aviation Programs

    DTIC Science & Technology

    2005-03-18

    IDS, the treatment and handling of Boeing World Headquarters (BWHQ) costs, common or shared systems costs, Shared Services Group costs, fringe...these expenses.15 One such example is the addition of the Shared Services Group (SSG) expense to the Mesa and Philadelphia accounting ledgers. Under

  9. 47 CFR 27.1166 - Reimbursement under the Cost-Sharing Plan.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... licensed frequency band may seek full reimbursement through the clearinghouse of compensable costs, up to... are expected to act in good faith in satisfying the cost-sharing obligations under §§ 27.1160 through... 47 Telecommunication 2 2014-10-01 2014-10-01 false Reimbursement under the Cost-Sharing Plan. 27...

  10. 47 CFR 27.1166 - Reimbursement under the Cost-Sharing Plan.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... licensed frequency band may seek full reimbursement through the clearinghouse of compensable costs, up to... are expected to act in good faith in satisfying the cost-sharing obligations under §§ 27.1160 through... 47 Telecommunication 2 2013-10-01 2013-10-01 false Reimbursement under the Cost-Sharing Plan. 27...

  11. How do high cost-sharing policies for physician care affect inpatient care use and costs among people with chronic disease?

    PubMed

    Xin, Haichang

    2015-01-01

    Rapidly rising health care costs continue to be a significant concern in the United States. High cost-sharing strategies thus have been widely used to address rising health care costs. Since high cost-sharing policies can reduce needed care as well as unneeded care use, it raises the concern whether these policies for physician care are a good strategy for controlling costs among chronically ill patients, especially whether utilization and costs in inpatient care will increase in response. This study examined whether high cost sharing in physician care affects inpatient care utilization and costs differently between individuals with and without chronic conditions. Findings from this study will contribute to the insurance benefit design that can control care utilization and save costs of chronically ill individuals. Prior studies suffered from gaps that limit both internal validity and external validity of their findings. This study has its unique contributions by filling these gaps jointly. The study used data from the 2007 Medical Expenditure Panel Survey, a nationally representative sample, with a cross-sectional study design. Instrumental variable technique was used to address the endogeneity between health care utilization and cost-sharing levels. We used negative binomial regression to analyze the count data and generalized linear models for costs data. To account for national survey sampling design, weight and variance were adjusted. The study compared the effects of high cost-sharing policies on inpatient care utilization and costs between individuals with and without chronic conditions to answer the research question. The final study sample consisted of 4523 individuals; among them, 752 had hospitalizations. The multivariate analysis demonstrated consistent patterns. Compared with low cost-sharing policies, high cost-sharing policies for physician care were not associated with a greater increase in inpatient care utilization (P = .86 for chronically ill people and P = .67 for healthy people, respectively) and costs (P = .38 for chronically ill people and P = .68 for healthy people, respectively). The sensitivity analysis with a 10% cost-sharing level also generated consistent insignificant results for both chronically ill and healthy groups. Relative to nonchronically ill individuals, chronically ill individuals may increase their utilization and expenditures of inpatient care to a similar extent in response to increased physician care cost sharing. This may be due to cost pressure from inpatient care and short observation window. Although this study did not find evidence that high cost-sharing policies for physician care increase inpatient care differently for individuals with and without chronic conditions, interpretation of this finding should be cautious. It is possible that in the long run, these sick people would demonstrate substantial demands for medical care and there could be a total cost increase for health plans ultimately. Health plans need to be cautious of policies for chronically ill enrollees.

  12. Quantifying the conservation gains from shared access to linear infrastructure.

    PubMed

    Runge, Claire A; Tulloch, Ayesha I T; Gordon, Ascelin; Rhodes, Jonathan R

    2017-12-01

    The proliferation of linear infrastructure such as roads and railways is a major global driver of cumulative biodiversity loss. One strategy for reducing habitat loss associated with development is to encourage linear infrastructure providers and users to share infrastructure networks. We quantified the reductions in biodiversity impact and capital costs under linear infrastructure sharing of a range of potential mine to port transportation links for 47 mine locations operated by 28 separate companies in the Upper Spencer Gulf Region of South Australia. We mapped transport links based on least-cost pathways for different levels of linear-infrastructure sharing and used expert-elicited impacts of linear infrastructure to estimate the consequences for biodiversity. Capital costs were calculated based on estimates of construction costs, compensation payments, and transaction costs. We evaluated proposed mine-port links by comparing biodiversity impacts and capital costs across 3 scenarios: an independent scenario, where no infrastructure is shared; a restricted-access scenario, where the largest mining companies share infrastructure but exclude smaller mining companies from sharing; and a shared scenario where all mining companies share linear infrastructure. Fully shared development of linear infrastructure reduced overall biodiversity impacts by 76% and reduced capital costs by 64% compared with the independent scenario. However, there was considerable variation among companies. Our restricted-access scenario showed only modest biodiversity benefits relative to the independent scenario, indicating that reductions are likely to be limited if the dominant mining companies restrict access to infrastructure, which often occurs without policies that promote sharing of infrastructure. Our research helps illuminate the circumstances under which infrastructure sharing can minimize the biodiversity impacts of development. © 2017 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.

  13. Trends in Cost-Sharing in the US and Potential International Implications

    ERIC Educational Resources Information Center

    Taylor, Barrett J.; Morphew, Christopher C.

    2015-01-01

    "Cost­-sharing" refers to the principle that a variety of sources contribute to the cost of higher education. This study utilizes university-­level data from the United States to explore the increasing shift of cost burdens from governments to students. Panel regression results suggest that the share of expenditures drawn from tuition…

  14. Cost Sharing in Education: Public Finance, School and Household Perspectives. Education Research Paper.

    ERIC Educational Resources Information Center

    Penrose, Perran

    This report examines cost sharing, a term that combines the concepts of direct-cost recovery and indirect contributions from pupils, their parents, and sponsors. Such contributions may be voluntary, quasi-compulsory, or even compulsory. For the study reported here, cost sharing is used when the subject under discussion is not restricted to…

  15. How Low-Income Subsidy Recipients Respond to Medicare Part D Cost Sharing.

    PubMed

    Stuart, Bruce; Hendrick, Franklin B; Xu, Jing; Dougherty, J Samantha

    2017-06-01

    To determine the magnitude and mechanisms of response to Medicare Part D cost sharing by low-income subsidy (LIS) recipients using oral hypoglycemic agents (OHAs) and statins. Medicare data for a 5 percent random sample of beneficiaries with diabetes enrolled in fee-for-service Part D drug plans in 2008. We evaluated the impact of differences between generic and brand cost sharing rates among cohorts of LIS and non-LIS recipients to determine if wider price spreads increased the generic dispensing rate (GDR) and reduced total drug use and cost. We found little association between cost sharing and aggregate OHA and statin use. In adjusted analyses, non-LIS beneficiaries who paid 46 percent of total OHA costs had 2.5 percent fewer OHA days supply than full benefit dual eligibles who paid just 5 percent of their therapy costs. For statins, the difference in days supply between those facing the lowest and highest cost sharing was 4.6 percent. Higher cost sharing was associated with filling fewer but larger prescriptions for both generics and brands. Higher generic and brand copays had little association with OHA and statin use among LIS recipients. This implies that modest changes in required cost sharing for these medicines would have very little substantive impact on generic dispensing or utilization patterns among LIS recipients and thus would have little effect on total program spending. At the same time, any increases in out-of-pocket costs would be expected to shift costs and place greater financial burden on low-income beneficiaries, particularly those in poor health. © Health Research and Educational Trust.

  16. 43 CFR 404.32 - Can Reclamation reduce the non-Federal cost-share required for an appraisal investigation?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Regulations Relating to Public Lands BUREAU OF RECLAMATION, DEPARTMENT OF THE INTERIOR RECLAMATION RURAL WATER SUPPLY PROGRAM Cost-Sharing § 404.32 Can Reclamation reduce the non-Federal cost-share required for an...

  17. Effects of a cost-sharing exemption on use of preventive services at one large employer.

    PubMed

    Busch, Susan H; Barry, Colleen L; Vegso, Sally J; Sindelar, Jody L; Cullen, Mark R

    2006-01-01

    In 2004, Alcoa introduced a new health benefit for a portion of its workforce, which eliminated cost sharing for preventive care while increasing cost sharing for many other services. In this era of increased consumerism, Alcoa's benefit redesign constituted an effort to reduce health care costs while preserving use of targeted services. Taking advantage of a unique natural experiment, we find that Alcoa was able to maintain rates of preventive service use. This evidence suggests that differential cost sharing can be used to preserve the use of critical health care services.

  18. Shared care or nurse consultations as an alternative to rheumatologist follow-up for rheumatoid arthritis (RA) outpatients with stable low disease-activity RA: cost-effectiveness based on a 2-year randomized trial.

    PubMed

    Sørensen, J; Primdahl, J; Horn, H C; Hørslev-Petersen, K

    2015-01-01

    To compare the cost-effectiveness of three types of follow-up for outpatients with stable low-activity rheumatoid arthritis (RA). In total, 287 patients were randomized to either planned rheumatologist consultations, shared care without planned consultations, or planned nurse consultations. Effectiveness measures included disease activity (Disease Activity Score based on 28 joint counts and C-reactive protein, DAS28-CRP), functional status (Health Assessment Questionnaire, HAQ), and health-related quality of life (EuroQol EQ-5D). Cost measures included activities in outpatient clinics and general practice, prescription and non-prescription medicine, dietary supplements, other health-care resources, and complementary and alternative care. Measures of effectiveness and costs were collected by self-reported questionnaires at inclusion and after 12 and 24 months. Incremental cost-effectiveness rates (ICERs) were estimated in comparison with rheumatologist consultations. Changes in disease activity, functional status, and health-related quality of life were not statistically significantly different for the three groups, although the mean scores were better for the shared care and nurse care groups compared with the rheumatologist group. Shared care and nurse care were non-significantly less costly than rheumatologist care. As both shared care and nurse care were associated with slightly better EQ-5D improvements and lower costs, they dominated rheumatologist care. At EUR 10,000 per quality-adjusted life year (QALY) threshold, shared care and nurse care were cost-effective with more than 90% probability. Nurse care was cost-effective in comparison with shared care with 75% probability. Shared care and nurse care seem to cost less but provide broadly similar health outcomes compared with rheumatologist outpatient care. However, it is still uncertain whether nurse care and shared care are cost-effective in comparison with rheumatologist outpatient care.

  19. 7 CFR 624.7 - Cost-sharing.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 6 2013-01-01 2013-01-01 false Cost-sharing. 624.7 Section 624.7 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES CONSERVATION SERVICE, DEPARTMENT OF AGRICULTURE WATER RESOURCES EMERGENCY WATERSHED PROTECTION § 624.7 Cost-sharing. (a) Except as provided in...

  20. 7 CFR 624.7 - Cost-sharing.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 6 2014-01-01 2014-01-01 false Cost-sharing. 624.7 Section 624.7 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES CONSERVATION SERVICE, DEPARTMENT OF AGRICULTURE WATER RESOURCES EMERGENCY WATERSHED PROTECTION § 624.7 Cost-sharing. (a) Except as provided in...

  1. 7 CFR 624.7 - Cost-sharing.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 6 2011-01-01 2011-01-01 false Cost-sharing. 624.7 Section 624.7 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES CONSERVATION SERVICE, DEPARTMENT OF AGRICULTURE WATER RESOURCES EMERGENCY WATERSHED PROTECTION § 624.7 Cost-sharing. (a) Except as provided in...

  2. 7 CFR 624.7 - Cost-sharing.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 6 2012-01-01 2012-01-01 false Cost-sharing. 624.7 Section 624.7 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES CONSERVATION SERVICE, DEPARTMENT OF AGRICULTURE WATER RESOURCES EMERGENCY WATERSHED PROTECTION § 624.7 Cost-sharing. (a) Except as provided in...

  3. 43 CFR 404.34 - Can Reclamation reduce the amount of non-Federal cost-share required for a feasibility study?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Regulations Relating to Public Lands BUREAU OF RECLAMATION, DEPARTMENT OF THE INTERIOR RECLAMATION RURAL WATER SUPPLY PROGRAM Cost-Sharing § 404.34 Can Reclamation reduce the amount of non-Federal cost-share required...

  4. 45 CFR 156.130 - Cost-sharing requirements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS HEALTH INSURANCE ISSUER STANDARDS UNDER THE AFFORDABLE CARE ACT, INCLUDING STANDARDS RELATED TO EXCHANGES Essential Health Benefits Package § 156.130 Cost-sharing requirements. (a) Annual limitation on cost sharing. (1...

  5. 45 CFR 156.130 - Cost-sharing requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Public Welfare Department of Health and Human Services REQUIREMENTS RELATING TO HEALTH CARE ACCESS HEALTH INSURANCE ISSUER STANDARDS UNDER THE AFFORDABLE CARE ACT, INCLUDING STANDARDS RELATED TO EXCHANGES Essential Health Benefits Package § 156.130 Cost-sharing requirements. (a) Annual limitation on cost sharing. (1...

  6. The Impact of Cost Sharing on Internal Efficiency of Public Secondary Schools in Ndivisi Division, Bungoma District Kenya

    ERIC Educational Resources Information Center

    Kiveu, Noah Murumba; Mayio, Julius

    2009-01-01

    Adoption of cost sharing policy in education has witnessed the return to communities and parents a substantial proportion of financial responsibility for schooling. With increased poverty levels, many parents and communities have not been able to meet the cost requirements under cost sharing policy. Thus their investment in education and support…

  7. 43 CFR 404.34 - Can Reclamation reduce the amount of non-Federal cost-share required for a feasibility study?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...-Federal cost-share required for a feasibility study? 404.34 Section 404.34 Public Lands: Interior... for a feasibility study? Yes. Reclamation may reduce the non-Federal cost-share required for a feasibility study to an amount less than 50 percent of the study costs if: (a) Reclamation determines that...

  8. Alternative Fuels Data Center

    Science.gov Websites

    assistance to qualified E85 or dual E15 and biodiesel retailers. Cost-share grants are available to upgrade or install new E85 or dual E15 and biodiesel infrastructure. Three-year cost-share grants are available for up to 50% of the total cost of the total project, up to $30,000, and five-year cost-share

  9. Should health authorities offer risk-sharing contracts to pharmaceutical firms? A theoretical approach.

    PubMed

    Antonanzas, Fernando; Juarez-Castello, Carmelo; Rodriguez-Ibeas, Roberto

    2011-07-01

    In this paper, we characterise the risk-sharing contracts that health authorities can design when they face a regulatory decision on drug pricing and reimbursement in a context of uncertainty. We focus on two types of contracts. On the one hand, the health authority can reimburse the firm for each treated patient regardless of health outcomes (non risk-sharing). Alternatively, the health authority can pay for the drug only when the patient is cured (risk-sharing contract). The optimal contract depends on the trade-off between the monitoring costs, the marginal production cost and the utility derived from treatment. A non-risk-sharing agreement will be preferred by the health authority, if patients who should not be treated impose a relatively low cost to the health system. When this cost is high, the health authority would prefer a risk-sharing agreement for relatively low monitoring costs.

  10. 14 CFR 1274.205 - Consortia as recipients.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... better share the projects financial costs (e.g., the 50 percent recipient's cost share or other costs of... issues; (8) Internal and external reporting requirements; (9) Management structure of the consortium; (10... the consortia members (12) Agreements, if any, to share existing technology and data; (13) The firm...

  11. 14 CFR 1274.205 - Consortia as recipients.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... better share the projects financial costs (e.g., the 50 percent recipient's cost share or other costs of... issues; (8) Internal and external reporting requirements; (9) Management structure of the consortium; (10... the consortia members (12) Agreements, if any, to share existing technology and data; (13) The firm...

  12. 36 CFR 1206.45 - What rules govern subgrant distribution, cost sharing, grant administration, and reporting?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... distribution, cost sharing, grant administration, and reporting? 1206.45 Section 1206.45 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION GENERAL RULES NATIONAL HISTORICAL..., cost sharing, grant administration, and reporting? (a) The Commission will annually establish guidance...

  13. 42 CFR 447.54 - Maximum allowable and nominal charges.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... nonemergency services furnished in a hospital emergency room. (c) Institutional services. For institutional... Deductible, Coinsurance, Co-Payment Or Similar Cost-Sharing Charge § 447.54 Maximum allowable and nominal... that cost sharing amounts be nominal. Upon approval from CMS, the requirement that cost sharing charges...

  14. 42 CFR 438.108 - Cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Cost sharing. 438.108 Section 438.108 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Enrollee Rights and Protections § 438.108 Cost sharing. The contract must...

  15. 7 CFR 624.7 - Cost-sharing.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Cost-sharing. 624.7 Section 624.7 Agriculture... AGRICULTURE WATER RESOURCES EMERGENCY WATERSHED PROTECTION § 624.7 Cost-sharing. (a) Except as provided in paragraph (b) of this section, the Federal contribution toward the implementation of emergency measures may...

  16. Financial Impact of Liver Sharing and Organ Procurement Organizations' Experience With Share 35: Implications for National Broader Sharing.

    PubMed

    Fernandez, H; Weber, J; Barnes, K; Wright, L; Levy, M

    2016-01-01

    The Share 35 policy for organ allocation, which was adopted in June 2013, allocates livers regionally for candidates with Model for End-Stage Liver Disease scores of 35 or greater. The authors analyzed the costs resulting from the increased movement of allografts related to this new policy. Using a sample of nine organ procurement organizations, representing 17% of the US population and 19% of the deceased donors in 2013, data were obtained on import and export costs before Share 35 implementation (June 15, 2012, to June 14, 2013) and after Share 35 implementation (June 15, 2013, to June 14, 2014). Results showed that liver import rates increased 42%, with an increased cost of 51%, while export rates increased 112%, with an increased cost of 127%. When the costs of importing and exporting allografts were combined, the total change in costs for all nine organ procurement organizations was $11 011 321 after Share 35 implementation. Extrapolating these costs nationally resulted in an increased yearly cost of $68 820 756 by population or $55 056 605 by number of organ donors. Any alternative allocation proposal needs to account for the financial implications to the transplant infrastructure. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

  17. 14 CFR § 1274.205 - Consortia as recipients.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... better share the projects financial costs (e.g., the 50 percent recipient's cost share or other costs of... issues; (8) Internal and external reporting requirements; (9) Management structure of the consortium; (10... the consortia members (12) Agreements, if any, to share existing technology and data; (13) The firm...

  18. 7 CFR 632.17 - Cost-share rates.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... level required to obtain participation if the main benefits of reclamation are offsite (in the public... 7 Agriculture 6 2010-01-01 2010-01-01 false Cost-share rates. 632.17 Section 632.17 Agriculture... AGRICULTURE LONG TERM CONTRACTING RURAL ABANDONED MINE PROGRAM Qualifications § 632.17 Cost-share rates. (a...

  19. 23 CFR 505.13 - Federal Government's share of project cost.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... INFRASTRUCTURE MANAGEMENT PROJECTS OF NATIONAL AND REGIONAL SIGNIFICANCE EVALUATION AND RATING § 505.13 Federal Government's share of project cost. (a) Based on engineering studies, studies of economic feasibility, and... 23 Highways 1 2010-04-01 2010-04-01 false Federal Government's share of project cost. 505.13...

  20. 10 CFR 420.34 - Matching contributions or cost-sharing.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 3 2013-01-01 2013-01-01 false Matching contributions or cost-sharing. 420.34 Section 420.34 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION STATE ENERGY PROGRAM Implementation of Special Projects Financial Assistance § 420.34 Matching contributions or cost-sharing. DOE may require (as set...

  1. 10 CFR 420.34 - Matching contributions or cost-sharing.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 3 2011-01-01 2011-01-01 false Matching contributions or cost-sharing. 420.34 Section 420.34 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION STATE ENERGY PROGRAM Implementation of Special Projects Financial Assistance § 420.34 Matching contributions or cost-sharing. DOE may require (as set...

  2. 10 CFR 420.34 - Matching contributions or cost-sharing.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 3 2012-01-01 2012-01-01 false Matching contributions or cost-sharing. 420.34 Section 420.34 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION STATE ENERGY PROGRAM Implementation of Special Projects Financial Assistance § 420.34 Matching contributions or cost-sharing. DOE may require (as set...

  3. 10 CFR 420.34 - Matching contributions or cost-sharing.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 3 2014-01-01 2014-01-01 false Matching contributions or cost-sharing. 420.34 Section 420.34 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION STATE ENERGY PROGRAM Implementation of Special Projects Financial Assistance § 420.34 Matching contributions or cost-sharing. DOE may require (as set...

  4. 10 CFR 420.34 - Matching contributions or cost-sharing.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Matching contributions or cost-sharing. 420.34 Section 420.34 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION STATE ENERGY PROGRAM Implementation of Special Projects Financial Assistance § 420.34 Matching contributions or cost-sharing. DOE may require (as set...

  5. 10 CFR 603.575 - Repayment of Federal cost share.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Repayment of Federal cost share. 603.575 Section 603.575 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Pre-Award Business Evaluation Accounting, Payments, and Recovery of Funds § 603.575 Repayment of Federal cost share...

  6. 36 CFR 230.43 - Cost-share assistance-prohibited practices.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 36 Parks, Forests, and Public Property 2 2012-07-01 2012-07-01 false Cost-share assistance-prohibited practices. 230.43 Section 230.43 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE STATE AND PRIVATE FORESTRY ASSISTANCE Forest Land Enhancement Program § 230.43 Cost-share...

  7. 36 CFR 230.43 - Cost-share assistance-prohibited practices.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 2 2014-07-01 2014-07-01 false Cost-share assistance-prohibited practices. 230.43 Section 230.43 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE STATE AND PRIVATE FORESTRY ASSISTANCE Forest Land Enhancement Program § 230.43 Cost-share...

  8. 36 CFR 230.43 - Cost-share assistance-prohibited practices.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 2 2011-07-01 2011-07-01 false Cost-share assistance-prohibited practices. 230.43 Section 230.43 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE STATE AND PRIVATE FORESTRY ASSISTANCE Forest Land Enhancement Program § 230.43 Cost-share...

  9. 36 CFR 230.43 - Cost-share assistance-prohibited practices.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 2 2013-07-01 2013-07-01 false Cost-share assistance-prohibited practices. 230.43 Section 230.43 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE STATE AND PRIVATE FORESTRY ASSISTANCE Forest Land Enhancement Program § 230.43 Cost-share...

  10. 42 CFR 447.70 - General alternative cost sharing protections.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false General alternative cost sharing protections. 447.70 Section 447.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payments: General Provisions Alternative Premiums and Cost Sharing Under...

  11. 42 CFR 447.70 - General alternative cost sharing protections.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false General alternative cost sharing protections. 447.70 Section 447.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payments: General Provisions Alternative Premiums and Cost Sharing Under...

  12. 42 CFR 447.70 - General alternative cost sharing protections.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false General alternative cost sharing protections. 447.70 Section 447.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payments: General Provisions Alternative Premiums and Cost Sharing Under...

  13. 42 CFR 447.70 - General alternative cost sharing protections.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false General alternative cost sharing protections. 447.70 Section 447.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payments: General Provisions Alternative Premiums and Cost Sharing Under...

  14. 42 CFR 447.54 - Maximum allowable and nominal charges.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... nonemergency services furnished in a hospital emergency room. (c) Institutional services. For institutional... hospital emergency department. (a) The agency may impose cost sharing for non-emergency services provided... exempt from cost sharing under § 447.56(a), the agency may impose cost sharing for non-emergency use of...

  15. 45 CFR 63.22 - Cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Cost sharing. 63.22 Section 63.22 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION GRANT PROGRAMS ADMINISTERED BY THE OFFICE OF THE ASSISTANT SECRETARY FOR PLANNING AND EVALUATION Financial Provisions § 63.22 Cost sharing. Policy...

  16. 22 CFR 145.23 - Cost sharing or matching.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... authorizes recipients to donate buildings or land for construction/facilities acquisition projects or long..., buildings or land, the total value of the donated property may be claimed as cost sharing or matching. (2... determining cost sharing or matching for donated equipment, buildings and land for which title passes to the...

  17. 49 CFR 19.23 - Cost sharing or matching.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... agency authorizes recipients to donate buildings or land for construction/facilities acquisition projects... equipment, buildings or land, the total value of the donated property may be claimed as cost sharing or... determining cost sharing or matching for donated equipment, buildings and land for which title passes to the...

  18. 49 CFR 19.23 - Cost sharing or matching.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... agency authorizes recipients to donate buildings or land for construction/facilities acquisition projects... equipment, buildings or land, the total value of the donated property may be claimed as cost sharing or... determining cost sharing or matching for donated equipment, buildings and land for which title passes to the...

  19. 49 CFR 19.23 - Cost sharing or matching.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... agency authorizes recipients to donate buildings or land for construction/facilities acquisition projects... equipment, buildings or land, the total value of the donated property may be claimed as cost sharing or... determining cost sharing or matching for donated equipment, buildings and land for which title passes to the...

  20. 22 CFR 145.23 - Cost sharing or matching.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... authorizes recipients to donate buildings or land for construction/facilities acquisition projects or long..., buildings or land, the total value of the donated property may be claimed as cost sharing or matching. (2... determining cost sharing or matching for donated equipment, buildings and land for which title passes to the...

  1. 22 CFR 145.23 - Cost sharing or matching.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... authorizes recipients to donate buildings or land for construction/facilities acquisition projects or long..., buildings or land, the total value of the donated property may be claimed as cost sharing or matching. (2... determining cost sharing or matching for donated equipment, buildings and land for which title passes to the...

  2. 49 CFR 19.23 - Cost sharing or matching.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... agency authorizes recipients to donate buildings or land for construction/facilities acquisition projects... equipment, buildings or land, the total value of the donated property may be claimed as cost sharing or... determining cost sharing or matching for donated equipment, buildings and land for which title passes to the...

  3. 22 CFR 145.23 - Cost sharing or matching.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... authorizes recipients to donate buildings or land for construction/facilities acquisition projects or long..., buildings or land, the total value of the donated property may be claimed as cost sharing or matching. (2... determining cost sharing or matching for donated equipment, buildings and land for which title passes to the...

  4. 49 CFR 19.23 - Cost sharing or matching.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... agency authorizes recipients to donate buildings or land for construction/facilities acquisition projects... equipment, buildings or land, the total value of the donated property may be claimed as cost sharing or... determining cost sharing or matching for donated equipment, buildings and land for which title passes to the...

  5. 22 CFR 145.23 - Cost sharing or matching.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... authorizes recipients to donate buildings or land for construction/facilities acquisition projects or long..., buildings or land, the total value of the donated property may be claimed as cost sharing or matching. (2... determining cost sharing or matching for donated equipment, buildings and land for which title passes to the...

  6. 33 CFR 241.5 - Procedures for estimating the alternative cost-share.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... THE ARMY, DEPARTMENT OF DEFENSE FLOOD CONTROL COST-SHARING REQUIREMENTS UNDER THE ABILITY TO PAY.... Determine the maximum possible reduction in the level of non-Federal cost-sharing for any project. (1) Calculate the ratio of flood control benefits (developed using the Water Resources Council's Principles and...

  7. 33 CFR 241.5 - Procedures for estimating the alternative cost-share.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... THE ARMY, DEPARTMENT OF DEFENSE FLOOD CONTROL COST-SHARING REQUIREMENTS UNDER THE ABILITY TO PAY.... Determine the maximum possible reduction in the level of non-Federal cost-sharing for any project. (1) Calculate the ratio of flood control benefits (developed using the Water Resources Council's Principles and...

  8. 33 CFR 241.5 - Procedures for estimating the alternative cost-share.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... THE ARMY, DEPARTMENT OF DEFENSE FLOOD CONTROL COST-SHARING REQUIREMENTS UNDER THE ABILITY TO PAY.... Determine the maximum possible reduction in the level of non-Federal cost-sharing for any project. (1) Calculate the ratio of flood control benefits (developed using the Water Resources Council's Principles and...

  9. 33 CFR 241.5 - Procedures for estimating the alternative cost-share.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... THE ARMY, DEPARTMENT OF DEFENSE FLOOD CONTROL COST-SHARING REQUIREMENTS UNDER THE ABILITY TO PAY.... Determine the maximum possible reduction in the level of non-Federal cost-sharing for any project. (1) Calculate the ratio of flood control benefits (developed using the Water Resources Council's Principles and...

  10. 33 CFR 241.5 - Procedures for estimating the alternative cost-share.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... THE ARMY, DEPARTMENT OF DEFENSE FLOOD CONTROL COST-SHARING REQUIREMENTS UNDER THE ABILITY TO PAY.... Determine the maximum possible reduction in the level of non-Federal cost-sharing for any project. (1) Calculate the ratio of flood control benefits (developed using the Water Resources Council's Principles and...

  11. 34 CFR 75.604 - Availability of cost-sharing funds.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 1 2014-07-01 2014-07-01 false Availability of cost-sharing funds. 75.604 Section 75... Must Be Met by a Grantee? Construction § 75.604 Availability of cost-sharing funds. A grantee shall... facility. (Authority: 20 U.S.C. 1221e-3 and 3474) ...

  12. An Update on Physician Practice Cost Shares

    PubMed Central

    Dayhoff, Debra A.; Cromwell, Jerry; Rosenbach, Margo L.

    1993-01-01

    The 1988 physicians' practice costs and income survey (PPCIS) collected detailed costs, revenues, and incomes data for a sample of 3,086 physicians. These data are utilized to update the Health Care Financing Administration (HCFA) cost shares used in calculating the medicare economic index (MEI) and the geographic practice cost index (GPCI). Cost shares were calculated for the national sample, for 16 specialty groupings, for urban and rural areas, and for 9 census divisions. Although statistical tests reveal that cost shares differ across specialties and geographic areas, sensitivity analysis shows that these differences are small enough to have trivial effects in computing the MEI and GPCI. These results may inform policymakers on one aspect of the larger issue of whether physician payments should vary by geographic location or specialty. PMID:10130573

  13. How do high cost-sharing policies for physician care affect total care costs among people with chronic disease?

    PubMed

    Xin, Haichang; Harman, Jeffrey S; Yang, Zhou

    2014-01-01

    This study examines whether high cost-sharing in physician care is associated with a differential impact on total care costs by health status. Total care includes physician care, emergency room (ER) visits and inpatient care. Since high cost-sharing policies can reduce needed care as well as unneeded care use, it raises the concern whether these policies are a good strategy for controlling costs among chronically ill patients. This study used the 2007 Medical Expenditure Panel Survey data with a cross-sectional study design. Difference in difference (DID), instrumental variable technique, two-part model, and bootstrap technique were employed to analyze cost data. Chronically ill individuals' probability of reducing any overall care costs was significantly less than healthier individuals (beta = 2.18, p = 0.04), while the integrated DID estimator from split results indicated that going from low cost-sharing to high cost-sharing significantly reduced costs by $12,853.23 more for sick people than for healthy people (95% CI: -$17,582.86, -$8,123.60). This greater cost reduction in total care among sick people likely resulted from greater cost reduction in physician care, and may have come at the expense of jeopardizing health outcomes by depriving patients of needed care. Thus, these policies would be inappropriate in the short run, and unlikely in the long run to control health plans costs among chronically ill individuals. A generous benefit design with low cost-sharing policies in physician care or primary care is recommended for both health plans and chronically ill individuals, to save costs and protect these enrollees' health status.

  14. 7 CFR 632.31 - Cost-share payment.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... out the contract, the land user is indebted to the United States for the cost of the misused material... contract. The cost-share payment is to be determined by one of the following methods: (1) Average cost. (2) Actual cost but not more than the average cost. (3) Specified maximum cost. If the average cost or the...

  15. 7 CFR 632.31 - Cost-share payment.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... out the contract, the land user is indebted to the United States for the cost of the misused material... contract. The cost-share payment is to be determined by one of the following methods: (1) Average cost. (2) Actual cost but not more than the average cost. (3) Specified maximum cost. If the average cost or the...

  16. 7 CFR 632.31 - Cost-share payment.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... out the contract, the land user is indebted to the United States for the cost of the misused material... contract. The cost-share payment is to be determined by one of the following methods: (1) Average cost. (2) Actual cost but not more than the average cost. (3) Specified maximum cost. If the average cost or the...

  17. 7 CFR 632.31 - Cost-share payment.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... out the contract, the land user is indebted to the United States for the cost of the misused material... contract. The cost-share payment is to be determined by one of the following methods: (1) Average cost. (2) Actual cost but not more than the average cost. (3) Specified maximum cost. If the average cost or the...

  18. 7 CFR 632.31 - Cost-share payment.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... out the contract, the land user is indebted to the United States for the cost of the misused material... contract. The cost-share payment is to be determined by one of the following methods: (1) Average cost. (2) Actual cost but not more than the average cost. (3) Specified maximum cost. If the average cost or the...

  19. A game theoretic analysis of research data sharing.

    PubMed

    Pronk, Tessa E; Wiersma, Paulien H; van Weerden, Anne; Schieving, Feike

    2015-01-01

    While reusing research data has evident benefits for the scientific community as a whole, decisions to archive and share these data are primarily made by individual researchers. In this paper we analyse, within a game theoretical framework, how sharing and reuse of research data affect individuals who share or do not share their datasets. We construct a model in which there is a cost associated with sharing datasets whereas reusing such sets implies a benefit. In our calculations, conflicting interests appear for researchers. Individual researchers are always better off not sharing and omitting the sharing cost, at the same time both sharing and not sharing researchers are better off if (almost) all researchers share. Namely, the more researchers share, the more benefit can be gained by the reuse of those datasets. We simulated several policy measures to increase benefits for researchers sharing or reusing datasets. Results point out that, although policies should be able to increase the rate of sharing researchers, and increased discoverability and dataset quality could partly compensate for costs, a better measure would be to directly lower the cost for sharing, or even turn it into a (citation-) benefit. Making data available would in that case become the most profitable, and therefore stable, strategy. This means researchers would willingly make their datasets available, and arguably in the best possible way to enable reuse.

  20. 10 CFR 603.525 - Value and reasonableness of the recipient's cost sharing contribution.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Value and reasonableness of the recipient's cost sharing contribution. 603.525 Section 603.525 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Pre-Award Business Evaluation Cost Sharing § 603.525 Value and reasonableness of the...

  1. 42 CFR 447.52 - Minimum and maximum income-related charges.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... agency imposes cost sharing under § 447.54, the process by which hospital emergency room services are... option, cost sharing imposed for any service (other than for drugs and non-emergency services furnished... group under § 447.56(a), and (iii) For cost sharing imposed for non-emergency services furnished in an...

  2. 26 CFR 16A.126-1 - Certain cost-sharing payments-in general.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... CERTAIN CONSERVATION COST-SHARING PAYMENTS § 16A.126-1 Certain cost-sharing payments—in general. (a... certain conservation, reclamation and restoration programs may exclude all or a portion of those payments... purposes of conservation, (iii) Any government payment to the taxpayer which is in the nature of rent or...

  3. 7 CFR 625.9 - 10-year restoration cost-share agreements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false 10-year restoration cost-share agreements. 625.9... CONSERVATION SERVICE, DEPARTMENT OF AGRICULTURE WATER RESOURCES HEALTHY FORESTS RESERVE PROGRAM § 625.9 10-year restoration cost-share agreements. (a) The restoration plan developed under § 625.12 forms the basis for the...

  4. 2 CFR 215.23 - Cost sharing or matching.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... buildings or land for construction/facilities acquisition projects or long-term use, the value of the..., buildings or land, the total value of the donated property may be claimed as cost sharing or matching. (2... determining cost sharing or matching for donated equipment, buildings and land for which title passes to the...

  5. 2 CFR 215.23 - Cost sharing or matching.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... buildings or land for construction/facilities acquisition projects or long-term use, the value of the..., buildings or land, the total value of the donated property may be claimed as cost sharing or matching. (2... determining cost sharing or matching for donated equipment, buildings and land for which title passes to the...

  6. 2 CFR 215.23 - Cost sharing or matching.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... buildings or land for construction/facilities acquisition projects or long-term use, the value of the..., buildings or land, the total value of the donated property may be claimed as cost sharing or matching. (2... determining cost sharing or matching for donated equipment, buildings and land for which title passes to the...

  7. 10 CFR 455.102 - Energy conservation measure cost-share credit.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 3 2014-01-01 2014-01-01 false Energy conservation measure cost-share credit. 455.102 Section 455.102 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION GRANT PROGRAMS FOR SCHOOLS AND HOSPITALS... Energy conservation measure cost-share credit. To the extent a State provides in its State Plan, DOE may...

  8. 10 CFR 455.102 - Energy conservation measure cost-share credit.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Energy conservation measure cost-share credit. 455.102 Section 455.102 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION GRANT PROGRAMS FOR SCHOOLS AND HOSPITALS... Energy conservation measure cost-share credit. To the extent a State provides in its State Plan, DOE may...

  9. 10 CFR 455.102 - Energy conservation measure cost-share credit.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 3 2012-01-01 2012-01-01 false Energy conservation measure cost-share credit. 455.102 Section 455.102 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION GRANT PROGRAMS FOR SCHOOLS AND HOSPITALS... Energy conservation measure cost-share credit. To the extent a State provides in its State Plan, DOE may...

  10. 7 CFR 1410.41 - Levels and rates for cost-share payments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Levels and rates for cost-share payments. 1410.41... CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CONSERVATION RESERVE PROGRAM § 1410.41 Levels and rates for cost-share payments. (a) As determined by the Deputy Administrator, CCC...

  11. Sharing the Costs of Higher Education. Student Financial Assistance in the United Kingdom, the Federal Republic of Germany, France, Sweden, and the United States.

    ERIC Educational Resources Information Center

    Johnstone, D. Bruce

    The educational and living costs of undergraduate studies and the ways these costs are shared among parents, students, taxpayers, and philanthropists/donors are considered for five countries: the United States, the United Kingdom, the Federal Republic of Germany, France, and Sweden. Five policy issues that are linked to how costs are shared by…

  12. Lowering Cost Share May Improve Rates of Home Glucose Monitoring Among Patients with Diabetes Using Insulin.

    PubMed

    Xie, Yiqiong; Agiro, Abiy; Bowman, Kevin; DeVries, Andrea

    2017-08-01

    Not much is known about the extent to which lower cost share for blood glucose strips is associated with persistent filling. To evaluate the relationship between cost sharing for blood glucose testing strips and continued use of testing strips. This is a retrospective observational study using medical and pharmacy claims data integrated with laboratory hemoglobin A1c (A1c) values for patients using insulin and blood glucose testing strips. Diabetic patients using insulin who had at least 1 fill of blood glucose testing strips between 2010 and 2012 were included. Patients were divided into a low cost-share group (out-of-pocket cost percentage of total testing strip costs over a 1-year period from the initial fill < 20%; n = 3,575) and a high cost-share group (out-of-pocket cost percentage ≥ 20%; n = 3,580). We compared the likelihood of continued testing strip fills after the initial fill between the 2 groups by using modified Poisson regression models. Patients with low cost share had higher rates of continued testing strip fills compared with those with high cost share (89% vs. 82%, P < 0.001). Lower cost share was associated with greater probability of continued fills (adjusted risk ratio [aRR] = 1.05, 95% CI = 1.03-1.07, P < 0.001). Other patient characteristics associated with continued fills included type 1 diabetes diagnosis, types of insulin regimens, and health insurance plan type. In a subset analysis of patients whose A1c values at baseline were above the target level (8%) set by the National Committee for Quality Assurance guidelines, we saw a slight increase in magnitude of relationship between cost share and continued fills (RR = 1.06, 95% CI = 1.03-1.10, P < 0.01). There was a statistically significant association between cost share for testing strips and continued blood glucose self-monitoring. Among patients not achieving A1c control at baseline, there was an increase in the magnitude of relationship. Lowering cost share for testing strips can remove a barrier to persistence in diabetes self-management. Funding for this study was provided by Anthem, which had no role in the study design, data interpretation, or preparation or review of the manuscript. The decision to publish was strictly that of the authors. Xie, Agiro, and DeVries are employees of HealthCore, a wholly owned subsidiary of Anthem. Bowman is an employee of Anthem. Study concept and design were contributed by all the authors. Xie took the lead in data collection, along with Agiro, and data interpretation was performed by all the authors. The manuscript was written by Xie and Agiro, along with DeVries, and revised by Xie, Agiro, and Devries, along with Bowman.

  13. 7 CFR 634.24 - Cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... designated management agency will annually set maximum individual BMP cost-share levels for the project area... offsite water quality, and (2) The matching share requirements would place a burden on the landowner or... shared must have a positive effect on water quality by reducing the amount of agricultural nonpoint...

  14. 7 CFR 634.24 - Cost sharing.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... designated management agency will annually set maximum individual BMP cost-share levels for the project area... offsite water quality, and (2) The matching share requirements would place a burden on the landowner or... shared must have a positive effect on water quality by reducing the amount of agricultural nonpoint...

  15. 50 CFR 85.40 - Cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Use/Acceptance of Funds § 85.40 Cost sharing. (a) The Federal share shall not exceed 75% of total... grant objectives and represent the current market value of noncash contributions furnished as part of...

  16. Diversity and dynamics of patient cost-sharing for physicians' and hospital services in the 27 European Union countries.

    PubMed

    Tambor, Marzena; Pavlova, Milena; Woch, Piotr; Groot, Wim

    2011-10-01

    During the past decades, many governments have introduced patient cost-sharing in their public health-care system. This trend in health-care reforms affected the European Union (EU) member states as well. This article presents a review of patient cost-sharing for health-care services in the 27 EU countries, and discusses directions for their improvement. Data are collected based on a review of international data bases, national laws and regulations, as well as scientific and policy reports. The analysis presents a combination of qualitative and quantitative research techniques. Patient cost-sharing arrangements in the EU have been changing considerably over the past two decades (mostly being extended) and are quite diverse at present. There is a relation between patient cost-sharing arrangements and some characteristics of the health-care system in a country. In a few EU countries, a mix of formal and informal charges exists, which creates a double financial burden for health-care consumers. The adequacy of patient cost-sharing arrangements in EU countries needs to be reconsidered. Most importantly, it is essential to deal with informal patient payments (where applicable) and to assure adequate exemption mechanisms to diminish the adverse equity effects of patient cost-sharing. A close communication with the public is needed to clarify the objectives and content of a patient payment policy in a country.

  17. Consumer cost sharing in private health insurance: on the threshold of change.

    PubMed

    Goff, Veronica

    2004-05-14

    Employers are asking employees to pay more for health care through higher premium contributions, share of contribution, and out-of-pocket maximums, along with variations in deductibles, co-pays, and coinsurance based on choice of providers, networks, drugs, and other services. This issue brief examines consumer cost-sharing trends in private insurance, discusses the outlook for cost sharing in employment-based benefits, and considers public policies to support health care markets for consumers.

  18. Cost-Benefit Analysis of Implementing a Car-Sharing Model to the Navy’s Passenger Vehicle Fleet

    DTIC Science & Technology

    2016-12-01

    and Public Policy iv THIS PAGE INTENTIONALLY LEFT BLANK v COST - BENEFIT ANALYSIS OF IMPLEMENTING A CAR- SHARING MODEL TO THE NAVY’S PASSENGER...the public good. This CBA will be conducted using a federal government perspective and standing (whose costs and benefits will be counted) will be...NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA MBA PROFESSIONAL REPORT COST - BENEFIT ANALYSIS OF IMPLEMENTING A CAR-SHARING

  19. 77 FR 5262 - Notice of Adjustment of Statewide Per Capita Indicator for Recommending a Cost Share Adjustment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-02

    ...] Notice of Adjustment of Statewide Per Capita Indicator for Recommending a Cost Share Adjustment AGENCY... per capita indicator for recommending cost share adjustments for major disasters declared on or after... INFORMATION: Pursuant to 44 CFR 206.47, the statewide per capita indicator that is used to recommend an...

  20. 78 FR 9935 - Notice of Adjustment of Statewide Per Capita Indicator for Recommending a Cost Share Adjustment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-12

    ...] Notice of Adjustment of Statewide Per Capita Indicator for Recommending a Cost Share Adjustment AGENCY... per capita indicator for recommending cost share adjustments for major disasters declared on or after... INFORMATION: Pursuant to 44 CFR 206.47, the statewide per capita indicator that is used to recommend an...

  1. 45 CFR 2541.240 - Matching or cost sharing.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... parties. (2) The value of third party in-kind contributions applicable to the period to which the cost... costs-sharing requirements. Neither costs nor the values of third party in-kind contributions may count... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  2. 45 CFR 2541.240 - Matching or cost sharing.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... parties. (2) The value of third party in-kind contributions applicable to the period to which the cost... costs-sharing requirements. Neither costs nor the values of third party in-kind contributions may count... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  3. 45 CFR 2541.240 - Matching or cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... parties. (2) The value of third party in-kind contributions applicable to the period to which the cost... costs-sharing requirements. Neither costs nor the values of third party in-kind contributions may count... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  4. 45 CFR 2541.240 - Matching or cost sharing.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... parties. (2) The value of third party in-kind contributions applicable to the period to which the cost... costs-sharing requirements. Neither costs nor the values of third party in-kind contributions may count... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  5. 45 CFR 2541.240 - Matching or cost sharing.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... parties. (2) The value of third party in-kind contributions applicable to the period to which the cost... costs-sharing requirements. Neither costs nor the values of third party in-kind contributions may count... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  6. 47 CFR 27.1180 - The cost-sharing formula.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... § 27.1180 The cost-sharing formula. (a) An AWS licensee that relocates a BRS system with which it... forth in paragraph (b) of this section. (b) C is the actual cost of relocating the system, and includes... equipment; engineering costs (design/path survey); installation; systems testing; FCC filing costs; site...

  7. Value-based cost sharing in the United States and elsewhere can increase patients' use of high-value goods and services.

    PubMed

    Thomson, Sarah; Schang, Laura; Chernew, Michael E

    2013-04-01

    This article reviews efforts in the United States and several other member countries of the Organization for Economic Cooperation and Development to encourage patients, through cost sharing, to use goods such as medications, services, and providers that offer better value than other options--an approach known as value-based cost sharing. Among the countries we reviewed, we found that value-based approaches were most commonly applied to drug cost sharing. A few countries, including the United States, employed financial incentives, such as lower copayments, to encourage use of preferred providers or preventive services. Evidence suggests that these efforts can increase patients' use of high-value services--although they may also be associated with high administrative costs and could exacerbate health inequalities among various groups. With careful design, implementation, and evaluation, value-based cost sharing can be an important tool for aligning patient and provider incentives to pursue high-value care.

  8. Impact of medicare part D plan features on use of generic drugs.

    PubMed

    Tang, Yan; Gellad, Walid F; Men, Aiju; Donohue, Julie M

    2014-06-01

    Little is known about how Medicare Part D plan features influence choice of generic versus brand drugs. To examine the association between Part D plan features and generic medication use. Data from a 2009 random sample of 1.6 million fee-for-service, Part D enrollees aged 65 years and above, who were not dually eligible or receiving low-income subsidies, were used to examine the association between plan features (generic cost-sharing, difference in brand and generic copay, prior authorization, step therapy) and choice of generic antidepressants, antidiabetics, and statins. Logistic regression models accounting for plan-level clustering were adjusted for sociodemographic and health status. Generic cost-sharing ranged from $0 to $9 for antidepressants and statins, and from $0 to $8 for antidiabetics (across 5th-95th percentiles). Brand-generic cost-sharing differences were smallest for statins (5th-95th percentiles: $16-$37) and largest for antidepressants ($16-$64) across plans. Beneficiaries with higher generic cost-sharing had lower generic use [adjusted odds ratio (OR)=0.97, 95% confidence interval (CI), 0.95-0.98 for antidepressants; OR=0.97, 95% CI, 0.96-0.98 for antidiabetics; OR=0.94, 95% CI, 0.92-0.95 for statins]. Larger brand-generic cost-sharing differences and prior authorization were significantly associated with greater generic use in all categories. Plans could increase generic use by 5-12 percentage points by reducing generic cost-sharing from the 75th ($7) to 25th percentiles ($4-$5), increasing brand-generic cost-sharing differences from the 25th ($25-$26) to 75th ($32-$33) percentiles, and using prior authorization and step therapy. Cost-sharing features and utilization management tools were significantly associated with generic use in 3 commonly used medication categories.

  9. Cost sharing and branded antidepressant initiation among patients treated with generics.

    PubMed

    Buxbaum, Jason D; Chernew, Michael E; Bonafede, Machaon; Vlahiotis, Anna; Walter, Deborah; Mucha, Lisa; Fendrick, A Mark

    2018-04-01

    To determine the relationship between consumer cost sharing for branded antidepressants and the initiation of branded therapy among patients with major depressive disorder (MDD) filling a prescription for generic MDD medication.  Retrospective cross-sectional analyses. Patients aged 18 to 64 years with MDD who filled a generic antidepressant were identified in commercial claims data for 2012 to 2014. For each year-specific analysis, an average cost-sharing index for branded antidepressants at the level of the plan was computed. Multivariable models were used to estimate the relationship between plan-level cost sharing for branded antidepressant medications and the filling of branded prescriptions, with demographic and clinical variables as covariates. For patients with MDD filling a generic prescription, increases in branded cost sharing were associated with significant decreases in the likelihood of filling a branded antidepressant in each year (P <.001). Results in 2012 imply that a shift from the 0th to 90th percentile in the branded cost-sharing index corresponded with a 9.5% decrease in the relative likelihood of a branded fill among patients receiving a generic antidepressant. The corresponding figures for 2013 and 2014 were 9.3% and 3.5%, respectively. In MDD, patients and clinicians who dutifully adhere to guidelines requiring a trial of first-line medication may ultimately require therapy with alternate agents to achieve adequate disease control. A "reward the good soldier" benefit design would lower cost sharing for higher-tier evidence-based therapies when clinically indicated. Results suggest that narrowing the gap in cost sharing between branded and generic medications following a trial of a generic agent might improve access to second-line treatment in MDD.

  10. The ACA's Zero Cost-Sharing Mandate and Trends in Out-of-Pocket Expenditures on Well-Child and Screening Mammography Visits.

    PubMed

    Kirby, James B; Davidoff, Amy J; Basu, Jayasree

    2016-12-01

    Starting in September of 2010, the Patient Protection and Affordable Care Act required most health insurance policies to cover evidence-based preventive care with no cost-sharing (no copays, coinsurance, or deductibles). It is unknown, however, whether declines in out-of-pocket costs for preventive services are large enough to prompt increases in utilization, the ultimate goal of the policy. In this study, we use a nationally representative sample of ambulatory care visits to estimate the impact of the zero cost-sharing mandate on out-of-pocket expenditures on well-child and screening mammography visits. Estimates are made using 2-part interrupted time-series models, with well-woman visits serving as the control group because they were not covered under the zero cost-sharing mandate until after our study period. Results indicate a substantial reduction in out-of-pocket costs attributable to the Affordable Care Act. Between January 2011 and September 2012, the zero cost-sharing mandate reduced per-visit out-of-pocket costs for well-child visits from $18.46 to $8.08 (56%) and out-of-pocket costs for screening mammography visits from $25.43 to $6.50 (74%). No reduction was apparent for well-woman visits. The Affordable Care Act's zero cost-sharing mandate for preventive care has had a large impact on out-of-pocket expenditures for well-child and mammography visits. To increase preventive service use, research is needed to better understand barriers to obtaining preventive care that are not directly related to cost.

  11. Trends in cost sharing among selected high income countries--2000-2010.

    PubMed

    Hossein, Zare; Gerard, Anderson

    2013-09-01

    Many high income countries increased their level of patient cost sharing between 2000 and 2010 as one component of their policy agenda to reduce the level of health care spending. We use data from the OECD, European Observatory, and country-specific resources to analyze trends in the UK, Germany, Japan, France, and the United States. Some forms of cost sharing-deductibles, co-insurance, or co-payments-increased in all these countries, with the highest rates of increase occurring in the pharmaceutical sector. In spite of higher levels of cost-sharing, out-of-pocket spending as a percentage of total spending remained unchanged in most of these countries because they instituted programs to protect certain categories of individuals by creating out-of-pocket limits, exempting people with certain chronic diseases, or eliminating cost sharing for certain demographic groups and low-income people. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  12. Cost Sharing in Higher Education in Kenya: Examining the Undesired Policy Outcomes

    ERIC Educational Resources Information Center

    Ngolovoi, Mary S.

    2010-01-01

    Cost sharing in higher education is a policy that comes from the United States. The policy advocates that costs of higher education should be shared between the government, parents, students and/or donor organizations. Proponents of the policy (such as the World Bank) have over the years been advocating for its implementation in African countries.…

  13. 42 CFR 457.555 - Maximum allowable cost-sharing charges on targeted low-income children in families with income...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... maximum amount of $11.35 for services furnished in a hospital emergency room if those services are not... 42 Public Health 4 2012-10-01 2012-10-01 false Maximum allowable cost-sharing charges on targeted... Requirements: Enrollee Financial Responsibilities § 457.555 Maximum allowable cost-sharing charges on targeted...

  14. 14 CFR 1274.801 - Adjustments to performance costs.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... NASA's initial cost share or funding levels, detailed cost analysis techniques may be applied, which... shall continue to maintain the share ratio requirements (normally 50/50) stated in § 1274.204(b). ...

  15. 42 CFR 422.6 - Cost-sharing in enrollment-related costs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM General Provisions § 422.6 Cost-sharing in... for the drug benefit). (c) Applicability. The fee assessment also applies to those demonstrations for...

  16. 14 CFR § 1273.24 - Matching or cost sharing.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... parties. (2) The value of third party in-kind contributions applicable to the period to which the cost... costs-sharing requirements. Neither costs nor the values of third party in-kind contributions may count... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  17. 40 CFR 35.6285 - Recipient payment of response costs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... payment of response costs. The recipient may pay for its share of response costs using cash, services... costs in the form of cash. (b) Services. The recipient may provide equipment and services to satisfy its... CFR part 300). (d) Excess cash cost share contributions/overmatch. The recipient may direct EPA to...

  18. 7 CFR 2902.9 - Funding for testing.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... program for cost sharing for determining life cycle costs, environmental and health benefits, and... annually the solicitation of proposals for cost sharing for life cycle costs, environmental and health... first for high priority products of small and emerging private business enterprises. If funds remain to...

  19. ACA-mandated elimination of cost sharing for preventive screening has had limited early impact.

    PubMed

    Mehta, Shivan J; Polsky, Daniel; Zhu, Jingsan; Lewis, James D; Kolstad, Jonathan T; Loewenstein, George; Volpp, Kevin G

    2015-07-01

    The Affordable Care Act eliminated patient cost sharing for evidence-based preventive care, yet the impact of this policy on colonoscopy and mammography rates is unclear. We examined the elimination of cost sharing among small business beneficiaries of Humana, a large national insurer. This was a retrospective interrupted time series analysis of whether the change in cost-sharing policy was associated with a change in screening utilization, using grandfathered plans as a comparison group. We compared beneficiaries in small business nongrandfathered plans that were required to eliminate cost sharing (intervention) with those in grandfathered plans that did not have to change cost sharing (control). There were 63,246 men and women aged 50 to 64 years eligible for colorectal cancer screening, and 30,802 women aged 50 to 64 years eligible for breast cancer screening. The primary outcome variables were rates of colonoscopy and mammography per person-month, with secondary analysis of colonoscopy rates coded as preventive only. There was no significant change in the level or slope of colonoscopy and mammography utilization for intervention plans relative to the control plans. There was also no significant relevant change among those colonoscopies coded as preventive. The results suggest that the implementation of the policy is not having its intended effects, as cost sharing rates for colonoscopy and mammography did not change substantially, and utilization of colonoscopy and mammography changed little, following this new policy approach.

  20. High deductible health plans: does cost sharing stimulate increased consumer sophistication?

    PubMed

    Gupta, Neal; Polsky, Daniel

    2015-06-01

    To determine whether increased cost sharing in health insurance plans induces higher levels of consumer sophistication in a non-elderly population. This analysis is based on the collection of survey and demographic data collected from enrollees in the RAND health insurance experiment (HIE). During the RAND HIE, enrollees were randomly assigned to different levels of cost sharing (0, 25, 50 and 95%). The study population compromises about 2000 people enrolled in the RAND HIE, between the years 1974 and 1982. Effects on health-care decision making were measured using the results of a standardized questionnaire, administered at the beginning and end of the experiment. Points of enquiry included whether or not enrollees' (i) recognized the need for second opinions (ii) questioned the effectiveness of certain therapies and (iii) researched the background/skill of their medical providers. Consumer sophistication was also measured for regular health-care consumers, as indicated by the presence of a chronic disease. We found no statically significant changes (P < 0.05) in the health-care decision-making strategies between individuals randomized to high cost sharing plans and low cost sharing plans. Furthermore, we did not find a stronger effect for patients with a chronic disease. The evidence from the RAND HIE does not support the hypothesis that a higher level of cost sharing incentivizes the development of consumer sophistication. As a result, cost sharing alone will not promote individuals to become more selective in their health-care decision-making. © 2012 Blackwell Publishing Ltd.

  1. First-dollar cost-sharing for skilled nursing facility care in medicare advantage plans.

    PubMed

    Keohane, Laura M; Grebla, Regina C; Rahman, Momotazur; Mukamel, Dana B; Lee, Yoojin; Mor, Vincent; Trivedi, Amal

    2017-08-29

    The initial days of a Medicare-covered skilled nursing facility (SNF) stay may have no cost-sharing or daily copayments depending on beneficiaries' enrollment in traditional Medicare or Medicare Advantage. Some policymakers have advocated imposing first-dollar cost-sharing to reduce post-acute expenditures. We examined the relationship between first-dollar cost-sharing for a SNF stay and use of inpatient and SNF services. We identified seven Medicare Advantage plans that introduced daily SNF copayments of $25-$150 in 2009 or 2010. Copays began on the first day of a SNF admission. We matched these plans to seven matched control plans that did not introduce first-dollar cost-sharing. In a difference-in-differences analysis, we compared changes in SNF and inpatient utilization for the 172,958 members of intervention and control plans. In intervention plans the mean annual number of SNF days per 100 continuously enrolled inpatients decreased from 768.3 to 750.6 days when cost-sharing changes took effect. Control plans experienced a concurrent increase: 721.7 to 808.1 SNF days per 100 inpatients (adjusted difference-in-differences: -87.0 days [95% CI (-112.1,-61.9)]). In intervention plans, we observed no significant changes in the probability of any SNF service use or the number of inpatient days per hospitalized member relative to concurrent trends among control plans. Among several strategies Medicare Advantage plans can employ to moderate SNF use, first-dollar SNF cost-sharing may be one influential factor. Not applicable.

  2. The role of personal values in children's costly sharing and non-costly giving.

    PubMed

    Abramson, Lior; Daniel, Ella; Knafo-Noam, Ariel

    2018-01-01

    This study examined whether children's values, global and abstract motivations serving as guiding principles, are organized similarly to those of adults, whether values can predict individual differences in children's sharing behaviors, and whether the normative nature of the situation influences the expression of these individual differences. Children (N=243, ages 5-12years) participated in a values ranking task as part of a visit to a science museum. The majority of children (n=150) also participated in a task examining costly sharing (i.e., sharing that results in giving up part of one's own resources) and non-costly giving (i.e., giving that does not influence one's own share). Starting from 5years of age, children showed a structure of values similar to that of adolescents and adults, specifically contrasting preferences for opposing values (i.e., self-transcendence with self-enhancement and openness to change with conservation). Importance given to self-transcendence values related positively to costly sharing but not to non-costly giving, indicating that in situations where it is more normative to share, individual differences in values are less expressed in children's actual sharing. In addition, children's sex and age moderated the relation between values and behavior. Children's values are an important aspect of their developing personalities. Taking them into consideration can greatly promote the research of prosocial and normative development as well as our understanding of individual differences in children's behavior. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. When patients have to pay a share of drug costs: effects on frequency of physician visits, hospital admissions and filling of prescriptions.

    PubMed

    Anis, Aslam H; Guh, Daphne P; Lacaille, Diane; Marra, Carlo A; Rashidi, Amir A; Li, Xin; Esdaile, John M

    2005-11-22

    Previous research has shown that patient cost-sharing leads to a reduction in overall health resource utilization. However, in Canada, where health care is provided free of charge except for prescription drugs, the converse may be true. We investigated the effect of prescription drug cost-sharing on overall health care utilization among elderly patients with rheumatoid arthritis. Elderly patients (> or = 65 years) were selected from a population-based cohort with rheumatoid arthritis. Those who had paid the maximum amount of dispensing fees (200 dollars) for the calendar year (from 1997 to 2000) were included in the analysis for that year. We defined the period during which the annual maximum co-payment had not been reached as the "cost-sharing period" and the one beyond which the annual maximum co-payment had been reached as the "free period." We compared health services utilization patterns between these periods during the 4 study years, including the number of hospital admissions, the number of physician visits, the number of prescriptions filled and the number of prescriptions per physician visit. Overall, 2968 elderly patients reached the annual maximum cost-sharing amount at least once during the study periods. Across the 4 years, there were 0.38 more physician visits per month (p < 0.001), 0.50 fewer prescriptions filled per month (p = 0.001) and 0.52 fewer prescriptions filled per physician visit (p < 0.001) during the cost-sharing period than during the free period. Among patients who were admitted to the hospital at least once, there were 0.013 more admissions per month during the cost-sharing period than during the free period (p = 0.03). In a predominantly publicly funded health care system, the implementation of cost-containment policies such as prescription drug cost-sharing may have the unintended effect of increasing overall health utilization among elderly patients with rheumatoid arthritis.

  4. 14 CFR 1260.123 - Cost sharing or matching.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... accordance with the applicable cost principles. If NASA authorizes recipients to donate buildings or land for construction/facilities acquisition projects or long-term use, the value of the donated property for cost.... (g) The method used for determining cost sharing or matching for donated equipment, buildings and...

  5. 14 CFR 1260.123 - Cost sharing or matching.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... accordance with the applicable cost principles. If NASA authorizes recipients to donate buildings or land for construction/facilities acquisition projects or long-term use, the value of the donated property for cost.... (g) The method used for determining cost sharing or matching for donated equipment, buildings and...

  6. 14 CFR 1260.123 - Cost sharing or matching.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... accordance with the applicable cost principles. If NASA authorizes recipients to donate buildings or land for construction/facilities acquisition projects or long-term use, the value of the donated property for cost.... (g) The method used for determining cost sharing or matching for donated equipment, buildings and...

  7. 14 CFR 1260.123 - Cost sharing or matching.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... accordance with the applicable cost principles. If NASA authorizes recipients to donate buildings or land for construction/facilities acquisition projects or long-term use, the value of the donated property for cost.... (g) The method used for determining cost sharing or matching for donated equipment, buildings and...

  8. 32 CFR 37.570 - What must I do if a CAS-covered participant accounts differently for its own and the Federal...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... accounts differently for its own and the Federal Government shares of project costs? 37.570 Section 37.570... the Federal Government shares of project costs? (a) If a participant has Federal procurement contracts... Government's share of project costs under the TIA. This may arise, for example, if a for-profit firm or other...

  9. 32 CFR 37.570 - What must I do if a CAS-covered participant accounts differently for its own and the Federal...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... accounts differently for its own and the Federal Government shares of project costs? 37.570 Section 37.570... the Federal Government shares of project costs? (a) If a participant has Federal procurement contracts... Government's share of project costs under the TIA. This may arise, for example, if a for-profit firm or other...

  10. 32 CFR 37.570 - What must I do if a CAS-covered participant accounts differently for its own and the Federal...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... accounts differently for its own and the Federal Government shares of project costs? 37.570 Section 37.570... the Federal Government shares of project costs? (a) If a participant has Federal procurement contracts... Government's share of project costs under the TIA. This may arise, for example, if a for-profit firm or other...

  11. 32 CFR 37.570 - What must I do if a CAS-covered participant accounts differently for its own and the Federal...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... accounts differently for its own and the Federal Government shares of project costs? 37.570 Section 37.570... the Federal Government shares of project costs? (a) If a participant has Federal procurement contracts... Government's share of project costs under the TIA. This may arise, for example, if a for-profit firm or other...

  12. 47 CFR 27.1176 - Cost-sharing requirements for AWS in the 2150-2160/62 MHz band.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Cost-sharing requirements for AWS in the 2150... 2150-2160/62 Mhz Band § 27.1176 Cost-sharing requirements for AWS in the 2150-2160/62 MHz band. (a) Frequencies in the 2150-2160/62 MHz band have been reallocated from the Broadband Radio Service (BRS) to AWS...

  13. 47 CFR 27.1176 - Cost-sharing requirements for AWS in the 2150-2160/62 MHz band.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 2 2011-10-01 2011-10-01 false Cost-sharing requirements for AWS in the 2150... 2150-2160/62 Mhz Band § 27.1176 Cost-sharing requirements for AWS in the 2150-2160/62 MHz band. (a) Frequencies in the 2150-2160/62 MHz band have been reallocated from the Broadband Radio Service (BRS) to AWS...

  14. 26 CFR 1.482-7T - Methods to determine taxable income in connection with a cost sharing arrangement (temporary).

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 6 2013-04-01 2013-04-01 false Methods to determine taxable income in connection with a cost sharing arrangement (temporary). 1.482-7T Section 1.482-7T Internal Revenue INTERNAL...) Adjustments § 1.482-7T Methods to determine taxable income in connection with a cost sharing arrangement...

  15. 26 CFR 1.482-7T - Methods to determine taxable income in connection with a cost sharing arrangement (temporary).

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 6 2012-04-01 2012-04-01 false Methods to determine taxable income in connection with a cost sharing arrangement (temporary). 1.482-7T Section 1.482-7T Internal Revenue INTERNAL...) Adjustments § 1.482-7T Methods to determine taxable income in connection with a cost sharing arrangement...

  16. The Effect of Infrastructure Sharing in Estimating Operations Cost of Future Space Transportation Systems

    NASA Technical Reports Server (NTRS)

    Sundaram, Meenakshi

    2005-01-01

    NASA and the aerospace industry are extremely serious about reducing the cost and improving the performance of launch vehicles both manned or unmanned. In the aerospace industry, sharing infrastructure for manufacturing more than one type spacecraft is becoming a trend to achieve economy of scale. An example is the Boeing Decatur facility where both Delta II and Delta IV launch vehicles are made. The author is not sure how Boeing estimates the costs of each spacecraft made in the same facility. Regardless of how a contractor estimates the cost, NASA in its popular cost estimating tool, NASA Air force Cost Modeling (NAFCOM) has to have a method built in to account for the effect of infrastructure sharing. Since there is no provision in the most recent version of NAFCOM2002 to take care of this, it has been found by the Engineering Cost Community at MSFC that the tool overestimates the manufacturing cost by as much as 30%. Therefore, the objective of this study is to develop a methodology to assess the impact of infrastructure sharing so that better operations cost estimates may be made.

  17. Rising out-of-pocket costs in disease management programs.

    PubMed

    Chernew, Michael E; Rosen, Allison B; Fendrick, A Mark

    2006-03-01

    To document the rise in copayments for patients in disease management programs and to call attention to the inherent conflicts that exist between these 2 approaches to benefit design. Data from 2 large health plans were used to compare cost sharing in disease management programs with cost sharing outside of disease management programs. The copayments charged to participants in disease management programs usually do not differ substantially from those charged to other beneficiaries. Cost sharing and disease management result in conflicting approaches to benefit design. Increasing copayments may lead to underuse of recommended services, thereby decreasing the clinical effectiveness and increasing the overall costs of disease management programs. Policymakers and private purchasers should consider the use of targeted benefit designs when implementing disease management programs or redesigning cost-sharing provisions. Current information systems and health services research are sufficiently advanced to permit these benefit designs.

  18. 38 CFR 43.24 - Matching or cost sharing.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... from non-Federal third parties. (2) The value of third party in-kind contributions applicable to the... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  19. 43 CFR 12.64 - Matching or cost sharing.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... donations from non-Federal third parties. (2) The value of third party in-kind contributions applicable to... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  20. 7 CFR 3016.24 - Matching or cost sharing.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... others cash donations from non-Federal third parties. (2) The value of third party in-kind contributions... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  1. 36 CFR 1207.24 - Matching or cost sharing.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... others cash donations from non-Federal third parties. (2) The value of third party in-kind contributions... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  2. 40 CFR 31.24 - Matching or cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... from non-Federal third parties. (2) The value of third party in-kind contributions applicable to the... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  3. 7 CFR 3016.24 - Matching or cost sharing.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... others cash donations from non-Federal third parties. (2) The value of third party in-kind contributions... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  4. 38 CFR 43.24 - Matching or cost sharing.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... from non-Federal third parties. (2) The value of third party in-kind contributions applicable to the... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  5. 43 CFR 12.64 - Matching or cost sharing.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... donations from non-Federal third parties. (2) The value of third party in-kind contributions applicable to... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  6. 32 CFR 33.24 - Matching or cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... from non-Federal third parties. (2) The value of third party in-kind contributions applicable to the... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  7. 36 CFR § 1207.24 - Matching or cost sharing.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... others cash donations from non-Federal third parties. (2) The value of third party in-kind contributions... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  8. 7 CFR 3016.24 - Matching or cost sharing.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... others cash donations from non-Federal third parties. (2) The value of third party in-kind contributions... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  9. 41 CFR 105-71.124 - Matching or cost sharing.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... donations from non-Federal third parties. (2) The value of third party in-kind contributions applicable to... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  10. 43 CFR 12.64 - Matching or cost sharing.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... donations from non-Federal third parties. (2) The value of third party in-kind contributions applicable to... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  11. 38 CFR 43.24 - Matching or cost sharing.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... from non-Federal third parties. (2) The value of third party in-kind contributions applicable to the... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  12. 32 CFR 33.24 - Matching or cost sharing.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... from non-Federal third parties. (2) The value of third party in-kind contributions applicable to the... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  13. 43 CFR 12.64 - Matching or cost sharing.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... donations from non-Federal third parties. (2) The value of third party in-kind contributions applicable to... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  14. 41 CFR 105-71.124 - Matching or cost sharing.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... donations from non-Federal third parties. (2) The value of third party in-kind contributions applicable to... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  15. 40 CFR 31.24 - Matching or cost sharing.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... from non-Federal third parties. (2) The value of third party in-kind contributions applicable to the... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  16. 38 CFR 43.24 - Matching or cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... from non-Federal third parties. (2) The value of third party in-kind contributions applicable to the... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  17. 40 CFR 31.24 - Matching or cost sharing.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... from non-Federal third parties. (2) The value of third party in-kind contributions applicable to the... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  18. 41 CFR 105-71.124 - Matching or cost sharing.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... donations from non-Federal third parties. (2) The value of third party in-kind contributions applicable to... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  19. 38 CFR 43.24 - Matching or cost sharing.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... from non-Federal third parties. (2) The value of third party in-kind contributions applicable to the... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  20. 41 CFR 105-71.124 - Matching or cost sharing.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... donations from non-Federal third parties. (2) The value of third party in-kind contributions applicable to... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  1. 7 CFR 3016.24 - Matching or cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... others cash donations from non-Federal third parties. (2) The value of third party in-kind contributions... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  2. 7 CFR 3016.24 - Matching or cost sharing.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... others cash donations from non-Federal third parties. (2) The value of third party in-kind contributions... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  3. 32 CFR 33.24 - Matching or cost sharing.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... from non-Federal third parties. (2) The value of third party in-kind contributions applicable to the... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  4. 32 CFR 33.24 - Matching or cost sharing.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... from non-Federal third parties. (2) The value of third party in-kind contributions applicable to the... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  5. 41 CFR 105-71.124 - Matching or cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... donations from non-Federal third parties. (2) The value of third party in-kind contributions applicable to... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  6. 32 CFR 33.24 - Matching or cost sharing.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... from non-Federal third parties. (2) The value of third party in-kind contributions applicable to the... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  7. 40 CFR 31.24 - Matching or cost sharing.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... from non-Federal third parties. (2) The value of third party in-kind contributions applicable to the... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  8. 36 CFR 1207.24 - Matching or cost sharing.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... others cash donations from non-Federal third parties. (2) The value of third party in-kind contributions... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  9. 43 CFR 12.64 - Matching or cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... donations from non-Federal third parties. (2) The value of third party in-kind contributions applicable to... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  10. 40 CFR 31.24 - Matching or cost sharing.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... from non-Federal third parties. (2) The value of third party in-kind contributions applicable to the... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  11. 36 CFR 1207.24 - Matching or cost sharing.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... others cash donations from non-Federal third parties. (2) The value of third party in-kind contributions... towards other Federal costs-sharing requirements. Neither costs nor the values of third party in-kind... records of grantees and subgrantee or cost-type contractors. These records must show how the value placed...

  12. 48 CFR 1516.303-73 - Types of cost-sharing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., cost matching, or other in-kind contributions. (b) In-kind contributions represent non-cash... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Types of cost-sharing. 1516... CONTRACTING METHODS AND CONTRACT TYPES TYPES OF CONTRACTS Cost-Reimbursement Contracts 1516.303-73 Types of...

  13. 32 CFR 3.6 - Limitations on cost-sharing.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... THAN CONTRACTS, GRANTS, OR COOPERATIVE AGREEMENTS FOR PROTOTYPE PROJECTS § 3.6 Limitations on cost... prototype project and cost-sharing is the reason for using OT authority, then the non-Federal amounts... the OT agreement becomes effective. Costs that were incurred for a prototype project by the business...

  14. Eliminating cost-sharing requirements for colon cancer screening in Medicare.

    PubMed

    Howard, David H; Guy, Gery P; Ekwueme, Donatus U

    2014-12-15

    Medicare beneficiaries do not have to pay for screening colonoscopies but must pay coinsurance if a polyp is removed via polypectomy. Likewise, beneficiaries do not have to pay for fecal occult blood tests but are liable for cost-sharing for diagnostic colonoscopies after a positive test. Legislative and regulatory requirements related to colorectal cancer screening are described, and on the basis of Medicare claims, it is estimated that Medicare spending would increase by $48 million annually if Medicare were to waive cost-sharing requirements for these services. The economic impact on Medicare if beneficiaries were not responsible for any cost-sharing requirements related to colorectal cancer screening services is described. © 2014 American Cancer Society.

  15. Effects of Caps on Cost Sharing for Skilled Nursing Facility Services in Medicare Advantage Plans.

    PubMed

    Keohane, Laura M; Rahman, Momotazur; Thomas, Kali S; Trivedi, Amal N

    2018-03-12

    To evaluate a federal regulation effective in 2011 that limited how much that Medicare Advantage (MA) plans could charge for the first 20 days of care in a skilled nursing facility (SNF). Difference-in-differences retrospective analysis comparing SNF utilization trends from 2008-2012. Select MA plans. Members of 27 plans with mandatory cost sharing reductions (n=132,000) and members of 21 plans without such reductions (n=138,846). Mean monthly number of SNF admissions and days per 1,000 members; annual proportion of MA enrollees exiting the plan. In plans with mandated cost sharing reductions, cost sharing for the first 20 days of SNF care decreased from an average of $2,039 in 2010 to $992 in 2011. In adjusted analyses, plans with mandated cost-sharing reductions averaged 158.1 SNF days (95% confidence interval (CI)=153.2-163.1 days) per 1,000 members per month before the cost sharing cap. This measure increased by 14.3 days (95% CI=3.8-24.8 days, p=0.009) in the 2 years after cap implementation. However, increases in SNF utilization did not significantly differ between plans with and without mandated cost-sharing reductions (adjusted between-group difference: 7.1 days per 1,000 members, 95% CI=-6.5-20.8, p=.30). Disenrollment patterns did not change after the cap took effect. When a federal regulation designed to protect MA members from high out-of-pocket costs for postacute care took effect, the use of SNF services did not change. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

  16. Changes in Consumer Cost-Sharing for Health Plans Sold in the ACA's Insurance Marketplaces, 2015 to 2016.

    PubMed

    Gabel, Jon; Green, Matthew; Call, Adrienne; Whitmore, Heidi; Stromberg, Sam; Oran, Rebecca

    2016-05-01

    This brief examines changes in consumer health plan cost-sharing--deductibles, copayments, coinsurance, and out-of-pocket limits--for coverage offered in the Affordable Care Act's marketplaces between 2015 and 2016. Three of seven measures studied rose moderately in 2016, an increase attributable in part to a shift in the mix of plans offered in the marketplaces, from plans with higher actuarial value (platinum and gold plans) to those that have less generous coverage (bronze and silver plans). Nearly 60 percent of enrollees in marketplace plans receive cost-sharing reductions as part of income-based assistance. For enrollees without cost-sharing reductions, average copayments, deductibles, and out-of-pocket limits remain considerably higher under bronze and silver plans than under employer-based plans; cost-sharing is similar in gold plans and employer plans. Marketplace plans are more likely than employer-based plans to impose a deductible for prescription drugs but no less likely to do so for primary care visits.

  17. 26 CFR 1.936-7 - Manner of making election under section 936 (h)(5); special election for export sales; revocation...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... election to use the cost sharing method or profit split method? A. 1: A possessions corporation makes an election to use the cost sharing or profit split method by filing Form 5712-A (“Election and Verification of the Cost Sharing or Profit Split Method Under Section 936(h)(5)”) and attaching it to its tax...

  18. Understanding Barriers to Participation in Cost-Share Programs For Pollinator Conservation by Wisconsin (USA) Cranberry Growers.

    PubMed

    Gaines-Day, Hannah R; Gratton, Claudio

    2017-08-01

    The expansion of modern agriculture has led to the loss and fragmentation of natural habitat, resulting in a global decline in biodiversity, including bees. In many countries, farmers can participate in cost-share programs to create natural habitat on their farms for the conservation of beneficial insects, such as bees. Despite their dependence on bee pollinators and the demonstrated commitment to environmental stewardship, participation in such programs by Wisconsin cranberry growers has been low. The objective of this study was to understand the barriers that prevent participation by Wisconsin cranberry growers in cost-share programs for on-farm conservation of native bees. We conducted a survey of cranberry growers (n = 250) regarding farming practices, pollinators, and conservation. Although only 10% of growers were aware of federal pollinator cost-share programs, one third of them were managing habitat for pollinators without federal aid. Once informed of the programs, 50% of growers expressed interest in participating. Fifty-seven percent of growers manage habitat for other wildlife, although none receive cost-share funding to do so. Participation in cost-share programs could benefit from outreach activities that promote the programs, a reduction of bureaucratic hurdles to participate, and technical support for growers on how to manage habitat for wild bees.

  19. Understanding Barriers to Participation in Cost-Share Programs For Pollinator Conservation by Wisconsin (USA) Cranberry Growers

    PubMed Central

    Gratton, Claudio

    2017-01-01

    The expansion of modern agriculture has led to the loss and fragmentation of natural habitat, resulting in a global decline in biodiversity, including bees. In many countries, farmers can participate in cost-share programs to create natural habitat on their farms for the conservation of beneficial insects, such as bees. Despite their dependence on bee pollinators and the demonstrated commitment to environmental stewardship, participation in such programs by Wisconsin cranberry growers has been low. The objective of this study was to understand the barriers that prevent participation by Wisconsin cranberry growers in cost-share programs for on-farm conservation of native bees. We conducted a survey of cranberry growers (n = 250) regarding farming practices, pollinators, and conservation. Although only 10% of growers were aware of federal pollinator cost-share programs, one third of them were managing habitat for pollinators without federal aid. Once informed of the programs, 50% of growers expressed interest in participating. Fifty-seven percent of growers manage habitat for other wildlife, although none receive cost-share funding to do so. Participation in cost-share programs could benefit from outreach activities that promote the programs, a reduction of bureaucratic hurdles to participate, and technical support for growers on how to manage habitat for wild bees. PMID:28763038

  20. Financial barriers to care among low-income children with asthma: health care reform implications.

    PubMed

    Fung, Vicki; Graetz, Ilana; Galbraith, Alison; Hamity, Courtnee; Huang, Jie; Vollmer, William M; Hsu, John; Wu, Ann Chen

    2014-07-01

    The Patient Protection and Affordable Care Act (ACA) includes subsidies that reduce patient cost sharing for low-income families. Limited information on the effects of cost sharing among children is available to guide these efforts. To examine the associations between cost sharing, income, and care seeking and financial stress among children with asthma. A telephone survey in 2012 about experiences during the prior year within an integrated health care delivery system. Respondents included 769 parents of children aged 4 to 11 years with asthma. Of these, 25.9% of children received public subsidies; 21.7% were commercially insured with household incomes at or below 250% of the federal poverty level (FPL) and 18.2% had higher cost-sharing levels for all services (e.g., ≥$75 for emergency department visits). We classified children with asthma based on (1) current receipt of a subsidy (i.e., Medicaid or Children's Health Insurance Program) or potential eligibility for ACA low-income cost sharing or premium subsidies in 2014 (i.e., income ≤250%, 251%-400%, or >400% of the FPL) and (2) cost-sharing levels for prescription drugs, office visits, and emergency department visits. We examined the frequency of changes in care seeking and financial stress due to asthma care costs across these groups using logistic regression, adjusted for patient/family characteristics. Switching to cheaper asthma drugs, using less medication than prescribed, delaying/avoiding any office or emergency department visits, and financial stress (eg, cutting back on necessities) because of the costs of asthma care. After adjustment, parents at or below 250% of the FPL with lower vs higher cost-sharing levels were less likely to delay or avoid taking their children to a physician's office visit (3.8% vs. 31.6%; odds ratio, 0.07 [95% CI, 0.01-0.39]) and the emergency department (1.2% vs. 19.4%; 0.05 [0.01-0.25]) because of cost; higher-income parents and those whose children were receiving public subsidies (eg, Medicaid) were also less likely to forego their children's care than parents at or below 250% of the FPL with higher cost-sharing levels. Overall, 15.6% of parents borrowed money or cut back on necessities to pay for their children's asthma care. Cost-related barriers to care among children with asthma were concentrated among low-income families with higher cost-sharing levels. The ACA's low-income subsidies could reduce these barriers for many families, but millions of dependents for whom employer-sponsored family coverage is unaffordable could remain at risk for cost-related problems because of ACA subsidy eligibility rules.

  1. Exploring the cost and value of private versus shared bedrooms in nursing homes.

    PubMed

    Calkins, Margaret; Cassella, Christine

    2007-04-01

    There is debate about the relative merits and costs of private versus shared bedrooms in nursing homes, particularly in light of the current efforts at creating both cost-efficient and person-centered care facilities. The purpose of this project was to explore the extent to which there is evidence-based information that supports the merits of three different bedroom configurations: traditional shared, enhanced shared, and private. We developed a framework of four broad domains that were related to the different bedroom configurations: psychosocial, clinical, operational, and construction or building factors. Within each dimension, we identified individual factors through the literature, interviews, and focus groups, with the goal of determining the breadth, depth, and quality of evidence supporting the benefits of one configuration over another. The vast majority of factors identified in this study, regardless of whether there was solid empirical data, information from the focus groups, or other anecdotal evidence, indicated better outcomes associated with private rooms over shared rooms in nursing homes. Cost estimates suggest that construction cost (plus debt service) differences range from roughly $20,506 per bed for a traditional shared room to $36,515 for a private one, and that such differences are recouped in less than 2 years if beds are occupied, and in less than 3 months if a shared bed remains unoccupied at average private-pay room costs. Despite limited empirical evidence in some areas, this project provides the foundation for an evidence-based life-cycle costing perspective regarding the relative merits of different bedroom configurations.

  2. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Feibel, C.E.

    This study uses multiple data collection and research methods including in depth interviews, 271 surveys of shared taxi and minibus operators, participant observation, secondary sources, and the literature on public transport from low, medium, and high-income countries. Extensive use is also made of a survey administered in Istanbul in 1976 to 1935 paratransit operators. Primary findings are that private buses are more efficient than public buses on a cost per passenger-km basis, and that private minibuses are as efficient as public buses. In terms of energy efficiency, minibuses are almost as efficient as public and private buses using actual-occupancy levels.more » Large shared taxis are twice as cost and energy efficient as cars, and small shared taxis 50% more efficient. In terms of investment cost per seat, large shared taxis have the lowest cost followed by smaller shared taxis, minibuses, and buses. Considering actual occupancy levels, minibuses are only slightly less effective in terms of congestion than buses, and large and small shared taxis are twice as effective as cars. It is also shown that minibuses and shared taxis have better service quality than buses because of higher frequencies and speeds, and because they provide a much higher probability of getting a seat than buses. Analysis of regulation and policy suggests that there are many unintended cost of public-transport regulations.« less

  3. 15 CFR 24.24 - Matching or cost sharing.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...) The value of third party in-kind contributions applicable to the period to which the cost sharing or.... Neither costs nor the values of third party in-kind contributions may count towards satisfying a cost... contractors. These records must show how the value placed on third party in-kind contributions was derived. To...

  4. 45 CFR 92.24 - Matching or cost sharing.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...) The value of third party in-kind contributions applicable to the period to which the cost sharing or.... Neither costs nor the values of third party in-kind contributions may count towards satisfying a cost... contractors. These records must show how the value placed on third party in-kind contributions was derived. To...

  5. 14 CFR 1273.24 - Matching or cost sharing.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...) The value of third party in-kind contributions applicable to the period to which the cost sharing or.... Neither costs nor the values of third party in-kind contributions may count towards satisfying a cost... contractors. These records must show how the value placed on third party in-kind contributions was derived. To...

  6. 29 CFR 1470.24 - Matching or cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) The value of third party in-kind contributions applicable to the period to which the cost sharing or.... Neither costs nor the values of third party in-kind contributions may count towards satisfying a cost... contractors. These records must show how the value placed on third party in-kind contributions was derived. To...

  7. 45 CFR 92.24 - Matching or cost sharing.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...) The value of third party in-kind contributions applicable to the period to which the cost sharing or.... Neither costs nor the values of third party in-kind contributions may count towards satisfying a cost... contractors. These records must show how the value placed on third party in-kind contributions was derived. To...

  8. 29 CFR 1470.24 - Matching or cost sharing.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...) The value of third party in-kind contributions applicable to the period to which the cost sharing or.... Neither costs nor the values of third party in-kind contributions may count towards satisfying a cost... contractors. These records must show how the value placed on third party in-kind contributions was derived. To...

  9. 13 CFR 143.24 - Matching or cost sharing.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...) The value of third party in-kind contributions applicable to the period to which the cost sharing or.... Neither costs nor the values of third party in-kind contributions may count towards satisfying a cost... contractors. These records must show how the value placed on third party in-kind contributions was derived. To...

  10. 29 CFR 1470.24 - Matching or cost sharing.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) The value of third party in-kind contributions applicable to the period to which the cost sharing or.... Neither costs nor the values of third party in-kind contributions may count towards satisfying a cost... contractors. These records must show how the value placed on third party in-kind contributions was derived. To...

  11. 45 CFR 92.24 - Matching or cost sharing.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...) The value of third party in-kind contributions applicable to the period to which the cost sharing or.... Neither costs nor the values of third party in-kind contributions may count towards satisfying a cost... contractors. These records must show how the value placed on third party in-kind contributions was derived. To...

  12. 14 CFR 1273.24 - Matching or cost sharing.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...) The value of third party in-kind contributions applicable to the period to which the cost sharing or.... Neither costs nor the values of third party in-kind contributions may count towards satisfying a cost... contractors. These records must show how the value placed on third party in-kind contributions was derived. To...

  13. 45 CFR 92.24 - Matching or cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) The value of third party in-kind contributions applicable to the period to which the cost sharing or.... Neither costs nor the values of third party in-kind contributions may count towards satisfying a cost... contractors. These records must show how the value placed on third party in-kind contributions was derived. To...

  14. 45 CFR 92.24 - Matching or cost sharing.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...) The value of third party in-kind contributions applicable to the period to which the cost sharing or.... Neither costs nor the values of third party in-kind contributions may count towards satisfying a cost... contractors. These records must show how the value placed on third party in-kind contributions was derived. To...

  15. 15 CFR 24.24 - Matching or cost sharing.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...) The value of third party in-kind contributions applicable to the period to which the cost sharing or.... Neither costs nor the values of third party in-kind contributions may count towards satisfying a cost... contractors. These records must show how the value placed on third party in-kind contributions was derived. To...

  16. 13 CFR 143.24 - Matching or cost sharing.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...) The value of third party in-kind contributions applicable to the period to which the cost sharing or.... Neither costs nor the values of third party in-kind contributions may count towards satisfying a cost... contractors. These records must show how the value placed on third party in-kind contributions was derived. To...

  17. 13 CFR 143.24 - Matching or cost sharing.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...) The value of third party in-kind contributions applicable to the period to which the cost sharing or.... Neither costs nor the values of third party in-kind contributions may count towards satisfying a cost... contractors. These records must show how the value placed on third party in-kind contributions was derived. To...

  18. 13 CFR 143.24 - Matching or cost sharing.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...) The value of third party in-kind contributions applicable to the period to which the cost sharing or.... Neither costs nor the values of third party in-kind contributions may count towards satisfying a cost... contractors. These records must show how the value placed on third party in-kind contributions was derived. To...

  19. 15 CFR 24.24 - Matching or cost sharing.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...) The value of third party in-kind contributions applicable to the period to which the cost sharing or.... Neither costs nor the values of third party in-kind contributions may count towards satisfying a cost... contractors. These records must show how the value placed on third party in-kind contributions was derived. To...

  20. 14 CFR 1273.24 - Matching or cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...) The value of third party in-kind contributions applicable to the period to which the cost sharing or.... Neither costs nor the values of third party in-kind contributions may count towards satisfying a cost... contractors. These records must show how the value placed on third party in-kind contributions was derived. To...

  1. 15 CFR 24.24 - Matching or cost sharing.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...) The value of third party in-kind contributions applicable to the period to which the cost sharing or.... Neither costs nor the values of third party in-kind contributions may count towards satisfying a cost... contractors. These records must show how the value placed on third party in-kind contributions was derived. To...

  2. 14 CFR 1273.24 - Matching or cost sharing.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...) The value of third party in-kind contributions applicable to the period to which the cost sharing or.... Neither costs nor the values of third party in-kind contributions may count towards satisfying a cost... contractors. These records must show how the value placed on third party in-kind contributions was derived. To...

  3. 29 CFR 1470.24 - Matching or cost sharing.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) The value of third party in-kind contributions applicable to the period to which the cost sharing or.... Neither costs nor the values of third party in-kind contributions may count towards satisfying a cost... contractors. These records must show how the value placed on third party in-kind contributions was derived. To...

  4. 29 CFR 1470.24 - Matching or cost sharing.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) The value of third party in-kind contributions applicable to the period to which the cost sharing or.... Neither costs nor the values of third party in-kind contributions may count towards satisfying a cost... contractors. These records must show how the value placed on third party in-kind contributions was derived. To...

  5. 13 CFR 143.24 - Matching or cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...) The value of third party in-kind contributions applicable to the period to which the cost sharing or.... Neither costs nor the values of third party in-kind contributions may count towards satisfying a cost... contractors. These records must show how the value placed on third party in-kind contributions was derived. To...

  6. Formal Professional Relationships Between General Practitioners and Specialists in Shared Care: Possible Associations with Patient Health and Pharmacy Costs.

    PubMed

    Lublóy, Ágnes; Keresztúri, Judit Lilla; Benedek, Gábor

    2016-04-01

    Shared care in chronic disease management aims at improving service delivery and patient outcomes, and reducing healthcare costs. The introduction of shared-care models is coupled with mixed evidence in relation to both patient health status and cost of care. Professional interactions among health providers are critical to a successful and efficient shared-care model. This article investigates whether the strength of formal professional relationships between general practitioners (GPs) and specialists (SPs) in shared care affects either the health status of patients or their pharmacy costs. In strong GP-SP relationships, the patient health status is expected to be high, due to efficient care coordination, and the pharmacy costs low, due to effective use of resources. This article measures the strength of formal professional relationships between GPs and SPs through the number of shared patients and proxies the patient health status by the number of comorbidities diagnosed and treated. To test the hypotheses and compare the characteristics of the strongest GP-SP connections with those of the weakest, this article concentrates on diabetes-a chronic condition where patient care coordination is likely important. Diabetes generates the largest shared patient cohort in Hungary, with the highest frequency of specialist medication prescriptions. This article finds that stronger ties result in lower pharmacy costs, but not in higher patient health status. Overall drug expenditure may be reduced by lowering patient care fragmentation through channelling a GP's patients to a small number of SPs.

  7. Patient cost sharing and medical expenditures for the Elderly.

    PubMed

    Fukushima, Kazuya; Mizuoka, Sou; Yamamoto, Shunsuke; Iizuka, Toshiaki

    2016-01-01

    Despite the rapidly aging population, relatively little is known about how cost sharing affects the elderly's medical spending. Exploiting longitudinal claims data and the drastic reduction of coinsurance from 30% to 10% at age 70 in Japan, we find that the elderly's demand responses are heterogeneous in ways that have not been previously reported. Outpatient services by orthopedic and eye specialties, which will continue to increase in an aging society, are particularly price responsive and account for a large share of the spending increase. Lower cost sharing increases demand for brand-name drugs but not for generics. These high price elasticities may call for different cost-sharing rules for these services. Patient health status also matters: receiving medical services appears more discretionary for the healthy than the sick in the outpatient setting. Finally, we found no evidence that additional medical spending improved short-term health outcomes. Copyright © 2015 Elsevier B.V. All rights reserved.

  8. 50 CFR 80.12 - Cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) FINANCIAL ASSISTANCE-WILDLIFE SPORT FISH RESTORATION PROGRAM ADMINISTRATIVE REQUIREMENTS, PITTMAN-ROBERTSON WILDLIFE RESTORATION AND DINGELL-JOHNSON SPORT FISH RESTORATION ACTS § 80.12 Cost sharing. Federal...

  9. 48 CFR 3416.303 - Cost-sharing contracts.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost-sharing contracts. 3416.303 Section 3416.303 Federal Acquisition Regulations System DEPARTMENT OF EDUCATION ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES TYPES OF CONTRACTS Cost-Reimbursement Contracts 3416.303...

  10. Regional cost and experience, not size or hospital inclusion, helps predict ACO success.

    PubMed

    Schulz, John; DeCamp, Matthew; Berkowitz, Scott A

    2017-06-01

    The Medicare Shared Savings Program (MSSP) continues to expand and now includes 434 accountable care organizations (ACOs) serving more than 7 million beneficiaries. During 2014, 86 of these ACOs earned over $300 million in shared savings payments by promoting higher-quality patient care at a lower cost.Whether organizational characteristics, regional cost of care, or experience in the MSSP are associated with the ability to achieve shared savings remains uncertain.Using financial results from 2013 and 2014, we examined all 339 MSSP ACOs with a 2012, 2013, or 2014 start-date. We used a cross-sectional analysis to examine all ACOs and used a multivariate logistic model to predict probability of achieving shared savings.Experience, as measured by years in the MSSP program, was associated with success and the ability to earn shared savings varied regionally. This variation was strongly associated with differences in regional Medicare fee-for-service per capita costs: ACOs in high cost regions were more likely to earn savings. In the multivariate model, the number of ACO beneficiaries, inclusion of a hospital or involvement of an academic medical center, was not associated with likelihood of earning shared savings, after accounting for regional baseline cost variation.These results suggest ACOs are learning and improving from their experience. Additionally, the results highlight regional differences in ACO success and the strong association with variation in regional per capita costs, which can inform CMS policy to help promote ACO success nationwide.

  11. Shared use of school facilities with community organizations and afterschool physical activity program participation: a cost-benefit assessment.

    PubMed

    Kanters, Michael A; Bocarro, Jason N; Filardo, Mary; Edwards, Michael B; McKenzie, Thomas L; Floyd, Myron F

    2014-05-01

    Partnerships between school districts and community-based organizations to share school facilities during afterschool hours can be an effective strategy for increasing physical activity. However, the perceived cost of shared use has been noted as an important reason for restricting community access to schools. This study examined shared use of middle school facilities, the amount and type of afterschool physical activity programs provided at middle schools together with the costs of operating the facilities. Afterschool programs were assessed for frequency, duration, and type of structured physical activity programs provided and the number of boys and girls in each program. School operating costs were used to calculate a cost per student and cost per building square foot measure. Data were collected at all 30 middle schools in a large school district over 12 months in 2010-2011. Policies that permitted more use of school facilities for community-sponsored programs increased participation in afterschool programs without a significant increase in operating expenses. These results suggest partnerships between schools and other community agencies to share facilities and create new opportunities for afterschool physical activity programs are a promising health promotion strategy. © 2014, American School Health Association.

  12. 44 CFR 206.47 - Cost-share adjustments.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Cost-share adjustments. 206.47 Section 206.47 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE The Declaration Process § 206.47 Cost...

  13. 34 CFR 74.23 - Cost sharing or matching.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... accordance with the applicable cost principles. If the Secretary authorizes recipients to donate buildings or land for construction/facilities acquisition projects or long-term use, the value of the donated.... (g) The method used for determining cost sharing or matching for donated equipment, buildings, and...

  14. 34 CFR 74.23 - Cost sharing or matching.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... accordance with the applicable cost principles. If the Secretary authorizes recipients to donate buildings or land for construction/facilities acquisition projects or long-term use, the value of the donated.... (g) The method used for determining cost sharing or matching for donated equipment, buildings, and...

  15. 34 CFR 74.23 - Cost sharing or matching.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... accordance with the applicable cost principles. If the Secretary authorizes recipients to donate buildings or land for construction/facilities acquisition projects or long-term use, the value of the donated.... (g) The method used for determining cost sharing or matching for donated equipment, buildings, and...

  16. 22 CFR 226.23 - Cost sharing or matching.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... accordance with the applicable cost principles. If USAID authorizes recipients to donate buildings or land for construction/facilities acquisition projects or long-term use, the value of the donated property.... (g) The method used for determining cost sharing or matching for donated equipment, buildings and...

  17. 22 CFR 226.23 - Cost sharing or matching.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... accordance with the applicable cost principles. If USAID authorizes recipients to donate buildings or land for construction/facilities acquisition projects or long-term use, the value of the donated property.... (g) The method used for determining cost sharing or matching for donated equipment, buildings and...

  18. 34 CFR 74.23 - Cost sharing or matching.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... accordance with the applicable cost principles. If the Secretary authorizes recipients to donate buildings or land for construction/facilities acquisition projects or long-term use, the value of the donated.... (g) The method used for determining cost sharing or matching for donated equipment, buildings, and...

  19. 22 CFR 226.23 - Cost sharing or matching.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... accordance with the applicable cost principles. If USAID authorizes recipients to donate buildings or land for construction/facilities acquisition projects or long-term use, the value of the donated property.... (g) The method used for determining cost sharing or matching for donated equipment, buildings and...

  20. 34 CFR 74.23 - Cost sharing or matching.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... accordance with the applicable cost principles. If the Secretary authorizes recipients to donate buildings or land for construction/facilities acquisition projects or long-term use, the value of the donated.... (g) The method used for determining cost sharing or matching for donated equipment, buildings, and...

  1. 22 CFR 226.23 - Cost sharing or matching.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... accordance with the applicable cost principles. If USAID authorizes recipients to donate buildings or land for construction/facilities acquisition projects or long-term use, the value of the donated property.... (g) The method used for determining cost sharing or matching for donated equipment, buildings and...

  2. Retrospective interrupted time series examining hypertension and diabetes medicines usage following changes in patient cost sharing in the 'Farmácia Popular' programme in Brazil.

    PubMed

    Emmerick, Isabel Cristina Martins; Campos, Monica Rodrigues; Luiza, Vera Lucia; Chaves, Luisa Arueira; Bertoldi, Andrea Dâmaso; Ross-Degnan, Dennis

    2017-11-03

    'Farmácia Popular' (FP) programme was launched in 2004, expanded in 2006 and changed the cost sharing for oral hypoglycaemic (OH) and antihypertensive (AH) medicines in 2009 and in 2011. This paper describes patterns of usage and continuity of coverage for OH and AH medicines following changes in patient cost sharing in the FP. Interrupted time series study using retrospective administrative data. Monthly programme participation (PP) and proportion of days covered (PDC) were the two outcome measures. The open cohort included all patients with two or more dispensings for a given study medicine in 2008-2012. The interventions were an increase in patient cost sharing in 2009 and zero patient cost sharing for key medicines in 2011. A total of 3.6 and 9.5 million patients receiving treatment for diabetes and hypertension, respectively, qualified for the study. Before the interventions, PP was growing by 7.3% per month; median PDC varied by medicine from 50% to 75%. After patient cost sharing increased in 2009, PP reduced by 56.5% and PDC decreased for most medicines (median 60.3%). After the 2011 free medicine programme, PP surged by 121 000 new dispensings per month and PDC increased for all covered medicines (80.7%). Cost sharing was found to be a barrier to continuity of treatment in Brazil's private sector FP programme. Making essential medicines free to patients appear to increase participation and continuity of treatment to clinically beneficial levels (PDC >80%). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. DataView: Business, Households, and Government: Health Spending, 1994

    PubMed Central

    Cowan, Cathy A.; Braden, Bradley R.; McDonnell, Patricia A.; Sivarajan, Lekha

    1996-01-01

    During the 1990s, growth in health care costs slowed considerably, helping to lessen the spending strain on business, government, and households. Although cost growth has slowed, the Federal Government continues to pay an ever-increasing share of the total health care bill. This article reviews important health care spending trends, and for the first time, provides separate estimates of the employer and employee share of the premium costs for employer-sponsored private health insurance. This article also highlights some of the emerging trends in the employer-sponsored insurance market, including managed care, cost-sharing, and employment shifts. PMID:10165707

  4. Affordable Care Act's Mandate Eliminating Contraceptive Cost Sharing Influenced Choices Of Women With Employer Coverage.

    PubMed

    Carlin, Caroline S; Fertig, Angela R; Dowd, Bryan E

    2016-09-01

    Patient cost sharing for contraceptive prescriptions was eliminated for certain insurance plans as part of the Affordable Care Act. We examined the impact of this change on women's patterns of choosing prescription contraceptive methods. Using claims data for a sample of midwestern women ages 18-46 with employer-sponsored coverage, we examined the contraceptive choices made by women in employer groups whose coverage complied with the mandate, compared to the choices of women in groups whose coverage did not comply. We found that the reduction in cost sharing was associated with a 2.3-percentage-point increase in the choice of any prescription contraceptive, relative to the 30 percent rate of choosing prescription contraceptives before the change in cost sharing. A disproportionate share of this increase came from increased selection of long-term contraception methods. Thus, the removal of cost as a barrier seems to be an important factor in contraceptive choice, and our findings about long-term methods may have implications for rates of unintended pregnancy that require further study. Project HOPE—The People-to-People Health Foundation, Inc.

  5. Excluded Facility Financial Status and Options for Payment System Modification

    PubMed Central

    Schneider, John E.; Cromwell, Jerry; McGuire, Thomas P.

    1993-01-01

    Psychiatric, rehabilitation, long-term care, and children's facilities have remained under the reimbursement system established under the Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 (Public Law 97-248). The number of TEFRA facilities and discharges has been increasing while their average profit rates have been steadily declining. Modifying TEFRA would require either rebasing the target amount or adjusting cost sharing for facilities exceeding their cost target. Based on our simulations of alternative payment systems, we recommend rebasing facilities' target amounts using a 50/50 blend of own costs and national average costs. Cost sharing above the target amount could be increased to include more government sharing of losses. PMID:10135345

  6. 48 CFR 48.104-4 - Sharing alternative-no-cost settlement method.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...-cost settlement method. 48.104-4 Section 48.104-4 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACT MANAGEMENT VALUE ENGINEERING Policies and Procedures 48.104-4 Sharing alternative—no-cost settlement method. In selecting an appropriate mechanism for incorporating a VECP into a...

  7. Cost Sharing-Past, Present-and Future?

    ERIC Educational Resources Information Center

    Hardy, Robert B.

    2000-01-01

    Addresses ongoing issues in research cost sharing between government and universities in the context of the current Presidential Review Directive on the Government-University Research Partnership. Issues include the procurement vs. assistance conundrum, systemic shifting of costs of research from the government to universities, and the failure of…

  8. 24 CFR 84.23 - Cost sharing or matching.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... applicable cost principles. If HUD authorizes recipients to donate buildings or land for construction.... (g) The method used for determining cost sharing or matching for donated equipment, buildings and... in the acquisition of equipment, buildings or land, the total value of the donated property may be...

  9. 24 CFR 84.23 - Cost sharing or matching.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... applicable cost principles. If HUD authorizes recipients to donate buildings or land for construction.... (g) The method used for determining cost sharing or matching for donated equipment, buildings and... in the acquisition of equipment, buildings or land, the total value of the donated property may be...

  10. 20 CFR 435.23 - Cost sharing or matching.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... SSA authorizes recipients to donate buildings or land for construction/facilities acquisition projects... acquisition of equipment, buildings or land, the total value of the donated property may be claimed as cost... method used for determining cost sharing or matching for donated equipment, buildings and land for which...

  11. 20 CFR 435.23 - Cost sharing or matching.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... SSA authorizes recipients to donate buildings or land for construction/facilities acquisition projects... acquisition of equipment, buildings or land, the total value of the donated property may be claimed as cost... method used for determining cost sharing or matching for donated equipment, buildings and land for which...

  12. 20 CFR 435.23 - Cost sharing or matching.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... SSA authorizes recipients to donate buildings or land for construction/facilities acquisition projects... acquisition of equipment, buildings or land, the total value of the donated property may be claimed as cost... method used for determining cost sharing or matching for donated equipment, buildings and land for which...

  13. 24 CFR 84.23 - Cost sharing or matching.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... applicable cost principles. If HUD authorizes recipients to donate buildings or land for construction.... (g) The method used for determining cost sharing or matching for donated equipment, buildings and... in the acquisition of equipment, buildings or land, the total value of the donated property may be...

  14. 24 CFR 84.23 - Cost sharing or matching.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... applicable cost principles. If HUD authorizes recipients to donate buildings or land for construction.... (g) The method used for determining cost sharing or matching for donated equipment, buildings and... in the acquisition of equipment, buildings or land, the total value of the donated property may be...

  15. 20 CFR 435.23 - Cost sharing or matching.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... SSA authorizes recipients to donate buildings or land for construction/facilities acquisition projects... acquisition of equipment, buildings or land, the total value of the donated property may be claimed as cost... method used for determining cost sharing or matching for donated equipment, buildings and land for which...

  16. 20 CFR 435.23 - Cost sharing or matching.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... SSA authorizes recipients to donate buildings or land for construction/facilities acquisition projects... acquisition of equipment, buildings or land, the total value of the donated property may be claimed as cost... method used for determining cost sharing or matching for donated equipment, buildings and land for which...

  17. 24 CFR 84.23 - Cost sharing or matching.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... applicable cost principles. If HUD authorizes recipients to donate buildings or land for construction.... (g) The method used for determining cost sharing or matching for donated equipment, buildings and... in the acquisition of equipment, buildings or land, the total value of the donated property may be...

  18. Financing Higher Education: Lessons from China

    ERIC Educational Resources Information Center

    Fengliang, Li

    2012-01-01

    In China, debates about higher education finance led to the introduction of a cost-sharing model, whereby students were required to pay tuition fees, over a decade ago. However, there is still significant resistance towards such a system within the broader society. In order to share insights into the development of the cost-sharing policy in China…

  19. 47 CFR 27.1160 - Cost-sharing requirements for AWS.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 2 2011-10-01 2011-10-01 false Cost-sharing requirements for AWS. 27.1160...-sharing requirements for AWS. Frequencies in the 2110-2150 MHz and 2160-2180 MHz bands listed in § 101.147 of this chapter have been reallocated from Fixed Microwave Services (FMS) to use by AWS (as reflected...

  20. 47 CFR 27.1160 - Cost-sharing requirements for AWS.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Cost-sharing requirements for AWS. 27.1160...-sharing requirements for AWS. Frequencies in the 2110-2150 MHz and 2160-2180 MHz bands listed in § 101.147 of this chapter have been reallocated from Fixed Microwave Services (FMS) to use by AWS (as reflected...

  1. 33 CFR 241.4 - General policy.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... interest at a lower level than the standard non-Federal share that would be required under the provisions...) Any reductions in the level of non-Federal cost-sharing as a result of the application of this test... ability to pay test should be structured so that reductions in the level of cost-sharing will be granted...

  2. The association of consumer cost-sharing and direct-to-consumer advertising with prescription drug use.

    PubMed

    Hansen, Richard A; Schommer, Jon C; Cline, Richard R; Hadsall, Ronald S; Schondelmeyer, Stephen W; Nyman, John A

    2005-06-01

    Previous research on the impact of various cost-sharing strategies on prescription drug use has not considered the impact of direct-to-consumer (DTC) advertising. To explore the association of cost-containment strategies with prescription drug use and to determine if the association is moderated by DTC prescription drug advertising. The study population included 288 280 employees and dependents aged 18 to 65 years with employer-sponsored health insurance contributing to the MEDSTAT MarketScan administrative data set. Person-level enrollment and claims data were obtained for beneficiaries enrolled continuously during July 1997 through December 1998. Direct-to-consumer advertising data were obtained from Competitive Media Reporting and linked to the MEDSTAT enrollment files. Localized DTC advertising expenditures for one class of medication were evaluated and matched with prescription claims for eligible MEDSTAT contributors. The association of various types and levels of cost-sharing incentives with incident product use was evaluated, controlling for the level of DTC advertising, health status, and other demographic covariates. The relationship of cost-sharing amounts with drug use was modified by the level of DTC advertising in a geographic market. This relationship was dependent on the type of cost-sharing, distinguishing between co-payments for provider visits and co-payments for prescription drugs. Compared with low-advertising markets, individuals residing in markets with high levels of advertising and paying provider co-payments of $10.00 or more were more likely to use the advertised product. In the same markets, higher prescription drug co-payments were associated with a decreased likelihood of using the advertised product. A similar relationship was not observed for the nonadvertised competitor. Among insured individuals, response to cost-sharing strategies is moderated by DTC prescription drug advertising. The relative ability of cost-sharing strategies to influence drug use should be interpreted with caution in the presence of DTC advertising.

  3. 42 CFR 423.578 - Exceptions process.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... cost-sharing structure. Each Part D plan sponsor that provides prescription drug benefits for Part D... sponsor required to cover a non-preferred drug at the generic drug cost-sharing level if the plan... tier in which it places very high cost and unique items, such as genomic and biotech products, the...

  4. 44 CFR 206.110 - Federal assistance to individuals and households.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... housing assistance to be provided under this section based on considerations of cost effectiveness... needs; or (4) Housing is not available on the private market. (i) Cost sharing. (1) Except as provided in paragraph (i)(2) of this section, the Federal share of eligible costs paid under this subpart...

  5. 44 CFR 206.203 - Federal grant assistance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... eligible costs documented by a grantee. Such $35,000 amount shall be adjusted annually to reflect changes... procedures applicable to each. (b) Cost sharing. All projects approved under State disaster assistance grants will be subject to the cost sharing provisions established in the FEMA-State Agreement and the Stafford...

  6. 10 CFR 603.550 - Acceptability of intellectual property.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... contributions of cash or tangible assets. The purpose of cost share is to ensure that the recipient incurs real... AGREEMENTS Pre-Award Business Evaluation Cost Sharing § 603.550 Acceptability of intellectual property. (a) In most instances, the contracting officer should not count costs of patents and other intellectual...

  7. 47 CFR 27.1180 - The cost-sharing formula.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... system with which it interferes is entitled to pro rata reimbursement based on the cost-sharing formula... system, and includes, but is not limited to, such items as: Radio terminal equipment (TX and/or RX...; monitoring or control equipment; engineering costs (design/path survey); installation; systems testing; FCC...

  8. 47 CFR 27.1180 - The cost-sharing formula.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...-sharing formula. (a) An AWS licensee that relocates a BRS system with which it interferes is entitled to... this section. (b) C is the actual cost of relocating the system, and includes, but is not limited to... (design/path survey); installation; systems testing; FCC filing costs; site acquisition and civil works...

  9. 47 CFR 27.1180 - The cost-sharing formula.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...-sharing formula. (a) An AWS licensee that relocates a BRS system with which it interferes is entitled to... this section. (b) C is the actual cost of relocating the system, and includes, but is not limited to... (design/path survey); installation; systems testing; FCC filing costs; site acquisition and civil works...

  10. 32 CFR 32.23 - Cost sharing or matching.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 1 2014-07-01 2014-07-01 false Cost sharing or matching. 32.23 Section 32.23 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DoD GRANT AND AGREEMENT... efficient accomplishment of project or program objectives. (4) Are allowable under the applicable cost...

  11. 32 CFR 32.23 - Cost sharing or matching.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false Cost sharing or matching. 32.23 Section 32.23 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DoD GRANT AND AGREEMENT... efficient accomplishment of project or program objectives. (4) Are allowable under the applicable cost...

  12. 32 CFR 32.23 - Cost sharing or matching.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 1 2011-07-01 2011-07-01 false Cost sharing or matching. 32.23 Section 32.23 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DoD GRANT AND AGREEMENT... efficient accomplishment of project or program objectives. (4) Are allowable under the applicable cost...

  13. 32 CFR 32.23 - Cost sharing or matching.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 1 2012-07-01 2012-07-01 false Cost sharing or matching. 32.23 Section 32.23 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DoD GRANT AND AGREEMENT... efficient accomplishment of project or program objectives. (4) Are allowable under the applicable cost...

  14. 32 CFR 32.23 - Cost sharing or matching.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 1 2013-07-01 2013-07-01 false Cost sharing or matching. 32.23 Section 32.23 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DoD GRANT AND AGREEMENT... efficient accomplishment of project or program objectives. (4) Are allowable under the applicable cost...

  15. 22 CFR 518.23 - Cost sharing or matching.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ..., buildings or land, the total value of the donated property may be claimed as cost sharing or matching. (2... applicable cost principles. If a Federal awarding agency authorizes recipients to donate buildings or land for construction/facilities acquisition projects or long-term use, the value of the donated property...

  16. 22 CFR 518.23 - Cost sharing or matching.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ..., buildings or land, the total value of the donated property may be claimed as cost sharing or matching. (2... applicable cost principles. If a Federal awarding agency authorizes recipients to donate buildings or land for construction/facilities acquisition projects or long-term use, the value of the donated property...

  17. 15 CFR 14.23 - Cost sharing or matching.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    .... If DoC authorizes recipients to donate buildings or land for construction/facilities acquisition... acquisition of equipment, buildings or land, the total value of the donated property may be claimed as cost... method used for determining cost sharing or matching for donated equipment, buildings and land for which...

  18. 15 CFR 14.23 - Cost sharing or matching.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    .... If DoC authorizes recipients to donate buildings or land for construction/facilities acquisition... acquisition of equipment, buildings or land, the total value of the donated property may be claimed as cost... method used for determining cost sharing or matching for donated equipment, buildings and land for which...

  19. 22 CFR 518.23 - Cost sharing or matching.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., buildings or land, the total value of the donated property may be claimed as cost sharing or matching. (2... applicable cost principles. If a Federal awarding agency authorizes recipients to donate buildings or land for construction/facilities acquisition projects or long-term use, the value of the donated property...

  20. 22 CFR 518.23 - Cost sharing or matching.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ..., buildings or land, the total value of the donated property may be claimed as cost sharing or matching. (2... applicable cost principles. If a Federal awarding agency authorizes recipients to donate buildings or land for construction/facilities acquisition projects or long-term use, the value of the donated property...

  1. 15 CFR 14.23 - Cost sharing or matching.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    .... If DoC authorizes recipients to donate buildings or land for construction/facilities acquisition... acquisition of equipment, buildings or land, the total value of the donated property may be claimed as cost... method used for determining cost sharing or matching for donated equipment, buildings and land for which...

  2. 15 CFR 14.23 - Cost sharing or matching.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    .... If DoC authorizes recipients to donate buildings or land for construction/facilities acquisition... acquisition of equipment, buildings or land, the total value of the donated property may be claimed as cost... method used for determining cost sharing or matching for donated equipment, buildings and land for which...

  3. 22 CFR 518.23 - Cost sharing or matching.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ..., buildings or land, the total value of the donated property may be claimed as cost sharing or matching. (2... applicable cost principles. If a Federal awarding agency authorizes recipients to donate buildings or land for construction/facilities acquisition projects or long-term use, the value of the donated property...

  4. 15 CFR 14.23 - Cost sharing or matching.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    .... If DoC authorizes recipients to donate buildings or land for construction/facilities acquisition... acquisition of equipment, buildings or land, the total value of the donated property may be claimed as cost... method used for determining cost sharing or matching for donated equipment, buildings and land for which...

  5. The Effects of Cost Sharing on Adherence to Medications Prescribed for Concurrent Use: Do Definitions Matter?

    PubMed

    Sacks, Naomi C; Burgess, James F; Cabral, Howard J; McDonnell, Marie E; Pizer, Steven D

    2015-08-01

    Accurate estimates of the effects of cost sharing on adherence to medications prescribed for use together, also called concurrent adherence, are important for researchers, payers, and policymakers who want to reduce barriers to adherence for chronic condition patients prescribed multiple medications concurrently. But measure definition consensus is lacking, and the effects of different definitions on estimates of cost-related nonadherence are unevaluated. To (a) compare estimates of cost-related nonadherence using different measure definitions and (b) provide guidance for analyses of the effects of cost sharing on concurrent adherence. This is a retrospective cohort study of Medicare Part D beneficiaries aged 65 years and older who used multiple oral antidiabetics concurrently in 2008 and 2009. We compared patients with standard coverage, which contains cost-sharing requirements in deductible (100%), initial (25%), and coverage gap (100%) phases, to patients with a low-income subsidy (LIS) and minimal cost-sharing requirements. Data source was the IMS Health Longitudinal Prescription Database. Patients with standard coverage were propensity matched to controls with LIS coverage. Propensity score was developed using logistic regression to model likelihood of Part D standard enrollment, controlling for sociodemographic and health status characteristics. For analysis, 3 definitions were used for unadjusted and adjusted estimates of adherence: (1) patients adherent to All medications; (2) patients adherent on Average; and (3) patients adherent to Any medication. Analyses were conducted using the full study sample and then repeated in analytic subgroups where patients used (a) 1 or more costly branded oral antidiabetics or (b) inexpensive generics only. We identified 12,771 propensity matched patients with Medicare Part D standard (N = 6,298) or LIS (N = 6,473) coverage who used oral antidiabetics in 2 or more of the same classes in 2008 and 2009. In this sample, estimates of the effects of cost sharing on concurrent adherence varied by measure definition, coverage type, and proportion of patients using more costly branded drugs. Adherence rates ranged from 37% (All: standard patients using 1+ branded) to 97% (Any: LIS using generics only). In adjusted estimates, standard patients using branded drugs had 0.63 (95% CI = 0.57-0.70) and 0.70 (95% CI = 0.63-0.77) times the odds of concurrent adherence using All and Average definitions, respectively. The Any subgroup was not significant (OR = 0.89, 95% CI = 0.87-1.17). Estimates also varied in the full-study sample (All: OR = 0.79, 95% CI = 0.74-0.85; Average: OR = 0.83, 95% CI = 0.77-0.89) and generics-only subgroup, although cost-sharing effects were smaller. The Any subgroup generated no significant estimates. Different concurrent adherence measure definitions lead to markedly different findings of the effects of cost sharing on concurrent adherence, with All and Average subgroups sensitive to these effects. However, when more study patients use inexpensive generics, estimates of these effects on adherence to branded medications with higher cost-sharing requirements may be diluted. When selecting a measure definition, researchers, payers, and policy analysts should consider the range of medication prices patients face, use a measure sensitive to the effects of cost sharing on adherence, and perform subgroup analyses for patients prescribed more medications for which they must pay more, since these patients are most vulnerable to cost-related nonadherence.

  6. Maintenance service contract model for heavy equipment in mining industry using principal agent theory

    NASA Astrophysics Data System (ADS)

    Pakpahan, Eka K. A.; Iskandar, Bermawi P.

    2015-12-01

    Mining industry is characterized by a high operational revenue, and hence high availability of heavy equipment used in mining industry is a critical factor to ensure the revenue target. To maintain high avaliability of the heavy equipment, the equipment's owner hires an agent to perform maintenance action. Contract is then used to control the relationship between the two parties involved. The traditional contracts such as fixed price, cost plus or penalty based contract studied is unable to push agent's performance to exceed target, and this in turn would lead to a sub-optimal result (revenue). This research deals with designing maintenance contract compensation schemes. The scheme should induce agent to select the highest possible maintenance effort level, thereby pushing agent's performance and achieve maximum utility for both parties involved. Principal agent theory is used as a modeling approach due to its ability to simultaneously modeled owner and agent decision making process. Compensation schemes considered in this research includes fixed price, cost sharing and revenue sharing. The optimal decision is obtained using a numerical method. The results show that if both parties are risk neutral, then there are infinite combination of fixed price, cost sharing and revenue sharing produced the same optimal solution. The combination of fixed price and cost sharing contract results in the optimal solution when the agent is risk averse, while the optimal combination of fixed price and revenue sharing contract is obtained when agent is risk averse. When both parties are risk averse, the optimal compensation scheme is a combination of fixed price, cost sharing and revenue sharing.

  7. 10 CFR 600.30 - Cost sharing.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... requirement does not apply to: (1) An award under the small business innovation research program or the small..., taking into consideration any technological risk relating to the activity. (d) Cost share shall be...

  8. Coordinating Cognition: The Costs and Benefits of Shared Gaze during Collaborative Search

    ERIC Educational Resources Information Center

    Brennan, Susan E.; Chen, Xin; Dickinson, Christopher A.; Neider, Mark B.; Zelinsky, Gregory J.

    2008-01-01

    Collaboration has its benefits, but coordination has its costs. We explored the potential for remotely located pairs of people to collaborate during visual search, using shared gaze and speech. Pairs of searchers wearing eyetrackers jointly performed an O-in-Qs search task alone, or in one of three collaboration conditions: shared gaze (with one…

  9. 43 CFR 404.35 - Is there a different non-Federal cost-share requirement for feasibility studies that involve a...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...-share requirement for feasibility studies that involve a community greater than 50,000 inhabitants? 404... non-Federal cost-share requirement for feasibility studies that involve a community greater than 50,000 inhabitants? Yes. If the feasibility study involves a rural water supply system that will serve a...

  10. Shared Use of School Facilities with Community Organizations and Afterschool Physical Activity Program Participation: A Cost-Benefit Assessment

    ERIC Educational Resources Information Center

    Kanters, Michael A.; Bocarro, Jason N.; Filardo, Mary; Edwards, Michael B.; McKenzie, Thomas L.; Floyd, Myron F.

    2014-01-01

    Background: Partnerships between school districts and community-based organizations to share school facilities during afterschool hours can be an effective strategy for increasing physical activity. However, the perceived cost of shared use has been noted as an important reason for restricting community access to schools. This study examined…

  11. Assessment of cost sharing in the Pima County Marketplace.

    PubMed

    Jennings, Nicholas B; Eng, Howard J

    2017-01-01

    The Patient Protection and Affordable Care Act established health insurance marketplaces to allow consumers to make educated decisions about their health care coverage. During the first open enrollment period in 2013, the federally facilitated marketplace in Pima County, Arizona listed 119 plans, making it one of the most competitive markets in the country. This study compares these plans based on differences in consumer cost sharing, including deductibles, co-pays and premiums. Consumer costs were reviewed using specific cases including a normal delivery pregnancy, the management of Type II Diabetes, and the utilization of specialty drugs to treat Hepatitis C. Total cost of care was calculated as the cost of managing the condition or event plus the cost of monthly premiums, evaluated as a single individual age 27. Evaluating a plan on premium alone is not sufficient as cost sharing can dramatically raise the cost of care. A rating system and better cost transparency tools could provider easier access to pertinent information for consumers. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. The effects of patient cost sharing on inpatient utilization, cost, and outcome.

    PubMed

    Xu, Yuan; Li, Ning; Lu, Mingshan; Dixon, Elijah; Myers, Robert P; Jelley, Rachel J; Quan, Hude

    2017-01-01

    Health insurance and provider payment reforms all over the world beg a key empirical question: what are the potential impacts of patient cost-sharing on health care utilization, cost and outcomes? The unique health insurance system and rich electronic medical record (EMR) data in China provides us a unique opportunity to study this topic. Four years (2010 to 2014) of EMR data from one medical center in China were utilized, including 10,858 adult patients with liver diseases. We measured patient cost-sharing using actual reimbursement ratio (RR) which is allowed us to better capture financial incentive than using type of health insurance. A rigorous risk adjustment method was employed with both comorbidities and disease severity measures acting as risk adjustors. Associations between RR and health use, costs and outcome were analyzed by multivariate analyses. After risk adjustment, patients with more generous health insurance coverage (higher RR) were found to have longer hospital stay, higher total cost, higher medication cost, and higher ratio of medication to total cost, as well as higher number and likelihood that specific procedures were performed. Our study implied that patient cost-sharing affects health care services use and cost. This reflects how patients and physicians respond to financial incentives in the current healthcare system in China, and the responses could be a joint effect of both demand and supply side moral hazard. In order to contain cost and improve efficiency in the system, reforming provide payment and insurance scheme is urgently needed.

  13. 44 CFR 13.24 - Matching or cost sharing.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... grants or by others cash donations from non-Federal third parties. (2) The value of third party in-kind... contributions counted towards other Federal costs-sharing requirements. Neither costs nor the values of third... must show how the value placed on third party in-kind contributions was derived. To the extent feasible...

  14. 29 CFR 97.24 - Matching or cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... grants or by others cash donations from non-Federal third parties. (2) The value of third party in-kind... contributions counted towards other Federal costs-sharing requirements. Neither costs nor the values of third... must show how the value placed on third party in-kind contributions was derived. To the extent feasible...

  15. 45 CFR 1157.24 - Matching or cost sharing.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... grants or by others cash donations from non-Federal third parties. (2) The value of third party in-kind... contributions counted towards other Federal costs-sharing requirements. Neither costs nor the values of third... records must show how the value placed on third party in-kind contributions was derived. To the extent...

  16. 44 CFR 13.24 - Matching or cost sharing.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... grants or by others cash donations from non-Federal third parties. (2) The value of third party in-kind... contributions counted towards other Federal costs-sharing requirements. Neither costs nor the values of third... must show how the value placed on third party in-kind contributions was derived. To the extent feasible...

  17. 24 CFR 85.24 - Matching or cost sharing.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... grants or by others cash donations from non-Federal third parties. (2) The value of third party in-kind... contributions counted towards other Federal costs-sharing requirements. Neither costs nor the values of third... must show how the value placed on third party in-kind contributions was derived. To the extent feasible...

  18. 45 CFR 1157.24 - Matching or cost sharing.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... grants or by others cash donations from non-Federal third parties. (2) The value of third party in-kind... contributions counted towards other Federal costs-sharing requirements. Neither costs nor the values of third... records must show how the value placed on third party in-kind contributions was derived. To the extent...

  19. 29 CFR 97.24 - Matching or cost sharing.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... grants or by others cash donations from non-Federal third parties. (2) The value of third party in-kind... contributions counted towards other Federal costs-sharing requirements. Neither costs nor the values of third... must show how the value placed on third party in-kind contributions was derived. To the extent feasible...

  20. 29 CFR 97.24 - Matching or cost sharing.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... grants or by others cash donations from non-Federal third parties. (2) The value of third party in-kind... contributions counted towards other Federal costs-sharing requirements. Neither costs nor the values of third... must show how the value placed on third party in-kind contributions was derived. To the extent feasible...

  1. 49 CFR 18.24 - Matching or cost sharing.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... grants or by others cash donations from non-Federal third parties. (2) The value of third party in-kind... contributions counted towards other Federal costs-sharing requirements. Neither costs nor the values of third... must show how the value placed on third party in-kind contributions was derived. To the extent feasible...

  2. 49 CFR 18.24 - Matching or cost sharing.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... grants or by others cash donations from non-Federal third parties. (2) The value of third party in-kind... contributions counted towards other Federal costs-sharing requirements. Neither costs nor the values of third... must show how the value placed on third party in-kind contributions was derived. To the extent feasible...

  3. 29 CFR 97.24 - Matching or cost sharing.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... grants or by others cash donations from non-Federal third parties. (2) The value of third party in-kind... contributions counted towards other Federal costs-sharing requirements. Neither costs nor the values of third... must show how the value placed on third party in-kind contributions was derived. To the extent feasible...

  4. 49 CFR 18.24 - Matching or cost sharing.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... grants or by others cash donations from non-Federal third parties. (2) The value of third party in-kind... contributions counted towards other Federal costs-sharing requirements. Neither costs nor the values of third... must show how the value placed on third party in-kind contributions was derived. To the extent feasible...

  5. 24 CFR 85.24 - Matching or cost sharing.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... grants or by others cash donations from non-Federal third parties. (2) The value of third party in-kind... contributions counted towards other Federal costs-sharing requirements. Neither costs nor the values of third... must show how the value placed on third party in-kind contributions was derived. To the extent feasible...

  6. 29 CFR 97.24 - Matching or cost sharing.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... grants or by others cash donations from non-Federal third parties. (2) The value of third party in-kind... contributions counted towards other Federal costs-sharing requirements. Neither costs nor the values of third... must show how the value placed on third party in-kind contributions was derived. To the extent feasible...

  7. 34 CFR 80.24 - Matching or cost sharing.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... grants or by others cash donations from non-Federal third parties. (2) The value of third party in-kind... contributions counted towards other Federal costs-sharing requirements. Neither costs nor the values of third... must show how the value placed on third party in-kind contributions was derived. To the extent feasible...

  8. 44 CFR 13.24 - Matching or cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... grants or by others cash donations from non-Federal third parties. (2) The value of third party in-kind... contributions counted towards other Federal costs-sharing requirements. Neither costs nor the values of third... must show how the value placed on third party in-kind contributions was derived. To the extent feasible...

  9. 24 CFR 85.24 - Matching or cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... grants or by others cash donations from non-Federal third parties. (2) The value of third party in-kind... contributions counted towards other Federal costs-sharing requirements. Neither costs nor the values of third... must show how the value placed on third party in-kind contributions was derived. To the extent feasible...

  10. 44 CFR 13.24 - Matching or cost sharing.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... grants or by others cash donations from non-Federal third parties. (2) The value of third party in-kind... contributions counted towards other Federal costs-sharing requirements. Neither costs nor the values of third... must show how the value placed on third party in-kind contributions was derived. To the extent feasible...

  11. 34 CFR 80.24 - Matching or cost sharing.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... grants or by others cash donations from non-Federal third parties. (2) The value of third party in-kind... contributions counted towards other Federal costs-sharing requirements. Neither costs nor the values of third... must show how the value placed on third party in-kind contributions was derived. To the extent feasible...

  12. 44 CFR 13.24 - Matching or cost sharing.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... grants or by others cash donations from non-Federal third parties. (2) The value of third party in-kind... contributions counted towards other Federal costs-sharing requirements. Neither costs nor the values of third... must show how the value placed on third party in-kind contributions was derived. To the extent feasible...

  13. 24 CFR 85.24 - Matching or cost sharing.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... grants or by others cash donations from non-Federal third parties. (2) The value of third party in-kind... contributions counted towards other Federal costs-sharing requirements. Neither costs nor the values of third... must show how the value placed on third party in-kind contributions was derived. To the extent feasible...

  14. 34 CFR 80.24 - Matching or cost sharing.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... grants or by others cash donations from non-Federal third parties. (2) The value of third party in-kind... contributions counted towards other Federal costs-sharing requirements. Neither costs nor the values of third... must show how the value placed on third party in-kind contributions was derived. To the extent feasible...

  15. 34 CFR 80.24 - Matching or cost sharing.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... grants or by others cash donations from non-Federal third parties. (2) The value of third party in-kind... contributions counted towards other Federal costs-sharing requirements. Neither costs nor the values of third... must show how the value placed on third party in-kind contributions was derived. To the extent feasible...

  16. 24 CFR 85.24 - Matching or cost sharing.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... grants or by others cash donations from non-Federal third parties. (2) The value of third party in-kind... contributions counted towards other Federal costs-sharing requirements. Neither costs nor the values of third... must show how the value placed on third party in-kind contributions was derived. To the extent feasible...

  17. 45 CFR 1157.24 - Matching or cost sharing.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... grants or by others cash donations from non-Federal third parties. (2) The value of third party in-kind... contributions counted towards other Federal costs-sharing requirements. Neither costs nor the values of third... records must show how the value placed on third party in-kind contributions was derived. To the extent...

  18. 49 CFR 18.24 - Matching or cost sharing.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... grants or by others cash donations from non-Federal third parties. (2) The value of third party in-kind... contributions counted towards other Federal costs-sharing requirements. Neither costs nor the values of third... must show how the value placed on third party in-kind contributions was derived. To the extent feasible...

  19. 45 CFR 1157.24 - Matching or cost sharing.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... grants or by others cash donations from non-Federal third parties. (2) The value of third party in-kind... contributions counted towards other Federal costs-sharing requirements. Neither costs nor the values of third... records must show how the value placed on third party in-kind contributions was derived. To the extent...

  20. 34 CFR 80.24 - Matching or cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... grants or by others cash donations from non-Federal third parties. (2) The value of third party in-kind... contributions counted towards other Federal costs-sharing requirements. Neither costs nor the values of third... must show how the value placed on third party in-kind contributions was derived. To the extent feasible...

  1. 45 CFR 1157.24 - Matching or cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... grants or by others cash donations from non-Federal third parties. (2) The value of third party in-kind... contributions counted towards other Federal costs-sharing requirements. Neither costs nor the values of third... records must show how the value placed on third party in-kind contributions was derived. To the extent...

  2. 42 CFR 417.454 - Charges to Medicare enrollees.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... preventive services (as defined in § 410.152(l)). (e) Services for which cost sharing may not exceed cost...(b)(14)(B) of the Act. (3) Skilled nursing care defined as services provided during a covered stay in a skilled nursing facility during the period for which cost sharing would apply under Original...

  3. 42 CFR 417.454 - Charges to Medicare enrollees.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... preventive services (as defined in § 410.152(l)). (e) Services for which cost sharing may not exceed cost...(b)(14)(B) of the Act. (3) Skilled nursing care defined as services provided during a covered stay in a skilled nursing facility during the period for which cost sharing would apply under Original...

  4. 42 CFR 417.454 - Charges to Medicare enrollees.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... preventive services (as defined in § 410.152(l)). (e) Services for which cost sharing may not exceed cost...(b)(14)(B) of the Act. (3) Skilled nursing care defined as services provided during a covered stay in a skilled nursing facility during the period for which cost sharing would apply under Original...

  5. 32 CFR 37.550 - May I accept intellectual property as cost sharing?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... software) as cost sharing, because: (1) It is difficult to assign values to these intangible contributions... offer the use of commercially available software for which there is an established license fee for use of the product. The costs of the development of the software would not be a reasonable basis for...

  6. 32 CFR 37.550 - May I accept intellectual property as cost sharing?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... offer the use of commercially available software for which there is an established license fee for use of the product. The costs of the development of the software would not be a reasonable basis for... software) as cost sharing, because: (1) It is difficult to assign values to these intangible contributions...

  7. 47 CFR 27.1166 - Reimbursement under the Cost-Sharing Plan.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... frequency band may seek full reimbursement through the clearinghouse of compensable costs, up to the... act in good faith in satisfying the cost-sharing obligations under §§ 27.1160 through 27.1174. The... interference from MSS space-to-Earth downlink operations, but may elect to do so, in which case the MSS...

  8. 47 CFR 27.1166 - Reimbursement under the Cost-Sharing Plan.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... frequency band may seek full reimbursement through the clearinghouse of compensable costs, up to the... act in good faith in satisfying the cost-sharing obligations under §§ 27.1160 through 27.1174. The... interference from MSS space-to-Earth downlink operations, but may elect to do so, in which case the MSS...

  9. 47 CFR 27.1166 - Reimbursement under the Cost-Sharing Plan.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... frequency band may seek full reimbursement through the clearinghouse of compensable costs, up to the... act in good faith in satisfying the cost-sharing obligations under §§ 27.1160 through 27.1174. The... interference from MSS space-to-Earth downlink operations, but may elect to do so, in which case the MSS...

  10. Economic Value of Greater Access to Bariatric Procedures for Patients With Severe Obesity and Diabetes.

    PubMed

    Kim, David D; Arterburn, David E; Sullivan, Sean D; Basu, Anirban

    2018-05-12

    Designing optimal insurance is important to ensure access to care for individuals that are most likely to benefit. We examined the potential impact of lowering patient cost-sharing for bariatric procedures. After defining 10 subgroups by body mass index (BMI) and type 2 diabetes mellitus (T2DM), we analyzed the National Health and Nutrition Examination Survey datasets to estimate the prevalence of each subgroup. The MarketScan claims database provided utilization rates and costs of bariatric procedures. Using an existing cost-effectiveness model, we estimated the economic value of bariatric procedures under various cost-sharing levels (0%-25%) with 2 frameworks: (1) a traditional cost-effectiveness analysis and (2) a new approach that incorporates utilization effects across subgroups. The utilization rate was higher among individuals with T2DM than those without T2DM (90.4 vs. 59.1 cases per 100,000) for bariatric procedures, which were more cost-effective for those with T2DM and a higher BMI. After accounting for utilization effects, the economic value of bariatric surgery was $177 and $63 per individual from a lifetime and a 5-year time horizon, respectively. Under no patient cost-sharing for individuals with BMI≥40 and T2DM, utilization rates were expected to increase by 21 cases per 100,000, resulting in additional $2 realized value per patient and $7.07 million in returns at the US population level. Cost-sharing is a barrier to uptake of a clinical and cost-effective treatment for severe obesity. Reducing cost-sharing for patients with severe obesity and T2DM could potentially increase the utilization of bariatric procedures and result in greater economic value to payers.

  11. Punishment in the form of shared cost promotes altruism in the cooperative dilemma games.

    PubMed

    Zhang, Chunyan; Zhu, Yuying; Chen, Zengqiang; Zhang, Jianlei

    2017-05-07

    One phenomenon or social institution often observed in multi-agent interactions is the altruistic punishment, i.e. the punishment of unfair behavior by others at a personal cost. Inspired by the works focusing on punishment and the intricate mechanism behind it, we theoretically study the strategy evolution in the framework of two-strategy game models with the punishment on defectors, moreover, the cost of punishing will be evenly shared among the cooperators. Theoretical computations suggest that larger punishment on defectors or smaller punishment cost incurred by cooperators will enhance the fixation of altruistic cooperation in the population. Through the replicate dynamics, the group size of the randomly selected individuals from the sufficiently large population will notably affect the strategy evolution in populations nested within a dilemma. By theoretical modeling the concept of shared cost for punishment from one point of view, our findings underscore the importance of punishment with shared cost as a factor in real-life decisions in an evolutionary game context. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. The magnitude, share and determinants of unpaid care costs for home-based palliative care service provision in Toronto, Canada.

    PubMed

    Chai, Huamin; Guerriere, Denise N; Zagorski, Brandon; Coyte, Peter C

    2014-01-01

    With increasing emphasis on the provision of home-based palliative care in Canada, economic evaluation is warranted, given its tremendous demands on family caregivers. Despite this, very little is known about the economic outcomes associated with home-based unpaid care-giving at the end of life. The aims of this study were to (i) assess the magnitude and share of unpaid care costs in total healthcare costs for home-based palliative care patients, from a societal perspective and (ii) examine the sociodemographic and clinical factors that account for variations in this share. One hundred and sixty-nine caregivers of patients with a malignant neoplasm were interviewed from time of referral to a home-based palliative care programme provided by the Temmy Latner Centre for Palliative Care at Mount Sinai Hospital, Toronto, Canada, until death. Information regarding palliative care resource utilisation and costs, time devoted to care-giving and sociodemographic and clinical characteristics was collected between July 2005 and September 2007. Over the last 12 months of life, the average monthly cost was $14 924 (2011 CDN$) per patient. Unpaid care-giving costs were the largest component - $11 334, accounting for 77% of total palliative care expenses, followed by public costs ($3211; 21%) and out-of-pocket expenditures ($379; 2%). In all cost categories, monthly costs increased exponentially with proximity to death. Seemingly unrelated regression estimation suggested that the share of unpaid care costs of total costs was driven by patients' and caregivers' sociodemographic characteristics. Results suggest that overwhelming the proportion of palliative care costs is unpaid care-giving. This share of costs requires urgent attention to identify interventions aimed at alleviating the heavy financial burden and to ultimately ensure the viability of home-based palliative care in future. © 2013 John Wiley & Sons Ltd.

  13. Social inequalities and pharmaceutical cost sharing in Italian regions.

    PubMed

    Terraneo, Marco; Sarti, Simone; Tognetti Bordogna, Mara

    2014-01-01

    In recent years, Italian citizens have increasingly been asked to share pharmaceutical costs, but at the same time, households' medicines expenditure has decreased. Cost-sharing policies have to be assessed not just in terms of limitation of moral hazard and revenue to the state, but also for equal opportunities for citizen users accessing health services. The aim of this article is to analyze how Italian co-payment policies ("ticket") on medicines may affect pharmaceutical expenditure of households, considering territorial and social groups variation. We reviewed the per capita private spending on medicines of Italian regions, separating pharmaceutical outlay and "ticket." Across the period 2001-2010 we found that the overall per capita private spending on medicines remained substantially stable, although medicine expenditure decreases while the "ticket" increases. When cost sharing rises, out-of-pocket spending on medicines by poorer families seems to remain unchanged; however, poorer families seem to reduce their pharmaceutical expenditure. Our analysis suggests that applying co-payment in Italy is partly successful, in terms of greater revenue to the health system, but in the last few years, cost-sharing increases would seem to have rebounded negatively on more vulnerable families, due to the economic crisis.

  14. Attrition in the RAND Health Insurance Experiment: a response to Nyman.

    PubMed

    Newhouse, Joseph P; Brook, Robert H; Duan, Naihua; Keeler, Emmett B; Leibowitz, Arleen; Manning, Willard G; Marquis, M Susan; Morris, Carl N; Phelps, Charles E; Rolph, John E

    2008-04-01

    In a prior article in this journal, John Nyman argues that the effect on health care use and spending found in the RAND Health Insurance Experiment is an artifact of greater voluntary attrition in the cost-sharing plans relative to the free care plan. Specifically, he speculates that those in the cost-sharing plans, when faced with a hospitalization, withdrew. His argument is implausible because (1) families facing a hospitalization would be worse off financially by withdrawing; (2) a large number of observational studies find a similar effect of cost sharing on use; (3) those who left did not differ in their utilization prior to leaving; (4) if there had been no attrition and cost sharing did not reduce hospitalization rates, each adult in each family that withdrew would have had to have been hospitalized once each year for the duration of time they would otherwise have been in the experiment, an implausibly high rate; (5) there are benign explanations for the higher attrition in the cost-sharing plans. Finally, we obtained follow-up health-status data on the great majority of those who left prematurely. We found the health-status findings were insensitive to the inclusion of the attrition cases.

  15. Association between prescription cost sharing and adherence to initial combination antiretroviral therapy in commercially insured antiretroviral-naïve patients with HIV.

    PubMed

    Johnston, Stephen S; Juday, Timothy; Seekins, Daniel; Espindle, Derek; Chu, Bong-Chul

    2012-03-01

    In treatment of human immunodeficiency virus (HIV), high levels of adherence to combination antiretroviral therapy (cART) are required to prevent failure of virologic suppression, development of drug resistance, and permanent loss of therapeutic options. No published research has assessed the association between cART prescription cost sharing and adherence to cART. To analyze the association between cART prescription cost sharing and adherence to initial cART in commercially insured antiretroviral (ARV)-naïve patients with HIV. This retrospective observational cohort study used 2002-2008 data from a large U.S. claims database of more than 56 million commercially insured individuals. Study subjects were patients aged 18 years or older who initiated cART during the period January 1, 2003, to December 31, 2007, had no ARV claims during the 6-month period prior to the initiation date, and had at least 1 ICD-9-CM diagnosis code for HIV infection (042, 795.71, V08) from 12 months before to 12 months after cART initiation. A minimum 12-month period of continuous enrollment after cART initiation was used to construct a patient-quarter repeated measures panel dataset in which each quarter of data that a patient contributed represented an observation. The evaluation period extended from cART initiation until the occurrence of 1 of the following events: addition of an ARV that was not part of the initial cART regimen, 30-day gap in possession of an ARV within the initiated cART regimen, hospitalization of 30 or more days, loss to follow-up due to study end (December 31, 2008), or disenrollment. The study's outcome was quarterly adherence to cART, defined as the number of days within the quarter that a patient possessed all components of the initial cART regimen. Each patient's cART cost-sharing amount was calculated per 30-day supply of the entire cART regimen. Adherence was dichotomized for analysis at the clinically meaningful thresholds of 95% and 78%. The dichotomized adherence outcomes were separately modeled using population-averaged generalized estimating equations (GEEs) with time-varying and time-constant covariates and an exchangeable working correlation structure. Independent variables included cost-sharing amount; sequential quarter number after cART initiation; interaction between cost-sharing amount and sequential quarter number (to capture any changes in the association of cost sharing with adherence that may occur over time after initiation of cART); and patient demographic, clinical, and insurance characteristics. For each sequential quarter after cART initiation, the GEE models were used to generate average predicted probabilities of adherence reaching each threshold (95% and 78%) at cost-sharing levels of $25, $75, and $144, which represented the 25th, 75th, and 90th percentiles of the cost-sharing distribution, respectively. The study sample included 19,199 patient-quarters and 3,731 patients: mean age 41.1 years; 83.2% male; mean (SD) duration of post-index period 5.1 (4.2) quarters; mean (SD) daily cART pill count 3.2 (2.2); mean (median) cost sharing per 30-day supply of the entire cART regimen $67 ($40). In the unadjusted analyses of patient-quarters, mean adherence ranged from 97.2% for cost-sharing levels within the 0-20th percentiles (from $0 to $20 per 30-day cART supply) to 94.0% for cost-sharing levels exceeding the 80th percentile (from $84 to $3,832 per 30-day cART supply). In the adjusted analyses for the second quarter (25th percentile of follow-up duration, n = 3,117 cases still under observation) at the cost-sharing levels of $25, $75, and $144, the predicted probabilities of at least 95% adherence were 0.782, 0.770, and 0.752, respectively, and the predicted probabilities of at least 78% adherence were 0.936, 0.931, and 0.924, respectively. The differences in the predicted probabilities of adherence grew over time. By the seventh quarter (the 75th percentile of follow-up duration, n = 1,096 cases still under observation), the predicted probabilities were 0.773, 0.746, and 0.707 for 95% adherence and 0.933, 0.922, and 0.904 for 78% adherence at cost-sharing levels of $25, $75, and $144, respectively. Increasing cART prescription cost sharing was associated with modestly decreased probability of maintaining clinically meaningful levels of cART adherence.

  16. 42 CFR 447.68 - Alternative copayments, coinsurance, deductibles, or similar cost sharing charges: State plan...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL... defined at § 447.78, track beneficiaries' incurred premiums and cost sharing through a mechanism developed...

  17. 42 CFR 447.68 - Alternative copayments, coinsurance, deductibles, or similar cost sharing charges: State plan...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL... defined at § 447.78, track beneficiaries' incurred premiums and cost sharing through a mechanism developed...

  18. 42 CFR 417.454 - Charges to Medicare enrollees.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... § 410.152(l)). (e) Services for which cost sharing may not exceed cost sharing under original Medicare... nursing care defined as services provided during a covered stay in a skilled nursing facility during the...

  19. 48 CFR 1516.303-76 - Fee on cost-sharing contracts by subcontractors.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... alert to a potential vulnerability for the Government under cost-sharing contracts when evaluating... subcontractor is a wholly-owned subsidiary of the prime. The vulnerability consists of the subsidiary earning a...

  20. Reducing financial barriers to emergency obstetric care: experience of cost-sharing mechanism in a district hospital in Burkina Faso.

    PubMed

    Richard, F; Ouédraogo, C; Compaoré, J; Dubourg, D; De Brouwere, V

    2007-08-01

    To describe the implementation of a cost-sharing system for emergency obstetric care in an urban health district of Ouagadougou, Burkina Faso and analyse its results after 1 year of activity. Service availability and use, service quality, knowledge of the cost-sharing system in the community and financial viability of the system were measured before and after the system was implemented. Different sources of data were used: community survey, anthropological study, routine data from hospital files and registers and specific data collected on major obstetric interventions (MOI) in all the hospitals utilized by the district population. Direct costs of MOI were collected for each patient through an individual form and monitored during the year 2005. Rates of MOI for absolute maternal indications (AMI) were calculated for the period 2003-2005. The direct cost of a MOI was on average 136US$, including referral cost. Through the cost-sharing system this amount was shared between families (46US$), health centres (15US$), Ministry of Health (38US$) and local authority (37US$). The scheme was started in January 2005. The rate of cost recovery was 91.3% and the balance at the end of 2005 was slightly positive (4.7% of the total contribution). The number of emergency referrals by health centres increased from 84 in 2004 to 683 in 2005. MOI per 100 expected births increased from 1.95% in 2003 to 3.56% in 2005 and MOI for AMI increased from 0.75% to 1.42%. The dramatic increase in MOI suggests that the cost-sharing scheme decreased financial and geographical barriers to emergency obstetric care. Other positive effects on quality of care were documented but the sustainability of such a system remains uncertain in the dynamic context of Burkina Faso (decentralization).

  1. Association between drug insurance cost sharing strategies and outcomes in patients with chronic diseases: a systematic review.

    PubMed

    Mann, Bikaramjit S; Barnieh, Lianne; Tang, Karen; Campbell, David J T; Clement, Fiona; Hemmelgarn, Brenda; Tonelli, Marcello; Lorenzetti, Diane; Manns, Braden J

    2014-01-01

    Prescription drugs are used in people with hypertension, diabetes, and cardiovascular disease to manage their illness. Patient cost sharing strategies such as copayments and deductibles are often employed to lower expenditures for prescription drug insurance plans, but the impact on health outcomes in these patients is unclear. To determine the association between drug insurance and patient cost sharing strategies on medication adherence, clinical and economic outcomes in those with chronic diseases (defined herein as diabetes, hypertension, hypercholesterolemia, coronary artery disease, and cerebrovascular disease). Studies were included if they examined various cost sharing strategies including copayments, coinsurance, fixed copayments, deductibles and maximum out-of-pocket expenditures. Value-based insurance design and reference based pricing studies were excluded. Two reviewers independently identified original intervention studies (randomized controlled trials, interrupted time series, and controlled before-after designs). MEDLINE, EMBASE, Cochrane Library, CINAHL, and relevant reference lists were searched until March 2013. Two reviewers independently assessed studies for inclusion, quality, and extracted data. Eleven studies, assessing the impact of seven policy changes, were included: 2 separate reports of one randomized controlled trial, 4 interrupted time series, and 5 controlled before-after studies. Outcomes included medication adherence, clinical events (myocardial infarction, stroke, death), quality of life, healthcare utilization, or cost. The heterogeneity among the studies precluded meta-analysis. Few studies reported the impact of cost sharing strategies on mortality, clinical and economic outcomes. The association between patient copayments and medication adherence varied across studies, ranging from no difference to significantly lower adherence, depending on the amount of the copayment. Lowering cost sharing in patients with chronic diseases may improve adherence, but the impact on clinical and economic outcomes is uncertain.

  2. High cost sharing and specialty drug initiation under Medicare Part D: a case study in patients with newly diagnosed chronic myeloid leukemia.

    PubMed

    Doshi, Jalpa A; Li, Pengxiang; Huo, Hairong; Pettit, Amy R; Kumar, Rishab; Weiss, Brenda M; Huntington, Scott F

    2016-03-01

    Specialty drugs often offer medical advances but are frequently subject to high cost sharing. This is particularly true with Medicare Part D, where after meeting a deductible, patients without low-income subsidies (non-LIS) typically face 25% to 33% coinsurance (initial coverage phase with "specialty tier" cost sharing), followed by ~50% coinsurance (coverage gap phase), and then 5% coinsurance (catastrophic phase). Yet, no studies have examined the impact of such high cost sharing on specialty drug initiation under Part D. Oral tyrosine kinase inhibitors (TKIs) have revolutionized the treatment of chronic myeloid leukemia (CML), making it an apt case study. A retrospective claims-based analysis utilizing 2011 to 2013 100% Medicare claims. TKI initiation rates and time to initiation were compared between fee-for-service non-LIS Part D patients newly diagnosed with CML and their LIS counterparts who faced nominal cost sharing of ≤ $5. The first 30-day TKI fill "straddled" benefit phases, for a mean out-of-pocket cost of $2600 or more for non-LIS patients. Non-LIS patients were less likely than LIS patients to have a TKI claim within 6 months of diagnosis (45.3% vs 66.9%; P < .001) and those initiating a TKI took twice as long to fill it (mean = 50.9 vs 23.7 days; P < .001). Cox regressions controlling for sociodemographic, clinical, and plan characteristics confirmed descriptive findings (hazard ratio, 0.59; 95% CI, 0.45-0.76). Extensive sensitivity analyses confirmed the robustness of our findings. High cost sharing was associated with reduced and/or delayed initiation of TKIs. We discuss policy strategies to reduce current financial barriers that adversely impact access to critical therapies under Medicare Part D.

  3. Distribution and sharing of palliative care costs in rural areas of Canada.

    PubMed

    Dumont, Serge; Jacobs, Philip; Turcotte, Véronique; Turcotte, Stéphane; Johnston, Grace

    2014-01-01

    Few data are available on the costs occurring during the palliative phase of care and on the sharing of these costs in rural areas. This study aimed to evaluate the costs related to all resources used by rural palliative care patients and to examine how these costs were shared between the public healthcare system (PHCS), patients' families, and not-for-profit organizations (NFPOs). A prospective longitudinal study was undertaken of 82 palliative care patients and their main informal caregivers in rural areas of four Canadian provinces. Telephone interviews were completed at two-week intervals. The mean total cost per patient for a six-month participation in a palliative care program was CA$31,678 +/- 1,160. A large part of this cost was attributable to inpatient hospital stays and was assumed by the PHCS. The patient's family contributed less than a quarter of the mean total cost per patient, and this was mainly attributable to caregiving time.

  4. The effect of cost-sharing in private health insurance on the utilization of health care services between private insurance purchasers and non-purchasers: a study of the Korean health panel survey (2008-2012).

    PubMed

    Choi, Young; Kim, Jae-Hyun; Yoo, Ki-Bong; Cho, Kyoung Hee; Choi, Jae-Woo; Lee, Tae Hoon; Kim, Woorim; Park, Eun-Cheol

    2015-10-28

    Private health insurance in South Korea mainly functions as supplementary and complementary health insurance that compensates for insufficient coverage by National Health Insurance. However, full private coverage of public sector cost-sharing led to the problem of encouraging moral hazard-induced utilization, resulting in a policy change that occurred in October 2009. At that time, the Korean government introduced a minimum cost-sharing policy for indemnity health insurance. The purpose of this study was to analyze the effect of cost-sharing in private health insurance on health care utilization. We analyzed data collected from the Korean Health Panel Survey from October 2008 to December 2011. We restricted the two groups to 803 purchasers with indemnity health insurance and 7023 non-purchasers who did not obtain any private health insurance. A difference-in-difference analysis was used to evaluate the effect of the 2009 policy. After the policy change, the utilization of outpatient visits by purchasers gradually decreased more than non-purchasers (0.015 in 2009 [p = 0.758], -0.117 in 2010 [p < 0.016], and -0.140 in 2011 [p = 0.004]). However, utilization of inpatient services was not statistically significant. Notably, the magnitude of the cost-sharing effect in indemnity health insurance was stronger for those receiving medical aid. Among this group, utilization of outpatient services (after the policy change in 2009) decreased more so than non-purchasers. Patients with three or more chronic diseases have not changed their health care utilization. Our results implied meaningful lessons for decision-makers and future health insurance policies in Korea and other countries in terms of cost-sharing in medical care. When policy makers intend to implement the cost-sharing, a different copayment scheme is needed according to the socioeconomic status or disease severity.

  5. The practice of quality-associated costing: application to transfusion manufacturing processes.

    PubMed

    Trenchard, P M; Dixon, R

    1997-01-01

    This article applies the new method of quality-associated costing (QAC) to the mixture of processes that create red cell and plasma products from whole blood donations. The article compares QAC with two commonly encountered but arbitrary models and illustrates the invalidity of clinical cost-benefit analysis based on these models. The first, an "isolated" cost model, seeks to allocate each whole process cost to only one product class. The other is a "shared" cost model, and it seeks to allocate an approximately equal share of all process costs to all associated products.

  6. 77 FR 8143 - Section 482; Methods To Determine Taxable Income in Connection With a Cost Sharing Arrangement...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-14

    ... 482; Methods To Determine Taxable Income in Connection With a Cost Sharing Arrangement; Correction... on Thursday, December 22, 2011 (76 FR 80082), relating to section 482 and methods to determine... revisions read as follows: Sec. 1.482-7 Methods to determine taxable income in connection with a cost...

  7. 7 CFR 632.15 - Eligible uses and treatment of reclaimed lands.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... are eligible for cost sharing, and (2) Maintain, as applicable, lists of average costs of applying... Qualifications § 632.15 Eligible uses and treatment of reclaimed lands. (a) Reclaimed lands and water may be used... not eligible for cost sharing. (b) Reclaimed land use is determined by the objectives of the land user...

  8. 7 CFR 632.15 - Eligible uses and treatment of reclaimed lands.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... are eligible for cost sharing, and (2) Maintain, as applicable, lists of average costs of applying... Qualifications § 632.15 Eligible uses and treatment of reclaimed lands. (a) Reclaimed lands and water may be used... not eligible for cost sharing. (b) Reclaimed land use is determined by the objectives of the land user...

  9. Cost-effectiveness of diagnostic for malaria in Extra-Amazon Region, Brazil

    PubMed Central

    2012-01-01

    Background Rapid diagnostic tests (RDT) for malaria have been demonstrated to be effective and they should replace microscopy in certain areas. Method The cost-effectiveness of five RDT and thick smear microscopy was estimated and compared. Data were collected on Brazilian Extra-Amazon Region. Data sources included the National Malaria Control Programme of the Ministry of Health, the National Healthcare System reimbursement table, laboratory suppliers and scientific literature. The perspective was that of the Brazilian public health system, the analytical horizon was from the start of fever until the diagnostic results provided to patient and the temporal reference was that of year 2010. Two costing methods were produced, based on exclusive-use microscopy or shared-use microscopy. The results were expressed in costs per adequately diagnosed cases in 2010 U.S. dollars. One-way sensitivity analysis was performed considering key model parameters. Results In the cost-effectiveness analysis with exclusive-use microscopy, the RDT CareStart™ was the most cost-effective diagnostic strategy. Microscopy was the most expensive and most effective, with an additional case adequately diagnosed by microscopy costing US$ 35,550.00 in relation to CareStart™. In opposite, in the cost-effectiveness analysis with shared-use microscopy, the thick smear was extremely cost-effective. Introducing into the analytic model with shared-use microscopy a probability for individual access to the diagnosis, assuming a probability of 100% of access for a public health system user to any RDT and, hypothetically, of 85% of access to microscopy, this test saw its effectiveness reduced and was dominated by the RDT CareStart™. Conclusion The analysis of cost-effectiveness of malaria diagnosis technologies in the Brazilian Extra-Amazon Region depends on the exclusive or shared use of the microscopy. Following the assumptions of this study, shared-use microscopy would be the most cost-effective strategy of the six technologies evaluated. However, if used exclusively for diagnosing malaria, microscopy would be the worst use of resources. Microscopy would not be the most cost-effective strategy, even when structure is shared with other programmes, when the probability of a patient having access to it was reduced. Under these circumstances, the RDT CareStart™ would be the most cost-effective strategy. PMID:23176717

  10. Health benefits of reduced patient cost sharing in Japan.

    PubMed

    Nishi, Akihiro; McWilliams, J Michael; Noguchi, Haruko; Hashimoto, Hideki; Tamiya, Nanako; Kawachi, Ichiro

    2012-06-01

    To assess the effect on out-of-pocket medical spending and physical and mental health of Japan's reduction in health-care cost sharing from 30% to 10% when people turn 70 years of age. Study data came from a 2007 nationally-representative cross-sectional survey of 10 293 adults aged 64 to 75 years. Physical health was assessed using a 16-point scale based on self-reported data on general health, mobility, self-care, activities of daily living and pain. Mental health was assessed using a 24-point scale based on the Kessler-6 instrument for nonspecific psychological distress. The effect of reduced cost sharing was estimated using a regression discontinuity design. For adults aged 70 to 75 years whose income made them ineligible for reduced cost sharing, neither out-of-pocket spending nor health outcomes differed from the values expected on the basis of the trend observed in 64- to 69-year-olds. However, for eligible adults aged 70 to 75 years, out-of-pocket spending was significantly lower (P < 0.001) and mental health was significantly better (P < 0.001) than expected. These differences emerged abruptly at the age of 70 years. Moreover, the mental health benefits were similar in individuals who were and were not using health-care services (P = 0.502 for interaction). The improvement in physical health after the age of 70 years in adults eligible for reduced cost-sharing tended to be greater than in non-eligible adults (P = 0.084). Reduced cost sharing was associated with lower out-of-pocket medical spending and improved mental health in older Japanese adults.

  11. International Space Station operations: New dimensions - October 13, 1987

    NASA Technical Reports Server (NTRS)

    Paules, Granville E.; Lyman, Peter; Shelley, Carl B.

    1987-01-01

    One of the principal goals of the participants in the International Space Station program is to provide a management support structure which is equitable and fair to all participants, responsive to the needs of users, responsible to other partners, and mutually supportive to the participation of other partners. Shared-utilization, shared-cost, and shared-operations policies considerations are discussed. Special attention is given to the methodology for identifying costs and benefits of this program, in which each partner should be provided with benefits in proportion to his contribution, and no partner would be forced to share in cost the inefficiencies introduced by other partners. The Space Station hierarchy of operations functions are identified, and the recommended framework planning and control hierarchy is presented.

  12. Improving the assessment of prescribing: use of a 'substitution index'.

    PubMed

    Kunisawa, Susumu; Otsubo, Tetsuya; Lee, Jason; Imanaka, Yuichi

    2013-07-01

    To analyse the current and potential utilization of generic drugs in Japan, to examine the maximum possible cost savings from generic drug use and to develop a fairer measure to assess the level of generic drug substitution. We conducted a cross-sectional retrospective analysis of nine million dispensing records during January to March 2010 in Kyoto Prefecture. Maximum potential quantity-based shares were defined as the quantity of generic drugs used plus the quantity of branded drugs that could have been replaced by generic drugs divided by the quantity of all drugs dispensed. We developed a 'substitution index', defined as the proportion of generic drugs out of the total drugs substitutable with generic drugs (based on quantity rather than cost). Generic drugs had a quantity-based share of 17.9%, a cost-based share of 8.9% and a maximum potential quantity-based share of 50.1%, which is lower than the actual generic drug shares of some other countries. The maximum possible cost savings as a result of generic drug substitution was 16.5%. We also observed wide variations in maximum potential quantity-based shares between health care sectors and health care institutions. Simple comparisons based on quantity-based shares may misrepresent the actual generic drug use. A substitution index that takes into account the maximum potential quantity-based share of generic drugs as a fairer measure may promote more realistic goals and encourage generic drug usage.

  13. 47 CFR 27.1176 - Cost-sharing requirements for AWS in the 2150-2160/62 MHz band.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    .... All AWS entities who benefit from another AWS entity's clearance of BRS incumbents from this spectrum... licensee enters into a spectrum leasing arrangement and the spectrum lessee triggers a cost-sharing...

  14. Does a One-Size-Fits-All Cost-Sharing Approach Incentivize Appropriate Medication Use? A Roundtable on the Fairness and Ethics Associated with Variable Cost Sharing.

    PubMed

    Graff, Jennifer S; Shih, Chuck; Barker, Thomas; Dieguez, Gabriela; Larson, Cheryl; Sherman, Helen; Dubois, Robert W

    2017-06-01

    Tiered formularies, in which patients pay copays or coinsurance out-of-pocket (OOP), are used to manage costs and encourage more efficient health care resource use. Formulary tiers are typically based on the cost of treatment rather than the medical appropriateness for the patient. Cost sharing may have unintended consequences on treatment adherence and health outcomes. Use of higher-cost, higher-tier medications can be due to a variety of factors, including unsuccessful treatment because of lack of efficacy or side effects, patient clinical or genetic characteristics, patient preferences to avoid potential side effects, or patient preferences based on the route of administration. For example, patients with rheumatoid arthritis may be required to fail low-cost generic treatments before obtaining coverage for a higher-tier tumor necrosis factor alpha inhibitor for which they would have a larger financial burden. Little is known about stakeholders' views on the acceptability of greater patient cost sharing if the individual patient characteristics lead to the higher-cost treatments. To identify and discuss the trade-offs associated with variable cost sharing in pharmacy benefits. To discuss the trade-offs associated with variable cost sharing in pharmacy benefits, we convened an expert roundtable of patient, payer, and employer representatives (panelists). Panelists reviewed background white papers, including an ethics framework; actuarial analysis; legal review; and stakeholder perspectives representing health plan, employer, and patient views. Using case studies, panelists were asked to consider (a) when it would be more (or less) acceptable to require higher cost sharing; (b) the optimal distribution of financial burdens across patients, all plan members, and employers; and (c) the existing barriers and potential solutions to align OOP costs with medically appropriate treatments. Panelists felt it was least acceptable for patients to have greater OOP costs if the use of the higher-cost treatment was due to biological reasons such as step therapy (6 = unacceptable, 9 = neutral, 2 = acceptable) or diagnostic results (5 = unacceptable, 10 = neutral, and 2 = acceptable). In contrast, panelists felt it was more acceptable for patients to pay greater OOP costs when treatment choice was based on preferences to avoid a side-effect risk (1 = unacceptable, 3 = neutral, and 13 = acceptable) or the route/frequency of administration (1 = unacceptable, 1 = neutral, and 15 = acceptable). Five guiding principles emerged from the discussion: When patients have tried lower-cost therapies unsuccessfully, the benefits of higher-cost treatments were certain and significant, the cost difference between treatments was aligned with improved benefits, and penalties due to bad luck were mitigated, then cost-sharing differences should be minimized but not eliminated. Patient OOP costs can affect the use of both inappropriate and appropriate medications. This study identified 5 guiding principles to determine when it was more (or less) acceptable for patients with the same or similar conditions to have different OOP costs. Barriers that hinder the alignment of care and patient cost sharing exist. Policies that facilitate the alignment of patient cost sharing with appropriate care are needed. Funding for this roundtable was provided by the National Pharmaceutical Council (NPC). Graff and Dubois are employed by the NPC. Shih was employed by the NPC at the time of this study. Barker, Dieguez, Sherman, and Larson received consulting fees for participation in this study. Larson also reports receiving grants and other payment from multiple major pharmaceutical manufacturers outside of this study. The NPC employees developed the study design and chose the case studies in collaboration with the white paper authors. The roundtable was facilitated by Dubois, and the meeting summary and manuscript were written by Graff and Shih, with revisions by all roundtable participants. The abstract for this article was previously presented as a poster at the following meetings: Stakeholder perspectives on balancing patient-centeredness and drug costs in the design of pharmacy benefits. Presented at: Academy of Managed Care Pharmacy 27th Annual Meeting & Expo; San Diego, California; April 8, 2015. Considering efficiency and fairness in the design of prescription drug benefits: seeking a balanced approach to improve patient access to medically appropriate medication and manage drug costs. Presented at: AcademyHealth Annual Research Meeting; Minneapolis, Minnesota; June 15, 2015. Study concept and design were contributed by Shih, Dubois, and Graff, along with Barker and Dieguez. Barker and Dieguez took the lead in data collection, assisted by Graff, Shih, and Dubois. Data interpretation was performed by Shih, Larson, Sherman, and Graff, with assistance from Dubois. The manuscript was written and revised by Graff and Shih, with assistance from the other authors.

  15. Exploring the Cost and Value of Private versus Shared Bedrooms in Nursing Homes

    ERIC Educational Resources Information Center

    Calkins, Margaret; Cassella, Christine

    2007-01-01

    Purpose: There is debate about the relative merits and costs of private versus shared bedrooms in nursing homes, particularly in light of the current efforts at creating both cost-efficient and person-centered care facilities. The purpose of this project was to explore the extent to which there is evidence-based information that supports the…

  16. Is Job Sharing Worthwhile? A Cost-Benefit Analysis in UK Universities.

    ERIC Educational Resources Information Center

    Harris, Geoff

    1997-01-01

    Data from a survey of personnel directors in United Kingdom universities were used to conduct a cost-benefit analysis of job sharing from the institutions' perspective. Results show a 5% rise in productivity would raise the ratio of benefits to cost to 14.3 to 1. Retention of staff, reduction of stress, and reduced unemployment are also benefits.…

  17. A cost-sharing formula for online circulation and a union catalog through a regional, multitype library cooperative.

    PubMed Central

    Arcari, R D

    1987-01-01

    The experience of the Capitol Region Library Council and the University of Connecticut Health Center in developing a cost allocation formula for a circulation and online catalog shared by twenty-nine libraries is reviewed. The resulting formula identifies a basic unit cost as a minimum for each system participant. PMID:3676536

  18. Out-Of-Pocket Prescription Costs Under A Typical Silver Plan Are Twice As High As They Are In The Average Employer Plan.

    PubMed

    Thorpe, Kenneth E; Allen, Lindsay; Joski, Peter

    2015-10-01

    The health insurance Marketplaces created under the Affordable Care Act have attracted nearly ten million enrollees, including many people who were previously insured by an employer-sponsored plan. The most popular Marketplace plan--the silver plan--has significantly higher cost sharing than does a typical employer-sponsored plan, which may cause patients to reduce the use of cost-saving services that are essential for managing chronic conditions. We estimated the impact of higher cost sharing on drug and medical spending among patients with chronic conditions. Using national data, we compared cost sharing and prescription and medical spending for patients covered by employer-sponsored plans to the spending for those in a typical silver plan in the Marketplaces. Our results show that out-of-pocket expenses for medications in a typical silver plan are twice as high as they are in the average employer-sponsored plan, resulting in fewer prescriptions filled and refilled and in higher spending on other medical services. Maintaining the use of cost-effective prescription medications might require lower cost sharing for patients with chronic conditions than is currently found in the Marketplaces. Project HOPE—The People-to-People Health Foundation, Inc.

  19. The ACA’s Cost-Sharing Reduction Plans: A Key to Affordable Health Coverage for Millions of U.S. Workers.

    PubMed

    Gabel, Jon; Whitmore, Heidi; Green, Matthew; Call, Adrienne; Stromberg, Sam; Oran, Rebecca

    2016-10-01

    Issue: Without the cost-sharing reductions (CSRs) made available by the Affordable Care Act, health plans sold in the marketplaces may be unaffordable for many low-income people. CSRs are available to households earning between 100 percent and 250 percent of the federal poverty level that choose a silver-level marketplace plan. In 2016, about 7 million people received cost-sharing reductions that substantially lowered their deductibles, copayments, coinsurance, and out-of-pocket limits. Goal: To examine variations in consumer cost-sharing reductions between silver-level plans with CSRs to traditional marketplace plans and to employer-based insurance. Methods: Data analysis of 1,209 CSR-eligible plans sold in individual marketplaces in all 50 states and Washington, D.C. Key findings and conclusions: Cost-sharing amounts in silver plans with CSRs are much less than those in non-CSR base silver plans; silver plans with CSRs generally offer far better financial protection than those without. General annual deductibles range from $246 for CSR silver plans with a platinum-level actuarial value (94%) to as much as $3,063 for non-CSR silver plans. Out-of-pocket limits vary from $6,223 in base silver plans to $1,102 in silver plans with CSRs and a platinum-level actuarial level.

  20. Early Impact Of The Affordable Care Act On Oral Contraceptive Cost Sharing, Discontinuation, And Nonadherence.

    PubMed

    Pace, Lydia E; Dusetzina, Stacie B; Keating, Nancy L

    2016-09-01

    The oral contraceptive pill is the contraceptive method most commonly used by US women, but inconsistent use of the pill is a contributor to high rates of unintended pregnancy. The relationship between consumer cost sharing and consistent use of the pill is not well understood, and the impact of the elimination of cost sharing for oral contraceptive pills in a mandate in the Affordable Care Act (ACA) is not yet known. We analyzed insurance claims for 635,075 women with employer-sponsored insurance who were initiating use of the pill, to examine rates of discontinuation and nonadherence, their relationship with cost sharing, and trends before and during the first year after implementation of the ACA mandate. We found that cost sharing for oral contraceptives decreased markedly following implementation, more significantly for generic than for brand-name versions. Higher copays were associated with greater discontinuation of and nonadherence to generic pills than was the case with zero copayments. Discontinuation of the use of generic or brand-name pills decreased slightly but significantly following ACA implementation, as did nonadherence to brand-name pills. Our findings suggest a modest early impact of the ACA on improving consistent use of oral contraceptives among women initiating their use. Project HOPE—The People-to-People Health Foundation, Inc.

  1. The Role of Medicare's Inpatient Cost-Sharing in Medicaid Entry.

    PubMed

    Keohane, Laura M; Trivedi, Amal N; Mor, Vincent

    2018-04-01

    To isolate the effect of greater inpatient cost-sharing on Medicaid entry among Medicare beneficiaries. Medicare administrative data (years 2007-2010) were linked to nursing home assessments and area-level socioeconomic indicators. Medicare beneficiaries who are readmitted to a hospital must pay an additional deductible ($1,100 in 2010) if their readmission occurs more than 59 days following discharge. In a regression discontinuity analysis, we take advantage of this Medicare benefit feature to test whether beneficiaries with greater cost-sharing have higher rates of Medicaid enrollment. We identified 221,248 Medicare beneficiaries with an initial hospital stay and a readmission 53-59 days later (no deductible) or 60-66 days later (charged a deductible). Among beneficiaries in low-socioeconomic areas with two hospitalizations, those readmitted 60-66 days after discharge were 21 percent more likely to join Medicaid compared with those readmitted 53-59 days following their initial hospitalization (absolute difference in adjusted risk of Medicaid entry: 3.7 percent vs. 3.1 percent, p = .01). Increasing Medicare cost-sharing requirements may promote Medicaid enrollment among low-income beneficiaries. Potential savings from an increased cost-sharing in the Medicare program may be offset by increased Medicaid participation. © Health Research and Educational Trust.

  2. Mayo Clinic employees responded to new requirements for cost sharing by reducing possibly unneeded health services use.

    PubMed

    Shah, Nilay D; Naessens, James M; Wood, Douglas L; Stroebel, Robert J; Litchy, William; Wagie, Amy; Fan, Jiaquan; Nesse, Robert

    2011-11-01

    Some health plans have experimented with increasing consumer cost sharing, on the theory that consumers will use less unnecessary health care if they are expected to bear some of the financial responsibility for it. However, it is unclear whether the resulting decrease in use is sustained beyond one or two years. In 2004 Mayo Clinic's self-funded health plan increased cost sharing for its employees and their dependents for specialty care visits (adding a $25 copayment to the high-premium option) and other services such as imaging, testing, and outpatient procedures (adding 10 or 20 percent coinsurance, depending on the option). The plan also removed all cost sharing for visits to primary care providers and for preventive services such as colorectal screening and mammography. The result was large decreases in the use of diagnostic testing and outpatient procedures that were sustained for four years, and an immediate decrease in the use of imaging that later rebounded (possibly to levels below the expected trend). Beneficiaries decreased visits to specialists but did not make greater use of primary care services. These results suggest that implementing relatively low levels of cost sharing can lead to a long-term decrease in utilization.

  3. The benefits, risks and costs of privacy: patient preferences and willingness to pay.

    PubMed

    Trachtenbarg, David E; Asche, Carl; Ramsahai, Shweta; Duling, Joy; Ren, Jinma

    2017-05-01

    Multiple surveys show that patients want medical privacy; however, there are costs to maintaining privacy. There are also risks if information is not shared. A review of previous surveys found that most surveys asked questions about patient's privacy concerns and willingness to share their medical information. We found only one study that asked about sharing medical information for better care and no survey that asked patients about the risk, cost or comparison between medical privacy and privacy in other areas. To fill this gap, we designed a survey to: (1) compare medical privacy preferences to privacy preferences in other areas; (2) measure willingness to pay the cost of additional privacy measures; and (3) measure willingness to accept the risks of not sharing information. A total of 834 patients attending physician offices at 14 sites completed all or part of an anonymous questionnaire. Over 95% of patients were willing to share all their medical information with their treating physicians. There was no difference in willingness to share between primary care and specialty sites including psychiatry and an HIV clinic. In our survey, there was no difference in sharing preference between standard medical information and information with additional legal protections including genetic testing, drug/alcohol treatment and HIV results. Medical privacy was ranked lower than sharing social security and credit card numbers, but was deemed more private than other information including tax returns and handgun purchases. There was no statistical difference for any questions by site except for HIV/AIDS clinic patients ranking privacy of the medical record more important than reducing high medical costs and risk of medical errors (p < .05). Most patients were willing to spend a modest amount of additional time for privacy, but few were willing to pay more for additional medical privacy. Most patients were unwilling to take on additional risks to keep medical information hidden. Patients were very willing to share medical information with their providers. They were able to see the importance of sharing medical information to provide the best possible care. They were unwilling to hide information from providers if there was increased medical risk. Patients were willing to spend additional time for privacy, but most were unwilling to spend extra money. Sixty-eight percent of patients favored reducing medical costs over privacy.

  4. A systematic review of cost-sharing strategies used within publicly-funded drug plans in member countries of the organisation for economic co-operation and development.

    PubMed

    Barnieh, Lianne; Clement, Fiona; Harris, Anthony; Blom, Marja; Donaldson, Cam; Klarenbach, Scott; Husereau, Don; Lorenzetti, Diane; Manns, Braden

    2014-01-01

    Publicly-funded drug plans vary in strategies used and policies employed to reduce continually increasing pharmaceutical expenditures. We systematically reviewed the utilization of cost-sharing strategies and physician-directed prescribing regulations in publicly-funded formularies within member nations of the Organization of Economic Cooperation and Development (OECD). Using the OECD nations as the sampling frame, a search for cost-sharing strategies and physician-directed prescribing regulations was done using published and grey literature. Collected data was verified by a system expert within the prescription drug insurance plan in each country, to ensure the accuracy of key data elements across plans. Significant variation in the use of cost-sharing mechanisms was seen. Copayments were the most commonly used cost-containment measure, though their use and amount varied for those with certain conditions, most often chronic diseases (in 17 countries), and by socio-economic status (either income or employment status), or with age (in 15 countries). Caps and deductibles were only used by five systems. Drug cost-containment strategies targeting physicians were also identified in 24 countries, including guideline-based prescribing, prescription monitoring and incentive structures. There was variable use of cost-containment strategies to limit pharmaceutical expenditures in publicly funded formularies within OECD countries. Further research is needed to determine the best approach to constrain costs while maintaining access to pharmaceutical drugs.

  5. HMO market penetration and costs of employer-sponsored health plans.

    PubMed

    Baker, L C; Cantor, J C; Long, S H; Marquis, M S

    2000-01-01

    Using two employer surveys, we evaluate the role of increased health maintenance organization (HMO) market share in containing costs of employer-sponsored coverage. Total costs for employer health plans are about 10 percent lower in markets in which HMOs' market share is above 45 percent than they are in markets with HMO enrollments of below 25 percent. This is the result of lower premiums for HMOs than for non-HMO plans, as well as the competitive effect of HMOs that leads to lower non-HMO premiums for employers that continue to offer these benefits. Slower growth in premiums in areas with high HMO enrollments suggests that expanded HMO market share may also lower the long-run growth in costs.

  6. Burden of physical inactivity and hospitalization costs due to chronic diseases

    PubMed Central

    Bielemann, Renata Moraes; da Silva, Bruna Gonçalves Cordeiro; Coll, Carolina de Vargas Nunes; Xavier, Mariana Otero; da Silva, Shana Ginar

    2015-01-01

    OBJECTIVE To evaluate the physical inactivity-related inpatient costs of chronic non-communicable diseases. METHODS This study used data from 2013, from Brazilian Unified Health System, regarding inpatient numbers and costs due to malignant colon and breast neoplasms, cerebrovascular diseases, ischemic heart diseases, hypertension, diabetes, and osteoporosis. In order to calculate the share physical inactivity represents in that, the physical inactivity-related risks, which apply to each disease, were considered, and physical inactivity prevalence during leisure activities was obtained from Pesquisa Nacional por Amostra de Domicílio (Brazil’s National Household Sample Survey). The analysis was stratified by genders and residing country regions of subjects who were 40 years or older. The physical inactivity-related hospitalization cost regarding each cause was multiplied by the respective share it regarded to. RESULTS In 2013, 974,641 patients were admitted due to seven different causes in Brazil, which represented a high cost. South region was found to have the highest patient admission rate in most studied causes. The highest prevalences for physical inactivity were observed in North and Northeast regions. The highest inactivity-related share in men was found for osteoporosis in all regions (≈ 35.0%), whereas diabetes was found to have a higher share regarding inactivity in women (33.0% to 37.0% variation in the regions). Ischemic heart diseases accounted for the highest total costs that could be linked to physical inactivity in all regions and for both genders, being followed by cerebrovascular diseases. Approximately 15.0% of inpatient costs from Brazilian Unified Health System were connected to physical inactivity. CONCLUSIONS Physical inactivity significantly impacts the number of patient admissions due to the evaluated causes and through their resulting costs, with different genders and country regions representing different shares. PMID:26487291

  7. Burden of physical inactivity and hospitalization costs due to chronic diseases.

    PubMed

    Bielemann, Renata Moraes; Silva, Bruna Gonçalves Cordeiro da; Coll, Carolina de Vargas Nunes; Xavier, Mariana Otero; Silva, Shana Ginar da

    2015-01-01

    To evaluate the physical inactivity-related inpatient costs of chronic non-communicable diseases. This study used data from 2013, from Brazilian Unified Health System, regarding inpatient numbers and costs due to malignant colon and breast neoplasms, cerebrovascular diseases, ischemic heart diseases, hypertension, diabetes, and osteoporosis. In order to calculate the share physical inactivity represents in that, the physical inactivity-related risks, which apply to each disease, were considered, and physical inactivity prevalence during leisure activities was obtained from Pesquisa Nacional por Amostra de Domicílio(Brazil's National Household Sample Survey). The analysis was stratified by genders and residing country regions of subjects who were 40 years or older. The physical inactivity-related hospitalization cost regarding each cause was multiplied by the respective share it regarded to. In 2013, 974,641 patients were admitted due to seven different causes in Brazil, which represented a high cost. South region was found to have the highest patient admission rate in most studied causes. The highest prevalences for physical inactivity were observed in North and Northeast regions. The highest inactivity-related share in men was found for osteoporosis in all regions (≈ 35.0%), whereas diabetes was found to have a higher share regarding inactivity in women (33.0% to 37.0% variation in the regions). Ischemic heart diseases accounted for the highest total costs that could be linked to physical inactivity in all regions and for both genders, being followed by cerebrovascular diseases. Approximately 15.0% of inpatient costs from Brazilian Unified Health System were connected to physical inactivity. Physical inactivity significantly impacts the number of patient admissions due to the evaluated causes and through their resulting costs, with different genders and country regions representing different shares.

  8. 7 CFR 631.7 - Conservation treatment eligible for cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... conservationist, in consultation with the state program committee, shall select the resource management systems....7 Section 631.7 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL... conservation systems, practices, or identifiable units eligible for GPCP cost sharing in the county. ...

  9. 42 CFR 457.515 - Co-payments, coinsurance, deductibles, or similar cost-sharing charges: State plan requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... group or groups of enrollees that may be subject to the cost-sharing charge; (d) The consequences for an... facility that does not participate in the enrollee's managed care network beyond the copayment amounts...

  10. 44 CFR 206.47 - Cost-share adjustments.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Cost-share adjustments. 206.47 Section 206.47 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE The Declaration Process § 206.47...

  11. 44 CFR 206.47 - Cost-share adjustments.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Cost-share adjustments. 206.47 Section 206.47 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE The Declaration Process § 206.47...

  12. 44 CFR 206.47 - Cost-share adjustments.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Cost-share adjustments. 206.47 Section 206.47 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE The Declaration Process § 206.47...

  13. 44 CFR 206.47 - Cost-share adjustments.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Cost-share adjustments. 206.47 Section 206.47 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE The Declaration Process § 206.47...

  14. 7 CFR 3430.52 - Cost sharing and matching.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 15 2011-01-01 2011-01-01 false Cost sharing and matching. 3430.52 Section 3430.52 Agriculture Regulations of the Department of Agriculture (Continued) NATIONAL INSTITUTE OF FOOD AND AGRICULTURE COMPETITIVE AND NONCOMPETITIVE NON-FORMULA FEDERAL ASSISTANCE PROGRAMS-GENERAL AWARD...

  15. 10 CFR 605.13 - Cost sharing.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Cost sharing. 605.13 Section 605.13 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS THE OFFICE OF ENERGY RESEARCH FINANCIAL ASSISTANCE PROGRAM... evaluation and selection process unless otherwise provided under § 605.10(d)(5). ...

  16. 10 CFR 605.13 - Cost sharing.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Cost sharing. 605.13 Section 605.13 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS THE OFFICE OF ENERGY RESEARCH FINANCIAL ASSISTANCE PROGRAM... evaluation and selection process unless otherwise provided under § 605.10(d)(5). ...

  17. 10 CFR 602.12 - Cost sharing.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Cost sharing. 602.12 Section 602.12 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS EPIDEMIOLOGY AND OTHER HEALTH STUDIES FINANCIAL ASSISTANCE... the evaluation and selection process unless otherwise provided under § 602.9(d)(5). ...

  18. 10 CFR 602.12 - Cost sharing.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Cost sharing. 602.12 Section 602.12 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS EPIDEMIOLOGY AND OTHER HEALTH STUDIES FINANCIAL ASSISTANCE... the evaluation and selection process unless otherwise provided under § 602.9(d)(5). ...

  19. 10 CFR 605.13 - Cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Cost sharing. 605.13 Section 605.13 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS THE OFFICE OF ENERGY RESEARCH FINANCIAL ASSISTANCE PROGRAM... evaluation and selection process unless otherwise provided under § 605.10(d)(5). ...

  20. 10 CFR 605.13 - Cost sharing.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Cost sharing. 605.13 Section 605.13 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS THE OFFICE OF ENERGY RESEARCH FINANCIAL ASSISTANCE PROGRAM... evaluation and selection process unless otherwise provided under § 605.10(d)(5). ...

  1. 10 CFR 602.12 - Cost sharing.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Cost sharing. 602.12 Section 602.12 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS EPIDEMIOLOGY AND OTHER HEALTH STUDIES FINANCIAL ASSISTANCE... the evaluation and selection process unless otherwise provided under § 602.9(d)(5). ...

  2. 10 CFR 605.13 - Cost sharing.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Cost sharing. 605.13 Section 605.13 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS THE OFFICE OF ENERGY RESEARCH FINANCIAL ASSISTANCE PROGRAM... evaluation and selection process unless otherwise provided under § 605.10(d)(5). ...

  3. 10 CFR 602.12 - Cost sharing.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Cost sharing. 602.12 Section 602.12 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS EPIDEMIOLOGY AND OTHER HEALTH STUDIES FINANCIAL ASSISTANCE... the evaluation and selection process unless otherwise provided under § 602.9(d)(5). ...

  4. 7 CFR 1467.3 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... than a conservation practice that is included in the WRPO or restoration cost-share agreement, as..., or enhanced through an easement, contract, or restoration cost-share agreement. Agreement means the... Conservation Service or the person delegated authority to act for the Chief. Commenced conversion wetland means...

  5. 47 CFR 27.1190 - Termination of cost-sharing obligations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 2 2013-10-01 2013-10-01 false Termination of cost-sharing obligations. 27.1190 Section 27.1190 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES 1710-1755 MHz, 2110-2155 MHz, 2000-2020 MHz, and...

  6. 47 CFR 27.1174 - Termination of cost-sharing obligations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 2 2013-10-01 2013-10-01 false Termination of cost-sharing obligations. 27.1174 Section 27.1174 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES 1710-1755 MHz, 2110-2155 MHz, 2000-2020 MHz, and...

  7. 47 CFR 24.253 - Termination of cost-sharing obligations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 2 2013-10-01 2013-10-01 false Termination of cost-sharing obligations. 24.253 Section 24.253 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PERSONAL COMMUNICATIONS SERVICES Broadband PCS Policies Governing Microwave Relocation from the 1850-1990...

  8. 47 CFR 24.253 - Termination of cost-sharing obligations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 2 2011-10-01 2011-10-01 false Termination of cost-sharing obligations. 24.253 Section 24.253 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PERSONAL COMMUNICATIONS SERVICES Broadband PCS Policies Governing Microwave Relocation from the 1850-1990...

  9. 47 CFR 24.253 - Termination of cost-sharing obligations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 2 2014-10-01 2014-10-01 false Termination of cost-sharing obligations. 24.253 Section 24.253 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PERSONAL COMMUNICATIONS SERVICES Broadband PCS Policies Governing Microwave Relocation from the 1850-1990...

  10. 47 CFR 24.253 - Termination of cost-sharing obligations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Termination of cost-sharing obligations. 24.253 Section 24.253 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PERSONAL COMMUNICATIONS SERVICES Broadband PCS Policies Governing Microwave Relocation from the 1850-1990...

  11. 42 CFR 422.100 - General requirements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... review and approval of MA benefits and associated cost sharing. CMS reviews and approves MA benefits and... services. (g) Benefits affecting screening mammography, influenza vaccine, and pneumoccal vaccine. (1... influenza vaccine. (2) MA organizations may not impose cost-sharing for influenza vaccine and pneumococcal...

  12. 42 CFR 422.100 - General requirements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... review and approval of MA benefits and associated cost sharing. CMS reviews and approves MA benefits and... services. (g) Benefits affecting screening mammography, influenza vaccine, and pneumoccal vaccine. (1... influenza vaccine. (2) MA organizations may not impose cost-sharing for influenza vaccine and pneumococcal...

  13. 42 CFR 422.100 - General requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... review and approval of MA benefits and associated cost sharing. CMS reviews and approves MA benefits and... services. (g) Benefits affecting screening mammography, influenza vaccine, and pneumoccal vaccine. (1... influenza vaccine. (2) MA organizations may not impose cost-sharing for influenza vaccine and pneumococcal...

  14. Consumer cost sharing and use of biopharmaceuticals for rheumatoid arthritis.

    PubMed

    Robinson, James C

    2013-06-01

    To evaluate the effect of consumer cost sharing on use of physician-administered and patient self-administered specialty drugs for rheumatoid arthritis. Multivariate statistical analysis of probability and use of physician-administered specialty drugs, patient self-injected specialty drugs, non-biologic disease-modifying anti-rheumatic drugs, and symptom relief drugs. Analyses were conducted for patients enrolling in preferred provider organization (PPO) plans and health maintenance organization (HMO) plans with different cost-sharing requirements, adjusted for patient demographics, health status, and geographical location. Professional, facility, and pharmaceutical claims for beneficiaries of CalPERS, the public employee insurance purchasing alliance in California, for 2008-2009. Consumer cost-sharing requirements were obtained for each type of drug and service for each type of insurance plan. PPO insurance enrollees face substantially higher cost sharing for physician-administered specialty drugs, compared with HMO enrollees in CalPERS. PPO patients with rheumatoid arthritis are only half as likely as HMO enrollees to choose a physician-administered specialty drug (4.2% vs 9.3%) (P ≤.05), and use 25% less of the drugs if they use any ($10,356 vs $13,678) (P ≤.05). They are 30% more likely to use a self-administered specialty drug than are HMO enrollees (29.3% vs 22.1%) (P ≤.05), and use 35% more of the drugs if any ($16,015 vs $12,378) (P ≤.05). Consumer cost sharing reduces the use of physician-administered specialty drugs for rheumatoid arthritis. The higher use of patient self-administered specialty drugs suggests that the disincentives for use of physician-administered drugs were offset by an increased incentive to use self-administered drugs.

  15. Screening Mammography for Free: Impact of Eliminating Cost Sharing on Cancer Screening Rates.

    PubMed

    Jena, Anupam B; Huang, Jie; Fireman, Bruce; Fung, Vicki; Gazelle, Scott; Landrum, Mary Beth; Chernew, Michael; Newhouse, Joseph P; Hsu, John

    2017-02-01

    To study the impact of eliminating cost sharing for screening mammography on mammography rates in a large Medicare Advantage (MA) health plan which in 2010 eliminated cost sharing in anticipation of the Affordable Care Act mandate. Large MA health maintenance organization offering individual-subscriber MA insurance and employer-supplemented group MA insurance. We investigated the impact on breast cancer screening of a policy that eliminated a $20 copayment for screening mammography in 2010 among 53,188 women continuously enrolled from 2007 to 2012 in an individual-subscriber MA plan, compared with 42,473 women with employer-supplemented group MA insurance in the same health maintenance organization who had full screening coverage during this period. We used differences-in-differences analysis to study the impact of cost-sharing elimination on mammography rates. Annual screening rates declined over time for both groups, with similar trends pre-2010 and a slower decline after 2010 among women whose copayments were eliminated. Among women aged 65-74 years in the individual-subscriber MA plan, 44.9 percent received screening in 2009 compared with 40.9 percent in 2012, while 49.5 percent of women in the employer-supplemented MA plan received screening in 2009 compared with 44.1 percent in 2012, that is, a difference-in-difference effect of 1.4 percentage points less decline in screening among women experiencing the cost-sharing elimination. Effects were concentrated among women without recent screening. There were no differences by neighborhood socioeconomic status or race/ethnicity. Eliminating cost sharing for screening mammography was associated with modesty lower decline in screening rates among women with previously low screening adherence. © Health Research and Educational Trust.

  16. Early Impact of the Affordable Care Act on Uptake of Long-acting Reversible Contraceptive Methods.

    PubMed

    Pace, Lydia E; Dusetzina, Stacie B; Keating, Nancy L

    2016-09-01

    The Affordable Care Act (ACA) required most private insurance plans to cover contraceptive services without patient cost-sharing as of January 2013 for most plans. Whether the ACA's mandate has impacted long-acting reversible contraceptives (LARC) use is unknown. The aim of this article is to assess trends in LARC cost-sharing and uptake before and one year after implementation of the ACA's contraceptive mandate. A retrospective cohort study using Truven Health MarketScan claims data from January 2010 to December 2013. Women aged 18-45 years with continuous insurance coverage with claims for oral contraceptive pills, patches, rings, injections, or LARC during 2010-2013 (N=3,794,793). Descriptive statistics were used to assess trends in LARC cost-sharing and uptake from 2010 through 2013. Interrupted time series models were used to assess the association of time, ACA, and time after the ACA on LARC cost-sharing and initiation rates, adjusting for patient and plan characteristics. The proportion of claims with $0 cost-sharing for intrauterine devices and implants, respectively, rose from 36.6% and 9.3% in 2010 to 87.6% and 80.5% in 2013. The ACA was associated with a significant increase in these proportions and in their rate of increase (level and slope change both P<0.001). LARC uptake increased over time with no significant change in level of LARC use after ACA implementation in January 2013 (P=0.44) and a slightly slower rate of growth post-ACA than previously reported (β coefficient for trend, -0.004; P<0.001). The ACA has significantly decreased LARC cost-sharing, but during its first year had not yet increased LARC initiation rates.

  17. The Economics and Politics of Cost Sharing in Higher Education: Comparative Perspectives

    ERIC Educational Resources Information Center

    Johnstone, Bruce, D

    2004-01-01

    Cost-sharing, or the shift in at least part of the higher educational cost burden from governments (or taxpayers) to parents and students, is a worldwide trend manifested in the introduction of (or in sharp increases in) tuition fees, user charges for lodging and food, and in the diminution of student grants. The phenomenon is seen even in Europe,…

  18. 22 CFR 226.23 - Cost sharing or matching.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ADMINISTRATION OF ASSISTANCE AWARDS TO U.S. NON-GOVERNMENTAL ORGANIZATIONS Post-award Requirements Financial and Program Management § 226.23 Cost sharing or... volunteer services shall be consistent with those paid for similar work in the recipient's organizations. In...

  19. The High Cost of Saving Energy Dollars.

    ERIC Educational Resources Information Center

    Rose, Patricia

    1985-01-01

    In alternative financing a private company provides the capital and expertise for improving school energy efficiency. Savings are split between the school system and the company. Options for municipal leasing, cost sharing, and shared savings are explained along with financial, procedural, and legal considerations. (MLF)

  20. 48 CFR 35.003 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... only when the principal purpose is the acquisition of supplies or services for the direct benefit or... purpose of the transaction is to stimulate or support research and development for another public purpose. (b) Cost sharing. Cost sharing policies (which are not otherwise required by law) under Government...

  1. 7 CFR 636.12 - Termination of cost-share agreements.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 6 2014-01-01 2014-01-01 false Termination of cost-share agreements. 636.12 Section 636.12 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES CONSERVATION SERVICE, DEPARTMENT OF AGRICULTURE LONG TERM CONTRACTING WILDLIFE HABITAT INCENTIVE PROGRAM § 636...

  2. 7 CFR 636.12 - Termination of cost-share agreements.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 6 2013-01-01 2013-01-01 false Termination of cost-share agreements. 636.12 Section 636.12 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES CONSERVATION SERVICE, DEPARTMENT OF AGRICULTURE LONG TERM CONTRACTING WILDLIFE HABITAT INCENTIVE PROGRAM § 636...

  3. 7 CFR 636.12 - Termination of cost-share agreements.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 6 2012-01-01 2012-01-01 false Termination of cost-share agreements. 636.12 Section 636.12 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES CONSERVATION SERVICE, DEPARTMENT OF AGRICULTURE LONG TERM CONTRACTING WILDLIFE HABITAT INCENTIVE PROGRAM § 636...

  4. 7 CFR 636.12 - Termination of cost-share agreements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 6 2011-01-01 2011-01-01 false Termination of cost-share agreements. 636.12 Section 636.12 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES CONSERVATION SERVICE, DEPARTMENT OF AGRICULTURE LONG TERM CONTRACTING WILDLIFE HABITAT INCENTIVE PROGRAM § 636...

  5. 7 CFR 636.12 - Termination of cost-share agreements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Termination of cost-share agreements. 636.12 Section 636.12 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES CONSERVATION SERVICE, DEPARTMENT OF AGRICULTURE LONG TERM CONTRACTING WILDLIFE HABITAT INCENTIVES PROGRAM § 636...

  6. 40 CFR 35.6235 - Cost sharing.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 1 2013-07-01 2013-07-01 false Cost sharing. 35.6235 Section 35.6235 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Cooperative Agreements and Superfund State Contracts for Superfund Response Actions Core Program...

  7. 40 CFR 35.6235 - Cost sharing.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 1 2014-07-01 2014-07-01 false Cost sharing. 35.6235 Section 35.6235 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Cooperative Agreements and Superfund State Contracts for Superfund Response Actions Core Program...

  8. 40 CFR 35.6235 - Cost sharing.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 1 2012-07-01 2012-07-01 false Cost sharing. 35.6235 Section 35.6235 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Cooperative Agreements and Superfund State Contracts for Superfund Response Actions Core Program...

  9. 75 FR 54591 - Notice of Agricultural Management Assistance Organic Certification Cost-Share Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-08

    ... DEPARTMENT OF AGRICULTURE Agricultural Marketing Service [Doc. No. AMS-NOP-10-0065; NOP-10-06] Notice of Agricultural Management Assistance Organic Certification Cost-Share Program AGENCY: Agricultural Marketing Service, USDA. ACTION: Notice of Funds Availability. Inviting Applications for the...

  10. 7 CFR 1467.20 - Market-based conservation initiatives.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS WETLANDS RESERVE PROGRAM § 1467... contract, or restoration cost-share agreement. NRCS asserts no direct or indirect interest in these credits... under a WRP easement, 30-year contract, or restoration cost-share agreement, participants are highly...

  11. 47 CFR 27.1162 - Administration of the Cost-Sharing Plan.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 2 2013-10-01 2013-10-01 false Administration of the Cost-Sharing Plan. 27.1162 Section 27.1162 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES 1710-1755 MHz, 2110-2155 MHz, 2000-2020 MHz, and...

  12. 47 CFR 27.1188 - Dispute resolution under the Cost-Sharing Plan.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 2 2013-10-01 2013-10-01 false Dispute resolution under the Cost-Sharing Plan. 27.1188 Section 27.1188 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES 1710-1755 MHz, 2110-2155 MHz, 2000-2020...

  13. 47 CFR 27.1178 - Administration of the Cost-Sharing Plan.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 2 2013-10-01 2013-10-01 false Administration of the Cost-Sharing Plan. 27.1178 Section 27.1178 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES 1710-1755 MHz, 2110-2155 MHz, 2000-2020 MHz, and...

  14. 47 CFR 27.1172 - Dispute Resolution Under the Cost-Sharing Plan.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 2 2013-10-01 2013-10-01 false Dispute Resolution Under the Cost-Sharing Plan. 27.1172 Section 27.1172 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES 1710-1755 MHz, 2110-2155 MHz, 2000-2020...

  15. 47 CFR 27.1182 - Reimbursement under the Cost-Sharing Plan.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 2 2013-10-01 2013-10-01 false Reimbursement under the Cost-Sharing Plan. 27.1182 Section 27.1182 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES 1710-1755 MHz, 2110-2155 MHz, 2000-2020 MHz, and...

  16. 28 CFR 70.23 - Cost sharing or matching.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... the Department authorizes recipients to donate buildings or land for construction/facilities... donation. (g) The method used for determining cost sharing or matching for donated equipment, buildings and... in the acquisition of equipment, buildings or land, the total value of the donated property may be...

  17. 2 CFR 215.23 - Cost sharing or matching.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... agency authorizes recipients to donate buildings or land for construction/facilities acquisition projects.... (g) The method used for determining cost sharing or matching for donated equipment, buildings and... the acquisition of equipment, buildings or land, the total value of the donated property may be...

  18. 28 CFR 70.23 - Cost sharing or matching.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... the Department authorizes recipients to donate buildings or land for construction/facilities... donation. (g) The method used for determining cost sharing or matching for donated equipment, buildings and... in the acquisition of equipment, buildings or land, the total value of the donated property may be...

  19. 41 CFR 105-72.303 - Cost sharing or matching.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... awarding agency authorizes recipients to donate buildings or land for construction/facilities acquisition.... (g) The method used for determining cost sharing or matching for donated equipment, buildings and... the acquisition of equipment, buildings or land, the total value of the donated property may be...

  20. 28 CFR 70.23 - Cost sharing or matching.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... the Department authorizes recipients to donate buildings or land for construction/facilities... donation. (g) The method used for determining cost sharing or matching for donated equipment, buildings and... in the acquisition of equipment, buildings or land, the total value of the donated property may be...

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