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). ...

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). ...

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.

Reducing social losses from forest fires

Treesearch

Gregory S. Amacher; Arun S. Malik; Robert G. Haight

2006-01-01

We evaluate two financial incentives to encourage nonindustrial forest landowners to undertake activities that mitigate fire losses: sharing of fire suppression costs by the landowner and sharing of fuel reduction costs by the government. First and second best outcomes are identified and compared to assess the effectiveness of these incentives in reducing social...

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.

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.

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.

10 CFR 603.535 - Value of proposed real property or equipment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Value of proposed real property or equipment. 603.535... AGREEMENTS Pre-Award Business Evaluation Cost Sharing § 603.535 Value of proposed real property or equipment. The contracting officer rarely should accept values for cost sharing contributions of real property or...

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

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.

Job Sharing Pilot Project in the Department of Education: Final Evaluation. A Report to the Legislature of the State of Hawaii. No. 81-10.

ERIC Educational Resources Information Center

Tanimura, Clinton T.

Evaluation of a three-year pilot project in the Hawaii Department of Education focused on the extent to which it demonstrated the feasibility of job sharing as an employment alternative for classroom teachers. It also assessed project effectiveness, examined costs incurred by the project, and analyzed job sharing as a permanent employment option…

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.

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.

Impact of the elimination of cost sharing for mammographic breast cancer screening among rural US women: A natural experiment.

PubMed

Peppercorn, Jeffrey; Horick, Nora; Houck, Kevin; Rabin, Julia; Villagra, Victor; Lyman, Gary H; Wheeler, Stephanie B

2017-07-01

Rural US women experience disparities in breast cancer screening and outcomes. In 2006, a national rural health insurance provider, the National Rural Electric Cooperative Association (NRECA), eliminated out-of-pocket costs for screening mammography. This study evaluated the elimination of cost sharing as a natural experiment: it compared trends in screening before and after the policy change. NRECA insurance claims data were used to identify all women aged 40 to 64 years who were eligible for breast cancer screening, and mammography utilization from 1998 through 2011 was evaluated. Repeated measures regression models were used to evaluate changes in utilization over time and the association between screening and sociodemographic factors. The analysis was based on 45,738 women enrolled in the NRECA membership database for an average of 6.1 years and included 279,940 person-years of enrollment. Between 1998 and 2011, the annual screening rate increased from 35% to a peak of 50% among women aged 40 to 49 years and from 49% to 58% among women aged 50 to 64 years. The biennial screening rate increased from 56% to 66% for women aged 40 to 49 years and from 68% to 73% for women aged 50 to 64 years. Screening rates increased significantly (P < .0001) after the elimination of cost sharing and then declined slightly after changes to government screening guidelines in 2009. Younger women experienced greater increases in both annual screening (6.2%) and biennial screening (5.6%) after the elimination of cost sharing in comparison with older women (3.0% and 2.6%, respectively). In a multivariate analysis, rural residence, lower population income, and lower population education were associated with modestly lower screening. In a national sample of predominantly rural working-age women, the elimination of cost sharing correlated with increased breast cancer screening. Cancer 2017;123:2506-15. © 2017 American Cancer Society. © 2017 American Cancer Society.

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.

The effectiveness and cost-effectiveness of shared care: protocol for a realist review.

PubMed

Hardwick, Rebecca; Pearson, Mark; Byng, Richard; Anderson, Rob

2013-02-12

Shared care (an enhanced information exchange over and above routine outpatient letters) is commonly used to improve care coordination and communication between a specialist and primary care services for people with long-term conditions. Evidence of the effectiveness and cost-effectiveness of shared care is mixed. Informed decision-making for targeting shared care requires a greater understanding of how it works, for whom it works, in what contexts and why. This protocol outlines how realist review methods can be used to synthesise evidence on shared care for long-term conditions.A further aim of the review is to explore economic evaluations of shared care. Economic evaluations are difficult to synthesise due to problems in accounting for contextual differences that impact on resource use and opportunity costs. Realist review methods have been suggested as a way to overcome some of these issues, so this review will also assess whether realist review methods are amenable to synthesising economic evidence. Database and web searching will be carried out in order to find relevant evidence to develop and test programme theories about how shared care works. The review will have two phases. Phase 1 will concentrate on the contextual conditions and mechanisms that influence how shared care works, in order to develop programme theories, which partially explain how it works. Phase 2 will focus on testing these programme theories. A Project Reference Group made up of health service professionals and people with actual experience of long-term conditions will be used to ground the study in real-life experience. Review findings will be disseminated through local and sub-national networks for integrated care and long-term conditions. This realist review will explore why and for whom shared care works, in order to support decision-makers working to improve the effectiveness of care for people outside hospital. The development of realist review methods to take into account cost and cost-effectiveness evidence is particularly innovative and challenging, and if successful will offer a new approach to synthesising economic evidence. This systematic review protocol is registered on the PROSPERO database (registration number: CRD42012002842).

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.

10 CFR 603.545 - Acceptability of costs of prior RD&D.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Acceptability of costs of prior RD&D. 603.545 Section 603.545 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Pre-Award Business Evaluation Cost Sharing § 603.545 Acceptability of costs of prior RD&D. The...

Has recommended preventive service use increased after elimination of cost-sharing as part of the Affordable Care Act in the United States?

PubMed

Han, Xuesong; Robin Yabroff, K; Guy, Gery P; Zheng, Zhiyuan; Jemal, Ahmedin

2015-09-01

An early provision of the Affordable Care Act (ACA) eliminated cost-sharing for a range of recommended preventive services. This provision took effect in September 2010, but little is known about its effect on preventive service use. We evaluated changes in the use of recommended preventive services from 2009 (before the implementation of ACA cost-sharing provision) to 2011/2012 (after the implementation) in the Medical Expenditure Panel Survey, a nationally representative household interview survey in the US. Specifically, we examined: blood pressure check, cholesterol check, flu vaccination, and cervical, breast, and colorectal cancer screening, controlling for demographic characteristics and stratifying by insurance type. There were 64,280 (21,310 before and 42,970 after the implementation of ACA cost-sharing provision) adults included in the analyses. Receipt of recent blood pressure check, cholesterol check and flu vaccination increased significantly from 2009 to 2011/2012, primarily in the privately insured population aged 18-64years, with adjusted prevalence ratios (95% confidence intervals) 1.03 (1.01-1.05) for blood pressure check, 1.13 (1.09-1.18) for cholesterol check and 1.04 (1.00-1.08) for flu vaccination (all p-values<0.05). However, few changes were observed for cancer screening. We observed little change in the uninsured population. These early observations suggest positive benefits from the ACA policy of eliminating cost-sharing for some preventive services. Future research is warranted to monitor and evaluate longer term effects of the ACA on access to care and health outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

Policy Framework for Covering Preventive Services Without Cost Sharing: Saving Lives and Saving Money?

PubMed

Chen, Stephanie C; Pearson, Steven D

2016-08-01

The US Affordable Care Act mandates that private insurers cover a list of preventive services without cost sharing. The list is determined by 4 expert committees that evaluate the overall health effect of preventive services. We analyzed the process by which the expert committees develop their recommendations. Each committee uses different criteria to evaluate preventive services and none of the committees consider cost systematically. We propose that the existing committees adopt consistent evidence review methodologies and expand the scope of preventive services reviewed and that a separate advisory committee be established to integrate economic considerations into the final selection of free preventive services. The comprehensive framework and associated criteria are intended to help policy makers in the future develop a more evidence-based, consistent, and ethically sound approach.

Positive density-dependent growth supports costs sharing hypothesis and population density sensing in a manipulative parasite.

PubMed

Gopko, Mikhail; Mikheev, Victor N; Taskinen, Jouni

2017-09-01

Parasites manipulate their hosts' phenotype to increase their own fitness. Like any evolutionary adaptation, parasitic manipulations should be costly. Though it is difficult to measure costs of the manipulation directly, they can be evaluated using an indirect approach. For instance, theory suggests that as the parasite infrapopulation grows, the investment of individual parasites in host manipulation decreases, because of cost sharing. Another assumption is that in environments where manipulation does not pay off for the parasite, it can decrease its investment in the manipulation to save resources. We experimentally infected rainbow trout Oncorhynchus mykiss with the immature larvae of the trematode Diplostomum pseudospathaceum, to test these assumptions. Immature D. pseudospathaceum metacercariae are known for their ability to manipulate the behaviour of their host enhancing its anti-predator defenses to avoid concomitant predation. We found that the growth rate of individual parasites in rainbow trout increased with the infrapopulation size (positive density-dependence) suggesting cost sharing. Moreover, parasites adjusted their growth to the intensity of infection within the eye lens where they were localized suggesting population density sensing. Results of this study support the hypothesis that macroparasites can adjust their growth rate and manipulation investment according to cost sharing level and infrapopulation size.

Comprehensive investigation into historical pipeline construction costs and engineering economic analysis of Alaska in-state gas pipeline

NASA Astrophysics Data System (ADS)

Rui, Zhenhua

This study analyzes historical cost data of 412 pipelines and 220 compressor stations. On the basis of this analysis, the study also evaluates the feasibility of an Alaska in-state gas pipeline using Monte Carlo simulation techniques. Analysis of pipeline construction costs shows that component costs, shares of cost components, and learning rates for material and labor costs vary by diameter, length, volume, year, and location. Overall average learning rates for pipeline material and labor costs are 6.1% and 12.4%, respectively. Overall average cost shares for pipeline material, labor, miscellaneous, and right of way (ROW) are 31%, 40%, 23%, and 7%, respectively. Regression models are developed to estimate pipeline component costs for different lengths, cross-sectional areas, and locations. An analysis of inaccuracy in pipeline cost estimation demonstrates that the cost estimation of pipeline cost components is biased except for in the case of total costs. Overall overrun rates for pipeline material, labor, miscellaneous, ROW, and total costs are 4.9%, 22.4%, -0.9%, 9.1%, and 6.5%, respectively, and project size, capacity, diameter, location, and year of completion have different degrees of impacts on cost overruns of pipeline cost components. Analysis of compressor station costs shows that component costs, shares of cost components, and learning rates for material and labor costs vary in terms of capacity, year, and location. Average learning rates for compressor station material and labor costs are 12.1% and 7.48%, respectively. Overall average cost shares of material, labor, miscellaneous, and ROW are 50.6%, 27.2%, 21.5%, and 0.8%, respectively. Regression models are developed to estimate compressor station component costs in different capacities and locations. An investigation into inaccuracies in compressor station cost estimation demonstrates that the cost estimation for compressor stations is biased except for in the case of material costs. Overall average overrun rates for compressor station material, labor, miscellaneous, land, and total costs are 3%, 60%, 2%, -14%, and 11%, respectively, and cost overruns for cost components are influenced by location and year of completion to different degrees. Monte Carlo models are developed and simulated to evaluate the feasibility of an Alaska in-state gas pipeline by assigning triangular distribution of the values of economic parameters. Simulated results show that the construction of an Alaska in-state natural gas pipeline is feasible at three scenarios: 500 million cubic feet per day (mmcfd), 750 mmcfd, and 1000 mmcfd.

The Comprehensive Benefit Evaluation of Take Shared Bicycles as Connecting to Public Transit

NASA Astrophysics Data System (ADS)

Zhang, J. Y.; Sun, H.; Li, P. F.; Li, C. C.

2017-10-01

Shared bicycles as an important way of connecting public transport, have few literature to evaluate its effectiveness.This paper taking Beijing city as an example, make anevaluationfor the six types of travel combinations which are commonly used by the citizens. The author selects four quantitative indicators: fuel consumption, economic cost, total time spent, and CO2 emission. And two qualitative indicators: degree of comfort and convenience. The relative efficiency of quantitative indicators is obtained by data envelopment analysis (DEA) and fuzzification and then take fuzzy synthetic evaluation with qualitative indicators.It was found that the choice of shared bicycles +subway+ shared bicycles and shared bicycles has good comprehensive benefits in medium distance travel. The findings also suggest that shared bicycles +subway+ shared bicycles is the best choice in the utilitarian trips. The conclusions not only provide suggestions for the travellers to select travel modes, but also can adjust the relevant factors to increase the proportion of green travel.

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.

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...

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.

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...

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...

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...

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

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.

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...

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...

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...

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...

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...

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...

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 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...

Hospital pharmacy decisions, cost containment, and the use of cost-effectiveness analysis.

PubMed

Sloan, F A; Whetten-Goldstein, K; Wilson, A

1997-08-01

The key hypothesis of the study was that hospital pharmacies under the pressure of managed care would be more likely to adopt process innovations to assure less costly and more cost-effective provision of care. We conducted a survey of 103 hospitals and analyzed secondary data on cost and staffing. Compared to the size of the reduction in length of stay, changes in the way that a day of care is delivered appear to be minor, even in areas with substantial managed care share. The vast majority of hospitals surveyed had implemented some form of therapeutic interchange and generic substitution. Most hospitals used some drug utilization guidelines, but as of mid 1995 these were not yet important management tools for hospital pharmacies. To our knowledge, ours was the first survey to investigate the link between hospital formularies and use of cost-effectiveness analysis. At most cost-effectiveness was a minor tool in pharmaceutical decision making in hospitals at present. We could determine no differences in use of such analyses by managed care market share in the hospital's market share. One impediment to the use of cost-effectiveness studies was the lack of timeliness of studies. Other stated reasons for not using cost-effectiveness analysis more often were: lack of information on hospitalized patients and hence on the potential cost offsets accruing to the hospital: lack of independent sponsorship, and inadequate expertise in economic evaluation.

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

Electric and hybrid electric vehicles: A technology assessment based on a two-stage Delphi study

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

Vyas, A.D.; Ng, H.K.; Santini, D.J.

1997-12-01

To address the uncertainty regarding future costs and operating attributes of electric and hybrid electric vehicles, a two stage, worldwide Delphi study was conducted. Expert opinions on vehicle attributes, current state of the technology, possible advancements, costs, and market penetration potential were sought for the years 2000, 2010, and 2020. Opinions related to such critical components as batteries, electric drive systems, and hybrid vehicle engines, as well as their respective technical and economic viabilities, were also obtained. This report contains descriptions of the survey methodology, analytical approach, and results of the analysis of survey data, together with a summary ofmore » other factors that will influence the degree of market success of electric and hybrid electric vehicle technologies. Responses by industry participants, the largest fraction among all the participating groups, are compared with the overall responses. An evaluation of changes between the two Delphi stages is also summarized. An analysis of battery replacement costs for various types is summarized, and variable operating costs for electric and hybrid vehicles are compared with those of conventional vehicles. A market penetration analysis is summarized, in which projected market shares from the survey are compared with predictions of shares on the basis of two market share projection models that use the cost and physical attributes provided by the survey. Finally, projections of market shares beyond the year 2020 are developed by use of constrained logit models of market shares, statistically fitted to the survey data.« less

43 CFR 404.39 - What factors will Reclamation consider in evaluating my capability to pay 25 percent or more of...

Code of Federal Regulations, 2010 CFR

2010-10-01

... RECLAMATION RURAL WATER SUPPLY PROGRAM Cost-Sharing § 404.39 What factors will Reclamation consider in... from water sales minus payments to supplies and employees); (7) Current (current bonds payable and... governments; (e) The existing cost of water and the cost to develop new water supplies in the region; and (f...

Implementing shared decision-making: consider all the consequences.

PubMed

Elwyn, Glyn; Frosch, Dominick L; Kobrin, Sarah

2016-08-08

The ethical argument that shared decision-making is "the right" thing to do, however laudable, is unlikely to change how healthcare is organized, just as evidence alone will be an insufficient factor: practice change is governed by factors such as cost, profit margin, quality, and efficiency. It is helpful, therefore, when evaluating new approaches such as shared decision-making to conceptualize potential consequences in a way that is broad, long-term, and as relevant as possible to multiple stakeholders. Yet, so far, evaluation metrics for shared decision-making have been mostly focused on short-term outcomes, such as cognitive or affective consequences in patients. The goal of this article is to hypothesize a wider set of consequences, that apply over an extended time horizon, and include outcomes at interactional, team, organizational and system levels, and to call for future research to study these possible consequences. To date, many more studies have evaluated patient decision aids rather than other approaches to shared decision-making, and the outcomes measured have typically been focused on short-term cognitive and affective outcomes, for example knowledge and decisional conflict. From a clinicians perspective, the shared decision-making process could be viewed as either intrinsically rewarding and protective, or burdensome and impractical, yet studies have not focused on the impact on professionals, either positive or negative. At interactional levels, group, team, and microsystem, the potential long-term consequences could include the development of a culture where deliberation and collaboration are regarded as guiding principles, where patients are coached to assess the value of interventions, to trade-off benefits versus harms, and assess their burdens-in short, to new social norms in the clinical workplace. At organizational levels, consistent shared decision-making might boost patient experience evaluations and lead to fewer complaints and legal challenges. In the long-term, shared decision-making might lead to changes in resource utilization, perhaps to reductions in cost, and to modification of workforce composition. Despite the gradual shift to value-based payment, some organizations, motivated by continued income derived from achieving high volumes of procedures and contacts, will see this as a negative consequence. We suggest that a broader conceptualization and measurement of shared decision-making would provide a more substantive evidence base to guide implementation. We outline a framework which illustrates a hypothesized set of proximal, distal, and distant consequences that might occur if collaboration and deliberation could be achieved routinely, proposing that well-informed preference-based patient decisions might lead to safer, more cost-effective healthcare, which in turn might result in reduced utilization rates and improved health outcomes.

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.

Realism and resources: Towards more explanatory economic evaluation

PubMed Central

Anderson, Rob; Hardwick, Rebecca

2016-01-01

To be successfully and sustainably adopted, policy-makers, service managers and practitioners want public programmes to be affordable and cost-effective, as well as effective. While the realist evaluation question is often summarised as what works for whom, under what circumstances, we believe the approach can be as salient to answering questions about resource use, costs and cost-effectiveness – the traditional domain of economic evaluation methods. This paper first describes the key similarities and differences between economic evaluation and realist evaluation. It summarises what health economists see as the challenges of evaluating complex interventions, and their suggested solutions. We then use examples of programme theory from a recent realist review of shared care for chronic conditions to illustrate two ways in which realist evaluations might better capture the resource requirements and resource consequences of programmes, and thereby produce explanations of how they are linked to outcomes (i.e. explanations of cost-effectiveness). PMID:27478402

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.

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.

Integrated Arrival and Departure Schedule Optimization Under Uncertainty

NASA Technical Reports Server (NTRS)

Xue, Min; Zelinski, Shannon

2014-01-01

In terminal airspace, integrating arrivals and departures with shared waypoints provides the potential of improving operational efficiency by allowing direct routes when possible. Incorporating stochastic evaluation as a post-analysis process of deterministic optimization, and imposing a safety buffer in deterministic optimization, are two ways to learn and alleviate the impact of uncertainty and to avoid unexpected outcomes. This work presents a third and direct way to take uncertainty into consideration during the optimization. The impact of uncertainty was incorporated into cost evaluations when searching for the optimal solutions. The controller intervention count was computed using a heuristic model and served as another stochastic cost besides total delay. Costs under uncertainty were evaluated using Monte Carlo simulations. The Pareto fronts that contain a set of solutions were identified and the trade-off between delays and controller intervention count was shown. Solutions that shared similar delays but had different intervention counts were investigated. The results showed that optimization under uncertainty could identify compromise solutions on Pareto fonts, which is better than deterministic optimization with extra safety buffers. It helps decision-makers reduce controller intervention while achieving low delays.

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...

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...

Access to Care for Medicare-Medicaid Dually Eligible Beneficiaries: The Role of State Medicaid Payment Policies.

PubMed

Zheng, Nan Tracy; Haber, Susan; Hoover, Sonja; Feng, Zhanlian

2017-12-01

Medicaid programs are not required to pay the full Medicare coinsurance and deductibles for Medicare-Medicaid dually eligible beneficiaries. We examined the association between the percentage of Medicare cost sharing paid by Medicaid and the likelihood that a dually eligible beneficiary used evaluation and management (E&M) services and safety net provider services. Medicare and Medicaid Analytic eXtract enrollment and claims data for 2009. Multivariate analyses used fee-for-service dually eligible and Medicare-only beneficiaries in 20 states. A comparison group of Medicare-only beneficiaries controlled for state factors that might influence utilization. Paying 100 percent of the Medicare cost sharing compared to 20 percent increased the likelihood (relative to Medicare-only) that a dually eligible beneficiary had any E&M visit by 6.4 percent. This difference in the percentage of cost sharing paid decreased the likelihood of using safety net providers, by 37.7 percent for federally qualified health centers and rural health centers, and by 19.8 percent for hospital outpatient departments. Reimbursing the full Medicare cost-sharing amount would improve access for dually eligible beneficiaries, although the magnitude of the effect will vary by state and type of service. © Health Research and Educational Trust.

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...

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...

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.

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...

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...

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...

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...

Acceptability and Feasibility of Sharing a Soapy Water System for Handwashing in a Low-Income Urban Community in Dhaka, Bangladesh: A Qualitative Study.

PubMed

Sultana, Farhana; Unicomb, Leanne E; Nizame, Fosiul A; Dutta, Notan Chandra; Ram, Pavani K; Luby, Stephen P; Winch, Peter J

2018-06-11

Handwashing with soap at key times is an effective means of reducing pathogen transmission. In a low-income community in urban Dhaka, we piloted and evaluated the acceptability and feasibility of a shared handwashing intervention. This included promotion by community health promoters of a homemade solution of detergent powder mixed with water and stored in a 1.5-L reclaimed mineral water bottle. Community health promoters encouraged sharing of the recurrent detergent cost among compound members. Of 152 participating compounds, fieldworkers randomly selected 60 for qualitative assessment. Fieldworkers conducted 30 in-depth interviews and five focus group discussions among purposively selected compound members. The reclaimed bottles served as an easily accessible dispenser for the soapy water, which could feasibly be retained next to the toilet and kitchen areas for communal use. Bottles functioned as a positive reminder for handwashing at recommended key times. Most compounds (45/60, 75%) shared a common soapy water system and its associated costs. There was reluctance to prepare soapy water for shared use in the remaining 25%. Soapy water was an acceptable hand cleaning agent, with the bottle as a feasible dispenser. It was simple in design, cost-effective, replicable, popular with intervention recipient, and neighboring nonrecipients, and commonly shared among nonrelated households. The need to share expenses and product preparation served as a barrier. Developing a sustainable maintenance system, therefore, is critical to ensuring the public health benefits of handwashing with soap.

7 CFR 636.19 - Access to operating unit.

Code of Federal Regulations, 2014 CFR

2014-01-01

..., DEPARTMENT OF AGRICULTURE LONG TERM CONTRACTING WILDLIFE HABITAT INCENTIVE PROGRAM § 636.19 Access to... information necessary to evaluate the habitat development performance specified in the cost-share agreements...

7 CFR 636.19 - Access to operating unit.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., DEPARTMENT OF AGRICULTURE LONG TERM CONTRACTING WILDLIFE HABITAT INCENTIVE PROGRAM § 636.19 Access to... information necessary to evaluate the habitat development performance specified in the cost-share agreements...

7 CFR 636.19 - Access to operating unit.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., DEPARTMENT OF AGRICULTURE LONG TERM CONTRACTING WILDLIFE HABITAT INCENTIVE PROGRAM § 636.19 Access to... information necessary to evaluate the habitat development performance specified in the cost-share agreements...

7 CFR 636.19 - Access to operating unit.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., DEPARTMENT OF AGRICULTURE LONG TERM CONTRACTING WILDLIFE HABITAT INCENTIVE PROGRAM § 636.19 Access to... information necessary to evaluate the habitat development performance specified in the cost-share agreements...

An economic evaluation of anonymised information sharing in a partnership between health services, police and local government for preventing violence-related injury.

PubMed

Florence, Curtis; Shepherd, Jonathan; Brennan, Iain; Simon, Thomas R

2014-04-01

To assess the costs and benefits of a partnership between health services, police and local government shown to reduce violence-related injury. Benefit-cost analysis. Anonymised information sharing and use led to a reduction in wounding recorded by the police that reduced the economic and social costs of violence by £6.9 million in 2007 compared with the costs the intervention city, Cardiff UK, would have experienced in the absence of the programme. This includes a gross cost reduction of £1.25 million to the health service and £1.62 million to the criminal justice system in 2007. By contrast, the costs associated with the programme were modest: setup costs of software modifications and prevention strategies were £107 769, while the annual operating costs of the system were estimated as £210 433 (2003 UK pound). The cumulative social benefit-cost ratio of the programme from 2003 to 2007 was £82 in benefits for each pound spent on the programme, including a benefit-cost ratio of 14.80 for the health service and 19.1 for the criminal justice system. Each of these benefit-cost ratios is above 1 across a wide range of sensitivity analyses. An effective information-sharing partnership between health services, police and local government in Cardiff, UK, led to substantial cost savings for the health service and the criminal justice system compared with 14 other cities in England and Wales designated as similar by the UK government where this intervention was not implemented.

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...

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...

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...

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...

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...

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.

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...

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...

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...

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...

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.

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

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...

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...

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...

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...

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...

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...

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...

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...

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...

Adaptive cover crop implementation and evaluation in the Chesapeake Bay watersheds

USDA-ARS?s Scientific Manuscript database

Four years of applied research, led by the USDA-ARS Choptank River Conservation Reserve Assessment Project (CEAP), have demonstrated that satellite remote sensing, used in combination with cost-share program farm implementation records, can provide a powerful tool for evaluating the nutrient conserv...

Proceedings of International Workshops on ITS Benefits, Evaluation and Costs at the 12th ITS World Congress, San Francisco, November 2005

DOT National Transportation Integrated Search

2005-01-10

This report summarises the proceedings of the technical workshops, in which experts in ITS evaluation and decision-makers from around the world were brought together to present results and share ideas and experiences.

DEP : a computer program for evaluating lumber drying costs and investments

Treesearch

Stewart Holmes; George B. Harpole; Edward Bilek

1983-01-01

The DEP computer program is a modified discounted cash flow computer program designed for analysis of problems involving economic analysis of wood drying processes. Wood drying processes are different from other processes because of the large amounts of working capital required to finance inventories, and because of relatively large shares of costs charged to inventory...

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...

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...

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...

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...

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...

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...

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...

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.

Evaluation and Assessment Processes in Nebraska Public Schools. A Staff Report. Education Interim Study LR 181.

ERIC Educational Resources Information Center

Nebraska Legislative Council, Lincoln. Legislative Research Div.

During the spring of 1987, the National Conference of State Legislatures awarded the Nebraska Legislature a cost-sharing award to study local school evaluation processes. Embodied in Legislative Resolution 181, which has the purpose of studying school evaluation procedures, the study attempts to provide legislators, educators, local school…

DEVELOPMENT OF A SYSTEM FOR AN EDUCATIONAL PRODUCTS INFORMATION EXCHANGE. FINAL REPORT.

ERIC Educational Resources Information Center

KOMOSKI, P. KENNETH

THIS STUDY WAS UNDERTAKEN TO DESIGN AN EASILY ACCESSIBLE NATIONWIDE SYSTEM FOR EXCHANGING DESCRIPTIVE, EVALUATIVE PRODUCT INFORMATION AMONG ALL SECTORS OF THE EDUCATIONAL COMMUNITY ON A COOPERATIVE COST-SHARING BASIS. THE FEASIBILITY OF SUCH A COLLECTION AND EXCHANGE OF DESCRIPTIVE AND EVALUATIVE INFORMATION ABOUT INSTRUCTIONAL MATERIALS SYSTEMS…

The District Capital, City of Toyota : experiments of advanced transportation information, park and ride at events, shared use of low emission vehicles

DOT National Transportation Integrated Search

2000-11-09

On Thursday, November 9, 2000, the Benefits, Evaluation and Costs (BEC) Committee of ITS America hosted a workshop entitled International Workshop on ITS Benefits: How Evaluation Results Are Used in Transportation Decision-Making in Turin, Ital...

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…

Protect the sick: health insurance reform in one easy lesson.

PubMed

Stone, Deborah

2008-01-01

In thinking about how to expand insurance coverage, the issue that matters is whether insurance enables sick and high-risk people to get medical care. Over the course of three decades, market-oriented insurance reforms have shifted more costs of illness onto people who need and use medical care. By making the users of care pay for it (or even some of it), cost-sharing discourages sick people from getting care, even if they have insurance, and for people with low-incomes and tight budgets, cost-sharing can effectively deny them access to care. Thus, covering or not covering sick people is the core issue of health insurance reform, both as a determinant of support and opposition to proposals, and as the proper yardstick for evaluating reform ideas.

A critical analysis of studies of state drug reimbursement policies: research in need of discipline.

PubMed

Soumerai, S B; Ross-Degnan, D; Fortess, E E; Abelson, J

1993-01-01

Concerns over pharmaceutical costs and appropriateness of medication use have led state Medicaid programs to restrict drug reimbursement. This article critically reviews 20 years of research on cost sharing, drug reimbursement limits, and administrative limitations on access to particular drugs via formularies, category exclusions, or prior authorization requirements; evaluates their methodological rigor; summarizes the state of current knowledge; and proposes future research directions. Drug reimbursement caps and modest cost sharing can reduce the use of both essential and less important drugs in Medicaid populations; severe reimbursement caps may precipitate serious unintended effects. Limitations on access to particular drugs can cause both rational and irrational drug substitution effects; it is unclear whether such limits reduce expenditures either for drugs or for overall health care.

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

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).

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...

An economic evaluation of anonymised information sharing in a partnership between health services, police and local government for preventing violence-related injury

PubMed Central

Florence, Curtis; Shepherd, Jonathan; Brennan, Iain; Simon, Thomas

2018-01-01

Objective To assess the costs and benefits of a partnership between health services, police and local government shown to reduce violence related injury. Methods Cost benefit analysis Results Anonymised information sharing and use led to a reduction in wounding recorded by the police that reduced the economic and social costs of violence by £6.9 million in 2007 compared to the costs the intervention city, Cardiff UK, would have experienced in the absence of the programme. This includes a gross cost reduction of £1.25 million to the health service and £1.62 million to the criminal justice system in 2007. In contrast, the costs associated with the programme are modest: setup costs of software modifications and prevention strategies were £107,769, while the annual operating costs of the system were estimated as £210,433 (2003 UK Pound). The cumulative social benefit/cost ratio of the programme from 2003 to 2007 was £82 in benefits for each pound spent on the programme, including a benefit cost ratio of 14.8 for the health service and 19.1 for the criminal justice system. Each of these benefit/cost ratios is above 1 across a wide range of sensitivity analyses. Conclusions An effective information sharing partnership between health services, police, and local government in Cardiff, UK, led to substantial cost savings to the health service and the criminal justice system compared with 14 other cities in England and Wales designated as similar by the UK government where this intervention was not implemented. PMID:24048916

Increased cost sharing and changes in noncompliance with specialty referrals in The Netherlands.

PubMed

van Esch, Thamar E M; Brabers, Anne E M; van Dijk, Christel E; Gusdorf, Lisette; Groenewegen, Peter P; de Jong, Judith D

2017-02-01

The compulsory deductible, a form of patient cost-sharing in the Netherlands, has more than doubled during the past years. There are indications that as a result, refraining from medical care has increased. We studied the relation between patient cost-sharing and refraining from medical care by evaluating noncompliance with referrals to medical specialists over several years. Noncompliance with specialty referrals was assessed in the Netherlands from 2008 until 2013, using routinely recorded referrals from general practitioners to medical specialists and claims from medical specialists to health insurers. Associations with patient characteristics were estimated using multilevel logistic regression analyses. Noncompliance rates were approximately stable from 2008 to 2010 and increased from 18% in 2010 to 27% in 2013. Noncompliance was highest in adults aged 25-39 years. The increase was highest in children and patients with chronic diseases. No significantly higher increase among patients from urban deprived areas was found. Noncompliance increased during the rise of the compulsory deductible. Our results do not suggest a one-to-one relationship between increased patient cost-sharing and noncompliance with specialty referrals. In order to develop effective policy for reducing noncompliance, it is advisable to focus on the mechanisms for noncompliance in the groups with the highest noncompliance rates (young adults) and with the highest increase in noncompliance (children and patients with chronic diseases). Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Impact of drug cost sharing on service use and adverse clinical outcomes in elderly receiving antidepressants.

PubMed

Wang, Philip S; Patrick, Amanda R; Dormuth, Colin; Maclure, Malcolm; Avorn, Jerry; Canning, Claire F; Schneeweiss, Sebastian

2010-03-01

Depression imposes enormous burdens on the elderly. Despite this, rates of initiation of and adherence to recommended pharmacotherapy are frequently low in this population. Although initiatives such as the Medicare Modernization Act (MMA) have improved seniors' access to antidepressants, there are concerns that the patient cost-sharing incorporated in the MMA may have unintended consequences if it reduces essential drug use. Age-related pharmacokinetic and pharmacodynamic changes could make seniors particularly vulnerable to antidepressant regimens used inappropriately to save costs, increasing their risks of morbidity, hospitalizations, and nursing home placements. Two sequential large-scale "natural experiments'' in British Columbia provide a unique opportunity to evaluate the effect of cost sharing on outcomes and mental health service use among seniors. In January 2002 the province introduced a CAD 25 copay (CAD10 for low-income seniors). In May 2003 this copay policy was replaced by a second policy consisting of an income-based deductible, 25% coinsurance once the deductible was met, and full coverage once an out-of-pocket ceiling was met. The transition between the two policies is analogous to what many U.S. seniors experience when they transition from private insurance requiring copays to Medicare Part D requiring deductibles and coinsurance. To evaluate whether declines in antidepressant initiation after the introduction of two drug cost-sharing policies in British Columbia were associated with increased use of physician services, hospitalizations, and nursing home admissions among all British Columbia residents aged 65+. Records of physician service use, inpatient hospitalizations, and residential care admissions were obtained from administrative databases. Population-level patterns over time were plotted, and effects of implementing the cost-sharing policies examined in segmented linear regression models. Neither policy affected the rates of visits to physicians or psychiatrists for depression, hospitalizations with a depression diagnosis, or long-term care admissions. The cost-sharing policies studied may have contained non-essential antidepressant use without substantially increasing mental health service utilization. However, it is possible that the policies had effects that we were unable to detect, such as increasing rates of visits to social workers or psychologists or forcing patients to reduce other spending. Further, the sequential implementation of the policy changes, makes it difficult to estimate the effect of a direct change from full coverage to a coinsurance/income-based deductible policy. It may be possible to design policies to contain non-essential antidepressant use without substantially increasing other service utilization or adverse events. However, because undertreatment remains a serious problem among depressed elderly, well-designed prescription drug policies should be coupled with interventions to address under-treatment.

Impact of Drug Cost Sharing on Service Use and Adverse Clinical Outcomes In Elderly Receiving Antidepressants

PubMed Central

Wang, Philip S.; Patrick, Amanda R.; Dormuth, Colin; Maclure, Malcolm; Avorn, Jerry; Canning, Claire F.; Schneeweiss, Sebastian

2010-01-01

Background Depression imposes enormous burdens on the elderly. Despite this, rates of initiation of and adherence to recommended pharmacotherapy are frequently low in this population. Although initiatives such as the Medicare Modernization Act (MMA) in have improved seniors' access to antidepressants, there are concerns that the patient cost-sharing incorporated in the MMA may have unintended consequences if it reduces essential drug use. Age-related pharmacokinetic and pharmacodynamic changes could make seniors particularly vulnerable to antidepressant regimens used inappropriately to save costs, increasing their risks of morbidity, hospitalizations, and nursing home placements. Two sequential large-scale “natural experiments” in British Columbia provide a unique opportunity to evaluate the effect of cost sharing on outcomes and mental health service use among seniors. In January 2002 the province introduced a $25 Canadian copay ($10 for low-income seniors). In May 2003 this copay policy was replaced by a second policy consisting of an income-based deductible, 25% coinsurance once the deductible was met, and full coverage once an out-of-pocket ceiling was met. The transition between the two policies is analogous to what many U.S. seniors experience when they transition from private insurance requiring copays to Medicare Part D requiring deductibles and coinsurance. Aims To evaluate whether declines in antidepressant initiation after the introduction of two drug cost-sharing policies in British Columbia were associated with increased use of physician services, hospitalizations, and nursing home admissions among all British Columbia residents aged 65+. Methods Records of physician service use, inpatient hospitalizations, and residential care admissions were obtained from administrative databases. Population-level patterns over time were plotted, and effects of implementing the cost-sharing policies examined in segmented linear regression models. Results Neither policy affected the rates of visits to physicians or psychiatrists for depression, hospitalizations with a depression diagnosis, or long-term care admissions. Discussion The cost-sharing policies studied may have contained non-essential antidepressant use without substantially increasing mental health service utilization. However, it is possible that the policies had effects that we were unable to detect, such as increasing rates of visits to social workers or psychologists or forcing patients to reduce other spending. Further, the sequential implementation of the policy changes, makes it difficult to estimate the effect of a direct change from full coverage to a coinsurance/income-based deductible policy. Implications for Health Policies It may be possible to design policies to contain non-essential antidepressant use without substantially increasing other service utilization or adverse events. However, because undertreatment remains a serious problem among depressed elderly, well-designed prescription drug policies should be coupled with interventions to address under-treatment. PMID:20571181

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...

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...

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...

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...

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...

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...

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

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...

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...

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...

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...

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...

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.

23 CFR 505.17 - Applicability of Title 23, U.S. Code.

Code of Federal Regulations, 2010 CFR

2010-04-01

... INFRASTRUCTURE MANAGEMENT PROJECTS OF NATIONAL AND REGIONAL SIGNIFICANCE EVALUATION AND RATING § 505.17... until expended and the Federal share of the cost of a Project of National and Regional Significance...

Progress in Evaluating Quantitative Optical Gas Imaging

EPA Science Inventory

Development of advanced fugitive emission detection and assessment technologies that facilitate cost effective leak and malfunction mitigation strategies is an ongoing goal shared by industry, regulators, and environmental groups. Optical gas imaging (OGI) represents an importan...

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...

The performance of disk arrays in shared-memory database machines

NASA Technical Reports Server (NTRS)

Katz, Randy H.; Hong, Wei

1993-01-01

In this paper, we examine how disk arrays and shared memory multiprocessors lead to an effective method for constructing database machines for general-purpose complex query processing. We show that disk arrays can lead to cost-effective storage systems if they are configured from suitably small formfactor disk drives. We introduce the storage system metric data temperature as a way to evaluate how well a disk configuration can sustain its workload, and we show that disk arrays can sustain the same data temperature as a more expensive mirrored-disk configuration. We use the metric to evaluate the performance of disk arrays in XPRS, an operational shared-memory multiprocessor database system being developed at the University of California, Berkeley.

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.

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...

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...

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...

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. ...

The Impact of Redistricting Proposals on Health Care Expenditures for Liver Transplant Candidates and Recipients.

PubMed

Gentry, S E; Chow, E K H; Dzebisashvili, N; Schnitzler, M A; Lentine, K L; Wickliffe, C E; Shteyn, E; Pyke, J; Israni, A; Kasiske, B; Segev, D L; Axelrod, D A

2016-02-01

Redistricting, which means sharing organs in novel districts developed through mathematical optimization, has been proposed to reduce pervasive geographic disparities in access to liver transplantation. The economic impact of redistricting was evaluated with two distinct data sources, Medicare claims and the University HealthSystem Consortium (UHC). We estimated total Medicare payments under (i) the current allocation system (Share 35), (ii) full regional sharing, (iii) an eight-district plan, and (iv) a four-district plan for a simulated population of patients listed for liver transplant over 5 years, using the liver simulated allocation model. The model predicted 5-year transplant volumes (Share 35, 29,267; regional sharing, 29,005; eight districts, 29,034; four districts, 28,265) and a reduction in overall mortality, including listed and posttransplant patients, of up to 676 lives. Compared with current allocation, the eight-district plan was estimated to reduce payments for pretransplant care ($1638 million to $1506 million, p < 0.001), transplant episode ($5607 million to $5569 million, p < 0.03) and posttransplant care ($479 million to $488 million, p < 0.001). The eight-district plan was estimated to increase per-patient transportation costs for organs ($8988 to $11,874 per patient, p < 0.001) and UHC estimated hospital costs ($4699 per case). In summary, redistricting appears to be potentially cost saving for the health care system but will increase the cost of performing liver transplants for some transplant centers. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

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.

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

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...

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...

Performance-based risk-sharing arrangements-good practices for design, implementation, and evaluation: report of the ISPOR good practices for performance-based risk-sharing arrangements task force.

PubMed

Garrison, Louis P; Towse, Adrian; Briggs, Andrew; de Pouvourville, Gerard; Grueger, Jens; Mohr, Penny E; Severens, J L Hans; Siviero, Paolo; Sleeper, Miguel

2013-01-01

There is a significant and growing interest among both payers and producers of medical products for agreements that involve a "pay-for-performance" or "risk-sharing" element. These payment schemes-called "performance-based risk-sharing arrangements" (PBRSAs)-involve a plan by which the performance of the product is tracked in a defined patient population over a specified period of time and the amount or level of reimbursement is based on the health and cost outcomes achieved. There has always been considerable uncertainty at product launch about the ultimate real-world clinical and economic performance of new products, but this appears to have increased in recent years. PBRSAs represent one mechanism for reducing this uncertainty through greater investment in evidence collection while a technology is used within a health care system. The objective of this Task Force report was to set out the standards that should be applied to "good practices"-both research and operational-in the use of a PBRSA, encompassing questions around the desirability, design, implementation, and evaluation of such an arrangement. This report provides practical recommendations for the development and application of state-of-the-art methods to be used when considering, using, or reviewing PBRSAs. Key findings and recommendations include the following. Additional evidence collection is costly, and there are numerous barriers to establishing viable and cost-effective PBRSAs: negotiation, monitoring, and evaluation costs can be substantial. For good research practice in PBRSAs, it is critical to match the appropriate study and research design to the uncertainties being addressed. Good governance processes are also essential. The information generated as part of PBRSAs has public good aspects, bringing ethical and professional obligations, which need to be considered from a policy perspective. The societal desirability of a particular PBRSA is fundamentally an issue as to whether the cost of additional data collection is justified by the benefits of improved resource allocation decisions afforded by the additional evidence generated and the accompanying reduction in uncertainty. The ex post evaluation of a PBRSA should, however, be a multidimensional exercise that assesses many aspects, including not only the impact on long-term cost-effectiveness and whether appropriate evidence was generated but also process indicators, such as whether and how the evidence was used in coverage or reimbursement decisions, whether budget and time were appropriate, and whether the governance arrangements worked well. There is an important gap in the literature of structured ex post evaluation of PBRSAs. As an innovation in and of themselves, PBRSAs should also be evaluated from a long-run societal perspective in terms of their impact on dynamic efficiency (eliciting the optimal amount of innovation). Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

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...

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...

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.

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.

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...

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...

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...

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...

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...

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...

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...

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...

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...

12 strategies for managing capital projects.

PubMed

Stoudt, Richard L

2013-05-01

To reduce the amount of time and cost associated with capital projects, healthcare leaders should: Begin the project with a clear objective and a concise master facilities plan. Select qualified team members who share the vision of the owner. Base the size of the project on a conservative business plan. Minimize incremental program requirements. Evaluate the cost impact of the building footprint. Consider alternative delivery methods.

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.

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...

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...

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...

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...

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...

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...

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…

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

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...

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...

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.

Economic analysis of centralized vs. decentralized electronic data capture in multi-center clinical studies.

PubMed

Walden, Anita; Nahm, Meredith; Barnett, M Edwina; Conde, Jose G; Dent, Andrew; Fadiel, Ahmed; Perry, Theresa; Tolk, Chris; Tcheng, James E; Eisenstein, Eric L

2011-01-01

New data management models are emerging in multi-center clinical studies. We evaluated the incremental costs associated with decentralized vs. centralized models. We developed clinical research network economic models to evaluate three data management models: centralized, decentralized with local software, and decentralized with shared database. Descriptive information from three clinical research studies served as inputs for these models. The primary outcome was total data management costs. Secondary outcomes included: data management costs for sites, local data centers, and central coordinating centers. Both decentralized models were more costly than the centralized model for each clinical research study: the decentralized with local software model was the most expensive. Decreasing the number of local data centers and case book pages reduced cost differentials between models. Decentralized vs. centralized data management in multi-center clinical research studies is associated with increases in data management costs.

Economic Analysis of Centralized vs. Decentralized Electronic Data Capture in Multi-Center Clinical Studies

PubMed Central

Walden, Anita; Nahm, Meredith; Barnett, M. Edwina; Conde, Jose G.; Dent, Andrew; Fadiel, Ahmed; Perry, Theresa; Tolk, Chris; Tcheng, James E.; Eisenstein, Eric L.

2012-01-01

Background New data management models are emerging in multi-center clinical studies. We evaluated the incremental costs associated with decentralized vs. centralized models. Methods We developed clinical research network economic models to evaluate three data management models: centralized, decentralized with local software, and decentralized with shared database. Descriptive information from three clinical research studies served as inputs for these models. Main Outcome Measures The primary outcome was total data management costs. Secondary outcomes included: data management costs for sites, local data centers, and central coordinating centers. Results Both decentralized models were more costly than the centralized model for each clinical research study: the decentralized with local software model was the most expensive. Decreasing the number of local data centers and case book pages reduced cost differentials between models. Conclusion Decentralized vs. centralized data management in multi-center clinical research studies is associated with increases in data management costs. PMID:21335692

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…

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…

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...

Innovation and The Welfare Effects of Public Drug Insurance*

PubMed Central

Lakdawalla, Darius; Sood, Neeraj

2010-01-01

Rewarding inventors with inefficient monopoly power has long been regarded as the price of encouraging innovation. Prescription drug insurance escapes that trade-off and achieves an elusive goal: lowering static deadweight loss, without reducing incentives for innovation. As a result of this feature, the public provision of drug insurance can be welfare-improving, even for risk-neutral and purely self-interested consumers. The design of insurers’ cost-sharing schedules can either reinforce or mitigate this result. Schedules that impose higher consumer cost-sharing requirements on more expensive drugs help ensure that insurance subsidies translate into higher utilization, rather than pure increases in manufacturer profits. Moreover, some degree of price-negotiation with manufacturers is likely to be welfare-improving, but the optimal degree depends on the size of such transactions costs, as well as the social cost of weakening innovation incentives by lowering innovator profits. These results have practical implications for the evaluation of public drug insurance programs like the US Medicaid and Medicare Part D programs, along with European insurance schemes. PMID:20454467

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.

A systematic review of contemporary models of shared HIV care and HIV in primary care in high-income settings.

PubMed

Mapp, Fiona; Hutchinson, Jane; Estcourt, Claudia

2015-12-01

HIV shared care is uncommon in the UK although shared care could be a beneficial model of care. We review the literature on HIV shared care to determine current practice and clinical, economic and patient satisfaction outcomes. We searched MEDLINE, EMBASE, NICE Evidence, Cochrane collaboration, Google and websites of the British HIV Association, Aidsmap, Public Health England, World Health Organization and Terrence Higgins Trust using relevant search terms in August 2014. Studies published after 2000, from healthcare settings comparable to the UK that described links between primary care and specialised HIV services were included and compared using principles of the Critical Appraisal Skills Programme and Authority, Accuracy, Coverage, Objectivity, Date, Significance frameworks. Three of the nine included models reported clinical or patient satisfaction outcomes but data collection and analyses were inadequate. None reported economic outcomes although some provided financial costings. Facilitators of shared care included robust clinical protocols, training and timely communication. Few published examples of HIV shared care exist and quality of evidence is poor. There is no consistent association with improved clinical outcomes, cost effectiveness or acceptability. Models are context specific, driven by local need, although some generalisable features could inform novel service delivery. Further evaluative research is needed to determine optimal components of shared HIV care. © The Author(s) 2015.

Improving Value for Patients with Eczema.

PubMed

Block, Julie

2018-04-01

Chronic diseases now represent a cost majority in the United States health care system. Contributing factors to rising costs include expensive novel and emerging therapies, under-treatment of disease, under-management of comorbidities, and patient dissatisfaction with care results. Critical to identifying replicable improvement methods is a reliable model to measure value. If we understand value within healthcare consumerism to be equal to a patient's health outcome improvement over costs associated with care (Value=Outcomes/Costs), we can use this equation to measure the improvement of value. Research and literature show that patient activation-the skills and confidence that equip patients to become actively engaged in their health care-impact health outcomes, costs, and patient experience. Reaching patient activation through engagement methods including shared decision-making (SDM) lead to improved value of care received. The National Eczema Association (NEA) Shared Decision-Making Resource Center can be a transformative strategy to measure and evaluate value of health care interventions for eczema patients to advance a value-driven health care system in the United States. Through this Resource Center, NEA will measure patient value through their own perceptions using validated PRO instruments and other patient-generated health data. Assessment of this data will reveal findings that can assist researchers in evaluating the impact this care framework on patient-perceived value across other chronic diseases. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

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.

College Curriculum-Sharing Via CTS.

ERIC Educational Resources Information Center

Hudson, Heather E.; And Others

Domestic communication satellites and video compression techniques will increase communication channel capacity and reduce cost of video transmission. The National Aeronautics and Space Administration Ames Research Center, Stanford University, and Carleton University are participants in an experiment to develop, demonstrate, and evaluate the…

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...

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...

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...

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...

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...

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...

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...

Sharing of grant funds between academic institutions and community partners in community-based participatory research.

PubMed

Cain, Katrice D; Theurer, Jacqueline R; Sehgal, Ashwini R

2014-04-01

To determine how grant funds are shared between academic institutions and community partners in community-based participatory research (CBPR). Review of all 62 investigator-initiated R01 CBPR grants funded by the National Institutes of Health from January 2005 to August 2012. Using prespecified criteria, two reviewers independently categorized each budget item as being for an academic institution or a community partner. A third reviewer helped resolve any discrepancies. Among 49 evaluable grants, 68% of all grant funds were for academic institutions and 30% were for community partners. For 2% of funds, it was unclear whether they were for academic institutions or for community partners. Community partners' share of funds was highest in the categories of other direct costs (62%) and other personnel (48%) and lowest in the categories of equipment (1%) and indirect costs (7%). A majority of CBPR grant funds are allocated to academic institutions. In order to enhance the share that community partners receive, funders may wish to specify a minimum proportion of grant funds that should be allocated to community partners in CBPR projects. © 2014 Wiley Periodicals, Inc.

Determinants of change in Medicaid pharmaceutical cost sharing: does evidence affect policy?

PubMed

Soumerai, S B; Ross-Degnan, D; Fortess, E E; Walser, B L

1997-01-01

Since 1980, many Medicaid programs have instituted, adjusted, or abolished pharmaceutical copayments or limitations on the number of prescriptions per patient (caps). Studies indicate that prescription caps can harm patients and increase Medicaid costs. However, because there is little information on how state policy makers select and evaluate such policies, in-depth telephone interviews were conducted with key informants in Medicaid programs that had recently made changes in cost-sharing policies. Among the barriers to evidence-based policy making were lack of political power, skills, and infrastructure; crisis-oriented decisions; compartmentalized budgeting; lack of advocates for disadvantaged patients; and the absence of timely research. Research was applied successfully when the interests of patient advocates and the drug industry were aligned and when Medicaid analysis were able to identify and communicate relevant research to policy makers at the time, or "teachable moment," that policy was being changed.

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…

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...

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

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.

Wineries Evaluation of Costs and Benefits of Sustainability Certification Program: The Case of Terra Vitis in France.

PubMed

Jourjon, Frederique; Chou, Hsia-Chi; Gezart, Anna; Kadison, Amy E; Martinat, Lea; Pomarici, Eugenio; Vecchio, Riccardo

2016-01-01

The current paper analyses the evaluation of the costs and benefits of French wineries (N=69) participating in the sustainability program Terra Vitis, a widespread environmental certification scheme within the French wine industry. An online questionnaire was sent to all Terra Vitis participants, in order to analyse the evaluation of economic costs and benefits (together with environmental benefits) as perceived by wineries. Our findings reveal that older participants in the scheme (over 5 years), firms with higher export share (>40% of annual turnover) and cooperative wineries tend to be keener to assign a positive evaluation to the benefits/costs ratio in both the vineyard and the winery. In the context of increasing concerns regarding the economic and environmental performance of the French agricultural sector, such findings and also the patent research could be useful for policy makers and entrepreneurs in defining mainstream normative and corporate strategies. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

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...

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...

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...

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...

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...

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...

Multiple Drug Cost Containment Policies in Michigan’s Medicaid Program Saved Money Overall, Although Some Increased Costs

PubMed Central

Kibicho, Jennifer; Pinkerton, Steven D.

2014-01-01

Michigan’s Medicaid program implemented four policies (preferred lists, joint and multi-state purchasing arrangements, and maximum allowable cost) in 2002–2004 for its dual-eligible Medicaid and Medicare beneficiaries, taking antihypertensives and antihyperlipidemics prescriptions. We used interrupted time series analysis to evaluate the impact of each individual policy while holding the effect of all other policies constant. Preferred lists increased preferred and generic market share, and reduced daily cost. In contrast, maximum allowable cost increased daily cost, and is the only policy that did not generate cost savings. The joint and multi-state arrangements did not impact daily cost. Despite policy tradeoffs, the cumulative effect was a 10% decrease in daily cost and an annualized cost savings of $46,195. PMID:22492899

College curriculum-sharing via CTS. [Communications Technology Satellite

NASA Technical Reports Server (NTRS)

Hudson, H. E.; Guild, P. D.; Coll, D. C.; Lumb, D. R.

1975-01-01

Domestic communication satellites and video compression techniques will increase communication channel capacity and reduce cost of video transmission. NASA Ames Research Center, Stanford University and Carleton University are participants in an experiment to develop, demonstrate, and evaluate college course sharing techniques via satellite using video compression. The universities will exchange televised seminar and lecture courses via CTS. The experiment features real-time video compression with channel coding and quadra-phase modulation for reducing transmission bandwidth and power requirements. Evaluation plans and preliminary results of Carleton surveys on student attitudes to televised teaching are presented. Policy implications for the U.S. and Canada are outlined.

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.

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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) ...

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

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.

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...

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...

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...

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...

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...

OCLC for the hospital library: the justification plan for hospital administration.

PubMed

Allen, C W; Branson, J R

1982-07-01

This paper delineates the necessary steps to provide hospital administrators with the information needed to evaluate an automated system, OCLC, for addition to the medical library. Based on experience at the Norton-Children's Hospitals, included are: (1) cost analyses of present technical processing systems and cost comparisons with OCLC; (2) delineation of start-up costs for installing OCLC; (3) budgetary requirements for 1981; (4) the impact of automation on library systems, personnel, and services; (5) potential as a shared service; and (6) preparation of the proposal for administrative review.

OCLC for the hospital library: the justification plan for hospital administration.

PubMed Central

Allen, C W; Branson, J R

1982-01-01

This paper delineates the necessary steps to provide hospital administrators with the information needed to evaluate an automated system, OCLC, for addition to the medical library. Based on experience at the Norton-Children's Hospitals, included are: (1) cost analyses of present technical processing systems and cost comparisons with OCLC; (2) delineation of start-up costs for installing OCLC; (3) budgetary requirements for 1981; (4) the impact of automation on library systems, personnel, and services; (5) potential as a shared service; and (6) preparation of the proposal for administrative review. PMID:7116018

Health care evaluation, utilitarianism and distortionary taxes.

PubMed

Calcott, P

2000-09-01

Cost Utility Analysis (CUA) and Cost Benefit Analysis (CBA) are methods to evaluate allocations of health care resources. Problems are raised for both methods when income taxes do not meet the first best optimum. This paper explores the implications of three ways that taxes may fall short of this ideal. First, taxes may be distortionary. Second, they may be designed and administered without reference to information that is used by providers of health care. Finally, the share of tax revenue that is devoted to health care may be suboptimal. The two methods are amended to account for these factors.

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.

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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…

Intermodal Freight Technology Working Group asset tracking and "freight information highway" field operational test evaluation : final report executive summary

DOT National Transportation Integrated Search

2003-09-01

In January 2001, the Federal Highway Administration (FHWA) released a solicitation requesting "Cost Sharing Cooperative Agreements" to conduct operational tests to improve efficiencies in the intermodal freight operations and to establish the foundat...

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...

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...

Creating and sharing clinical decision support content with Web 2.0: Issues and examples.

PubMed

Wright, Adam; Bates, David W; Middleton, Blackford; Hongsermeier, Tonya; Kashyap, Vipul; Thomas, Sean M; Sittig, Dean F

2009-04-01

Clinical decision support is a powerful tool for improving healthcare quality and patient safety. However, developing a comprehensive package of decision support interventions is costly and difficult. If used well, Web 2.0 methods may make it easier and less costly to develop decision support. Web 2.0 is characterized by online communities, open sharing, interactivity and collaboration. Although most previous attempts at sharing clinical decision support content have worked outside of the Web 2.0 framework, several initiatives are beginning to use Web 2.0 to share and collaborate on decision support content. We present case studies of three efforts: the Clinfowiki, a world-accessible wiki for developing decision support content; Partners Healthcare eRooms, web-based tools for developing decision support within a single organization; and Epic Systems Corporation's Community Library, a repository for sharing decision support content for customers of a single clinical system vendor. We evaluate the potential of Web 2.0 technologies to enable collaborative development and sharing of clinical decision support systems through the lens of three case studies; analyzing technical, legal and organizational issues for developers, consumers and organizers of clinical decision support content in Web 2.0. We believe the case for Web 2.0 as a tool for collaborating on clinical decision support content appears strong, particularly for collaborative content development within an organization.

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...

Analyzing the Sensitivity of Hydrogen Vehicle Sales to Consumers' Preferences

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

Greene, David L; Lin, Zhenhong; Dong, Jing

2013-01-01

The success of hydrogen vehicles will depend on consumer behavior as well as technology, energy prices and public policy. This study examines the sensitivity of the future market shares of hydrogen-powered vehicles to alternative assumptions about consumers preferences. The Market Acceptance of Advanced Automotive Technologies model was used to project future market shares. The model has 1,458 market segments, differentiated by travel behavior, geography, and tolerance to risk, among other factors, and it estimates market shares for twenty advanced power-train technologies. The market potential of hydrogen vehicles is most sensitive to the improvement of drive train technology, especially cost reduction.more » The long-run market success of hydrogen vehicles is less sensitive to the price elasticity of vehicle choice, how consumers evaluate future fuel costs, the importance of fuel availability and limited driving range. The importance of these factors will likely be greater in the early years following initial commercialization of hydrogen vehicles.« less

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.

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.

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

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...

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...

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...

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...

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...

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...

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...

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...

Sustainability and shared smart and mutual--green growth (SSaM-GG) in Korean medical waste management.

PubMed

Koo, Ja-Kong; Jeong, Seung-Ik

2015-05-01

Since medical insurance was introduced in the Republic of Korea, there have been several increases concerning medical waste. In order to solve these problems, we have applied life cycle assessment and life cycle cost. But these methods cannot be a perfect decision-making tool because they can only evaluate environmental and economic burdens. Thus, as one of many practical methods the shared smart and mutual - green growth considers economic growth, environmental protection, social justice, science technology and art, and mutual voluntarism when applied to medical waste management in the Republic of Korea. Four systems were considered: incineration, incineration with heat recovery, steam sterilisation, and microwave disinfection. This research study aimed to assess pollutant emissions from treatment, transport, and disposal. Global warming potential, photochemical oxidant creation potential, acidifications potential, and human toxicity are considered to be environmental impacts. Total investment cost, transport cost, operation, and maintenance cost for the medical waste are considered in the economy evaluations though life cycle cost. The social development, science technology and art, and mutual voluntarism are analysed through the Delphi-method conducted by expert groups related to medical waste. The result is that incineration with heat recovery is the best solution. However, when heat recovery is impossible, incineration without heat recovery becomes the next best choice. That is why 95% of medical waste is currently treated by both incineration and incineration with heat recovery within the Republic of Korea. © The Author(s) 2015.

Funding the new biologics--public policy issues in drug formulary decision making.

PubMed

Lewis, Steven

2002-12-01

One function of drug formularies is to allow health care providers to exert some control over spending. Decisions about whether to include a given medication in a formulary are based on estimates of its costs and effectiveness, relative to other treatment strategies. These decisions are made from a societal perspective, as opposed to that of individual patients, which sometimes results in conflicts. The clinical response to a medication often varies widely among subjects, which means that a small subgroup of patients might benefit dramatically, while others with the same disease do not. The result would be that a drug might appear not to be cost effective in an economic analysis, even though it is of proven value for some patients. New and innovative medications are assessed according to high standards of cost effectiveness, even though established treatments are wasteful of valuable health care resources. Moreover, quality-adjusted life-years (QALYs) discriminate against certain patient groups, including those with diseases that are associated with a high morbidity but a low mortality. Such patients often incur high indirect costs, including loss of employment income and costs incurred by family caregivers that QALYs do not reflect. Therefore, even though QALYs are transparent and widely applicable, they are not necessarily appropriate in the evaluation of a particular therapeutic intervention. A new paradigm should be developed for evaluating emerging therapies. An example would be a risk-sharing approach, whereby the pharmaceutical industry and public insurers share in the costs and rewards of introducing new treatments. This would have implications for the prices charged for new medications.

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.

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.

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.

Determinants of Medicare plan choices: are beneficiaries more influenced by premiums or benefits?

PubMed

Jacobs, Paul D; Buntin, Melinda B

2015-07-01

To evaluate the sensitivity of Medicare beneficiaries to premiums and benefits when selecting healthcare plans after the introduction of Part D. We matched respondents in the 2008 Medicare Current Beneficiary Survey to the Medicare Advantage (MA) plans available to them using the Bid Pricing Tool and previously unavailable data on beneficiaries' plan choices. We estimated a 2-stage nested logit model of Medicare plan choice decision making, including the decision to choose traditional fee-for-service (FFS) Medicare or an MA plan, and for those choosing MA, which specific plan they chose. Beneficiaries living in areas with higher average monthly rebates available from MA plans were more likely to choose MA rather than FFS. When choosing MA plans, beneficiaries are roughly 2 to 3 times more responsive to dollars spent to reduce cost sharing than reductions in their premium. We calculated an elasticity of plan choice with respect to the monthly MA premium of -0.20. Beneficiaries with lower incomes are more sensitive to plan premiums and cost sharing than higher-income beneficiaries. MA plans appear to have a limited incentive to aggressively price their products, and seem to compete primarily over reduced beneficiary cost sharing. Given the limitations of the current plan choice environment, policies designed to encourage the selection of lower-cost plans may require increasing premium differences between plans and providing the tools to enable beneficiaries to easily assess those differences.

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.

SOCIO-ECONOMIC IMPACT EVALUATION OF LAKE IMPROVEMENT PROJECTS AND LAKE MANAGEMENT GUIDELINES

EPA Science Inventory

Under Public Law 92-500, the U.S. Environmental Protection Agency embarked on a major program of cost sharing grants to implement lake rehabilitation and protection projects. Improvement of water quality impacts the lives of people and organizations; however, the methods used to ...

10 CFR 603.555 - Value of other contributions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Value of other contributions. 603.555 Section 603.555 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Pre-Award Business Evaluation Cost Sharing § 603.555 Value of other contributions. For types of participant...

Student Centered Financial Services: Innovations That Succeed

ERIC Educational Resources Information Center

Sinsabaugh, Nancy, Ed.

2007-01-01

This collection of best practices shares how 18 higher education institutions across the country have successfully evaluated and redesigned their student financial services programs to improve services to students and their parents and find cost savings for the institution. This volume illustrates how other institutions have successfully tackled…

Effects of primary care team social networks on quality of care and costs for patients with cardiovascular disease.

PubMed

Mundt, Marlon P; Gilchrist, Valerie J; Fleming, Michael F; Zakletskaia, Larissa I; Tuan, Wen-Jan; Beasley, John W

2015-03-01

Cardiovascular disease is the leading cause of mortality and morbidity in the United States. Primary care teams can be best suited to improve quality of care and lower costs for patients with cardiovascular disease. This study evaluates the associations between primary care team communication, interaction, and coordination (ie, social networks); quality of care; and costs for patients with cardiovascular disease. Using a sociometric survey, 155 health professionals from 31 teams at 6 primary care clinics identified with whom they interact daily about patient care. Social network analysis calculated variables of density and centralization representing team interaction structures. Three-level hierarchical modeling evaluated the link between team network density, centralization, and number of patients with a diagnosis of cardiovascular disease for controlled blood pressure and cholesterol, counts of urgent care visits, emergency department visits, hospital days, and medical care costs in the previous 12 months. Teams with dense interactions among all team members were associated with fewer hospital days (rate ratio [RR] = 0.62; 95% CI, 0.50-0.77) and lower medical care costs (-$556; 95% CI, -$781 to -$331) for patients with cardiovascular disease. Conversely, teams with interactions revolving around a few central individuals were associated with increased hospital days (RR = 1.45; 95% CI, 1.09-1.94) and greater costs ($506; 95% CI, $202-$810). Team-shared vision about goals and expectations mediated the relationship between social network structures and patient quality of care outcomes. Primary care teams that are more interconnected and less centralized and that have a shared team vision are better positioned to deliver high-quality cardiovascular disease care at a lower cost. © 2015 Annals of Family Medicine, Inc.

Effects of Primary Care Team Social Networks on Quality of Care and Costs for Patients With Cardiovascular Disease

PubMed Central

Mundt, Marlon P.; Gilchrist, Valerie J.; Fleming, Michael F.; Zakletskaia, Larissa I.; Tuan, Wen-Jan; Beasley, John W.

2015-01-01

PURPOSE Cardiovascular disease is the leading cause of mortality and morbidity in the United States. Primary care teams can be best suited to improve quality of care and lower costs for patients with cardiovascular disease. This study evaluates the associations between primary care team communication, interaction, and coordination (ie, social networks); quality of care; and costs for patients with cardiovascular disease. METHODS Using a sociometric survey, 155 health professionals from 31 teams at 6 primary care clinics identified with whom they interact daily about patient care. Social network analysis calculated variables of density and centralization representing team interaction structures. Three-level hierarchical modeling evaluated the link between team network density, centralization, and number of patients with a diagnosis of cardiovascular disease for controlled blood pressure and cholesterol, counts of urgent care visits, emergency department visits, hospital days, and medical care costs in the previous 12 months. RESULTS Teams with dense interactions among all team members were associated with fewer hospital days (rate ratio [RR] = 0.62; 95% CI, 0.50–0.77) and lower medical care costs (−$556; 95% CI, −$781 to −$331) for patients with cardiovascular disease. Conversely, teams with interactions revolving around a few central individuals were associated with increased hospital days (RR = 1.45; 95% CI, 1.09–1.94) and greater costs ($506; 95% CI, $202–$810). Team-shared vision about goals and expectations mediated the relationship between social network structures and patient quality of care outcomes. CONCLUSIONS Primary care teams that are more interconnected and less centralized and that have a shared team vision are better positioned to deliver high-quality cardiovascular disease care at a lower cost. PMID:25755035

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.…

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 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). ...

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...

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...

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...

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...

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.

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.

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.

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.

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.

10 CFR 603.540 - Acceptability of fully depreciated real property or equipment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Acceptability of fully depreciated real property or equipment. 603.540 Section 603.540 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Pre-Award Business Evaluation Cost Sharing § 603.540 Acceptability of fully depreciated...

Circuit Riding: A Method for Providing Reference Services.

ERIC Educational Resources Information Center

Plunket, Linda; And Others

1983-01-01

Discussion of the design and implementation of the Circuit Rider Librarian Program, a shared services project for delivering reference services to eight hospitals in Maine, includes a cost analysis of services and description of user evaluation survey. Five references, composite results of the survey, and postgrant options proposal are appended.…

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...

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...

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...

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...

[Evaluation of Direct and Indirect Expenditures for Management of Patients With Stable Ischemic Heart Disease After Stenting of Coronary Arteries].

PubMed

Sveshnikova, N D; Paleev, F N

2016-03-01

Assessment of cost of management of patients during 1 year after stenting of coronary arteries has shown that priority should be given to active introduction into practical health care of technologies increasing duration of life and lowering probability of invalidization. We stress the need for evaluation of indirect expenditures on patients care because of their substantial share in the total cost. We also consider essential to elaborate measures of state regulation of medication supply irrespective of type of treatment for shifting expenditures from hospital to ambulatory sector and improvement of effectiveness of pharmacotherapy.

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...

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...

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...

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...

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...

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...

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...

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...

An e-consent-based shared EHR system architecture for integrated healthcare networks.

PubMed

Bergmann, Joachim; Bott, Oliver J; Pretschner, Dietrich P; Haux, Reinhold

2007-01-01

Virtual integration of distributed patient data promises advantages over a consolidated health record, but raises questions mainly about practicability and authorization concepts. Our work aims on specification and development of a virtual shared health record architecture using a patient-centred integration and authorization model. A literature survey summarizes considerations of current architectural approaches. Complemented by a methodical analysis in two regional settings, a formal architecture model was specified and implemented. Results presented in this paper are a survey of architectural approaches for shared health records and an architecture model for a virtual shared EHR, which combines a patient-centred integration policy with provider-oriented document management. An electronic consent system assures, that access to the shared record remains under control of the patient. A corresponding system prototype has been developed and is currently being introduced and evaluated in a regional setting. The proposed architecture is capable of partly replacing message-based communications. Operating highly available provider repositories for the virtual shared EHR requires advanced technology and probably means additional costs for care providers. Acceptance of the proposed architecture depends on transparently embedding document validation and digital signature into the work processes. The paradigm shift from paper-based messaging to a "pull model" needs further evaluation.

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.

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.

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

DDG 51 Operational Evaluation: Measures of Workload from Combat Information Center Communication Patterns

DTIC Science & Technology

1992-09-01

RAIDS ......... 39 ix I. INTRODUCTION Communication is the act of sharing information. This thesis is about human communication , but human ...high costs, high stakes, high drama, and Ligh workload. From a methodological perspective, this thesis is about using natural human communication patterns...34* Fourth. The Operational Test and Evaluation (OPEVAL) of USS ARLEIGH BURKE (DDG 51) presented an opportunity to examine human communication patterns

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.

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.

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...

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.

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

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.

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.

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

Applying secret sharing for HIS backup exchange.

PubMed

Kuroda, Tomohiro; Kimura, Eizen; Matsumura, Yasushi; Yamashita, Yoshinori; Hiramatsu, Haruhiko; Kume, Naoto; Sato, Atsushi

2013-01-01

To secure business continuity is indispensable for hospitals to fulfill its social responsibility under disasters. Although to back up the data of the hospital information system (HIS) at multiple remote sites is a key strategy of business continuity plan (BCP), the requirements to treat privacy sensitive data jack up the cost for the backup. The secret sharing is a method to split an original secret message up so that each individual piece is meaningless, but putting sufficient number of pieces together to reveal the original message. The secret sharing method eases us to exchange HIS backups between multiple hospitals. This paper evaluated the feasibility of the commercial secret sharing solution for HIS backup through several simulations. The result shows that the commercial solution is feasible to realize reasonable HIS backup exchange platform when template of contract between participating hospitals is ready.

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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 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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

Evaluating the risk of water distribution system failure: A shared frailty model

NASA Astrophysics Data System (ADS)

Clark, Robert M.; Thurnau, Robert C.

2011-12-01

Condition assessment (CA) Modeling is drawing increasing interest as a technique that can assist in managing drinking water infrastructure. This paper develops a model based on the application of a Cox proportional hazard (PH)/shared frailty model and applies it to evaluating the risk of failure in drinking water networks using data from the Laramie Water Utility (located in Laramie, Wyoming, USA). Using the risk model a cost/ benefit analysis incorporating the inspection value method (IVM), is used to assist in making improved repair, replacement and rehabilitation decisions for selected drinking water distribution system pipes. A separate model is developed to predict failures in prestressed concrete cylinder pipe (PCCP). Various currently available inspection technologies are presented and discussed.

Using U.S. Medicare records to evaluate the indirect health effects on spouses: a case study in Alzheimer's disease patients.

PubMed

Gilden, Daniel M; Kubisiak, Joanna M; Kahle-Wrobleski, Kristin; Ball, Daniel E; Bowman, Lee

2014-07-07

The burden experienced by spouses of patients with Alzheimer's disease (AD) may have negative consequences for their physical health. We describe here a method for analyzing United States Medicare records to determine the changes in health service use and costs experienced by spouses after their marital partner receives an AD diagnosis. We initially identified all beneficiaries in the 2001-2005 Medicare 5% sample who had multiple claims listing the ICD-9 diagnostic code for AD, 331.0. The 5% sample includes spouses who share a Medicare account with their marital partners because they lack a sufficient work history for full eligibility on their own. A matched cohort study assessed incremental health costs in the spouses of AD patients versus a control group of spouses of non-AD patients. Longitudinal and cross-sectional analyses tracked the impact of a patient's AD diagnosis on his or her spouse's healthcare costs. Our method located 54,593 AD patients of whom 11.5% had spouses identifiable via a shared Medicare account. AD diagnosis in one member of a couple was associated with significantly higher monthly Medicare payments for the other member's healthcare. The spouses' elevated costs commenced 2 to 3 months before their partners' AD diagnosis and persisted over the follow-up period. After 31 months, the cumulative additional Medicare reimbursements totaled a mean $4,600 in the spouses of AD patients. This excess was significant even after accounting for differences in baseline health status between the cohorts. The study methodology provides a framework for comprehensively evaluating medical costs of both chronically ill patients and their spouses. This method also provides monthly data, which makes possible a longitudinal evaluation of the cost effects of specific health events. The observed correlations provide a coherent demonstration of the interdependence between AD patients' and spouses' health. Future research should examine caregiving burden and other possible factors contributing to the AD spouses' health outcomes. It should also extend the method presented here to evaluations of other chronic diseases of the elderly.

Using U.S. Medicare records to evaluate the indirect health effects on spouses: a case study in Alzheimer’s disease patients

PubMed Central

2014-01-01

Background The burden experienced by spouses of patients with Alzheimer’s disease (AD) may have negative consequences for their physical health. We describe here a method for analyzing United States Medicare records to determine the changes in health service use and costs experienced by spouses after their marital partner receives an AD diagnosis. Methods We initially identified all beneficiaries in the 2001–2005 Medicare 5% sample who had multiple claims listing the ICD-9 diagnostic code for AD, 331.0. The 5% sample includes spouses who share a Medicare account with their marital partners because they lack a sufficient work history for full eligibility on their own. A matched cohort study assessed incremental health costs in the spouses of AD patients versus a control group of spouses of non-AD patients. Longitudinal and cross-sectional analyses tracked the impact of a patient’s AD diagnosis on his or her spouse’s healthcare costs. Results Our method located 54,593 AD patients of whom 11.5% had spouses identifiable via a shared Medicare account. AD diagnosis in one member of a couple was associated with significantly higher monthly Medicare payments for the other member’s healthcare. The spouses’ elevated costs commenced 2 to 3 months before their partners’ AD diagnosis and persisted over the follow-up period. After 31 months, the cumulative additional Medicare reimbursements totaled a mean $4,600 in the spouses of AD patients. This excess was significant even after accounting for differences in baseline health status between the cohorts. Conclusion The study methodology provides a framework for comprehensively evaluating medical costs of both chronically ill patients and their spouses. This method also provides monthly data, which makes possible a longitudinal evaluation of the cost effects of specific health events. The observed correlations provide a coherent demonstration of the interdependence between AD patients’ and spouses’ health. Future research should examine caregiving burden and other possible factors contributing to the AD spouses’ health outcomes. It should also extend the method presented here to evaluations of other chronic diseases of the elderly. PMID:25001114

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.

76 FR 44394 - Public Transportation on Indian Reservations Program; Tribal Transit Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-25

...) 366-0893, e-mail: [email protected] . A TDD is available at 1-800-877-8339 (TDD/FIRS.... Eligible Applicants B. Eligible Projects C. Cost Sharing and Matching D. Proposal Content E. Evaluation... grants.gov . E-mail, mail and fax submissions will not be accepted. Complete proposals for the Tribal...

Improving value of travel time savings estimation for more effective transportation project evaluation : [summary].

DOT National Transportation Integrated Search

2012-01-01

The daily commute to a job is a cost of working. Workers may share stories about the extent or rigors of their commute, or they may enjoy the time with reading, music, or drive-time radio personalities. For any trip, many factors contribute to a trav...

Improving Project Management of Complex or Major Systems

DTIC Science & Technology

2016-05-05

funding available through vehicle Mod-lines --- shared across various motor transport programs PB-17 $M (including OCO) Program ACAT FYDP (FY17...Requirements Description (CARD) ▪ ▪ ▪ ▪ ▪ ▪ DOT&E REPORT ON INITIAL OPERATIONAL TEST AND EVALUATION ( IOT &E) ▪ Development RFP Release Cost Assessment

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.

Estimating farm-level private expenditure on veterinary medical inputs in England.

PubMed

Gilbert, W; Rushton, J

2014-03-15

The current re-evaluation of responsibility and cost sharing between the public and private sectors with reference to animal health and welfare (AHW) would be improved by a greater understanding of the contributions made at farm level. This knowledge would facilitate the design of a cost-sharing system which best balances technical, economic and political objectives. This paper presents a framework by which the farm-level investment in AHW can be assessed. An evaluation of data available for the framework was made and, as a benchmark, an estimate of total expenditure on veterinary medical inputs for commercial agricultural holdings in England calculated. In 2010/2011 it is calculated that farmers on commercial holdings in England spent £230 million on veterinary medicines and fees, with an additional £160 million being spent for horses kept on non-commercial holdings. By contrast, for 2012/2013, Defra budgeted £277 million on AHW. The results presented emphasise the critical importance of generating sufficient evidence to support the development of an efficient, equitable and sustainable AHW strategy.

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...

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...

Comparison of the Revenue Situation in Interventional Radiology Based on the Example of Peripheral Artery Disease in the Case of a DRG Payment System and Various Internal Treatment Charges.

PubMed

Vogt, Florian M; Hunold, Peter; Haegele, Julian; Stahlberg, Erik; Barkhausen, Jörg; Goltz, Jan Peter

2018-04-01

 Calculation of process-orientated costs for inpatient endovascular treatment of peripheral artery disease (PAD) from an interventional radiology (IR) perspective. Comparison of revenue situations in consideration of different ways to calculate internal treatment charges (ITCs) and diagnosis-related groups (DRG) for an independent IR department.  Costs (personnel, operating, material, and indirect costs) for endovascular treatment of PAD patients in an inpatient setting were calculated on a full cost basis. These costs were compared to the revenue situation for IR for five different scenarios: 1) IR receives the total DRG amount. IR receives the following DRG shares using ITCs based on InEK shares for 2) "Radiology" cost center type, 3) "OP" cost center type, 4) "Radiology" and "OP" cost center type, and 5) based on DKG-NT (scale of charges of the German Hospital Society).  78 patients (mean age: 68.6 ± 11.4y) with the following DRGs were evaluated: F59A (n = 6), F59B (n = 14), F59C (n = 20) and F59 D (n = 38). The length of stay for these DRG groups was 15.8 ± 12.1, 9.4 ± 7.8, 2.8 ± 3.7 and 3.4 ± 6.5 days Material costs represented the bulk of all costs, especially if new and complex endovascular procedures were performed. Revenues for neither InEK shares nor ITCs based on DKG-NT were high enough to cover material costs. Contribution margins for the five scenarios were 1 = € 1,539.29, 2 = € -1,775.31, 3 = € -2,579.41, 4 = € -963.43, 5 = € -2,687.22 in F59A, 1 = € -792.67, 2 = € -2,685.00, 3 = € -2,600.81, 4 = € -1,618.94, 5 = € -3,060.03 in F59B, 1 = € -879.87, 2 = € -2,633.14, 3 = € -3,001.07, 4 = € -1,952.33, 5 = € -3,136.24 in F59C and 1 = € 703.65, 2 = € -106.35, 3 = € -773.86, 4 = € 205.14, 5 = € -647.22 in F59 D. InEK shares return on average € 150 - 500 more than ITCs based on the DKG-NT catalog.  In this study positive contribution margins were seen only if IR receives the complete DRG amount. InEK shares do not cover incurred costs, with material costs representing the main part of treatment costs. Internal treatment charges based on the DKG-NT catalog provide the worst cost coverage.   · Internal treatment charges based on the DKG-NT catalog provide the worst cost coverage for interventional radiology at our university hospital.. · Shares from the InEK matrix such as the cost center "radiology" or "OP" as revenue for IR are not sufficient to cover incurred costs. A positive contribution margin is achieved only in the case of a compensation method in which IR receives the total DRG amount.. · Vogt FM, Hunold P, Haegele J et al. Comparison of the Revenue Situation in Interventional Radiology Based on the Example of Peripheral Artery Disease in the Case of a DRG Payment System and Various Internal Treatment Charges. Fortschr Röntgenstr 2017; 190: 348 - 357. © Georg Thieme Verlag KG Stuttgart · New York.

Cost evaluation of clinical laboratory in Taiwan's National Health System by using activity-based costing.

PubMed

Su, Bin-Guang; Chen, Shao-Fen; Yeh, Shu-Hsing; Shih, Po-Wen; Lin, Ching-Chiang

2016-11-01

To cope with the government's policies to reduce medical costs, Taiwan's healthcare service providers are striving to survive by pursuing profit maximization through cost control. This article aimed to present the results of cost evaluation using activity-based costing performed in the laboratory in order to throw light on the differences between costs and the payment system of National Health Insurance (NHI). This study analyzed the data of costs and income of the clinical laboratory. Direct costs belong to their respective sections of the department. The department's shared costs, including public expenses and administrative assigned costs, were allocated to the department's respective sections. A simple regression equation was created to predict profit and loss, and evaluate the department's break-even point, fixed cost, and contribution margin ratio. In clinical chemistry and seroimmunology sections, the cost per test was lower than the NHI payment and their major laboratory tests had revenues with the profitability ratio of 8.7%, while the other sections had a higher cost per test than the NHI payment and their major tests were in deficit. The study found a simple linear regression model as follows: "Balance=-84,995+0.543×income (R2=0.544)". In order to avoid deficit, laboratories are suggested to increase test volumes, enhance laboratory test specialization, and become marginal scale. A hospital could integrate with regional medical institutions through alliances or OEM methods to increase volumes to reach marginal scale and reduce laboratory costs, enhancing the level and quality of laboratory medicine.

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.

Healthcare resource consumption for intermittent urinary catheterisation: cost-effectiveness of hydrophilic catheters and budget impact analyses

PubMed Central

Tarricone, Rosanna

2017-01-01

Objectives This study presents a cost-effectiveness analysis comparing hydrophilic coated to uncoated catheters for patients performing urinary intermittent catheterisation. A national budget impact analysis is also included to evaluate the impact of intermittent catheterisation for management of bladder dysfunctions over a period of 5 years. Design A Markov model (lifetime horizon, 1 year cycle length) was developed to project health outcomes (life years and quality-adjusted life years) and economic consequences related to patients using hydrophilic coated or uncoated catheters. The model was populated with catheter-related clinical efficacy data retrieved from randomised controlled trials and quality-of-life data (utility weights) from the literature. Cost data (EUR, 2015) were estimated on the basis of healthcare resource consumption derived from an e-survey addressed to key opinion leaders in the field. Setting Italian Healthcare Service perspective. Population Patients with spinal cord injury performing intermittent urinary catheterisation in the home setting. Main outcome measures Incremental cost-effectiveness and cost-utility ratios (ICER and ICUR) of hydrophilic coated versus uncoated catheters and associated healthcare budget impact. Results The base-case ICER and ICUR associated with hydrophilic coated catheters were €20 761 and €24 405, respectively. This implies that hydrophilic coated catheters are likely to be cost-effective in comparison to uncoated ones, as proposed Italian threshold values range between €25 000 and €66 400. Considering a market share at year 5 of 89% hydrophilic catheters and 11% uncoated catheters, the additional cost for Italy is approximately €12 million in the next 5 years (current market share scenario for year 0: 80% hydrophilic catheters and 20% uncoated catheters). Conclusions Considered over a lifetime, hydrophilic coated catheters are potentially a cost-effective choice in comparison to uncoated ones. These findings can assist policymakers in evaluating intermittent catheterisation in patients with spinal cord injury. PMID:28096251

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.

A partial economic evaluation of blended learning in teaching health research methods: a three-university collaboration in South Africa, Sweden, and Uganda

PubMed Central

Kumpu, Minna; Atkins, Salla; Zwarenstein, Merrick; Nkonki, Lungiswa

2016-01-01

Background Novel research training approaches are needed in global health, particularly in sub-Saharan African universities, to support strengthening of health systems and services. Blended learning (BL), combining face-to-face teaching with computer-based technologies, is also an accessible and flexible education method for teaching global health and related topics. When organised as inter-institutional collaboration, BL also has potential for sharing teaching resources. However, there is insufficient data on the costs of BL in higher education. Objective Our goal was to evaluate the total provider costs of BL in teaching health research methods in a three-university collaboration. Design A retrospective evaluation was performed on a BL course on randomised controlled trials, which was led by Stellenbosch University (SU) in South Africa and joined by Swedish and Ugandan universities. For all three universities, the costs of the BL course were evaluated using activity-based costing with an ingredients approach. For SU, the costs of the same course delivered with a classroom learning (CL) approach were also estimated. The learning outcomes of both approaches were explored using course grades as an intermediate outcome measure. Results In this contextually bound pilot evaluation, BL had substantially higher costs than the traditional CL approach in South Africa, even when average per-site or per-student costs were considered. Staff costs were the major cost driver in both approaches, but total staff costs were three times higher for the BL course at SU. This implies that inter-institutional BL can be more time consuming, for example, due to use of new technologies. Explorative findings indicated that there was little difference in students’ learning outcomes. Conclusions The total provider costs of the inter-institutional BL course were higher than the CL course at SU. Long-term economic evaluations of BL with societal perspective are warranted before conclusions on full costs and consequences of BL in teaching global health topics can be made. PMID:27725076

A partial economic evaluation of blended learning in teaching health research methods: a three-university collaboration in South Africa, Sweden, and Uganda.

PubMed

Kumpu, Minna; Atkins, Salla; Zwarenstein, Merrick; Nkonki, Lungiswa

2016-01-01

Novel research training approaches are needed in global health, particularly in sub-Saharan African universities, to support strengthening of health systems and services. Blended learning (BL), combining face-to-face teaching with computer-based technologies, is also an accessible and flexible education method for teaching global health and related topics. When organised as inter-institutional collaboration, BL also has potential for sharing teaching resources. However, there is insufficient data on the costs of BL in higher education. Our goal was to evaluate the total provider costs of BL in teaching health research methods in a three-university collaboration. A retrospective evaluation was performed on a BL course on randomised controlled trials, which was led by Stellenbosch University (SU) in South Africa and joined by Swedish and Ugandan universities. For all three universities, the costs of the BL course were evaluated using activity-based costing with an ingredients approach. For SU, the costs of the same course delivered with a classroom learning (CL) approach were also estimated. The learning outcomes of both approaches were explored using course grades as an intermediate outcome measure. In this contextually bound pilot evaluation, BL had substantially higher costs than the traditional CL approach in South Africa, even when average per-site or per-student costs were considered. Staff costs were the major cost driver in both approaches, but total staff costs were three times higher for the BL course at SU. This implies that inter-institutional BL can be more time consuming, for example, due to use of new technologies. Explorative findings indicated that there was little difference in students' learning outcomes. The total provider costs of the inter-institutional BL course were higher than the CL course at SU. Long-term economic evaluations of BL with societal perspective are warranted before conclusions on full costs and consequences of BL in teaching global health topics can be made.

Analysis of extreme values of the economic efficiency indicators of transport infrastructure projects

NASA Astrophysics Data System (ADS)

Korytárová, J.; Vaňková, L.

2017-10-01

Paper builds on previous research of the authors into the evaluation of economic efficiency of transport infrastructure projects evaluated by the economic efficiency ratio - NPV, IRR and BCR. Values of indicators and subsequent outputs of the sensitivity analysis show extremely favourable values in some cases. The authors dealt with the analysis of these indicators down to the level of the input variables and examined which inputs have a larger share of these extreme values. NCF for the calculation of above mentioned ratios is created by benefits that arise as the difference between zero and investment options of the project (savings in travel and operating costs, savings in travel time costs, reduction in accident costs and savings in exogenous costs) as well as total agency costs. Savings in travel time costs which contribute to the overall utility of projects by more than 70% appear to be the most important benefits in the long term horizon. This is the reason why this benefit emphasized. The outcome of the article has resulted how the particular basic variables contributed to the total robustness of economic efficiency of these project.

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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.

A Novel Cost Based Model for Energy Consumption in Cloud Computing

PubMed Central

Horri, A.; Dastghaibyfard, Gh.

2015-01-01

Cloud data centers consume enormous amounts of electrical energy. To support green cloud computing, providers also need to minimize cloud infrastructure energy consumption while conducting the QoS. In this study, for cloud environments an energy consumption model is proposed for time-shared policy in virtualization layer. The cost and energy usage of time-shared policy were modeled in the CloudSim simulator based upon the results obtained from the real system and then proposed model was evaluated by different scenarios. In the proposed model, the cache interference costs were considered. These costs were based upon the size of data. The proposed model was implemented in the CloudSim simulator and the related simulation results indicate that the energy consumption may be considerable and that it can vary with different parameters such as the quantum parameter, data size, and the number of VMs on a host. Measured results validate the model and demonstrate that there is a tradeoff between energy consumption and QoS in the cloud environment. Also, measured results validate the model and demonstrate that there is a tradeoff between energy consumption and QoS in the cloud environment. PMID:25705716

A novel cost based model for energy consumption in cloud computing.

PubMed

Horri, A; Dastghaibyfard, Gh

2015-01-01

Cloud data centers consume enormous amounts of electrical energy. To support green cloud computing, providers also need to minimize cloud infrastructure energy consumption while conducting the QoS. In this study, for cloud environments an energy consumption model is proposed for time-shared policy in virtualization layer. The cost and energy usage of time-shared policy were modeled in the CloudSim simulator based upon the results obtained from the real system and then proposed model was evaluated by different scenarios. In the proposed model, the cache interference costs were considered. These costs were based upon the size of data. The proposed model was implemented in the CloudSim simulator and the related simulation results indicate that the energy consumption may be considerable and that it can vary with different parameters such as the quantum parameter, data size, and the number of VMs on a host. Measured results validate the model and demonstrate that there is a tradeoff between energy consumption and QoS in the cloud environment. Also, measured results validate the model and demonstrate that there is a tradeoff between energy consumption and QoS in the cloud environment.

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

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.

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

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...

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…

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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…

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...

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...

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...

Combination of Sharing Matrix and Image Encryption for Lossless $(k,n)$ -Secret Image Sharing.

PubMed

Bao, Long; Yi, Shuang; Zhou, Yicong

2017-12-01

This paper first introduces a (k,n) -sharing matrix S (k, n) and its generation algorithm. Mathematical analysis is provided to show its potential for secret image sharing. Combining sharing matrix with image encryption, we further propose a lossless (k,n) -secret image sharing scheme (SMIE-SIS). Only with no less than k shares, all the ciphertext information and security key can be reconstructed, which results in a lossless recovery of original information. This can be proved by the correctness and security analysis. Performance evaluation and security analysis demonstrate that the proposed SMIE-SIS with arbitrary settings of k and n has at least five advantages: 1) it is able to fully recover the original image without any distortion; 2) it has much lower pixel expansion than many existing methods; 3) its computation cost is much lower than the polynomial-based secret image sharing methods; 4) it is able to verify and detect a fake share; and 5) even using the same original image with the same initial settings of parameters, every execution of SMIE-SIS is able to generate completely different secret shares that are unpredictable and non-repetitive. This property offers SMIE-SIS a high level of security to withstand many different attacks.

How Will Section 1115 Medicaid Expansion Demonstrations Inform Federal Policy?

PubMed

Rosenbaum, Sara; Schmucker, Sara; Rothenberg, Sara; Gunsalus, Rachel

2016-05-01

Section 1115 of the Social Security Act allows the U.S. Department of Health and Human Services and states to test innovations in Medicaid and other public welfare programs without formal legislative action. Six states currently operate their Medicaid expansions as demonstrations and several more are expected to seek permission to do so. While the current Medicaid expansion demonstrations vary, they share a major focus: increasing beneficiaries' financial responsibility for the cost of coverage and care. Demonstrations include requirements that Medicaid beneficiaries pay enrollment fees and cost-sharing that exceed traditional Medicaid limits. Others propose tying beneficiaries' financial responsibility to behavioral changes in health and wellness, while still others impose penalties for nonpayment of enrollment fees. Evaluations must consider the impact of these requirements on access, use of care, and health status, as well as the feasibility of demonstration reforms and their impact on administrative efficiency, providers, and health plans.

Presenting Germany's drug pricing rule as a cost-per-QALY rule.

PubMed

Gandjour, Afschin

2012-06-01

In Germany, the Institute for Quality and Efficiency in Health Care (IQWiG) makes recommendations for ceiling prices of drugs based on an evaluation of the relationship between costs and effectiveness. To set ceiling prices, IQWiG uses the following decision rule: the incremental cost-effectiveness ratio of a new drug compared with the next effective intervention should not be higher than that of the next effective intervention compared to its comparator. The purpose of this paper is to show that IQWiG's decision rule can be presented as a cost-per-QALY rule by using equity-weighted QALYs. This transformation shows where both rules share commonalities. Furthermore, it makes the underlying ethical implications of IQWiG's decision rule transparent and open to debate.

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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.

Accomplishments and economic evaluations of the Forestry Incentives Program: A review

Treesearch

Deborah A. Gaddis; Barry D. New; Fredrick W. Cubbage; Robert C. Abt; Robert J. Moulton

1995-01-01

The Forestry Incentives Program (FIP) is a federal financial cost-share program that is intended to increase the nation's timber supply by increasing tree planting and timber stand improvement on nonindustrial private forest lands. Timber harvest reductions on public lands in the West, environmental constraints on private lands throughout the U.S., and increased...

A Workflow for Learning Objects Lifecycle and Reuse: Towards Evaluating Cost Effective Reuse

ERIC Educational Resources Information Center

Sampson, Demetrios G.; Zervas, Panagiotis

2011-01-01

Over the last decade Learning Objects (LOs) have gained a lot of attention as a common format for developing and sharing digital educational content in the field of technology-enhanced learning. The main advantage of LOs is considered to be their potential for component-based reuse in different learning settings supporting different learning…

Effort to test, evaluate and deploy technologies to automate the measurement of real-time border wait times at United States-Canada land border crossings.

DOT National Transportation Integrated Search

2011-09-01

The United States and Canada share the largest bi-national trading relationship in the world. An efficient and cost-effective border crossing system for both freight and passenger vehicle traffic is thus vital to the economic well-being and security ...

Evaluation of a Shared Services Compact in Two Rural Ohio School Districts

ERIC Educational Resources Information Center

Dziczkowski, Jennifer E.

2011-01-01

School funding adequacy is a topic that has received increased attention throughout the United States since the late 1990s. Current economic conditions, deficit spending, and burgeoning health care costs have caused school districts to compete with state governments for scarce monetary resources. Ohio is one such state. In December of 2008, the…

Local governments LANDSAT applications program

NASA Technical Reports Server (NTRS)

1983-01-01

The approach used to develop the internal capabilities of local governments to handle and evaluate LANDSAT data included remote sensing training, development of a low-cost digital image processing system, and technical assistance. Cost sharing, program management and coordination, and networking were also employed to address problems related to land use, water resources, environmental assessment, and air quality as experienced by urban planners. Local experiences gained in Atlanta, Georgia; Henrico County, Virginia; Oklahoma City; Oklahoma; and San Jose, California are described. Policy recommendations formulated for transferring remote sensing technologies to local governments are included.

Value-Based Assessment of Radiology Reporting Using Radiologist-Referring Physician Two-Way Feedback System-a Design Thinking-Based Approach.

PubMed

Shaikh, Faiq; Hendrata, Kenneth; Kolowitz, Brian; Awan, Omer; Shrestha, Rasu; Deible, Christopher

2017-06-01

In the era of value-based healthcare, many aspects of medical care are being measured and assessed to improve quality and reduce costs. Radiology adds enormously to health care costs and is under pressure to adopt a more efficient system that incorporates essential metrics to assess its value and impact on outcomes. Most current systems tie radiologists' incentives and evaluations to RVU-based productivity metrics and peer-review-based quality metrics. In a new potential model, a radiologist's performance will have to increasingly depend on a number of parameters that define "value," beginning with peer review metrics that include referrer satisfaction and feedback from radiologists to the referring physician that evaluates the potency and validity of clinical information provided for a given study. These new dimensions of value measurement will directly impact the cascade of further medical management. We share our continued experience with this project that had two components: RESP (Referrer Evaluation System Pilot) and FRACI (Feedback from Radiologist Addressing Confounding Issues), which were introduced to the clinical radiology workflow in order to capture referrer-based and radiologist-based feedback on radiology reporting. We also share our insight into the principles of design thinking as applied in its planning and execution.

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.

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...

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…

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...

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…

A framework for improving the cost-effectiveness of DSM program evaluations

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

Sonnenblick, R.; Eto, J.

The prudence of utility demand-side management (DSM) investments hinges on their performance, yet evaluating performance is complicated because the energy saved by DSM programs can never be observed directly but only inferred. This study frames and begins to answer the following questions: (1) how well do current evaluation methods perform in improving confidence in the measurement of energy savings produced by DSM programs; (2) in view of this performance, how can limited evaluation resources be best allocated to maximize the value of the information they provide? The authors review three major classes of methods for estimating annual energy savings: trackingmore » database (sometimes called engineering estimates), end-use metering, and billing analysis and examine them in light of the uncertainties in current estimates of DSM program measure lifetimes. The authors assess the accuracy and precision of each method and construct trade-off curves to examine the costs of increases in accuracy or precision. Several approaches for improving evaluations for the purpose of assessing program cost effectiveness are demonstrated. The methods can be easily generalized to other evaluation objectives, such as shared savings incentive payments.« less

Budget Impact Analysis of Afatinib for First-Line Treatment of Patients with Metastatic Non-Small Cell Lung Cancer with Epidermal Growth Factor Receptor Exon 19 Deletions or Exon 21 Substitution Mutations in a U.S. Health Plan.

PubMed

Graham, Jonathan; Earnshaw, Stephanie; Burslem, Kate; Lim, Jonathan

2018-06-01

Afatinib is 1 of 3 tyrosine kinase inhibitors approved in the United States for the first-line treatment of patients with metastatic non-small cell lung cancer (NSCLC) whose tumors have epidermal growth factor receptor (EGFR) exon 19 deletions (del19) or exon 21 (L858R) substitution mutations. In clinical trials, afatinib has demonstrated improvement in progression-free survival versus standard chemotherapy and gefitinib. To analyze the impact of increases in afatinib treatment share on the cost and health outcomes in a commercial health plan in the United States. A decision model was developed to evaluate the budget impact of increases in afatinib share for the first-line treatment of patients with metastatic NSCLC with EGFR del19 or L858R substitution mutations over a 5-year time horizon. The model compared the total annual costs for a health plan with 1 million covered lives in a scenario in which afatinib share increased 5 percentage points annually to one in which all treatment shares remained constant over time. The number of patients eligible for treatment was estimated using published incidence data. Therapies included in the model were afatinib, erlotinib, gefitinib, and the chemotherapy doublet, pemetrexed in combination with cisplatin. The mean time spent by patients in progression-free and progressive disease states was based on survival data from clinical trials and a network meta-analysis. Therapy-related costs included monthly drug acquisition and administration costs and costs of managing adverse reactions. Disease management costs were also assessed in the model. Scenario analyses were performed to assess alternative scenarios of afatinib treatment share. Additionally, a one-way sensitivity analysis was performed to test the robustness of the model, given parameter uncertainty. Using the base-case parameter assumptions and a 5-percentage-point annual increase in afatinib treatment share, we estimated the total budget increases in years 1 through 5 to be $1,606, $65,542, $140,564, $209,272, and $303,368, respectively. These budget increases translated to per-member-per-month increases ranging from $0.00 to $0.03 in years 1 to 5. The increase in afatinib use resulted in the proportion of the treated population (134 patients treated over 5 years) remaining in progression-free disease increasing from 23.7% to 26.2% at the end of year 5, versus if afatinib treatment share had stayed constant. Increasing the treatment share of afatinib in a health plan for the first-line treatment of NSCLC with EGFR del19 or L858R mutations was estimated to increase the proportion of treated patients remaining in progression-free disease, while having small budget impact to the health plan. Boehringer Ingelheim Pharmaceuticals funded this study research and was involved in all stages of study conduct, including the analysis of data, and also undertook all costs associated with the development and publication of this manuscript. Graham and Earnshaw are employees of RTI Health Solutions, an independent contract research organization that has received research funding for this and other studies from Boehringer Ingelheim Pharmaceuticals. Lim and Burslem are employees of Boehringer Ingelheim Pharmaceuticals, which developed and produces afatinib, along with other pharmaceutical products.

Sensitivity of Medication Use to Formulary Controls in Medicare Beneficiaries: A Review of the Literature

PubMed Central

Shenolikar, Rahul; Bruno, Amanda Schofield; Eaddy, Michael; Cantrell, Christopher

2011-01-01

Background Several studies have examined the impact of formulary management strategies on medication use in the elderly, but little has been done to synthesize the findings to determine whether the results show consistent trends. Objective To summarize the effects of formulary controls (ie, tiered copays, step edits, prior authorization, and generic substitution) on medication use in the Medicare population to inform future Medicare Part D and other coverage decisions. Methods This systematic review included research articles (found via PubMed, Google Scholar, and specific scientific journals) that evaluated the impact of drug coverage or cost-sharing on medication use in elderly (aged ≥65 years) Medicare beneficiaries. The impact of drug coverage was assessed by comparing patients with some drug coverage to those with no drug coverage or by comparing varying levels of drug coverage (eg, full coverage vs $1000 coverage or capped benefits vs noncapped benefits). Articles that were published before 1995, were not original empirical research, were published in languages other than English, or focused on populations other than Medicare beneficiaries were excluded. All studies selected were classified as positive, negative, or neutral based on the significance of the relationship (P <.05 or as otherwise specified) between the formulary control mechanism and the medication use, and on the direction of that relationship. Results Included were a total of 47 research articles (published between 1995 and 2009) that evaluated the impact of drug coverage or cost-sharing on medication use in Medicare beneficiaries. Overall, 24 studies examined the impact of the level of drug coverage on medication use; of these, 96% (N = 23) supported the association between better drug coverage (ie, branded and generic vs generic-only coverage, capped benefit vs noncapped benefit, supplemental drug insurance vs no supplemental drug insurance) or having some drug coverage and enhanced medication use. Furthermore, 84% (N = 16) of the 19 studies that examined the effect of cost-sharing on medication use demonstrated that decreased cost-sharing was significantly associated with improved medication use. Conclusion Current evidence from the literature suggests that restricting drug coverage or increasing out-of-pocket expenses for Medicare beneficiaries may lead to decreased medication use in the elderly, with all its potential implications. PMID:25126370

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.

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...

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...

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...

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...

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...

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...

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...

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...

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...